Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0970-0564
ICR Reference No:
202107-0970-004
Status:
Historical Active
Previous ICR Reference No:
202102-0970-001
Agency/Subagency:
HHS/ACF
Agency Tracking No:
ORR
Title:
Monitoring and Compliance for Office of Refugee Resettlement (ORR) Care Provider Facilities
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
02/16/2021
OIRA Conclusion Action:
Approved without change
Conclusion Date:
07/12/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/12/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2021
08/31/2021
08/31/2021
Responses
9,364
0
9,364
Time Burden (Hours)
13,364
0
13,364
Cost Burden (Dollars)
0
0
0
Abstract:
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.
Emergency Justfication:
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.
Authorizing Statute(s):
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
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
86 FR 6340
01/21/2021
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
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-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
UC Questionnaires (Forms M-12A-B, E) - Respondents
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
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
ICR Summary of Burden
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
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$498,366
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Molly Buck 202 205-4724 mary.buck@acf.hhs.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
07/12/2021