General Services Administration
Background Investigations for Childcare Workers, GSA Form 176
OMB Control Number, 3090-0287
Justification
Overview of Information Collection:
Information collected on GSA Form 176 is in accordance with 34 U.S. Code § 20351(d)(1) employment applications for individuals seeking work for an agency of the Federal Government, or for a facility or program operated by (or through contract with) the Federal government, shall contain a question asking whether the individual has ever been arrested for or charged with a crime involving a child, and if so requiring a description of the disposition of the arrest or charge. An application shall state that it is being signed under penalty of perjury, with the applicable Federal punishment for perjury stated on the application.
This is an extension to an existing collection GSA Form 176 OMB Control Number: 3090-0287 Expiration Date: 11/30/2024 with no modifications.
Need & Method for the Information Collection.
Homeland Security Presidential Directive (HSPD) 12 “Policy for a Common Identification Standard for Federal Employees and Contractors” (the Directive) requires the implementation of a government-wide standard for secure and reliable forms of identification for Federal employees and contractors. OMB’s implementing instructions requires all contract employees requiring routine access to federally controlled facilities for greater than 6 months to receive a background investigation. The minimum background investigation is the Tier 1 and the Office of Personnel Management offers a Tier 1C for childcare.
However, there is no requirement in the law or HSPD-12 that requires childcare employees to be subject to the Tier 1C since employees of childcare providers are neither government employees nor government contractors. The childcare providers are required to complete the criminal history background checks mandated in the Crime Control Act of 1990, Pub. L. 101-647, dated November 29, 1990, as amended by Pub. L. 102-190, dated December 5, 1991. These statutes require that each employee of a childcare center located in a Federal building or in leased space must undergo a background check that is: 1) based on fingerprints taken by a law enforcement officer and on other identifying information, 2) conducted through the FBI's Identification Division and through the State criminal history repositories in each state in which the childcare employee has been a resident or has listed in an employment application, and 3) initiated through the personnel program of the applicable employing agency.
According to GSA policy childcare workers (as described above) will need to submit the following:
An original signed copy of a Basic National Agency Check Criminal History, GSA Form 176; and
Two (2) sets of fingerprints on Form SF-87 and /or electronic prints from an enrollment center
Electronically submit the e-QIP (SF85) application for completion of the Tier 1C
Use of the Information.
The Contracting Officer, Project Manager, Childcare Center Director, or other designated representative, referred to as “Sponsor”, is responsible for collecting and forwarding all necessary supporting documentation to perform the required background investigations for childcare workers. The law enforcement forms shall be submitted by the contractor or childcare employee to the Sponsor prior to the commencement of work. These materials will be forwarded to GSA for processing.
Use of Information Technology.
The GSA 176 requires hard copy signature; it can be filled out electronically, printed for signature and then scanned for electronic submission. There is no provision for electronic signature for this form.
The fingerprint charts can be submitted manually and/or electronically depending on the availability of fingerprint scanning equipment and the requirements of each state for processing of fingerprint checks.
The Electronic Questionnaires for Investigations Processing e-QIP (SF85) application is an electronic submission.
Non-duplication.
The only time this information may be duplicated is if the childcare worker were to require access to a federally controlled facility and the previous determination could not be verified and/or there was a break in service requiring the submission of a new 176.
Burden on Small Business.
The burden applied to small business is the minimum burden consistent with applicable laws, Executive Orders, regulations and prudent business practices.
Less Frequent Collection.
Collection of this information is necessary for childcare workers to be granted access and work in GSA controlled facilities. The collection of this information is required by law for childcare workers.
Paperwork Reduction Act Guidelines.
If the background investigation case comes back with questionable issues or conflicting information, the investigating and/or adjudicating offices may request that additional information be provided. Therefore, the applicant should be ready to provide a written response or additional documentation upon request.
A written response is generally required in less than fifteen (15) days after receipt to ensure the applicant can receive access to federally controlled facilities to perform in accordance with contract requirements.
Consultation and Public Comments.
A 60-day notice published in the Federal Register at 89 FR 59099 on July 22, 2024. One comment was received.
Comment: There has been suggestions that the child care provider keep form 176 on file for each employee- seems redundant - since HSPD and OPM have these files requiring the provider is over kill and really these clearance documents that the federal government require should not be in a private company's file as many of the questions asked are not things the private sector employers can ask for and by having them it can lead to the suggestion that we have used these question to dismiss employees or used to not hire them based on answers to clearance questions.
Response: There is no requirement to keep a Form 176 on file for each employee. However, the child care provider must comply with applicable requirements and adequately demonstrate such compliance, if necessary.
A 30-day notice published in the Federal Register at 89 FR on 88050 on November 6, 2024.
Gifts or Payment.
Not applicable.
Privacy & Confidentiality.
The Systems of Records Notices (SORNs) associated with this data collection is as follows:
--GSA/GOVT-7, HSPD-12 USAccess: published in the Federal Register at 80 FR 64416 (October 23, 2015).
This information is disclosed only to the extent consistent with agency regulations and applicable statutes.
Sensitive Questions.
The sensitive questions involved relate to an applicant’s criminal history and employment records and are required by law; they are deemed necessary to ensure adequate protection of GSA’s owned and leased facilities, as well as providing a level of protection and safety to the children and staff in those childcare centers located within those facilities.
12 & 13. Burden Estimate.
The estimated number of respondents annually is 3,060 childcare workers, with each respondent requiring .50 hour to complete the form, for a total of 1,530 hours.
For childcare workers, the cost will be incurred by the government.
Total Annual Requests 3060
Estimates hours/response x. 50
Total burden hours 1530
Average Cost/hour N/A
Total Cost to Public N/A
Estimated cost to the Government.
Estimate of the burden hours to the Federal Government is 1,530 hours annually. Reviewing and processing each response should take approximately .5 hour; the total number of responses is estimated to be 3,060 childcare worker clearances each year. 3,060 responses x .5 hour = 1,530 hours.
Based on the 1,530 burden hours to the Government, using the annual salary of a Government Program Analyst, grade 12, step 1, paid $59,383 annually includes fringe benefits (this does not include the locality adjustment); $28.45 per hour x 1,530 hours =$43,529.
Reviewing Time/hr. .5
Requests/year……………………………………... x 3,060
Review Time/year 1,530
Total Government Cost $43,529
Reasons for changes. Explain the reasons for any program changes or adjustments reported on the burden worksheet.
Publicizing Results.
The results will not be published.
OMB Not to Display Approval.
GSA is not seeking approval to not display the expiration date for OMB approval of the information collection.
Exceptions to "Certification for Paperwork Reduction Submissions." There are no exceptions to the certification statement, “Certification for Paperwork Reduction Act Submissions”.
Surveys, Censuses, and Other Collections that Employ Statistical Methods. This section is not applicable for the purposes of these forms.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Jennifer L. Fee |
| File Modified | 0000-00-00 |
| File Created | 2024-11-08 |