ORR UAC Path Pre Train-the-Trainer 2021 Survey FINAL

OMB Control Number: 0970-0401

Expiration date: 05/31/2021

HHS ACF ORR UAC Path Train-the-Trainer 2021 [English (United States)]

The UAC Path Training Team is gathering information on confirmed participants for the Train-the-Trainer in January 2021. If you will be participating in the rollout to Path as a Trail Guide, please complete the fields below and submit your responses by this [date TBD].

If you have any questions, please reach out to [Name] at [Email].

1. What is your first name?

____________________

2. What is your last name?

____________________

3. What is your work email address?

____________________

4. What is your role? 
Note: We will use this information to assign you to the proper profile in Salesforce for UAC Path. 

 UAC Path System Administrator

 Data Migration

 HS-PRS Provider: HS-PRS Staff

 HS-PRS Provider: HS-PRS Subcontractor

 UAC Monitor: ORR Monitoring Staff

 Program Performance Specialist: ORR Monitoring Staff

 Project Officer: ORR Monitoring Staff

 Intakes Team: ORR Intakes Staff

 DHS Staff

 DHUC Medical Team Member

 National Call Center

 Case Coordinator

 FFS Supervisor

 FFS: FFS Staff

 CFS: FFS Staff

 PSC Staff

 Director

 Lead Case Manager: Program Leadership

 Lead Clinician: Program Leadership

 Program Support Staff: Program Leadership

 Case Manager: Program Staff

 Clinician: Program Staff

 Medical Coordinator: Program Staff

 PSA Compliance Manager: Program Staff

 Legal Service Provider

 Other: ____________________

5. Please use this space to include any comments on the roles you selected above:

____________________

6. What is your work location?

 HQ

 AZ

 Central TX

 Houston / El Paso Region

 Mid-Atlantic

 Midwest

 Northeast

 South Texas/Rio Grande Valley

 South East

 Special Pop

 West Coast

 Other ____________________

7. Please rank the following question based on your familiarity with the current UAC Portal. 

		Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
I am very comfortable with the UAC Portal.						

8. Are/were you a Path User Acceptance Testing (UAT) participant?

 Yes, I participated in UAT

 No, I did NOT participate in UAT

 Response Text

9. Do you have prior Salesforce experience?

 Yes

 No

 Response Text

10. Do you have prior experience with using Trailhead, a training platform by Salesforce?

 Yes

 No

 Response Text

11. Is there any additional information you would like to share?

____________________

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR to gather information from grantee care provider programs for the Train-the-Trainer phase of UAC Path (ORR’s new case management system) implementation. Public reporting burden for this collection of information is estimated to average 5 minutes per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # for this collection is 0970-0401 and the expiration date is 05/31/2021. If you have any comments on this collection of information, please contact [email protected].