Administration and Oversight of the Unaccompanied Alien Children Program

Forms and Documents

Document Name	Status
Form A-12 Hotline Alert (Form A-12) Form	New
Form A-11 (Aggregate) UAC Satisfaction Survey Aggregate Data Form	New
Form A-10F Sexual Abuse Significant Incident Report Addendum (Form A-10F) Form	New
Form Form A-10E Sexual Abuse Significant Incident Report (Form A-10E) Form	New
Form A-10D Significant Incident Report Addendum (Form A-10D) Form	New
Form A-10C Significant Incident Report (Form A-10C) Form	New
Form A-10B Emergency Significant Incident Report Addendum (Form A-10B) Form	New
Form A-10A Emergency Significant Incident Report (Form A-10A) Form	New
Form A-9 Program Level Event (Form A-9) Form	New
Form A-5 Authorization for Release of Records (Form A-5) Form	New
Form A-4 Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form	New
Form A-1A Care Provider Facility Tour Request (Form A-1A) Form	New
Supporting Statement for Admin and Oversight (03.31.20) v2_4.24.docx Supporting Statement A	2020-04-24

IC Document Collections

IC ID	Document Title	Status
241082	Hotline Alert (Form A-12) Form	New
241081	UAC Satisfaction Survey Aggregate Data Form	New
241080	UAC Satisfaction Survey (Form A-11 & A-11s) Other-Survey	New
241079	Sexual Abuse Significant Incident Report Addendum (Form A-10F) Form	New
241078	Sexual Abuse Significant Incident Report (Form A-10E) Form	New
241077	Significant Incident Report Addendum (Form A-10D) Form	New
241076	Significant Incident Report (Form A-10C) Form	New
241075	Emergency Significant Incident Report Addendum (Form A-10B) Form	New
241074	Emergency Significant Incident Report (Form A-10A) Form	New
241073	Program Level Event (Form A-9) Form	New
241072	Authorization for Release of Records (Form A-5) Form	New
241070	Notice to UAC for Flores Visits (Forms A-4 & A-4s) Form	New
241067	Care Provider Facility Tour Request (Form A-1A) Form	New

ICR Details

OMB Control No: 0970-0547	ICR Reference No: 202004-0970-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR
Title: Administration and Oversight of the Unaccompanied Alien Children Program
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 04/17/2020
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/27/2020
	Date Received in OIRA: 04/13/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	6 Months From Approved
Responses	198,015	0	0
Time Burden (Hours)	63,561	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: These instruments allow ORR to facilitate stakeholder visits to care provider facilities; obtain consent from UAC to share their case file information; improve service delivery to UAC; and ensure that serious issues are elevated to ORR and that all incidents and the response to such incidents are documented and resolved in a way that protects the interests of UAC. This is a time sensitive request because many of these forms are already in use and must continue to be in use in order for the UAC Program to meet its statutory obligations.

Emergency Justfication: This is a time sensitive request because many of these forms are already in use and must continue to be in use in order for the UAC Program to meet its statutory obligations.

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Authorizing Statute(s): US Code: 6 USC 279 Name of Law: Homeland Security Act of 2002
   US Code: 8 USC 1232 Name of Law: rafficking Victim Protection Reauthorization Act of 2008
   PL: Pub.L. 113 - 4 1101(c) Name of Law: Violence Against Women Reauthorization Act of 2013
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 13

IC Title	Form No.	Form Name
Significant Incident Report Addendum (Form A-10D)	A-10D	Significant Incident Report Addendum
UAC Satisfaction Survey (Form A-11 & A-11s)
Care Provider Facility Tour Request (Form A-1A)	A-1A	Care Provider Facility Tour Request
Authorization for Release of Records (Form A-5)	A-5	Authorization for Release of Records
Notice to UAC for Flores Visits (Forms A-4 & A-4s)	A-4, A-4s	Notice to UAC for Flores Visits ,   Notice to UAC for Flores Visits
Program Level Event (Form A-9)	A-9	Program Level Event Report
Emergency Significant Incident Report (Form A-10A)	A-10A	Emergency Significant Incident Report
Emergency Significant Incident Report Addendum (Form A-10B)	A-10B	Emergency Significant Incident Report Addendum
Significant Incident Report (Form A-10C)	A-10C	Significant Incident Report
Sexual Abuse Significant Incident Report (Form A-10E)	Form A-10E	Sexual Abuse Significant Incident Report
Sexual Abuse Significant Incident Report Addendum (Form A-10F)	A-10F	Sexual Abuse Significant Incident Report Addendum
UAC Satisfaction Survey Aggregate Data	A-11 (Aggregate)	UAC Satisfaction Survey Aggregate Data
Hotline Alert (Form A-12)	A-12	Hotline Alert

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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	198,015	0	0	198,015	0	0
Annual Time Burden (Hours)	63,561	0	0	63,561	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: ORR is reorganizing the instruments currently approved under OMB 0970-0498 into separate collections based on the purpose of the information collected. This collection includes one instrument from OMB 0970-0498 that is related to administration and oversight tasks for the UAC Program, the Care Provider Facility Tour Request. This form was changed from a Word document to a fillable PDF and the formatting has been streamlined for ease of use. This collection also includes several other instruments that fall under this information collection category that are subject to PRA and require approval by OMB.

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Annual Cost to Federal Government: $4,795,610

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.     No

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? Uncollected

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Common Form ICR:  No

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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: 04/13/2020

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