OMB 0970-0564 [valid through MM/DD/2026]
(Revised date: 3/16/2022)
Staff Questionnaire – Case Manager/Lead Case Manager – Unlicensed Facility (UF) Quarterly Health and Safety Visit
Interview Details |
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Program Name: |
Past and Current Position(s) at Program: |
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 as a case manager.
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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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How do you keep up-to-date on current and new ORR policies and procedures?
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Do you feel that you receive adequate training to perform your case management duties? If not, please explain. (Lead Case Manager) Describe your system to assess ongoing staff training needs and opportunities for development? How is this working?
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Tell me about your staff meetings? How do you communicate with staff?
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Describe your working relationship with stakeholders.
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How do you encourage the participation of UC in the case management and reunification process?
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Do you have any recommendations, suggestions or concerns regarding the way your cases are reviewed/staffed? Please elaborate.
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How do you collaborate with other teams to ensure that UCs’ physical, mental health, developmental, social, and educational needs are being met?
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Tell me about staff and UC interactions.
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Describe the procedures when there is an allegation of child abuse or maltreatment. (Interviewer provide an example of child abuse or neglect and ask case management staff the procedures for reporting.) |
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Do you have any concerns about the treatment of UCs in care? Do you have 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 recommendations do you have for ORR that I can take back to share with our headquarter teams?
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Enter Additional Notes.
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 case managers and lead case managers 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 | Persad, Amanda (ACF) (CTR) |
File Modified | 0000-00-00 |
File Created | 2023-08-26 |