View Information Collection (IC)

View Information Collection (IC)

Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping
 
No New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form M-11A-UF Program Director Questionnaire 3 - Program Director Questionnaire (Form M-11A-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11C-UF Clinician Questionnaire 4 - Clinician Questionnaire (Form M-11C-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11E-UF Case Manager Questionnaire 5 - Case Manager Questionnaire (Form M-11E-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11G-UF Education Staff Questionnaire 6 - Education Staff Questionnaire (Form M-11G-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11I-UF Medical Coordinator Questionnaire 7 - Medical Coordinator Questionnaire (Form M-11I-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11J-UF Youth Care Worker Questionnaire 8 - Youth Care Worker Questionnaire (Form M-11J-UF).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11K-UF PSA Compliance Manager Questionnaire 9 - PSA Compliance Manager Questionnaire (Form M-11K-UF).docx Yes Yes Fillable Fileable

Community and Social Services Social Services

 

18 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   100 %

  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 1,800 0 1,800 0 0 0
Annual IC Time Burden (Hours) 1,800 0 1,800 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.