OMB 0970-0564 [valid through MM/DD/2026]
(Revised: 3/16/2022
Staff Questionnaire – Teacher – Unlicensed Facility (UF) Quarterly Health and Safety Visit
Interview Details |
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Program Name: |
Past and Current Position(s) at Program:
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Level of Care: |
Date/Time of Interview: |
Full Name: |
Interviewer: |
*Note: Before beginning the interview and/or providing this questionnaire to staff, provide a brief introduction, including monitor role and purpose of monitoring visit, confidentiality of staff interview, and clarify any questions. See Introduction Prompt for Staff for additional guidance as needed. Questions in bold should be asked during the interview if possible. Other questions are optional prompts to assist the interviewer.
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NOTES |
Tell me about your role and main responsibilities. |
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Explain how UC educational services are documented in the UC case file and in the UC Portal.
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Do you feel that you receive adequate training to perform your educational duties? If not, please explain.
(Lead Teacher) Describe your system to assess ongoing staff training needs and opportunities for development? How is this working?
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What does trauma-informed care mean to you?
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(Lead Teacher) Explain how you communicate with your teachers and teacher aids. Explain how you monitor their effectiveness in the classroom.
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How do you collaborate with other teams to ensure that UCs’ developmental, social, and educational needs are being met?
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Do you feel that you have enough supplies and equipment to teach the minors successfully? If not, explain.
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Are there any adjustments to the educational curriculum/schedule during the summer months and/or during long holidays/breaks? If so, please describe.
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How is the educational assessment used by the education department?
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How do you meet the individual academic needs of a child be it language, special needs (i.e. mental health), learning preferences, readiness level, etc.?
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(Optional) Describe your vocational education curriculum and how do you track it? (if applicable)
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Explain the methods that you use to check that youth are learning and that the material is meeting each child’s needs.
(Lead Teacher) How do you evaluate the quality of educational services that are being provided by the teaching staff? Examples: Education curriculum? Various levels of education? Effectiveness/quality of the classroom instruction?
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Describe the process for providing educational records at discharge.
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How do you handle behavior problems that occur in the classroom? Can you provide an example of recent behavior issues that you have experienced?
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Describe how you receive support, guidance, and evaluations from your supervisor.
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Do you have any concerns about the treatment of UCs in care? Do you have any concerns about any particular staff members (any staff members you think should NOT be working with UC)?
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What general recommendations do you have to strengthen the program? What improvements would you put in place?
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What are the things that you love/enjoy about your job? What are the challenges you face in your job?
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What recommendations do you have for ORR that I can take back to share with our headquarter teams?
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THE
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF
PUBLIC BURDEN: The purpose of this information collection is to
allow ORR contractor monitors to interview and document responses
from education staff during unlicensed facility quarterly site
visits. Public reporting burden for this collection of information
is estimated to average 1 hour per response for the care provider
and 1 hour per response for the contractor monitor, including the
time for reviewing instructions, gathering and maintaining the data
needed, and reviewing the collection of information. This is a
mandatory collection of information (Homeland Security Act, 6
U.S.C. 279). 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. If you have any
comments on this collection of information please contact
[email protected].
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Poole, Laura (ACF) (CTR) |
File Modified | 0000-00-00 |
File Created | 2023-08-31 |