Profit/Non-profit Sponsors and Child Care Centers

Erroneous Payments in Child Care Centers Study (EPICCS)

OMB: 0584-0618

IC ID: 222036

Documents and Forms
Document Name
Document Type
Other-Appendix B9 Sponsor Notificati
Other-Appendix B14 Call Guide and Wo
Other-Appendix B15 Call Guide and Wo
Other-Appendix C2 Sponsor & Child Ca
Other-Appendix C3 Center Enrollment
Other-Appendix C4 Income Eligibility
Other-Appendix C4a Round 2 & 3 Appli
Other-Appendix C5 Meal Observation F
Other-Appendix C6 Meal Observation F
Other-Appendix C8 Center Attendance
Other-Appendix C9 Center Meal Counts
Other-Appendix C10 (Sponsored) Cente
Other-Appendix C11 Sponsor Meal Clai
Other-Appendix C12 (Independent) Cen
Other-Appendix C14 Child Care Center
Other-Appendix C15 Head Start Sponso
Other-Appendix C16 Extended Attendan
Other-Appendix C17 Meal Counts for O
IC Document
IC Document
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Information Collection (IC) Details

View Information Collection (IC)

Profit/Non-profit Sponsors and Child Care Centers
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix C12 (Independent) Center Meal Claim to State for Target Month Appendix C12 (Independent) Center Meal Claim to State For Target Month.docx Yes No Fillable Printable
Other-Appendix C14 Child Care Center Sponsor Survey Appendix C14 Child Care Center Sponsor Survey.docx No   Paper Only
Other-Appendix C15 Head Start Sponsor Survey Appendix C15 Head Start Sponsor Survey.docx No   Paper Only
Other-Appendix C16 Extended Attendance Data Request Appendix C16 Extended Attendance Data Request.docx Yes Yes Fillable Fileable
Other-Appendix C17 Meal Counts for Observation Month Appendix C17 Meal Counts for Observation Month.docx Yes Yes Fillable Fileable
Other-Appendix C10 (Sponsored) Center Meal Count Claim to Sponsor for Target Month Appendix C10 (Sponsored) Center Meal Count Claim to Sponsor For Target Month.docx Yes No Fillable Printable
Other-Appendix C11 Sponsor Meal Claim to State for Target Month Appendix C11 Sponsor Meal Claim to State For Target Month.docx Yes No Fillable Printable
Other-Appendix B14 Call Guide and Worksheet for Sponsors Appendix B14 Call Guide and Worksheet for Sponsors.docx Yes Yes Fillable Fileable
Other-Appendix B15 Call Guide and Worksheet for Centers Appendix B15 Call Guide and Worksheet for Centers.docx Yes Yes Fillable Fileable
Other-Appendix C2 Sponsor & Child Care Center Pre-Visit Interview Appendix C02 Sponsor & Child Care Center Pre_Visit Interview.docx Yes Yes Fillable Fileable
Other-Appendix C3 Center Enrollment Form Appendix C03 Center Enrollment Form.docx Yes No Fillable Printable
Other-Appendix C4 Income Eligibility Application Abstration Form Appendix C04 Income Eligibility Application Abstraction Form.docx Yes No Fillable Printable
Other-Appendix C4a Round 2 & 3 Application Abstraction Scheduling Call Guide Appendix C04a Round 2 & 3 Application Abstraction Scheduling Call Guide.docx Yes Yes Fillable Fileable
Other-Appendix C5 Meal Observation Form - Restaurant/Cafeteria Style Appendix C05 Meal Observation Form Restaurant Cafeteria Style.docx No   Paper Only
Other-Appendix C6 Meal Observation Form - Family Style Appendix C06 Meal Observation Form Family Style.docx No   Paper Only
Other-Appendix C8 Center Attendance Form for Target Month Appendix C08 Center Attendance For Target Month.docx Yes No Fillable Printable
Other-Appendix C9 Center Meal Counts for Target Month Appendix C09 Center Meal Counts For Target Month.docx Yes No Fillable Printable
Other-Appendix B9 Sponsor Notification Letter Appendix B09 Sponsor Notification Letter.docx No   Paper Only

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports  56 FR 19078

1,402 498
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   58 %

  Approved 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 12,724 0 12,724 0 0 0
Annual IC Time Burden (Hours) 4,412 0 4,412 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix B8 Letter of Endorsement Appendix B08 Letter of Endorsement.docx 06/22/2016
Appendix B10 Independent Child Care Center Notification Letter Appendix B10 Independent Child Care Center Notification Letter.docx 06/22/2016
Appendix B11 Template Letter from Sponsor to Sampled Center (Notification of Selection for Study) Appendix B11 Template Letter from Sponsor to Center (Notification of Selection for Study).docx 06/22/2016
Appendix B12 Center (SCCC & HSC) Notification Letter Appendix B12 Center (SCCC & HSC) Notification Letter.docx 06/22/2016
Appendix B13 Fact Sheet (for Sponsors and Child Care Centers) Appendix B13 Fact Sheet (for Sponsors and Centers).docx 06/22/2016
Appendix C7 Example of Meal Transaction Sampling Appendix C07 Example of Sampling Meal Transactions (6-9-16).pdf 06/23/2016
Appendix C13 Sponsor Survey Cover Letter Appendix C13 Sponsor Survey Cover Letter.docx 06/23/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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