Permanency Innovations Initiative - AZ, CAPP, IL

Pre-testing of Evaluation Surveys

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0355 can be found here:

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
PII - CAPP Increase in Burden Memo 10.7.14.KM.docx NonSub Change Request to Increase # Respondents IC Document

Information Collection (IC) Details

IC Title:	Permanency Innovations Initiative - AZ, CAPP, IL	Agency IC Tracking Number:

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	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

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,001	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	443	21	422
Annual IC Time Burden (Hours)	545	24	521
Annual IC Cost Burden (Dollars)	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
NonSub Change Request to Increase # Respondents	PII - CAPP Increase in Burden Memo 10.7.14.KM.docx	10/07/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.