Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides

Formative Data Collections for ACF Program Support

1 - SURVEY_YM Local Provider

Refugee Support Services Youth Mentoring Set-Aside Programs Assessment Guides

OMB: 0970-0531

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Refugee Support Services (RSS) Set-Asides Assessment

Youth Mentoring Subrecipient Survey


Consent Notice

The Office of Refugee Resettlement (ORR), U.S. Department of Health and Human Services, invites you to participate in a survey to understand foundational aspects of your Youth Mentoring (YM) project. ORR will use collected data to inform program decisions to better serve ORR-eligible populations. This survey is voluntary and should take around 10 minutes to complete. The answers you give will be kept private and anonymous. Once you begin the survey, please complete it in one sitting. Do not close the webpage before you answer all the questions in the survey. While your responses will be automatically saved, you will not be able to re-enter the survey. Once you have answered all of the questions, click ‘Submit’. Please submit one response per agency/organization. Thank you for your participation.


  1. In which state is your agency or organization located? (drop-down list of states)



  1. Which of the following services does your YM project provide, per Policy Letter 22-09? Select all that apply.

    1. Supporting the development of social and life skills.

    2. Maintaining and celebrating the youth’s cultural heritage, while educating the youth on aspects of American culture.

    3. Providing opportunities for social engagement with peers.

    4. Providing information about opportunities to participate in civic and community service activities.

    5. Supporting youth in learning English, math, and other skills.

    6. Supporting youth in developing health and financial literacy.

    7. Providing academic support, such as helping with homework, and assisting with school transitions, such as the transition between middle school and high school or from high school to post-secondary education.

    8. Helping youth with career development, including providing opportunities for skill building, resume drafting, training, and educating youth on workers’ rights.


  1. Which of the following services does your YM project primarily provide, per Policy Letter 22-09? Please answer in accordance with which services ORR-eligible youth primarily access.

    1. Supporting the development of social and life skills.

    2. Maintaining and celebrating the youth’s cultural heritage, while educating the youth on aspects of American culture.

    3. Providing opportunities for social engagement with peers.

    4. Providing information about opportunities to participate in civic and community service activities.

    5. Supporting youth in learning English, math, and other skills.

    6. Supporting youth in developing health and financial literacy.

    7. Providing academic support, such as helping with homework, and assisting with school transitions, such as the transition between middle school and high school or from high school to post-secondary education.

    8. Helping youth with career development, including providing opportunities for skill building, resume drafting, training, and educating youth on workers’ rights.


  1. Does your program match participating youth with mentors? “Mentors” may include advisors, coaches, staff members, or other individuals serving in an advising capacity.

    1. No, we do not match youth with mentors.

    2. Yes, we match every youth with an individual mentor.

    3. Yes, we match every youth with a mentor using a group format.

    4. We match some youth with individual mentors and some youth with mentors in a group format.

    5. We match some youth with mentors, but not all.


  1. What factors may prevent you from matching youth with mentors? Select all that apply.

    1. Insufficient number of mentors

    2. Inability to find mentors who match the language(s), cultural backgrounds, skills, or other qualities that our refugee youth clients need

    3. Scheduling difficulties between the youth and mentor

    4. Low demand from eligible youth for the program


  1. Do you document services and activities provided to each participating youth? (yes/no)



  1. Does your state or replacement designee (RD) permit you to provide incentives to participating youth in accordance with Policy Letter 22-09?

    1. I am unaware of whether our state/RD allows us to provide incentives.

    2. Our state/RD does not permit provision of incentives.

    3. Our state/RD permits provision of incentives, but we do not choose to offer them in our YM project.

    4. Our state/RD permits provision of incentives, and we offer them in our YM project.



  1. What incentives does your YM project offer to youth? Select all that apply.

    1. We do not offer incentives (regardless of reason).

    2. We offer payment of registration fees or tuition costs for educational activities.

    3. We offer payment of registration fees or tuition costs for vocational activities.

    4. We offer payment of registration fees or tuition costs for apprenticeship activities.

    5. We offer payment of registration fees or tuition costs for career development activities.

    6. We offer provision of donated goods (e.g., computers).

    7. Other



  1. What skillsets do you primarily seek in the volunteer mentors you recruit?

    1. Mentors with similar or same cultural and/or linguistic background as participating youth

    2. Mentors who can provide academic support and coaching

    3. Mentors who can provide professional support or coaching for a particular field of interest


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. The control number for this project is 0970 – 0531. The control number expires on 9/30/2025.


RSS Set-Asides Assessment YM Local Provider Survey Page 3 of 3


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AuthorNesheim, Emily (ACF) (CTR)
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File Created2024-10-07

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