Generic for ACF Program Monitoring Activities

Forms and Documents

Document Name	Status
Form 1 Office of Head Start Improper Payment Reviews – Update 2023 Form	Unchanged
Form 1 Low Income Household Water Assistance Program (LIHWAP) Grantee Forecast Form	Modified
Form 1 Survivors of Torture Integrated Care Continuum (SOT-ICC) Form and Instruction	Unchanged
Form M-16 Annual Data Collection on Sexual Abuse and Sexual Harassment Involving Unaccompanied Children Form	Unchanged
Form M-11P Office of Refugee Resettlement's Staff Questionnaire - Interpreter Form	Unchanged
Form 1 Office of Head Start Disaster Recovery Improper Payment Reviews Form	Unchanged
Form 1 Office of Grants Management Financial Monitoring Review Form and Instruction	Unchanged
Change Request LIHWAP Forecast_fnl 7.27.23.docx Justification for No Material/Nonsubstantive Change	2023-07-28
Change Request ECSH 6_23 updated_cln.docx Justification for No Material/Nonsubstantive Change	2023-06-27
Change Request - ORR PSA Data Collection_Monitoring GenIC_6.5.23.docx Justification for No Material/Nonsubstantive Change	2023-06-05
Change Request RFCCMED 4 23.docx Justification for No Material/Nonsubstantive Change	2023-04-24
Change Request RCP 4 23.docx Justification for No Material/Nonsubstantive Change	2023-04-19
GenIC Example - Monitoring Activities - Regulation compliance.docx Supplementary Document	2020-09-10
GenIC Example - Monitoring Activities - Document Submission.docx Supplementary Document	2020-09-10
GenIC Example - Monitoring Activities - Daily Activities.docx Supplementary Document	2020-09-10
GenIC Example - Monitoring Activities - Assessment Survey.docx Supplementary Document	2020-09-10
Submission Template for Monitoring Generic _7.3.20.docx Supplementary Document	2020-09-10
SSA - ACF Generic for Monitoring - Final.docx Supporting Statement A	2020-09-10

IC Document Collections

IC ID	Document Title	Status
261246	Office of Refugee Resettlement Refugee Career Pathways Case File Requirements Other-Questionnaire	Unchanged
261245	Office of Refugee Resettlement Refugee Microenterprise Development Case File Requirements Other-Questionnaire	Unchanged
261244	Office of Refugee Resettlement Ethnic Community Self-Help (ECSH) Program Pre-Monitoring Questionnaire (PMQ) Other-Questionnaire	Unchanged
261233	Office of Refugee Resettlement Refugee Individual Development Accounts Program Pre-Monitoring Questionnaire Other-Questionnaire	Unchanged
260914	Office of Head Start Survey on COVID-19 Mitigation Plan Other-Survey	Unchanged
260658	Community Services Block Grant (CSBG) Work Plan Template Other-Template	Unchanged
259658	Office of Head Start Improper Payment Reviews – Update 2023 Form	Unchanged
257727	Monitoring the Status of Required Licensure Other-Instructions	Unchanged
256922	Low Income Household Water Assistance Program (LIHWAP) Grantee Forecast Form	Modified
256016	Survivors of Torture Integrated Care Continuum (SOT-ICC) Form and Instruction	Unchanged
255384	Office of Head Start Survey on Background Checks and Staffing Other-Survey	Unchanged
254691	Low Income Household Water Assistance Program (LIHWAP) Tribal Implementation Check-In Other-Interview Qs	Unchanged
254180	Office of Refugee Resettlement (ORR) Ethnic Community Self-Help (ECSH) Program Case Documentation Requirements Instruction	Unchanged
252566	Office of Refugee Resettlement (ORR) Refugee Agricultural Partnership Program (RAPP) Case File Requirements Instruction	Unchanged
252558	Office of Refugee Resettlement (ORR) Refugee Individual Development Accounts (IDA) Program Case File Requirements Instruction	Unchanged
252424	Office of Refugee Resettlement Refugee Family Child Care Microenterprise Development File Requirements Instruction	Unchanged
252423	Office of Refugee Resettlement Refugee Career Pathways Case File Requirements Instruction	Unchanged
252410	Office of Refugee Resettlement (ORR) Refugee Microenterprise Development (MED) Program Case File Requirements Instruction	Unchanged
251144	Annual Data Collection on Sexual Abuse and Sexual Harassment Involving Unaccompanied Children Form	Unchanged
250729	Office of Refugee Resettlement's Staff Questionnaire - Interpreter Form	Unchanged
249725	Office on Trafficking in Persons (OTIP) Grant Monitoring Tool (GMT) Other-Monitoring Tool	Unchanged
249675	Child Care and Development Fund (CCDF) State Monitoring Compliance Demonstration Packet Other-Monitoring Packet	Unchanged
248146	Office of Refugee Resettlement Waiver Request Form Other-Request Form	Unchanged
248125	Office of Refugee Resettlement Key Personnel Minimum Qualification Checklist and Attestation Other-Checklist	Unchanged
245964	Office of Head Start Disaster Recovery Improper Payment Reviews Form	Unchanged
244986	Office of Grants Management Financial Monitoring Review Form and Instruction	Unchanged

ICR Details

OMB Control No: 0970-0558	ICR Reference No: 202307-0970-014
Status: Received in OIRA	Previous ICR Reference No: 202306-0970-012
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Generic for ACF Program Monitoring Activities
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/31/2023

	Requested	Previously Approved
Expiration Date	11/30/2023	11/30/2023
Responses	4,500	4,500
Time Burden (Hours)	45,000	45,000
Cost Burden (Dollars)	2,184,300	2,184,300

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Abstract: This information collection request (ICR) is for a new overarching generic clearance. The proposed Generic for ACF Program Monitoring Activities would allow Administration for Children and Families (ACF) program offices to collect standardized information from recipients that receive Federal funds to ensure oversight, evaluation, support purposes, and stewardship of Federal funds. The information is necessary to ensure compliance with Federal and programmatic requirements, monitor progress on recipient activities, and determine and respond to recipient needs such as Training and Technical Assistance (T/TA).

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 41241	07/09/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 55461	09/08/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 26

IC Title	Form No.	Form Name
Annual Data Collection on Sexual Abuse and Sexual Harassment Involving Unaccompanied Children	M-16	Annual Data Collection on Sexual Abuse and Sexual Harassment Involving UC
Child Care and Development Fund (CCDF) State Monitoring Compliance Demonstration Packet
Community Services Block Grant (CSBG) Work Plan Template
Low Income Household Water Assistance Program (LIHWAP) Grantee Forecast	1	LIHWAP Forecast
Low Income Household Water Assistance Program (LIHWAP) Tribal Implementation Check-In
Monitoring the Status of Required Licensure
Office of Grants Management Financial Monitoring Review	1	Document Request List
Office of Head Start Disaster Recovery Improper Payment Reviews	1	Disaster Supplement Payment Management Reconciliation Example
Office of Head Start Improper Payment Reviews – Update 2023	1	Payment Management Reconciliation Instrument
Office of Head Start Survey on Background Checks and Staffing
Office of Head Start Survey on COVID-19 Mitigation Plan
Office of Refugee Resettlement (ORR) Ethnic Community Self-Help (ECSH) Program Case Documentation Requirements
Office of Refugee Resettlement (ORR) Refugee Agricultural Partnership Program (RAPP) Case File Requirements
Office of Refugee Resettlement (ORR) Refugee Individual Development Accounts (IDA) Program Case File Requirements
Office of Refugee Resettlement (ORR) Refugee Microenterprise Development (MED) Program Case File Requirements
Office of Refugee Resettlement Ethnic Community Self-Help (ECSH) Program Pre-Monitoring Questionnaire (PMQ)
Office of Refugee Resettlement Key Personnel Minimum Qualification Checklist and Attestation
Office of Refugee Resettlement Refugee Career Pathways Case File Requirements
Office of Refugee Resettlement Refugee Career Pathways Case File Requirements
Office of Refugee Resettlement Refugee Family Child Care Microenterprise Development File Requirements
Office of Refugee Resettlement Refugee Individual Development Accounts Program Pre-Monitoring Questionnaire
Office of Refugee Resettlement Refugee Microenterprise Development Case File Requirements
Office of Refugee Resettlement Waiver Request Form
Office of Refugee Resettlement's Staff Questionnaire - Interpreter	M-11P	Staff Questionnaire - Interpreter Questionnaire
Office on Trafficking in Persons (OTIP) Grant Monitoring Tool (GMT)
Survivors of Torture Integrated Care Continuum (SOT-ICC)	1	Survivors of Torture (SOT) Integrated Care Continuum (ICC)

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,500	4,500	0	0	0	0
Annual Time Burden (Hours)	45,000	45,000	0	0	0	0
Annual Cost Burden (Dollars)	2,184,300	2,184,300	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This request is for a new overarching generic clearance.

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Annual Cost to Federal Government: $200,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/31/2023

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