Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping

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

OMB: 0970-0564

IC ID: 256786

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Information Collection (IC) Details

View Information Collection (IC)

Unlicensed Facility Program Staff Questionnaires (Forms M-11A-UF to M-11K-UF) - Recordkeeping
 
No Unchanged
 
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 M-11A-UF Program Director Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11C-UF Clinician Questionnaire M-11C-UF Clinician Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11E-UF Case Manager Questionnaire M-11E-UF Case Manager Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11G-UF Education Staff Questionnaire M-11G-UF Education Staff Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11I-UF Medical Coordinator Questionnaire M-11I-UF Medical Coordinator Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11J-UF Youth Care Worker Questionnaire M-11J-UF Youth Care Worker Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction Form M-11K-UF PSA Compliance Manager Questionnaire M-11K-UF PSA Compliance Manager Questionnaire.docx Yes Yes Fillable Fileable

Community and Social Services Social Services

ORR Unaccompanied Refugee Minors Records  81 FR 46682

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

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