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Supporting Family Economic Well-Being through Home Visiting (HomeEc) Formative Evaluation
Formative Data Collections for ACF Program Support
OMB: 0970-0531
IC ID: 269199
OMB.report
HHS/ACF
OMB 0970-0531
ICR 202410-0970-003
IC 269199
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:
2024-11-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Instrument 1. Program Recruitment and Eligibility Screener.docx
Other-Screener
Instrument 2. Interview guide for needs identification.docx
Other-Interview Guide
Instrument 3. Discussion guide for strategic planning meetings.docx
Other-Discussion Guide
Instrument 4. Interview Guide for Learning Cycles.docx
Other-Interview Guide
Instrument 5. Caregiver participant survey for learning cycles.docx
Other-Survey
Instrument 6. Staff survey for learning cycles.docx
Other-Survey
HomeEc OSC3 Formative ACF Program Support_0970-0531_SSA GenIC.docx
SSA - Program Support GenIC: HomeEc Formative Evaluation
IC Document
HomeEc OSC3 Formative ACF Program Support_0970-0531_SSB GenIC_CLEAN.docx
SSB - Program Support GenIC: HomeEc Formative Evaluation
IC Document
Appendix A. Invitation to Participate in Recruitment Screener.docx
Appendix A. Invitation to Participate in Recruitment Screener
IC Document
Appendix B. Formative Evaluation Information.docx
Appendix B. Formative Evaluation Information
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Supporting Family Economic Well-Being through Home Visiting (HomeEc) Formative Evaluation
Agency IC Tracking Number:
OPRE
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Screener
Instrument 1. Program Recruitment and Eligibility Screener.docx
Yes
Yes
Fillable Fileable
Other-Interview Guide
Instrument 2. Interview guide for needs identification.docx
Yes
Yes
Printable Only
Other-Discussion Guide
Instrument 3. Discussion guide for strategic planning meetings.docx
Yes
Yes
Printable Only
Other-Interview Guide
Instrument 4. Interview Guide for Learning Cycles.docx
Yes
Yes
Printable Only
Other-Survey
Instrument 5. Caregiver participant survey for learning cycles.docx
Yes
Yes
Fillable Fileable
Other-Survey
Instrument 6. Staff survey for learning cycles.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Community and Social Services
Subfunction:
Social Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
292
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
99 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
876
0
0
0
0
876
Annual IC Time Burden (Hours)
222
0
0
0
0
222
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA - Program Support GenIC: HomeEc Formative Evaluation
HomeEc OSC3 Formative ACF Program Support_0970-0531_SSA GenIC.docx
07/05/2024
SSB - Program Support GenIC: HomeEc Formative Evaluation
HomeEc OSC3 Formative ACF Program Support_0970-0531_SSB GenIC_CLEAN.docx
07/05/2024
Appendix A. Invitation to Participate in Recruitment Screener
Appendix A. Invitation to Participate in Recruitment Screener.docx
07/05/2024
Appendix B. Formative Evaluation Information
Appendix B. Formative Evaluation Information.docx
07/05/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.