Corrective Action Plans

Finding 502898 (2023-002)

Significant Deficiency 2023

Ashtabula Metropolitan Housing Authority

OH

Questioned Costs HUD Housing Programs Procurement, Suspension & Debarment § 200.403

We are aware of the findings from the report and we will take the necessary steps to mitigate the issues.

View Audit 324839 Questioned Costs: $1

Finding 502707 (2023-007)

Material Weakness 2023

Grady County

OK

Procurement, Suspension & Debarment Subrecipient Monitoring Allowable Costs / Cost Principles § 200.303

The Board of County Commissioners will work with all County Officials to go over all grants and federal monies that the County receives to ensure that proper internal controls are implemented.

View Audit 324754

Finding 502706 (2023-006)

Material Weakness 2023

Grady County

OK

Procurement, Suspension & Debarment Subrecipient Monitoring Internal Control / Segregation of Duties

We will work to implement a risk assessment plan. We will implement controls to help make sure we comply with grant requirements and that federal funds are expended in accordance with grant agreements and in a timely manner. We will ensure employees have the current and correct compliance supplement...

We will work to implement a risk assessment plan. We will implement controls to help make sure we comply with grant requirements and that federal funds are expended in accordance with grant agreements and in a timely manner. We will ensure employees have the current and correct compliance supplement to work from.

View Audit 324754

Finding 502699 (2023-001)

Material Weakness 2023

Housing Authority of the City of Annapolis

MD

Questioned Costs HUD Housing Programs Matching / Level of Effort / Earmarking

Finding 2023-001 Federal Program Funds Utilized for Non-Federal Programs Recommendation: The Authority should locate additional sources of non-federal funds or reduce costs sufficiently so that the program can have enough cash to cover ongoing operations. Explanation of disagreement with audit findi...

Finding 2023-001 Federal Program Funds Utilized for Non-Federal Programs Recommendation: The Authority should locate additional sources of non-federal funds or reduce costs sufficiently so that the program can have enough cash to cover ongoing operations. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Authority has reevaluated its cost allocation plan, and restructured various department to better align staffing. This process helps ensure the COCC and funds are being properly charged for actual costs incurred. The Authority is also redeveloping its entire portfolio. This process had been and will continue to bring in developer and management fees to the COCC to help reduce the due to/due from activity. Name(s) of the contact person(s) responsible for corrective action: Cia Cook, Deputy Executive Director & CFO Planned completion date for corrective action plan: June 30, 2025

View Audit 324736 Questioned Costs: $1

Finding 502646 (2023-002)

Significant Deficiency 2023

J.h. Floyd Sunshine Village, Inc.

FL

Questioned Costs Allowable Costs / Cost Principles HUD Housing Programs

B. Finding 2023-002 Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects (Section 207/223(f)) (CFDA# 14.155) Allowable costs/cost principles The Project disbursed $47,837 of legal costs that were not operating expenses for the pro...

B. Finding 2023-002 Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects (Section 207/223(f)) (CFDA# 14.155) Allowable costs/cost principles The Project disbursed $47,837 of legal costs that were not operating expenses for the project. (1) Comments on the Finding and Each Recommendation Management concurs with this finding and the current management agent has ensured that $47,837 was reimbursed from entity non-project funds. (2) Actions Taken on the Finding The funds were reimbursed from entity non-project funds.

View Audit 324633 Questioned Costs: $1

Finding 502634 (2023-008)

Significant Deficiency 2023

Promise Healthcare Nfp

IL

Questioned Costs Allowable Costs / Cost Principles Cash Management § 200.403

Action taken in response to finding: 1. Create a standard procedure for tracking grant expenses: Completed 2. Train staff on procedures: Completed 3. Create an independent review process for all grant tracking: In progress Name of the contact person responsible for corrective action: Keith Flores, C...

Action taken in response to finding: 1. Create a standard procedure for tracking grant expenses: Completed 2. Train staff on procedures: Completed 3. Create an independent review process for all grant tracking: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609 Questioned Costs: $1

Finding 502630 (2023-006)

Significant Deficiency 2023

Promise Healthcare Nfp

IL

Allowable Costs / Cost Principles Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Action taken in response to finding: 1. Move all purchase and invoice approvals to Intacct: Complete 2. Establish approval matrix in accordance with delegation of authority: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for correc...

Action taken in response to finding: 1. Move all purchase and invoice approvals to Intacct: Complete 2. Establish approval matrix in accordance with delegation of authority: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609

Finding 502624 (2023-003)

Material Weakness 2023

Promise Healthcare Nfp

IL

Questioned Costs Internal Control / Segregation of Duties Allowable Costs / Cost Principles § 200.303

Action taken in response to finding: 1. Create a grant matrix to track employee grant allocations in one file: Complete 2. Utilize the matrix to apply allocation to each employee on every payroll occurrence: In Progress 3. Review the matrix with grant project managers monthly to ensure accuracy and ...

Action taken in response to finding: 1. Create a grant matrix to track employee grant allocations in one file: Complete 2. Utilize the matrix to apply allocation to each employee on every payroll occurrence: In Progress 3. Review the matrix with grant project managers monthly to ensure accuracy and capture changes: In Progress 4. Maintain records of for each payroll of grant matrix application: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609 Questioned Costs: $1

Finding 502597 (2023-003)

Significant Deficiency 2023

Family Service and Guidance Center of Topeka, Inc.

KS

Allowable Costs / Cost Principles

Comments on the Finding Recommendation The Center experienced unusual staff shortage which did not allow the necessary review of journal entries and grant reconciliations. Action Taken A grant procedure will be implemented that has guidance on the review of journal entries each month and a review o...

Comments on the Finding Recommendation The Center experienced unusual staff shortage which did not allow the necessary review of journal entries and grant reconciliations. Action Taken A grant procedure will be implemented that has guidance on the review of journal entries each month and a review of grant reconciliations before grant reports are submitted to the funding source.

View Audit 324583

Finding 502592 (2023-002)

Significant Deficiency 2023

Family Service and Guidance Center of Topeka, Inc.

KS

Allowable Costs / Cost Principles

Comments on the Finding Recommendation Staff at the Center did not have knowledge of the rule on the 10% de minimis indirect cost rate. Action Taken Center staff involved in writing grant proposals and grant budgets and staff responsible for grant reporting will be trained on the rules regarding th...

Comments on the Finding Recommendation Staff at the Center did not have knowledge of the rule on the 10% de minimis indirect cost rate. Action Taken Center staff involved in writing grant proposals and grant budgets and staff responsible for grant reporting will be trained on the rules regarding the 10% de minimis indirect cost rate.

View Audit 324583

Finding 502578 (2023-008)

Material Weakness 2023

Okanogan Behavioral Healthcare

WA

Allowable Costs / Cost Principles Eligibility Material Weakness

Action taken in response to finding: OBHC implemented new payroll software in March 2023. During FY24, staff were trained to directly allocate their time to programs in their electronic timecard. Effective Feb 2024, time and effort reporting was used to allocate salaries to the SOR program. Additio...

Action taken in response to finding: OBHC implemented new payroll software in March 2023. During FY24, staff were trained to directly allocate their time to programs in their electronic timecard. Effective Feb 2024, time and effort reporting was used to allocate salaries to the SOR program. Additionally, the OBHC team is currently working with the HCA in restructuring the rate schedule to incorporate the payroll costs into the direct service rates for the SOR/SABG grants. This effectively removes this issue going forward in FY25 once approved by the HCA. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion date for corrective action plan: Feb 2024 & Sep 2024

View Audit 324580

Finding 502577 (2023-007)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Cash Management Allowable Costs / Cost Principles Significant Deficiency

Action taken in response to finding: The grant biller performs additional review of grant billings for accuracy. In addition, the new CFO reviews and approves at a detailed level the grant billing. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion ...

Action taken in response to finding: The grant biller performs additional review of grant billings for accuracy. In addition, the new CFO reviews and approves at a detailed level the grant billing. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion date for corrective action plan: August 31, 2024

View Audit 324580

Finding 502576 (2023-006)

Material Weakness 2023

Okanogan Behavioral Healthcare

WA

Allowable Costs / Cost Principles Material Weakness

Action taken in response to finding: OBHC implemented new payroll software in March 2023. During FY24, staff were trained to directly allocate their time to programs in their electronic timecard. Effective Feb 2024, time and effort reporting was used to allocate salaries to the SABG program. Additi...

Action taken in response to finding: OBHC implemented new payroll software in March 2023. During FY24, staff were trained to directly allocate their time to programs in their electronic timecard. Effective Feb 2024, time and effort reporting was used to allocate salaries to the SABG program. Additionally, the OBHC team is currently working with the HCA in restructuring the rate schedule to incorporate the payroll costs into the direct service rates for the SOR/SABG grants. This effectively removes this issue going forward in FY25 once approved by the HCA. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion date for corrective action plan: Feb 2024 & Sep 2024

View Audit 324580

Finding 502575 (2023-005)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Cash Management Allowable Costs / Cost Principles Period of Performance

Action taken in response to finding: The new CFO reviews and approves federal grant draw requests prior to the submission to the granting agency. Name(s) of the contact person(s) responsible for corrective action: Carrie Anthony Planned completion date for corrective action plan: August 31, 2024

View Audit 324580

Finding 502574 (2023-004)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Significant Deficiency

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are charged appropriately, approved by a knowledgeable supervisor, and supporting documentation is main...

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are charged appropriately, approved by a knowledgeable supervisor, and supporting documentation is maintained on file. Additionally, AP and Finance team review supporting documentation and ensure completeness. Name(s) of the contact person(s) responsible for corrective action: Floral Reed Planned completion date for corrective action plan: June 30, 2024

View Audit 324580

Finding 502573 (2023-003)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Allowable Costs / Cost Principles Cash Management Period of Performance

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are incurred, charged appropriately and supporting documentation is maintained on file. Additionally, ...

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are incurred, charged appropriately and supporting documentation is maintained on file. Additionally, AP and Finance team review supporting documentation and ensure completeness. Name(s) of the contact person(s) responsible for corrective action: Floral Reed Planned completion date for corrective action plan: June 30, 2024

View Audit 324580

Finding 502571 (2023-001)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Allowable Costs / Cost Principles Period of Performance Significant Deficiency

Action taken in response to finding: The Finance team corrected their processes to ensure proper recording of payroll costs during the time of the FY22 Audit procedures; however, the changes were made to subsequent months and previously submitted months were not retroactively corrected. Additionall...

Action taken in response to finding: The Finance team corrected their processes to ensure proper recording of payroll costs during the time of the FY22 Audit procedures; however, the changes were made to subsequent months and previously submitted months were not retroactively corrected. Additionally, the OBHC team is currently working with the HCA in restructuring the rate schedule to incorporate the payroll costs into the direct service rates for the SOR/SABG grants. This effectively removes this issue going forward in FY25 once approved by the HCA. Name(s) of the contact person(s) responsible for corrective action: Carrie Anthony Planned completion date for corrective action plan: Sep 2023 & New rates: Sep 30, 2024

View Audit 324580

Finding 502558 (2023-002)

Significant Deficiency 2023

Puerto Rico Health Insurance Administration

PR

Allowable Costs / Cost Principles Reporting

The PRHIA was proactive to ensure compliance in submitting the 2023 Single Audit Report by due date, maximizing the human resources available, in collaboration with auditors. The PRHIA expects to ensure compliance by submitting the 2023 Single Audit Report by its due date.

View Audit 324551

Finding 502477 (2023-002)

Material Weakness 2023

Guam Memorial Hospital Authority

GU

Allowable Costs / Cost Principles § 200.439

Views of Auditee and Planned Corrective Actions: Being in constant financial constraints facing vendor delivery holds and discontinuing critical services, the Department of Administration (DOA) directly paid certain GMHA vendors. With the urgency of need and insufficient information about the sou...

Views of Auditee and Planned Corrective Actions: Being in constant financial constraints facing vendor delivery holds and discontinuing critical services, the Department of Administration (DOA) directly paid certain GMHA vendors. With the urgency of need and insufficient information about the source of funds’ eligibility requirements, an amount owed for an equipment purchase was included in the invoices DOA paid. Moving forward, GMHA will be more proactive in obtaining grants’ eligibility requirements to ensure compliance. In addition, accounting personnel directly involved in reviewing and approving federal grant expenditures will continuously participate in training related to Uniform Guidance Updates. On August 28, 2024, the Chief Financial Officer and the General Accounting Supervisor attended an OMB Uniform Guidance Updates training. Proposed Completion Date: Completed. Name of Contact Person: Yukari Hechanova, Chief Financial Officer

View Audit 324486

Finding 502435 (2023-003)

Material Weakness 2023

Tacoma Community House

WA

Allowable Costs / Cost Principles Material Weakness

This is a retiteration of Finding 2023-002. Please refer to corrective action plan under Finding 2023-002, as follows: Tacoma Community House will implement procedures to ensure disbursements are supported and approved before payment. Recurring payments will be identified and approved at the start ...

This is a retiteration of Finding 2023-002. Please refer to corrective action plan under Finding 2023-002, as follows: Tacoma Community House will implement procedures to ensure disbursements are supported and approved before payment. Recurring payments will be identified and approved at the start of the year. We will require credit card users to comply with documentation requirements. We will require supervisors to review credit card statements before processing for payment. We will require approval on all transactions before payment. The Executive Director, Aimee Khuu will be responsible for ensuring that the corrective actions take place as described. If you have any questions or require additional information, please feel free to contact her at 253-383-3951 Ext 105 or akhuu@tacomacommunityhouse.org.

View Audit 324450

Finding 502368 (2023-001)

Significant Deficiency 2023

Eger Health Care and Rehabilitation Center Fha 012-10056

NY

Allowable Costs / Cost Principles

Finding Reference Number 2023-001 1. Name of contact person responsible for corrective action Annmarie Covone, Executive Vice President/Chief Financial Officer 2. Corrective action planned Our organization will reach out to HRSA to request permission to resubmit our PRF period 5 submission of heal...

Finding Reference Number 2023-001 1. Name of contact person responsible for corrective action Annmarie Covone, Executive Vice President/Chief Financial Officer 2. Corrective action planned Our organization will reach out to HRSA to request permission to resubmit our PRF period 5 submission of health care expenses as lost revenue. 3. Anticipated Completion Date This is anticipated to be completed in October 2024 subject to HRSA’s permission to resubmit our Period 5 submission. 4. If the client does not agree with the findings or believes corrective action is not required, include an explanation and specific reasons We agree with Finding Reference No. 2023-001 Contact Information Annmarie Covone Executive Vice President/Chief Financial Officer 205 Lexington Avenue, 2nd Floor, New York, NY 10016 P (646) 633-4702 acovone@archcare.org

View Audit 324409

Finding 502366 (2023-001)

Material Weakness 2023

City of Hughson

CA

Allowable Costs / Cost Principles Reporting Matching / Level of Effort / Earmarking

Future funding for the City of Hughson will be thoroughly vetted to determine if there are any federal funds included in the monies to be received. Each new source of funding will be documented as to the source of the funding and the restrictions on its use. A thorough review of these funds will be ...

Future funding for the City of Hughson will be thoroughly vetted to determine if there are any federal funds included in the monies to be received. Each new source of funding will be documented as to the source of the funding and the restrictions on its use. A thorough review of these funds will be made at year end to determine if the City has met the $750,000 threshold to request a single audit in a timely manner.

View Audit 324399

Finding 502365 (2023-001)

Significant Deficiency 2023

Summer Scholars

CO

Allowable Costs / Cost Principles

The Organization understands the recommendation. We have established a second level of review ensuring all payroll data is reconciled by a third-party accounting firm. This firm is currently working with the Organization staff accountant to ensure all reconciliations are timely and accurate. We will...

The Organization understands the recommendation. We have established a second level of review ensuring all payroll data is reconciled by a third-party accounting firm. This firm is currently working with the Organization staff accountant to ensure all reconciliations are timely and accurate. We will utilize the third-party accounting firm through the end of the second quarter, at which point the responsibility will be passed to the director of finance. This regular review will be a review of time keeping and expense allocation and the general ledger in the accounting system prior to recording any payroll related entries. Review will also be performed on a monthly basis and at year-end by the Senior Director of Programs and the CEO.

View Audit 324398

Finding 502353 (2023-001)

Significant Deficiency 2023

Universal Technology College of Puerto Rico, INC

PR

Student Financial Aid Subrecipient Monitoring Allowable Costs / Cost Principles

This years Single Audit will be planned with enough time alongside the auditor in order to ensure submission before the due date. No later than October 15, 2024 we will already have engaged an auditor to perform and begin the Single Audit for the year ending September 30, 2024.

View Audit 324396

Finding 502111 (2023-003)

Significant Deficiency 2023

Independent School District No. 281

MN

Allowable Costs / Cost Principles

SIGNIFICANT DEFICIENCY IN INTERNAL CONTROL OVER COMPLIANCE – U.S. DEPARTMENT OF EDUCATION, PASSED THROUGH MINNESOTA DEPARTMENT OF EDUCATION, TITLE I GRANTS TO LOCAL EDUCATIONAL AGENCIES – ALN NO. 84.010 2023-003 Internal Control Over Compliance With Federal Allowable Cost Requirements Finding Sum...

SIGNIFICANT DEFICIENCY IN INTERNAL CONTROL OVER COMPLIANCE – U.S. DEPARTMENT OF EDUCATION, PASSED THROUGH MINNESOTA DEPARTMENT OF EDUCATION, TITLE I GRANTS TO LOCAL EDUCATIONAL AGENCIES – ALN NO. 84.010 2023-003 Internal Control Over Compliance With Federal Allowable Cost Requirements Finding Summary 2CFR Part 200, Subpart F, § 430(i) requires that charges to federal awards for salaries and wages must be based on records that accurately reflect the work performed and be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated. The District’s internal control system for documenting employee time supporting salaries charged to the Title I program for teachers assigned to the program as a single cost objective, requires the completion of semi-annual certifications approved by the employees’ supervisor. For three of five Title I teacher salaries tested, this documentation was either missing, incomplete, or lacking documentation of approval. Corrective Action Plan Actions Planned – District management will ensure that appropriate time and effort documentation is prepared, approved, and kept on file to support all salaries charged to federal programs going forward. Official Responsible – The District’s Chief Financial Officer, Kristen Hoheisel. Planned Completion Date – June 30, 2024. Disagreement With or Explanation of Finding – The District agrees with this finding. Plan to Monitor – The District’s Chief Financial Officer, Kristen Hoheisel, will monitor the documentation of time and effort for employees whose salaries are charged to federal programs complies with the District’s established internal controls over this area going forward.

View Audit 324326

Corrective Action Plans

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