OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Assessing Education Agency Staff Perceptions of School Climate and Youth Access to Services

ICR 201801-0920-007 · OMB 0920-1048 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
San Francisco Unified School District School Health Climate and Service Assessment Survey Form Modified Available
Los Angeles Unified School District School Health Climate and Service Assessment Survey Form Modified Available
Broward County School Health Climate and Service Assessment Survey Form Modified Available
Att 19-Example Data Analysis Table Shells.docx Supplementary Document Uploaded 2018-01-29 Available
Att 18-Consent School Climate Interviews.docx Supplementary Document Uploaded 2018-01-29 Available
Att 17-Consent_SanFrancisco.docx Supplementary Document Uploaded 2018-01-29 Repair queued
Att 16-Consent_LA.docx Supplementary Document Uploaded 2018-01-29 Available
Att 15-Consent_Broward County.docx Supplementary Document Uploaded 2018-01-29 Repair queued
Att 14-Contractor IRB Approval-CIIG (UPDATED).pdf Supplementary Document Uploaded 2018-01-29 Available
Att 13-Contractor IRB Approval-Screens.pdf Supplementary Document Uploaded 2018-01-29 Repair queued
Att 12-Consultants_on_the_IC.docx Supplementary Document Uploaded 2018-01-29 Repair queued
Att 2-60-dayFRN.pdf Supplementary Document Uploaded 2018-01-29 Available
Att 1-PHS Act Legislation.pdf Supplementary Document Uploaded 2018-01-29 Available
SSB.docx Supporting Statement B Uploaded 2018-01-29 Available
SSA.docx Supporting Statement A Uploaded 2018-01-29 Available
IC Document Collections
IC IDCollectionTypeStatusForm
213082 School Staff Interview Other-Interview Guide Modified
213081 School Level Administrator Interview Other-Interview Guide Modified
213079 District Level Administrator Interview Other-Interview Guide Modified
213075 San Francisco Unified School District School Health Climate and Service Assessment Survey Form Modified
213073 Los Angeles Unified School District School Health Climate and Service Assessment Survey Form Modified
213072 Broward County School Health Climate and Service Assessment Survey Form Modified
ICR Details
0920-1048 201801-0920-007
Historical Active 201409-0920-007
HHS/CDC 0920-1048
Assessing Education Agency Staff Perceptions of School Climate and Youth Access to Services
Revision of a currently approved collection   No
Regular
Approved without change 04/09/2018
Retrieve Notice of Action (NOA) 02/20/2018
  Inventory as of this Action Requested Previously Approved
04/30/2019 12 Months From Approved 04/30/2018
779 0 518
364 0 243
0 0 0
CDC requests a 1-year OMB approval to conduct the final data collection in a series of data collections. The information collection uses 2 separate, but complementary, information collections to conduct assessment of HIV and STD prevention efforts that are taking place in three local education agencies (LEA) funded by the CDC, Division of Adolescent and School Health (DASH) under strategy 4 (School-Centered HIV/STD Prevention for Young Men Who Have Sex with Men (YMSM) of PS13-1308: Promoting Adolescent Health through School-Based HIV/STD Prevention and School-Based Surveillance. These efforts include strategies to increase student access to key health services and improve the school climate.
US Code: 42 USC 301 Name of Law: Public Health Services Act
  
None
Not associated with rulemaking
  82 FR 39125 08/17/2017
83 FR 7186 02/20/2018
Yes
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 779 518 0 261 0 0
Annual Time Burden (Hours) 364 243 0 121 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Burden is recalculated for one data collection event over one year; previous approval was for two data collection events over 3 years.
$53,812
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/20/2018