OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

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

ICR 202305-0970-015 · OMB 0970-0564 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form Form M-17H PSA Audit Corrective Action Report (Form M-17H) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17H PSA Audit Corrective Action Report (Form M-17H) - Respondent Form and Instruction New Repair queued
Form Form M-17G Interview Guide: Unaccompanied Child (Form M-17G) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17G Interview Guide: Unaccompanied Child (Form M-17G) - Respondent Form and Instruction New Missing upstream
Form Form M-17F Interview Guide: Specialized Staff (Form M-17F) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17F Interview Guide: Specialized Staff (Form M-17F) - Respondent Form and Instruction New Missing upstream
Form Form M-17E Interview Guide: PSA Compliance Manager (Form M-17E) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17E Interview Guide: PSA Compliance Manager (Form M-17E) - Respondent Form and Instruction New Repair queued
Form Form M-17D Interview Guide: Program Director (Form M-17D) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17D Interview Guide: Program Director (Form M-17D) - Respondent Form and Instruction New Repair queued
Form Form M-17C Interview Guide: Random Sample of Staff Interview (Form M-17C) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17C Interview Guide: Random Sample of Staff Interview (Form M-17C) - Respondent Form and Instruction New Missing upstream
Form Form M-17B Instructions for Site Visit and Facility Tour (Form M-17B) - Recordkieeping Form and Instruction New Missing upstream
Form Form M-17B Instructions for Site Visit and Facility Tour (Form M-17B) - Respondent Form and Instruction New Missing upstream
Form Form M-17A Preaudit Questionnaire and Audit Documentation Requested Checklist (Form M-17A) - Recordkeeping Form and Instruction New Repair queued
Form Form M-17A Preaudit Questionnaire and Audit Documentation Requested Checklist (Form M-17A) - Respondent Form and Instruction New Repair queued
Form Form M-10E Influx Care Facility Personnel File Checklist (Form M-10E) - Recordkeeping Form and Instruction New Repair queued
Form M-9B-UF Unlicensed Facility Foster Home Onsite Monitoring Checklist (M-9B-UF) - Recordkeeping Form and Instruction New Repair queued
Form Form M-8D-UF Unlicensed Facility Staff Secure Addendum to Case File Checklist (Form M-8D-UF) - Recordkeeping Form and Instruction New Repair queued
Form Form M-8D-UF Unlicensed Facility Staff Secure Addendum to Case File Checklist (Form M-8D-UF) - Respondents Form and Instruction New Repair queued
Form Form M-8B-UF Unlicensed Facility Foster Care Unaccompanied Child Case File Checklist (Form M-8B-UF) - Recordkeeping Form and Instruction New Repair queued
Form Form M-8B-UF Unlicensed Facility Foster Care Unaccompanied Child Case File Checklist (Form M-8B-UF) - Respondents Form and Instruction New Repair queued
Form Form M-7G Influx Care Facility Monitoring Site Visit Guide (Form M-7G) - Recordkeeping Form and Instruction New Repair queued
Form Form M-7G Influx Care Facility Monitoring Site Visit Guide (Form M-7G) - Respondents Form and Instruction New Available
Form Form M-6E-UF Influx Care Facility Monitoring Notes (Form M-6E-UF) - Recordkeeping Form and Instruction New Missing upstream
Form Form M-6C-UF Unlicensed Facility Foster Care Monitoring Notes (Form M-6C-UF) - Recordkeeping Form and Instruction New Missing upstream
Form Form M-13E-UF Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13E-UF Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Respondent Form and Instruction Modified Missing upstream
Form Form M-13C-UF Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13C-UF Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Respondent Form and Instruction Modified Repair queued
Form Form M-12A-UF Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-12A-UF Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Respondents Form and Instruction Modified Repair queued
Form Form M-11P-UF Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-11P-UF Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Respondents Form and Instruction Modified Missing upstream
Form Form M-11A-UF Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-11A-UF Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Respondents Form and Instruction Modified Missing upstream
Form Form M-11P Interpreter Questionnaire (Form M-11P) Form and Instruction Modified Missing upstream
Form Form M-10A-UF Unlicensed Facility Personnel File Checklist (Form M-10A-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-9A-UF Unlicensed Facility OnSite Monitoring Checklist (Form M-9A-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-6A-UF Unlicensed Facility Monitoring Notes (Form M-6A-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-8A-UF Unlicensed Facility Unaccompanied Child Case File Checklist (Form M-8A-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-8A-UF Unlicensed Facility Unaccompanied Child Case File Checklist (Form M-8A-UF) - Respondents Form and Instruction Modified Repair queued
Form Form M-7A-UF Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-7A-UF Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Respondents Form and Instruction Modified Repair queued
Form Form M-7C Foster Care Site Visit Guide (Forms M-7C) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-7C Foster Care Site Visit Guide (Forms M-7C) - Respondents Form and Instruction Modified Repair queued
Form Form M-15 Monitoring Schedule (Form M-15) Form and Instruction Modified Repair queued
Form Form M-14 Monitoring Visit (Form M-14) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13E Case Coordinator Questionnaire (Form M-13E) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13E Case Coordinator Questionnaire (Form M-13E) - Respondents Form and Instruction Modified Repair queued
Form Form M-13D Foster Care Legal Service Provider Questionnaire (Form M-13D) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13D Foster Care Legal Service Provider Questionnaire (Form M-13D) - Respondents Form and Instruction Modified Repair queued
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-13C Legal Service Provider Questionnaire (Form M-13C) - Respondents Form and Instruction Modified Repair queued
Form Form M-13B Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-13B Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Respondents Form and Instruction Modified Available
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-13A Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form and Instruction Modified Repair queued
Form Form M-12D Secure Client Questionnaire (Form M-12D) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-12D Secure Client Questionnaire (Form M-12D) - Respondents Form and Instruction Modified Missing upstream
Form Form M-12C Foster Care Client Questionnaire (M-12C) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-12C Foster Care Client Questionnaire (M-12C) - Respondents Form and Instruction Modified Missing upstream
Form Form M-12A Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-12A Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Respondents Form and Instruction Modified Missing upstream
Form Form M-11O Foster Care Foster Parent Questionnaire (form M-11O) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-11O Foster Care Foster Parent Questionnaire (form M-11O) - Respondents Form and Instruction Modified Missing upstream
Form Form M-11N Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-11N Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Respondents Form and Instruction Modified Repair queued
Form Form M-11M Foster Care Home Finder Questionnaire (Form M-11M) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-11M Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form and Instruction Modified Repair queued
Form Form M-11L Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-11L Secure Detention Officer Questionnaire (Form M-11L) - Respondents Form and Instruction Modified Repair queued
Form Form M-11A Program Staff Questionnaires (Form M-11A-K) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-11A Program Staff Questionnaires (Form M-11A-K) - Respondents Form and Instruction Modified Repair queued
Form Form M-10D Foster Care Foster Parent Checklist (Form M-10D) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-10C Home Study and Post-Release Services Personnel File Checklist (Form M-10C) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-10B Supplement to Personnel File Checklist (Form M-10B) - Recordkeeping Form and Instruction Modified Missing upstream
Form Form M-10A Personnel File Checklist (Form M-10A) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form and Instruction Removed Repair queued
Form Form M-7F Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form and Instruction Removed Repair queued
Form Form M-7E Home Study and Post-Release Services Site Visit Guide (Form M-7E) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-7E Home Study and Post-Release Services Site Visit Guide (Form M-7E) - Respondents Form and Instruction Modified Missing upstream
Form Form M-7A Site Visit Guides (Forms M-7A) - Recordkeeping Form and Instruction Modified Repair queued
Form Form M-7A Site Visit Guides (Forms M-7A) - Respondents Form and Instruction Modified Missing upstream
Form Form M-5A Incident Reviews (Forms M-5A to M-5B) Form and Instruction Modified Missing upstream
Form Form M-4A Checklist for a Child-Friendly Environment (Form M-4a to M-4B) Form and Instruction Modified Repair queued
Form Form M-3B Out-of-Network Site Visit Report (Form M-3B) Form and Instruction Modified Repair queued
Form Form M-3A FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form and Instruction Modified Repair queued
Form M-1 Corrective Action Report (Form M-1) - Recordkeeping Form and Instruction Modified Repair queued
Form M-1 Corrective Action Report (Form M-1) - Respondents Form and Instruction Modified Available
SSA Attachment A_0970-0564_Monitoring and Compliance_005_2023 05 25.docx Supplementary Document Uploaded 2023-05-30 Missing upstream
Extension SSA_0970-0564_Monitoring and Compliance_005_2023 05 25 CLEAN.docx Supporting Statement A Uploaded 2023-05-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
260450 PSA Audit Corrective Action Report (Form M-17H) - Recordkeeping Form and Instruction New
260449 PSA Audit Corrective Action Report (Form M-17H) - Respondent Form and Instruction New
260448 Interview Guide: Unaccompanied Child (Form M-17G) - Recordkeeping Form and Instruction New
260447 Interview Guide: Unaccompanied Child (Form M-17G) - Respondent Form and Instruction New
260446 Interview Guide: Specialized Staff (Form M-17F) - Recordkeeping Form and Instruction New
260445 Interview Guide: Specialized Staff (Form M-17F) - Respondent Form and Instruction New
260444 Interview Guide: PSA Compliance Manager (Form M-17E) - Recordkeeping Form and Instruction New
260442 Interview Guide: PSA Compliance Manager (Form M-17E) - Respondent Form and Instruction New
260441 Interview Guide: Program Director (Form M-17D) - Recordkeeping Form and Instruction New
260439 Interview Guide: Program Director (Form M-17D) - Respondent Form and Instruction New
260438 Interview Guide: Random Sample of Staff Interview (Form M-17C) - Recordkeeping Form and Instruction New
260437 Interview Guide: Random Sample of Staff Interview (Form M-17C) - Respondent Form and Instruction New
260436 Instructions for Site Visit and Facility Tour (Form M-17B) - Recordkieeping Form and Instruction New
260435 Instructions for Site Visit and Facility Tour (Form M-17B) - Respondent Form and Instruction New
260434 Preaudit Questionnaire and Audit Documentation Requested Checklist (Form M-17A) - Recordkeeping Form and Instruction New
260433 Preaudit Questionnaire and Audit Documentation Requested Checklist (Form M-17A) - Respondent Form and Instruction New
260432 Influx Care Facility Personnel File Checklist (Form M-10E) - Recordkeeping Form and Instruction New
260431 Unlicensed Facility Foster Home Onsite Monitoring Checklist (M-9B-UF) - Recordkeeping Form and Instruction New
260430 Unlicensed Facility Staff Secure Addendum to Case File Checklist (Form M-8D-UF) - Recordkeeping Form and Instruction New
260429 Unlicensed Facility Staff Secure Addendum to Case File Checklist (Form M-8D-UF) - Respondents Form and Instruction New
260428 Unlicensed Facility Foster Care Unaccompanied Child Case File Checklist (Form M-8B-UF) - Recordkeeping Form and Instruction New
260427 Unlicensed Facility Foster Care Unaccompanied Child Case File Checklist (Form M-8B-UF) - Respondents Form and Instruction New
260425 Influx Care Facility Monitoring Site Visit Guide (Form M-7G) - Recordkeeping Form and Instruction New
260424 Influx Care Facility Monitoring Site Visit Guide (Form M-7G) - Respondents Form and Instruction New
260423 Influx Care Facility Monitoring Notes (Form M-6E-UF) - Recordkeeping Form and Instruction New
260422 Unlicensed Facility Foster Care Monitoring Notes (Form M-6C-UF) - Recordkeeping Form and Instruction New
256795 Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Recordkeeping Form and Instruction Modified
256793 Unlicensed Facility Case Coordinator Questionnaire (Form M-13E-UF) - Respondent Form and Instruction Modified
256792 Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Recordkeeping Form and Instruction Modified
256791 Unlicensed Facility Legal Service Provider Questionnaire (Form M-13C-UF) - Respondent Form and Instruction Modified
256790 Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Recordkeeping Form and Instruction Modified
256789 Unlicensed Facility Unaccompanied Child Questionnaires (M-12A-UF to M-12B-UF & M-12E-UF) - Respondents Form and Instruction Modified
256788 Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Recordkeeping Form and Instruction Modified
256787 Unlicensed Facility Interpreter Questionnaire (Form M-11P-UF) - Respondents Form and Instruction Modified
256786 Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping Form and Instruction Modified
256785 Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Respondents Form and Instruction Modified
256784 Interpreter Questionnaire (Form M-11P) Form and Instruction Modified
256783 Unlicensed Facility Personnel File Checklist (Form M-10A-UF) - Recordkeeping Form and Instruction Modified
256782 Unlicensed Facility OnSite Monitoring Checklist (Form M-9A-UF) - Recordkeeping Form and Instruction Modified
256781 Unlicensed Facility Monitoring Notes (Form M-6A-UF) - Recordkeeping Form and Instruction Modified
256780 Unlicensed Facility Unaccompanied Child Case File Checklist (Form M-8A-UF) - Recordkeeping Form and Instruction Modified
256779 Unlicensed Facility Unaccompanied Child Case File Checklist (Form M-8A-UF) - Respondents Form and Instruction Modified
256778 Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Recordkeeping Form and Instruction Modified
256777 Unlicensed Facility Site Visit Guide (Form M-7A-UF) - Respondents Form and Instruction Modified
245634 Foster Care Site Visit Guide (Forms M-7C) - Recordkeeping Form and Instruction Modified
245633 Foster Care Site Visit Guide (Forms M-7C) - Respondents Form and Instruction Modified
245632 Monitoring Schedule (Form M-15) Form and Instruction Modified
245631 Monitoring Visit (Form M-14) - Recordkeeping Form and Instruction Modified
245630 Case Coordinator Questionnaire (Form M-13E) - Recordkeeping Form and Instruction Modified
245629 Case Coordinator Questionnaire (Form M-13E) - Respondents Form and Instruction Modified
245628 Foster Care Legal Service Provider Questionnaire (Form M-13D) - Recordkeeping Form and Instruction Modified
245627 Foster Care Legal Service Provider Questionnaire (Form M-13D) - Respondents Form and Instruction Modified
245626 Legal Service Provider Questionnaire (Form M-13C) - Recordkeeping Form and Instruction Modified
245625 Legal Service Provider Questionnaire (Form M-13C) - Respondents Form and Instruction Modified
245624 Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Recordkeeping Form and Instruction Modified
245623 Home Study and Post-Release Services Caseworker Questionnaire (Form M-13B) - Respondents Form and Instruction Modified
245622 Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Recordkeeping Form and Instruction Modified
245621 Home Study and Post-Release Services Director Questionnaire (Form M-13A) - Respondents Form and Instruction Modified
245619 Secure Client Questionnaire (Form M-12D) - Recordkeeping Form and Instruction Modified
245618 Secure Client Questionnaire (Form M-12D) - Respondents Form and Instruction Modified
245617 Foster Care Client Questionnaire (M-12C) - Recordkeeping Form and Instruction Modified
245616 Foster Care Client Questionnaire (M-12C) - Respondents Form and Instruction Modified
245615 Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Recordkeeping Form and Instruction Modified
245614 Unaccompanied Child Questionnaires (Forms M-12A to M-12B & M-12E) - Respondents Form and Instruction Modified
245613 Foster Care Foster Parent Questionnaire (form M-11O) - Recordkeeping Form and Instruction Modified
245612 Foster Care Foster Parent Questionnaire (form M-11O) - Respondents Form and Instruction Modified
245611 Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Recordkeeping Form and Instruction Modified
245610 Foster Care Independent Living Life Skills Staff Questionnaire (Form M-11N) - Respondents Form and Instruction Modified
245609 Foster Care Home Finder Questionnaire (Form M-11M) - Recordkeeping Form and Instruction Modified
245608 Foster Care Home Finder Questionnaire (Form M-11M) - Respondents Form and Instruction Modified
245607 Secure Detention Officer Questionnaire (Form M-11L) - Recordkeeping Form and Instruction Modified
245606 Secure Detention Officer Questionnaire (Form M-11L) - Respondents Form and Instruction Modified
245605 Program Staff Questionnaires (Form M-11A-K) - Recordkeeping Form and Instruction Modified
245604 Program Staff Questionnaires (Form M-11A-K) - Respondents Form and Instruction Modified
245603 Foster Care Foster Parent Checklist (Form M-10D) - Recordkeeping Form and Instruction Modified
245602 Home Study and Post-Release Services Personnel File Checklist (Form M-10C) - Recordkeeping Form and Instruction Modified
245601 Supplement to Personnel File Checklist (Form M-10B) - Recordkeeping Form and Instruction Modified
245600 Personnel File Checklist (Form M-10A) - Recordkeeping Form and Instruction Modified
245588 Voluntary Agency Site Visit Guide (Form M-7F) - Recordkeeping Form and Instruction Removed
245587 Voluntary Agency Site Visit Guide (Form M-7F) - Respondents Form and Instruction Removed
245586 Home Study and Post-Release Services Site Visit Guide (Form M-7E) - Recordkeeping Form and Instruction Modified
245585 Home Study and Post-Release Services Site Visit Guide (Form M-7E) - Respondents Form and Instruction Modified
245584 Site Visit Guides (Forms M-7A) - Recordkeeping Form and Instruction Modified
245583 Site Visit Guides (Forms M-7A) - Respondents Form and Instruction Modified
245580 Incident Reviews (Forms M-5A to M-5B) Form and Instruction Modified
245579 Checklist for a Child-Friendly Environment (Form M-4a to M-4B) Form and Instruction Modified
245577 Out-of-Network Site Visit Report (Form M-3B) Form and Instruction Modified
245575 FFS Compliance and Safety Site Visit Report (Form M-3A) - Respondents Form and Instruction Modified
245574 Corrective Action Report (Form M-1) - Recordkeeping Form and Instruction Modified
245572 Corrective Action Report (Form M-1) - Respondents Form and Instruction Modified
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/ACF
OMB Control No0970-0564
Type of Information CollectionRevision of a currently approved collection
Previous ICR Reference No202211-0970-002
Agency Tracking NoORR
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31