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Permanency Innovations Initiative - AZ, CAPP, IL
Pre-testing of Evaluation Surveys
OMB: 0970-0355
IC ID: 205269
OMB.report
HHS/ACF
OMB 0970-0355
ICR 201404-0970-002
IC 205269
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:
2024-08-26 - Revision of a currently approved collection
2024-03-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
A1-A3 CAPP FAQ, Contact Information Form, Consent Script, Interview.docx
Other-CAPP Instruments
B1,2,4,7. ADES Child Assent, Care Provider FAQ, Child-Youth Interview.docx
Other-ADES Instruments
C1-7, 9 DCFS Instruments.docx
Other-DCFS Instruments
Supporting Statement A_AZ CAPP IL generic_FINAL 1.1.13.docx
Supporting Statement A_AZ CAPP IL generic_FINAL 1
IC Document
B3. ADES Care Provider FAQ.docx
B3
IC Document
Supporting Statement B_AZ CAPP IL generic_FINAL 1.1.13.docx
Supporting Statement B_AZ CAPP IL generic_FINAL 1
IC Document
B5. ADES Caseworker Introduction Email For Prospective-Homes-Found Interview.docx
B5
IC Document
B6. ADES Caseworker Introduction Email For Decision-Making Interview.docx
B6
IC Document
C8. DCFS CASI-ACASI Measures and Instruction Screens.docx
C8
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Permanency Innovations Initiative - AZ, CAPP, IL
Agency IC Tracking Number:
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-CAPP Instruments
A1-A3 CAPP FAQ, Contact Information Form, Consent Script, Interview.docx
Yes
Yes
Fillable Fileable
Other-ADES Instruments
B1,2,4,7. ADES Child Assent, Care Provider FAQ, Child-Youth Interview.docx
Yes
Yes
Fillable Fileable
Other-DCFS Instruments
C1-7, 9 DCFS Instruments.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:
954
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
422
0
0
0
0
422
Annual IC Time Burden (Hours)
521
0
0
0
0
521
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement A_AZ CAPP IL generic_FINAL 1
Supporting Statement A_AZ CAPP IL generic_FINAL 1.1.13.docx
01/02/2013
B3
B3. ADES Care Provider FAQ.docx
01/02/2013
Supporting Statement B_AZ CAPP IL generic_FINAL 1
Supporting Statement B_AZ CAPP IL generic_FINAL 1.1.13.docx
01/02/2013
B5
B5. ADES Caseworker Introduction Email For Prospective-Homes-Found Interview.docx
01/02/2013
B6
B6. ADES Caseworker Introduction Email For Decision-Making Interview.docx
01/02/2013
C8
C8. DCFS CASI-ACASI Measures and Instruction Screens.docx
01/02/2013
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.