Form 1 Runaway and Homeless Youth (RHY) Disaster Information Co

Generic Disaster Information Collection Forms

RHY Disaster Info Collection Instrument_clean_02222022

Runaway and Homeless Youth Disaster Information Collection Form

OMB: 0970-0476

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OMB Control Number: 0970-0476

Expiration Date: xx/ xx/xxxx

Family and Youth Services Bureau (FYSB)

Runaway and Homeless Youth (FHY) Program

Disaster Information Collection Form

Summary: When a disaster or emergency event occurs, ACF’s Watch Desk ([email protected]) will contact the designated point of contact for FYSB RHY (predetermined by RHY Director or designee). The Watch Desk will provide an Advisory about the event that will include what happened and where (with names of States, Tribes, and Territories affected). The Advisory will include a Request for Information. The Request for Information will routinely ask the same questions, which appear below. The RHY point of contact is requested to answer the questions within a specified amount of time (generally 4 hours), based on whatever information is available at that time, via email to the Watch Desk. If new information comes in during the days following the initial request, the RHY point of contact will send an update to the Watch Desk.

RHY Disaster Information Request for Information

Today’s Date: Click here to enter a date.

  1. Has RHY received any requests from grantees for technical assistance regarding this disaster?

☐ NO

☐ YES

(If yes, please list the kind of technical assistance that was requested.)

Click here to enter text.



  1. Are all children and youth in RHY programs (Basic Center Program, Transitional Living Program, Maternity Group Homes, etc.) safe and accounted for?

☐ NO

☐ YES

(If no, what are the next steps for ensuring children and youth safety?)

Click here to enter text.



  1. Have any of the RHY programs or centers (Basic Center Program, Transitional Living Program, Maternity Group Homes, etc.) been damaged?

(if yes, what is the estimated time for reopening?)

Click here to enter text.


  1. Have children and youth been relocated due to damages to centers or programs (Basic Center Program, Transitional Living Program, Maternity Group Homes, etc.)?

☐ NO

☐ YES

(If yes, where are the children and youth going?)

Click here to enter text.



  1. COMMENTS, if any: Click here to enter text.



































Public reporting burden of this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing 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 unless it displays a currently valid OMB control number.

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AuthorOHSEPR;CB
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File Created2022-10-06

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