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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:
202112-0970-003
Status:
Historical Active
Previous ICR Reference No:
202108-0970-016
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:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/13/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/10/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2024
10/31/2024
10/31/2024
Responses
8,342
0
8,342
Time Burden (Hours)
11,031
0
11,031
Cost Burden (Dollars)
0
0
0
Abstract:
The Monitoring and Compliance for 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 three versions of a questionnaire for UC – ages 5 and under; ages 6-12; and ages 13 and older (UC Questionnaires, Forms M-12A, M-12B and M-12E, respectively). ORR proposes including questions in forms M-12A and M-12B that will assist in monitoring ORR care provider programs that house Unaccompanied Afghan Minors (UAM) and solicit relevant information from all UC.
Authorizing Statute(s):
US Code:
6 USC 279
Name of Law: Homeland Security Act of 2002
US Code:
8 USC 1232
Name of Law: Trafficking Victim Protection Reauthorization Act of 2008
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
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 48707
08/31/2021
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
46
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) - Respondents
Form M-3A
FFS Compliance and Safety Site Visit Report
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 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
UC Incident Review
,
Adult Incident Review
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 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
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
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
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
UC Questionnaires (Forms M-12A-B, E) - Recordkeeping
Form M-12E, Form M-12A, Form M-12B, Form M-12Bs, Form M-12As, Form M-12Es
UC Questionnaire - Ages 6-12 Years Old - English
,
UC Questionnaire - Ages 13 and Older - English
,
UC Questionnaire - Ages 5 and Under - English
,
UC Questionnaire - Ages 6-12 Years Old - Spanish
,
UC Questionnaire - Ages 13 and Older - Spanish
,
UC Questionnaire - Ages 5 and Under - Spanish
UC Questionnaires (Forms M-12A-B, E) - Respondents
Form M-12A , Form M-12B, Form M-12E, Form M-12As, Form M-12Bs, Form M-12Es
UC Questionnaire - Ages 6-12 Years Old - English
,
UC Questionnaire - Ages 13 and Older - English
,
UC Questionnaire - Ages 5 and Under - English
,
UC Questionnaire - Ages 6-12 Years Old - Spanish
,
UC Questionnaire - Ages 13 and Older - Spanish
,
UC Questionnaire - Ages 5 and Under - Spanish
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
8,342
8,342
0
0
0
0
Annual Time Burden (Hours)
11,031
11,031
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:
Changes to burden result from the following adjustments: • Shelter Site Visit Guide (Form M-7A) – The average burden minutes per response was increased from 12 hours to 13 hours for respondents and from 28 hours to 29 hours for federal and contractor monitors. • Removal of the following instruments from the information collection. These instruments will be completed by federal staff as part of their normal job duties and by less than 10 contractor staff. Therefore, they are no longer subject to PRA requirements. o Monitoring Notes (Form M-6A) o Remote Monitoring Notes (Form M-6B) o Long Term Foster Care Monitoring Notes (Form M-6C) o Long Term Foster Care Remote Monitoring Notes (Form M-6D) o UC Case File Checklist (Form M-8A) o Long Term Foster Care Case File Checklist (Form M-8B) o Home Study and Post-Release Services Case File Checklist (Form M-8C) o Secure and Staff Secure Addendum to Case File Checklist (Form M-8D) o On Site Monitoring Checklist (Form M-9A) o Foster Home On Site Monitoring Checklist (Form M-9B) o Post-Release Services Home Observation (Form M-9C)
Annual Cost to Federal Government:
$854,348
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:
12/10/2021