Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648, Exp. Date: 05/31/2021)
PURPOSE: The NIH/OD/ORS/DOHS would like to evaluate our customer’s experience with our website located at https://www.ors.od.nih.gov/sr/dohs/Pages/default.aspx. The results of the survey will be used to inform potential strategies to improve the DOHS website including its content, navigation and overall navigation. The information will help develop potential targeted solutions to any identified problems reported. It is our intent to have a link to the electronic survey available on each webpage on the website.
DESCRIPTION OF RESPONDENTS: The respondents include current NIH federal employees and contractors.
TYPE OF COLLECTION: (Check one)
[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey [ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group
[ ] Focus Group [ ] Other:
I certify the following to be true:
The collection is voluntary.
The collection is low-burden for respondents and low-cost for the Federal Government.
The collection is non-controversial and does not raise issues of concern to other federal agencies.
The results are not intended to be disseminated to the public.
Information gathered will not be used for the purpose of substantially informing influential policy decisions.
The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.
Signature:
Name: Larry Johnson
Chief, OD, ORS, DOHS, Community Health Branch, NIH
9000 Wisconsin Avenue
13 South Drive, Building 13 Room 3K04
Bethesda, MD 20892
(301) 496-2960
To assist review, please provide answers to the following question:
Is personally identifiable information (PII) collected? [ ] Yes [X] No
If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No
If Applicable, has a System or Records Notice been published? [ ] Yes [X] No
Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No
Category of Respondent |
No. of Respondents |
No. of Responses per Respondent |
Time per Response (in hours) |
Total Burden Hours |
Individual/households
|
1,600 |
1 |
5/60 |
133 |
|
|
|
|
|
Totals |
|
1,600 |
|
133 |
Category of Respondent |
Total Burden Hours |
Hourly Wage Rate* |
Total Burden Cost |
Individual (Federal Government Employee and Contractor) |
133 |
$28.00 |
$3,724.00 |
|
|
|
|
Totals |
|
$28.00 |
$3,724.00 |
*https://www.bls.gov/oes/2017/May/oes_nat.htm#00-0000
FEDERAL COST: The estimated annual cost to the Federal government is $2,243.00.
Staff |
Grade/Step |
Salary |
% of Effort |
Fringe (if applicable) |
Total Cost to Gov’t |
Federal Oversight |
|
|
|
|
|
Chief, Community Health Branch |
GS13/9 |
$122,830.00 |
.5% |
|
$614.00 |
|
|
|
|
|
|
Contractor Cost |
|
|
|
|
|
Management Consultant in Communications |
|
$108,596.80 |
1.5% |
N/A |
$1,629.00 |
Travel |
|
|
|
|
|
Other Cost |
|
|
|
|
|
|
|
|
|
|
|
Total |
|
|
|
|
$2,243.00 |
*https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/2018/general-schedule/
The selection of your targeted respondents
1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe?
[ ] Yes [X] No
If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?
How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media [ ] Telephone
[ ] In-person [ ] Mail
[ ] Other, Explain
Will interviewers or facilitators be used? [ ] Yes [X] No
END OF SURVEY
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Generic Clearance Submission Template |
Subject | Generic Clearance Submission Template |
Author | OD/USER |
File Modified | 0000-00-00 |
File Created | 2021-02-20 |