OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities

ICR 202107-0970-004 · OMB 0970-0564 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form Form M-7C LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-7C LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Respondents Form and Instruction Unchanged Available
Form Form M-15 Monitoring Schedule (Form M-15) Form and Instruction Unchanged Repair queued
Form Form M-14 Monitoring Visit (Form M-14) Form and Instruction Unchanged Available
Form Form M-13E Case Coordinator Questionnaire (Form M-13E) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-13E Case Coordinator Questionnaire (Form M-13E) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-13D Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-13D Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Reporting Form and Instruction Unchanged Repair queued
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-13B Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-13B Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-12D Secure Client Questionnaire (Form M-12D) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-12D Secure Client Questionnaire (Form M-12D) - Respondents Form and Instruction Unchanged Available
Form Form M-12C Long Term Foster Care Client Questionnaire (M-12C) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-12C Long Term Foster Care Client Questionnaire (M-12C) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-12A UAC Questionnaires (Forms M-12A-B, E) - Recordkeeping Form and Instruction Modified Available
Form Form M-12A UC Questionnaires (Forms M-12A-B, E) - Respondents Form and Instruction Modified Repair queued
Form Form M-11O Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-11O Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-11N Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-11N Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-11M Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-11M Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-11L Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-11L Secure Detention Officer Questionnaire (Form M-11L) - Respondents Form and Instruction Unchanged Available
Form Form M-11A Program Staff Questionnaires (Form M-11A-K) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-11A Program Staff Questionnaires (Form M-11A-K) - Respondents Form and Instruction Unchanged Available
Form Form M-10D Long Term Foster Care Foster Parent Checklist (Form M-10D) Form and Instruction Unchanged Repair queued
Form Form M-10C Home Study and Post-Release Services Personnel File Checklist (Form M-10C) Form and Instruction Unchanged Repair queued
Form Form M-10B Supplement to Personnel File Checklist (Form M-10B) Form and Instruction Unchanged Available
Form Form M-10A Personnel File Checklist (Form M-10A) Form and Instruction Unchanged Repair queued
Form Form M-9C Post-Release Services Home Observation (Form M-9C) Form and Instruction Unchanged Repair queued
Form Form M-9 Foster Home On Site Monitoring Checklist (Form M-9B) Form and Instruction Unchanged Repair queued
Form Form M-9A On Site Monitoring Checklist (Form M-9A) Form and Instruction Unchanged Available
Form Form M-8D Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-8D Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-8C Home Study and Post-Release Services Case File Checklist (Form M-8C) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-8C Home Study and Post-Release Services Case File Checklist (Form M-8C) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-8B Long Term Foster Care File Checklist (Form M-8B) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-8B Long Term Foster Care File Checklist (Form M-8B) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-8A UAC Case File Checklist (Form M-8A) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-8A UAC Case File Checklist (Form M-8A) - Respondents Form and Instruction Unchanged Available
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-7E HS/PRS Site Visit Guide (Form M-7E) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-7E HS/PRS Site Visit Guide (Form M-7E) - Respondents Form and Instruction Unchanged Repair queued
Form Form M-7A Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-7A Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Respondents Form and Instruction Unchanged Available
Form Form M-6C LTFC Monitoring and LTFC Remote Monitoring Notes (Forms M-6C to M-6D) Form and Instruction Unchanged Repair queued
Form Form M-6A Monitoring and Remote Monitoring Notes (Forms M-6A to M-6B) Form and Instruction Unchanged Repair queued
Form Form M-5A Incident Reviews (Forms M-5A to M-5B) Form and Instruction Unchanged Repair queued
Form Form M-4A Checklist for a Child-Friendly Environment (Form M-4A to M4B) Form and Instruction Unchanged Repair queued
Form Form M-3B Out-of-Network Site Visit Report (Form M-3B) Form and Instruction Unchanged Repair queued
Form Form M-3A FFS Compliance and Safety Site Visit Report (Form M-3A) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-3A FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form and Instruction Unchanged Repair queued
Form M-1 Corrective Action Report (Form M-1) - Recordkeeping Form and Instruction Unchanged Repair queued
Form M-1 Corrective Action Report (Form M-1) - Respondents Form and Instruction Unchanged Available
0970-0564_Monitoring Compliance NonSub Chng Req_Tender Age 5 under_7.8.21.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-07-12 Repair queued
Supporting Statement - Monitoring Compliance - Emergency Request.docx Supporting Statement A Uploaded 2021-02-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
245634 LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Recordkeeping Form and Instruction Unchanged
245633 LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Respondents Form and Instruction Unchanged
245632 Monitoring Schedule (Form M-15) Form and Instruction Unchanged
245631 Monitoring Visit (Form M-14) Form and Instruction Unchanged
245630 Case Coordinator Questionnaire (Form M-13E) - Recordkeeping Form and Instruction Unchanged
245629 Case Coordinator Questionnaire (Form M-13E) - Respondents Form and Instruction Unchanged
245628 Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Recordkeeping Form and Instruction Unchanged
245627 Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Reporting Form and Instruction Unchanged
245626 Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form and Instruction Unchanged
245625 Legal Service Provider Questionnaire (Form M-13C) - Respondents Form and Instruction Unchanged
245624 Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Recordkeeping Form and Instruction Unchanged
245623 Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Respondents Form and Instruction Unchanged
245622 Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form and Instruction Unchanged
245621 Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form and Instruction Unchanged
245619 Secure Client Questionnaire (Form M-12D) - Recordkeeping Form and Instruction Unchanged
245618 Secure Client Questionnaire (Form M-12D) - Respondents Form and Instruction Unchanged
245617 Long Term Foster Care Client Questionnaire (M-12C) - Recordkeeping Form and Instruction Unchanged
245616 Long Term Foster Care Client Questionnaire (M-12C) - Respondents Form and Instruction Unchanged
245615 UAC Questionnaires (Forms M-12A-B, E) - Recordkeeping Form and Instruction Modified
245614 UC Questionnaires (Forms M-12A-B, E) - Respondents Form and Instruction Modified
245613 Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Recordkeeping Form and Instruction Unchanged
245612 Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Respondents Form and Instruction Unchanged
245611 Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Recordkeeping Form and Instruction Unchanged
245610 Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Respondents Form and Instruction Unchanged
245609 Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Recordkeeping Form and Instruction Unchanged
245608 Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form and Instruction Unchanged
245607 Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form and Instruction Unchanged
245606 Secure Detention Officer Questionnaire (Form M-11L) - Respondents Form and Instruction Unchanged
245605 Program Staff Questionnaires (Form M-11A-K) - Recordkeeping Form and Instruction Unchanged
245604 Program Staff Questionnaires (Form M-11A-K) - Respondents Form and Instruction Unchanged
245603 Long Term Foster Care Foster Parent Checklist (Form M-10D) Form and Instruction Unchanged
245602 Home Study and Post-Release Services Personnel File Checklist (Form M-10C) Form and Instruction Unchanged
245601 Supplement to Personnel File Checklist (Form M-10B) Form and Instruction Unchanged
245600 Personnel File Checklist (Form M-10A) Form and Instruction Unchanged
245599 Post-Release Services Home Observation (Form M-9C) Form and Instruction Unchanged
245598 Foster Home On Site Monitoring Checklist (Form M-9B) Form and Instruction Unchanged
245597 On Site Monitoring Checklist (Form M-9A) Form and Instruction Unchanged
245596 Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Recordkeeping Form and Instruction Unchanged
245595 Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Respondents Form and Instruction Unchanged
245594 Home Study and Post-Release Services Case File Checklist (Form M-8C) - Recordkeeping Form and Instruction Unchanged
245593 Home Study and Post-Release Services Case File Checklist (Form M-8C) - Respondents Form and Instruction Unchanged
245592 Long Term Foster Care File Checklist (Form M-8B) - Recordkeeping Form and Instruction Unchanged
245591 Long Term Foster Care File Checklist (Form M-8B) - Respondents Form and Instruction Unchanged
245590 UAC Case File Checklist (Form M-8A) - Recordkeeping Form and Instruction Unchanged
245589 UAC Case File Checklist (Form M-8A) - Respondents Form and Instruction Unchanged
245588 Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form and Instruction Unchanged
245587 Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form and Instruction Unchanged
245586 HS/PRS Site Visit Guide (Form M-7E) - Recordkeeping Form and Instruction Unchanged
245585 HS/PRS Site Visit Guide (Form M-7E) - Respondents Form and Instruction Unchanged
245584 Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Recordkeeping Form and Instruction Unchanged
245583 Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Respondents Form and Instruction Unchanged
245582 LTFC Monitoring and LTFC Remote Monitoring Notes (Forms M-6C to M-6D) Form and Instruction Unchanged
245581 Monitoring and Remote Monitoring Notes (Forms M-6A to M-6B) Form and Instruction Unchanged
245580 Incident Reviews (Forms M-5A to M-5B) Form and Instruction Unchanged
245579 Checklist for a Child-Friendly Environment (Form M-4A to M4B) Form and Instruction Unchanged
245577 Out-of-Network Site Visit Report (Form M-3B) Form and Instruction Unchanged
245576 FFS Compliance and Safety Site Visit Report (Form M-3A) - Recordkeeping Form and Instruction Unchanged
245575 FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form and Instruction Unchanged
245574 Corrective Action Report (Form M-1) - Recordkeeping Form and Instruction Unchanged
245572 Corrective Action Report (Form M-1) - Respondents Form and Instruction Unchanged
ICR Details
0970-0564 202107-0970-004
Active 202102-0970-001
HHS/ACF ORR
Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities
No material or nonsubstantive change to a currently approved collection   No
Emergency 02/16/2021
Approved without change 07/12/2021
Retrieve Notice of Action (NOA) 07/12/2021
  Inventory as of this Action Requested Previously Approved
08/31/2021 08/31/2021 08/31/2021
9,364 0 9,364
13,364 0 13,364
0 0 0
The Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities information collection consists of several forms that allow the Unaccompanied Children (UC) Program to monitor its care provider facilities for compliance with Federal and State laws and regulations, licensing and accreditation standards, ORR policies and procedures, and child welfare standards. Currently, there are two versions of a questionnaire for UCs ages 6-12 and ages 13 and older (UC Questionnaires, Forms M-12A and M-12B, respectively). ORR is proposing to include an alternate version of the UC questionnaire for UCs aged 5 and under. The alternate form (Form M-12E) is designed to gather information on the same topics as the current forms, but the version for 6-12-year-old UCs has been modified to be more child-friendly for children 5 and under.
Consistent with the Paperwork Reduction Act of 1995, and OMB procedures, the Department requests approval for emergency processing for Monitoring and Compliance forms for the Unaccompanied Children program. On January 21, 2021, the Department published a Notice of Request for Public Comment for the forms, initiating a 60-day period for the public to submit comments on the information collection. The 60-day comment period ends on March 22, 2021. The monitoring and compliance forms are necessary for the program to meet its statutory obligations (Homeland Security Act, 6 U.S.C. 279). The Department requests emergency OMB approval pursuant to 5 CFR 1320.13 in order for the monitoring and compliance forms to be used by ORR field offices while public comment is being sought. The Department plans to complete the ongoing PRA process for the three-year approval of the monitoring and compliance forms since approval based on emergency processing under the PRA is only granted for a maximum of 180 days, until August 2021.
US Code: 8 USC 1232 Name of Law: Trafficking Victim Protection Reauthorization Act of 2008
   US Code: 6 USC 279 Name of Law: Homeland Security Act of 2002
  
None
Not associated with rulemaking
  86 FR 6340 01/21/2021
No
60
IC Title Form No. Form Name
Case Coordinator Questionnaire (Form M-13E) - Recordkeeping Form M-13E Case Coordinator Questionnaire
Case Coordinator Questionnaire (Form M-13E) - Respondents Form M-13E Case Coordinator Questionnaire
Checklist for a Child-Friendly Environment (Form M-4A to M4B) Form M-4A, Form M-4B Checklist for a Child-Friendly Environment - Care Provider Facility ,   Checklist for a Child-Friendly Environment - Individual Foster Home
Corrective Action Report (Form M-1) - Recordkeeping M-1 Corrective Action Report (Form M-1)
Corrective Action Report (Form M-1) - Respondents M-1 Corrective Action Report (Form M-1)
FFS Compliance and Safety Site Visit Report (Form M-3A) - Recordkeeping Form M-3A FFS Compliance and Safety Site Visit Report
FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form M-3A FFS Compliance and Safety Site Visit Report
Foster Home On Site Monitoring Checklist (Form M-9B) Form M-9 Foster Home On Site Monitoring Checklist
HS/PRS Site Visit Guide (Form M-7E) - Recordkeeping Form M-7E HS PRS Site Visit Guide
HS/PRS Site Visit Guide (Form M-7E) - Respondents Form M-7E HS PRS Site Visit Guide
Home Study and Post-Release Services Case File Checklist (Form M-8C) - Recordkeeping Form M-8C Home Study and Post-Release Services Case File Checklist
Home Study and Post-Release Services Case File Checklist (Form M-8C) - Respondents Form M-8C Home Study and Post-Release Services Case File Checklist
Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Recordkeeping Form M-13B Home Study and Post-Release Services Caseworker Questionnaire
Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Respondents Form M-13B Home Study and Post-Release Services Caseworker Questionnaire
Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form M-13A 48 - HS PRS Program Director Questionnaire
Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form M-13A HS PRS Program Director Questionnaire
Home Study and Post-Release Services Personnel File Checklist (Form M-10C) Form M-10C Home Study and Post-Release Services Personnel File Checklist
Incident Reviews (Forms M-5A to M-5B) Form M-5A, Form M-5B UAC Incident Review ,   Adult Incident Review
LTFC Monitoring and LTFC Remote Monitoring Notes (Forms M-6C to M-6D) Form M-6C, Form M-6D LTFC Monitoring Notes ,   LTFC Remote Monitoring Notes
LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Recordkeeping Form M-7C, Form M-7D LTFC Site Visit Guide ,   LTFC Remote Site Visit Guide
LTFC Site Visit and LTFC Remote Monitoring Site Visit Guides (Forms M-7C to M-7D) - Respondents Form M-7C, Form M-7D LTFC Site Visit Guide ,   LTFC Remote Site Visit Guide
Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form M-13C Legal Service Provider Questionnaire
Legal Service Provider Questionnaire (Form M-13C) - Respondents Form M-13C Legal Service Provider Questionnaire
Long Term Foster Care Client Questionnaire (M-12C) - Recordkeeping Form M-12C LTFC Client Questionnaire
Long Term Foster Care Client Questionnaire (M-12C) - Respondents Form M-12C LTFC Client Questionnaire
Long Term Foster Care File Checklist (Form M-8B) - Recordkeeping Form M-8B Long Term Foster Care File Checklist
Long Term Foster Care File Checklist (Form M-8B) - Respondents Form M-8B Long Term Foster Care File Checklist
Long Term Foster Care Foster Parent Checklist (Form M-10D) Form M-10D Long Term Foster Care Foster Parent Checklist
Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Recordkeeping Form M-11O LTFC Foster Parent Questionnaire
Long Term Foster Care Foster Parent Questionnaire (form M-11O) - Respondents Form M-11O LTFC Foster Parent Questionnaire
Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Recordkeeping Form M-11M Long Term Foster Care Home Finder Questionnaire
Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form M-11M Long Term Foster Care Home Finder Questionnaire
Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Recordkeeping Form M-11N Long Term Foster Care Independent Living Life Skills Staff Questionnaire
Long Term Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Respondents Form M-11N Long Term Foster Care Independent Living Life Skills Staff Questionnaire
Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Recordkeeping Form M-13D LTFC Legal Service Provider Questionnaire
Long Term Foster Care Legal Service Provider Questionnaire (Form M-13D) - Reporting Form M-13D LTFC Legal Service Provider Questionnaire
Monitoring Schedule (Form M-15) Form M-15 Monitoring Schedule
Monitoring Visit (Form M-14) Form M-14 Monitoring Visit
Monitoring and Remote Monitoring Notes (Forms M-6A to M-6B) Form M-6A, Form M-6B Monitoring Notes ,   Remote Monitoring Notes
On Site Monitoring Checklist (Form M-9A) Form M-9A On Site Monitoring Checklist
Out-of-Network Site Visit Report (Form M-3B) Form M-3B Out-of-Network Site Visit Report
Personnel File Checklist (Form M-10A) Form M-10A Personnel File Checklist
Post-Release Services Home Observation (Form M-9C) Form M-9C Post-Release Services Home Observation
Program Staff Questionnaires (Form M-11A-K) - Recordkeeping Form M-11G, Form M-11D, Form M-11A, Form M-11B, Form M-11C, Form M-11E, Form M-11F, Form M-11H, Form M-11I, Form M-11J, Form M-11K Program Director Questionnaire ,   LTFC Program Director Questionnaire ,   Clinician Questionnaire ,   LTFC Clinician Questionnaire ,   Case Manager Questionnaire ,   LTFC Case Manager Questionnaire ,   Education Staff Questionnaire ,   LTFC Educational Staff Questionnaire ,   Medical Coordinator Questionnaire ,   Youth Care Worker Questionnaire ,   PSA Compliance Manager Questionnaire
Program Staff Questionnaires (Form M-11A-K) - Respondents Form M-11G, Form M-11A, Form M-11B, Form M-11C, Form M-11D, Form M-11E, Form M-11F, Form M-11H, Form M-11I, Form M-11J, Form M-11K Program Director Questionnaire ,   LTFC Program Director Questionnaire ,   Clinician Questionnaire ,   LTFC Clinician Questionnaire ,   Case Manager Questionnaire ,   LTFC Case Manager Questionnaire ,   Education Staff Questionnaire ,   LTFC Educational Staff Questionnaire ,   Medical Coordinator Questionnaire ,   Youth Care Worker Questionnaire ,   PSA Compliance Manager Questionnaire
Secure Client Questionnaire (Form M-12D) - Recordkeeping Form M-12D Secure Client Questionnaire
Secure Client Questionnaire (Form M-12D) - Respondents Form M-12D Secure Client Questionnaire
Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form M-11L Secure Detention Officer Questionnaire
Secure Detention Officer Questionnaire (Form M-11L) - Respondents Form M-11L Secure Detention Officer Questionnaire
Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Recordkeeping Form M-8D Secure and Staff Secure Addendum to Case File Checklist
Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) - Respondents Form M-8D Secure and Staff Secure Addendum to Case File Checklist
Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Recordkeeping Form M-7A, Form M-7B Site Visit Guide ,   Remote Monitoring Site Visit Guide
Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Respondents Form M-7A, Form M-7B Site Visit Guide ,   Remote Monitoring Site Visit Guide
Supplement to Personnel File Checklist (Form M-10B) Form M-10B Supplement to Personnel File Checklist
UAC Case File Checklist (Form M-8A) - Recordkeeping Form M-8A UAC Case File Checklist
UAC Case File Checklist (Form M-8A) - Respondents Form M-8A UAC Case File Checklist
UAC Questionnaires (Forms M-12A-B, E) - Recordkeeping Form M-12E, Form M-12A, Form M-12B UAC Questionnaire - Ages 6-12 Years Old ,   UAC Questionnaire - Ages 13 and Older ,   UC Questionnaire - Ages 5 and Under
UC Questionnaires (Forms M-12A-B, E) - Respondents Form M-12A, Form M-12B, Form M-12E UAC Questionnaire - Ages 6-12 Years Old ,   UAC Questionnaire - Ages 13 and Older ,   UC Questionnaire - Ages 5 and Under
Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form M-7F Voluntary Agency Site Visit Guide
Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form M-7F Voluntary Agency Site Visit Guide
  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 9,364 9,364 0 0 0 0
Annual Time Burden (Hours) 13,364 13,364 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$498,366
No
    Yes
    Yes
No
No
No
No
Molly Buck 202 205-4724 [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.
07/12/2021