Program Staff Questionnaires (Form M-11A-K) - Recordkeeping

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

OMB: 0970-0564

IC ID: 245605

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Information Collection (IC) Details

View Information Collection (IC)

Program Staff Questionnaires (Form M-11A-K) - Recordkeeping
 
No Modified
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form M-11A Program Director Questionnaire Program Director Questionnaire (Form M-11A).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11B LTFC Program Director Questionnaire LTFC Program Director Questionnaire (Form M-11B).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11C Clinician Questionnaire Clinician Questionnaire (Form M-11C).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11D LTFC Clinician Questionnaire LTFC Clinician Questionnaire (Form M-11D).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11E Case Manager Questionnaire Case Manager Questionnaire (Form M-11E).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11F LTFC Case Manager Questionnaire LTFC Case Manager Questionnaire (Form M-11F).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11G Education Staff Questionnaire Education Staff Questionnaire (Form M-11G).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11H LTFC Educational Staff Questionnaire LTFC Educational Staff Questionnaire (Form M-11H).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11I Medical Coordinator Questionnaire Medical Coordinator Questionnaire (Form M-11I).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11J Youth Care Worker Questionnaire Youth Care Worker Questionnaire (Form M-11J).docx Yes Yes Fillable Fileable
Form and Instruction Form M-11K PSA Compliance Manager Questionnaire PSA Compliance Manager Questionnaire (Form M-11K).docx Yes Yes Fillable Fileable

Community and Social Services Social Services

ORR Unaccompanied Refugee Minors Records  81 FR 46682

4 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 216 0 0 0 0 216
Annual IC Time Burden (Hours) 216 0 0 0 0 216
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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