OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202211-0970-002 · OMB 0970-0564 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form Form M-13E-UF Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Recordkeeping Form and Instruction New Repair queued
Form Form M-13E-UF Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Respondent Form and Instruction New Available
Form Form M-13C-UF Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Recordkeeping Form and Instruction New Available
Form Form M-13C-UF Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Respondent Form and Instruction New Available
Form Form M-12A-UF Unlicensed Facility UC Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping Form and Instruction New Available
Form Form M-12A-UF Unlicensed Facility UC Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Respondents Form and Instruction New Available
Form Form M-11P-UF Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Recordkeeping Form and Instruction New Available
Form Form M-11P-UF Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Respondents Form and Instruction New Available
Form Form M-11A-UF Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping Form and Instruction New Available
Form Form M-11A-UF Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Respondents Form and Instruction New Available
Form Form M-11P Interpreter Questionnaire (Form M-11P) Form and Instruction New Available
Form Form M-10A-UF Unlicensed Facility Personnel File Checklist (Form M-10A-UF) - Recordkeeping Form and Instruction New Available
Form Form M-9A-UF Unlicensed Facility On-Site Monitoring Checklist (Form M-9A-UF) - Recordkeeping Form and Instruction New Available
Form Form M-6A-UF Unlicensed Facility Monitoring Notes (Form M-6A-UF) - Recordkeeping Form and Instruction New Available
Form Form M-8A-UF Unlicensed Facility UC Case File Checklist (Form M-8A-UF) - Recordkeeping Form and Instruction New Available
Form Form M-8A-UF Unlicensed Facility UC Case File Checklist (Form M-8A-UF) - Respondents Form and Instruction New Available
Form Form M-7A-UF Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Recordkeeping Form and Instruction New Available
Form Form M-7A-UF Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Respondents Form and Instruction New Available
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 Available
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 Available
Form Form M-13E Case Coordinator Questionnaire (Form M-13E) - Respondents Form and Instruction Unchanged Available
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 Available
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Respondents Form and Instruction Unchanged Available
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 Available
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form and Instruction Unchanged Repair queued
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form and Instruction Unchanged Available
Form Form M-12D Secure Client Questionnaire (Form M-12D) - Recordkeeping Form and Instruction Unchanged Available
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 Available
Form Form M-12A UC Questionnaires (Forms M-12A-B, E) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-12A UC Questionnaires (Forms M-12A-B, E) - Respondents Form and Instruction Unchanged Available
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 Available
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 Available
Form Form M-11M Long Term Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form and Instruction Unchanged Available
Form Form M-11L Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form and Instruction Unchanged Available
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 Available
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 Available
Form Form M-10C Home Study and Post-Release Services Personnel File Checklist (Form M-10C) Form and Instruction Unchanged Available
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 Available
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form and Instruction Unchanged Available
Form Form M-7E HS/PRS Site Visit Guide (Form M-7E) - Recordkeeping Form and Instruction Unchanged Available
Form Form M-7E HS/PRS Site Visit Guide (Form M-7E) - Respondents Form and Instruction Unchanged Available
Form Form M-7A Site Visit and Remote Monitoring Site Visit Guides (Forms M-7A to M-7B) - Recordkeeping Form and Instruction Unchanged Available
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-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 Available
Form Form M-3B Out-of-Network Site Visit Report (Form M-3B) Form and Instruction Unchanged Available
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 Available
Form M-1 Corrective Action Report (Form M-1) - Respondents Form and Instruction Unchanged Available
Expedited Review FRN Monitoring and Compliance_0970-0564_10.26.22.pdf Supplementary Document Uploaded 2022-11-09 Available
Emergency SSA_0970-0564_Monitoring and Compliance_005_2022 11 09.docx Supporting Statement A Uploaded 2022-11-09 Available
IC Document Collections
IC IDCollectionTypeStatusForm
256795 Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Recordkeeping Form and Instruction New
256793 Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Respondent Form and Instruction New
256792 Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Recordkeeping Form and Instruction New
256791 Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Respondent Form and Instruction New
256790 Unlicensed Facility UC Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping Form and Instruction New
256789 Unlicensed Facility UC Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Respondents Form and Instruction New
256788 Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Recordkeeping Form and Instruction New
256787 Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Respondents Form and Instruction New
256786 Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping Form and Instruction New
256785 Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Respondents Form and Instruction New
256784 Interpreter Questionnaire (Form M-11P) Form and Instruction New
256783 Unlicensed Facility Personnel File Checklist (Form M-10A-UF) - Recordkeeping Form and Instruction New
256782 Unlicensed Facility On-Site Monitoring Checklist (Form M-9A-UF) - Recordkeeping Form and Instruction New
256781 Unlicensed Facility Monitoring Notes (Form M-6A-UF) - Recordkeeping Form and Instruction New
256780 Unlicensed Facility UC Case File Checklist (Form M-8A-UF) - Recordkeeping Form and Instruction New
256779 Unlicensed Facility UC Case File Checklist (Form M-8A-UF) - Respondents Form and Instruction New
256778 Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Recordkeeping Form and Instruction New
256777 Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Respondents Form and Instruction New
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 UC Questionnaires (Forms M-12A-B, E) - Recordkeeping Form and Instruction Unchanged
245614 UC Questionnaires (Forms M-12A-B, E) - Respondents Form and Instruction Unchanged
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
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
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
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
StatusActive
Agency/SubagencyHHS/ACF
OMB Control No0970-0564
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202112-0970-003
Agency Tracking NoORR
Date Submitted to OIRA2022-11-09
Requested Expiration Date2022-11-10