NOA - Office of Head Start Child Incident Reporting

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NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

09/03/2025

Department of Health and Human Services
Administration for Children and Families
FOR CERTIFYING OFFICIAL:

Kevin Duvall

FOR CLEARANCE OFFICER:

Catherine Howard

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
09/03/2025
ACTION REQUESTED: Generic IC
Office of Head Start Child Incident Reporting
IC TITLE:
ICR REFERENCE NUMBER:

202505-0970-014

AGENCY ICR TRACKING NUMBER:
TITLE:

ACF Programs

Generic for ACF Program Monitoring Activities

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved without change
OMB CONTROL NUMBER:

0970-0558

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 11/30/2026

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

Previous

6,197

48,000

0

New

6,197

48,000

0

Change due to New Statute

0

0

0

Change due to Agency Discretion

0

0

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Difference

TERMS OF CLEARANCE:

Terms of the Generic ICR remain in effect.

OMB Authorizing Official:

Dominic J. Mancini
Deputy Administrator,
Office Of Information And Regulatory Affairs

IC Title
Annual Data Collection M-16
on Sexual Abuse and
Sexual Harassment
Involving
Unaccompanied
Children
Child Care and
Development Fund
(CCDF) State
Monitoring Compliance
Demonstration Packet
Office of Grants
1
Management Financial
Monitoring Review
Office of Refugee
Resettlement (ORR)
Ethnic Community SelfHelp (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 (ORR)
Refugee Career
Pathways (RCP) Case
File Requirements
Office of Refugee
Resettlement (ORR)
Refugee Family Child
Care Microenterprise
Development
(RFCCMED) File
Requirements
Office on Trafficking in
Persons (OTIP) Grant
Monitoring Tool (GMT)
Survivors of Torture
1
Integrated Care
Continuum (SOT-ICC)
Office of Refugee
Resettlement
Monitoring of the Status
of Required Licensure
for Residential Care
Providers
Office of Head Start
1
Improper Payment
Reviews

Form No.

List of ICs
Form Name
Annual Data Collection on
Sexual Abuse and Sexual
Harassment Involving UC

CFR Citation

Hrs/$/Resp
450 / 0 / 300

850 / 0 / 17

Document Request List

380 / 0 / 380
435 / 0 / 87

500 / 0 / 25

620 / 0 / 31

600 / 0 / 30

840 / 0 / 42

150 / 0 / 15

1,050 / 0 / 105
Survivors of Torture (SOT)
Integrated Care
Continuum (ICC)

140 / 0 / 35
120 / 0 / 240

Payment Management
Reconciliation Instrument

300 / 0 / 300

IC Title
Community Services
Block Grant (CSBG)
Work Plan Template
Office of Head Start
Survey on COVID-19
Mitigation Plan
Office of Refugee
Resettlement Ethnic
Community Self-Help
(ECSH) Program PreMonitoring
Questionnaire (PMQ)
Office of Refugee
Resettlement Refugee
Individual Development
Accounts (IDA)
Program Pre-Monitoring
Questionnaire (PMQ)
Office of Refugee
Resettlement Refugee
Career Pathways (RCP)
Program Pre-Monitoring
Questionnaire (PMQ)
Office of Refugee
Resettlement Refugee
Microenterprise
Development (MED)
Program Pre-Monitoring
Questionnaire (PMQ)
Low Income Household 1
Water Assistance
Program (LIHWAP)
Grantee Forecast
Office of Refugee
Resettlement Services
to Afghan Survivors of
Combat (SASIC)
Program Notification
Letter and PreMonitoring
Questionnaire (PMQ)
Office of Refugee
Resettlement
Monitoring Residential
Care Provider Staffing &
Vacancies
Community Services
1
Block Grant (CSBG)
Training and Technical
Assistance Tracking
Form
Office of Refugee
Resettlement
Emergency Operations
Plan Survey
Child Care and
1
Development Fund
(CCDF) Lead Agency
Monitoring Profile &
Document Submission
Chart
Office of Refugee
1
Resettlement (ORR)
Care Provider
Healthcare Delivery
Report (HDR)

Form No.

List of ICs
Form Name

CFR Citation

Hrs/$/Resp
65 / 0 / 20
8 / 0 / 100
1,740 / 0 / 87

84 / 0 / 28

70 / 0 / 14

75 / 0 / 15

LIHWAP Forecast

304 / 0 / 152

120 / 0 / 24

6,480 / 0 / 4,320

CSBG TTA Tracking Form

60 / 0 / 80

74 / 0 / 99

Child Care and
Development Fund
(CCDF) Lead Agency
Monitoring Profile &
Document Submission
Chart
ORR HDR

520 / 0 / 52

338 / 0 / 225

IC Title

Form No.

List of ICs
Form Name

CFR Citation

Office of Head Start
Child Incident Reporting
Total Hours Actually Used for Information Collections Under Currently Approved ICR:

Hrs/$/Resp
800 / 0 / 4,800
17,173