Corrective Action Plans

Finding 554456 (2024-001)

Significant Deficiency 2024

Public Counsel

CA

Allowable Costs / Cost Principles Subrecipient Monitoring

Date: March 27, 2025 Cognizant or Oversight Agency: U.S. Department of the Treasury Public Counsel respectfully submits the following corrective action plan for the year ended August 31, 2024. Name and address of independent public accounting firm: Armanino, LLP 11766 Wilshire Blvd. 9th Floor Los An...

Date: March 27, 2025 Cognizant or Oversight Agency: U.S. Department of the Treasury Public Counsel respectfully submits the following corrective action plan for the year ended August 31, 2024. Name and address of independent public accounting firm: Armanino, LLP 11766 Wilshire Blvd. 9th Floor Los Angeles, CA 90025 Audit period: August 31, 2024 The finding from the August 31, 2024 schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDINGS-FINANCIAL STATEMENT AUDIT SIGNIFICANT DEFICIENCY 2024-001 The Uniform Guidance Cost principles require consistency in treatment of costs and, specifically, that compensation costs be consistent. In addition, the Uniform Guidance requires that there be a system of internal control which provides reasonable assurance that the charges are accurate, allowable and properly allocated and conform to the established accounting policies and practices of the Organization. Recommendation: The process implemented by management during the year appears to have addressed the ongoing variances satisfactorily, and management should continue with its new process. Action Taken: We agree with the auditors' recommendations, and we have already taken the following actions during the fiscal year ended August 31, 2024: We have updated the payroll allocation methodology to ensure that we are making allocations for employees on a fully pro rata basis and that there is a validation process to ensure that 100% of an employee’s time is appropriately allocated across Federal and non-Federal funding sources. The supporting documentation is saved in our shared network folders and attached to the journal entries within our financial system. For any future process or system changes, we will ensure that we have thoroughly assessed the impact of any change before we implement it and vet it in through our internal grant compliance team. We have already made changes to involve our Legal Data Manager to implement a reporting process to ensure that we have complete timeslips that reflect both employee and supervisor approvals for every pay period. We will maintain this approach in Legal Server, the Organization's case management and timekeeping system, and will attach these timeslips as support for each of our allocation entries. We will continue to assess our procedures and internal controls relevant to our Federal funding to ensure compliance with the requirements of Uniform Guidance. We will do a thorough review of our internal control system and update it as necessary to align with best practices as recipients of Federal funding. The Finance team will continue to actively seek training related to Uniform Guidance updates and other Federal rules and requirements. We will share and discuss this information across departments to maintain organization-wide compliance. Name of responsible person: Steven Godoy VP, Finance & CFO Anticipated completion date: August 31, 2025 If the U.S. Department of Treasury has questions regarding this plan, please call Steven Godoy, VP, Chief Financial Officer at (213) 393-1055. Sincerely yours, Steven Godoy VP, Chief Financial Officer

View Audit 353090

Finding 554369 (2024-001)

Significant Deficiency 2024

Monte Vista Community Center Housing Authority, Inc.

CO

Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties Subrecipient Monitoring § 200.303

Finding 2024-001: Rural Rental Housing Loans Assistance Listing Number: 10.415 U.S. Department of Agriculture Compliance Requirement: Eligibility Type of Finding: Internal Control Over Compliance (significant deficiency) Recommendation: The organ...

Finding 2024-001: Rural Rental Housing Loans Assistance Listing Number: 10.415 U.S. Department of Agriculture Compliance Requirement: Eligibility Type of Finding: Internal Control Over Compliance (significant deficiency) Recommendation: The organization should strengthen its internal controls with adopted policies and procedures to ensure a review process is established through adequate segregation of duties. The organization should consider assessing and realigning the duties and responsibilities of the Executive Director and Alamosa Site Manager to provide for a review process of tenant eligibility determinations. Action Taken: I have hired office personnel in the Monte Vista office. The procedures will be established to adequately segregate the duties. In the Alamosa office, either I or Priscilla Schimpf will be assisting Laura with adequately segregating the duties in that office. The process will become effective March 1, 2025. If there are questions regarding this plan, please call the responsible party at (719) 852-5505. Sincerely yours, Corinna Garcia Executive Director Monte Vista Community Center Housing Authority, Inc.

View Audit 352994

Finding 554316 (2024-003)

Material Weakness 2024

YWCA West Central Michigan

MI

Cash Management Matching / Level of Effort / Earmarking Allowable Costs / Cost Principles

The YWCA will implement the following changes in its accounting procedures: 1. Journal entries will be drafted by finance staff and reviewed by the CFO prior to being posted to the general ledger. CFO will post journal entry transactions in the accounting system after documentation is reviewed. 2. ...

The YWCA will implement the following changes in its accounting procedures: 1. Journal entries will be drafted by finance staff and reviewed by the CFO prior to being posted to the general ledger. CFO will post journal entry transactions in the accounting system after documentation is reviewed. 2. Payroll registers will be reviewed by the CFO each payroll. The end-of-month payroll entry (which encompasses all the payroll entries for the month) will be reviewed by the CFO prior to being uploaded to the MIP accounting software. 3. All invoices will be approved by the appropriate program director and account distribution will be reviewed by the CFO or Director of Grants/Compliance prior to entry into the accounts payable system. 4. Percentages used to allocate expenses across grants will be reviewed and updated annually at the beginning of the fiscal year. The allocation will be approved by the CEO. 5. Matching amounts for grants will be tracked and documented with supporting documentation saved in the appropriate folder within the Finance SharePoint folder.

View Audit 352907

Finding 554307 (2024-005)

Material Weakness 2024

YWCA West Central Michigan

MI

Questioned Costs Allowable Costs / Cost Principles § 200.405

Percentages used for allocations will be reviewed annually across all grants/programs and updated during the budget process. These allocations will be reviewed by the CFO.

View Audit 352907 Questioned Costs: $1

Finding 554306 (2024-004)

Material Weakness 2024

YWCA West Central Michigan

MI

Questioned Costs Period of Performance Allowable Costs / Cost Principles

The YWCA will implement the following changes in its accounting procedures. 1. The Staff Accountant will review the period each expenditure is related to and record the invoice to the appropriate period when entering it into accounts payable. The month and year will be noted on the invoice. 2. The C...

The YWCA will implement the following changes in its accounting procedures. 1. The Staff Accountant will review the period each expenditure is related to and record the invoice to the appropriate period when entering it into accounts payable. The month and year will be noted on the invoice. 2. The CFO will review the month and year noted by the Staff Accountant prior to entry into accounts payable.

View Audit 352907 Questioned Costs: $1

Finding 554300 (2024-002)

Significant Deficiency 2024

City of San Bruno

CA

Questioned Costs Allowable Costs / Cost Principles Reporting

The City will develop, document, and implement formal grant summary requirements review process and audit preparedness policy and procedures. The responsibilities, deliverables, and deadlines will be clearly outlined and communicated to all staff members. The City will remedy the customer account cr...

The City will develop, document, and implement formal grant summary requirements review process and audit preparedness policy and procedures. The responsibilities, deliverables, and deadlines will be clearly outlined and communicated to all staff members. The City will remedy the customer account credit balances by October 2025. Management intends to review and adjust the customer account balances.

View Audit 352902 Questioned Costs: $1

Finding 554250 (2024-003)

Significant Deficiency 2024

Sunrise County Economic Council

ME

Reporting Allowable Costs / Cost Principles Significant Deficiency § 200.508 § 200.510

Management attempted to contract with multiple accounting consultants for creating the SEFA but they were already at full capacity and were not available to assist with the creation of the report. When the relevant contract or grant award did not include the necessary information, SCEC management an...

Management attempted to contract with multiple accounting consultants for creating the SEFA but they were already at full capacity and were not available to assist with the creation of the report. When the relevant contract or grant award did not include the necessary information, SCEC management and program staff reached out to our contracting agencies to confirm whether federal funds were part of each award and to find out CFDA numbers and other contract information necessary to complete the form. Nevertheless, there were several errors that in the SEFA submitted to our auditors for review. For the two IRP and RMAP lending programs, the prior year balances were carried over into the FY 24 SEFA through a clerical error. The errors in item 11.037 and 11.419 are related to information we received from the contracting agency. In particular, 11.037 was listed under US Economic Development Administration according to the contracting agency and we were given the description of Economic Adjustment Assistance. The description for 11.419 was given to SCEC by the contracting agency as CDS – Congressionally Directed Spending. Finally, we provided two CFDA’s for the STEM Education award with the submission of the SEFA as we were waiting for confirmation from Program Managers about the correct CDFA numbers. The auditors were informed that we were waiting for these numbers when the SEFA was submitted. In FY24, SCEC had 29 different federal funding sources, from 14 different agencies. We are working to improve our capacity to report these awards without error before the review of our auditors.

View Audit 352825

Finding 554198 (2024-003)

Significant Deficiency 2024

Crossnore Communities for Children

NC

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Reporting § 200.430

Recommendation: During our review of the grant expenditures, it was noted that budgeted amounts were charged to the grant instead of the actual costs incurred. This practice was observed in multiple instances, leading to discrepancies between the reported expenditures and the actual costs. Managemen...

Recommendation: During our review of the grant expenditures, it was noted that budgeted amounts were charged to the grant instead of the actual costs incurred. This practice was observed in multiple instances, leading to discrepancies between the reported expenditures and the actual costs. Management did not review time and effort to make after-the-fact adjustments to the amounts charged to the grant. We recommend that the Organization establish a review process to ensure that all costs charged to the grant are based on actual expenditures and are properly documented Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management has established a review process to ensure that all costs charged to the grant are based on actual expenditures and are properly documented. Name(s) of the contact person(s) responsible for corrective action: Theresa Watters Planned completion date for corrective action plan: February 21, 2025

View Audit 352789

Finding 554197 (2024-002)

Significant Deficiency 2024

Crossnore Communities for Children

NC

Allowable Costs / Cost Principles Cash Management Significant Deficiency

Recommendation: Under 2 CRF 200.406, credits accruing to or received by the recipient of federal funding that relate to allowable costs must be credited to the Federal award as either a cost reduction or cash refund. The Organization did not have adequate internal controls designed to properly deter...

Recommendation: Under 2 CRF 200.406, credits accruing to or received by the recipient of federal funding that relate to allowable costs must be credited to the Federal award as either a cost reduction or cash refund. The Organization did not have adequate internal controls designed to properly determine the appropriate amounts to be submitted for reimbursement. We recommend the Organization review the expenditures submitted to SAMHSA and ensure that there is no "double dipping' of sales taxes. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management has implemented a review process for all expenditures submitted to SAMHSA. The review process ensures that there is no “double dipping” of sales tax. Name(s) of the contact person(s) responsible for corrective action: Theresa Watters Planned completion date for corrective action plan: February 21, 2025

View Audit 352789

Finding 554154 (2024-004)

Significant Deficiency 2024

Santa Fe Recovery Center, Inc.

NM

Questioned Costs Allowable Costs / Cost Principles Internal Control / Segregation of Duties § 200.403 § 200.430

Corrective action plan: Management is in the process of implementing a method for employees to charge their time to grants, as needed, from the payroll system. Personnel responsible for corrective action: Timothy Jodway, Interim Chief Financial Officer. Estimated corrective action completion date: M...

Corrective action plan: Management is in the process of implementing a method for employees to charge their time to grants, as needed, from the payroll system. Personnel responsible for corrective action: Timothy Jodway, Interim Chief Financial Officer. Estimated corrective action completion date: May 2025

View Audit 352776 Questioned Costs: $1

Finding 554116 (2024-007)

Significant Deficiency 2024

Tahoe Douglas Fire Protection District

NV

Equipment & Real Property Management Procurement, Suspension & Debarment Allowable Costs / Cost Principles § 200.313

Finding 2024-007 U.S. Department of Homeland Security Pass-through North Lake Tahoe Fire Protection District Assistance to Firefighters Grant, 97.044 Finding Summary: SCBA packs received as a sub-recipient of North Lake Tahoe Fire Protection Districts AFG grant did not have necessary information doc...

Finding 2024-007 U.S. Department of Homeland Security Pass-through North Lake Tahoe Fire Protection District Assistance to Firefighters Grant, 97.044 Finding Summary: SCBA packs received as a sub-recipient of North Lake Tahoe Fire Protection Districts AFG grant did not have necessary information documented on inventory schedule. Responsible Individuals: Scott Lindgren, Fire Chief, Tahoe Douglas Fire Protection District Kevin Lawson, Asst. Fire Chief, Tahoe Douglas Fire Protection District Bryce Cranch, Asst. Fire Chief, Tahoe Douglas Fire Protection District Carrie Nolting, Finance Manager, Tahoe Douglas Fire Protection District Corrective Action Plan: The inventory schedule for these items will be updated with all required fields of information. Inventory for the district will be assigned to a Chief officer who will be responsible for making sure property received from federal funding will be tracked appropriately in compliance with CFR 200. Anticipated Completion Date: April 30, 2025

View Audit 352768

Finding 554111 (2024-009)

Significant Deficiency 2024

Tahoe Douglas Fire Protection District

NV

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

Finding 2024-009 U.S. Department of the Interior Direct award and pass-through Tahoe Resource Conservation District Southern Nevada Public Land Management, 15.235 Finding Summary: Requests for reimbursements appeared to have not been reviewed by a second individual in the district. Responsible Indiv...

Finding 2024-009 U.S. Department of the Interior Direct award and pass-through Tahoe Resource Conservation District Southern Nevada Public Land Management, 15.235 Finding Summary: Requests for reimbursements appeared to have not been reviewed by a second individual in the district. Responsible Individuals: Scott Lindgren, Fire Chief, Tahoe Douglas Fire Protection District Keegan Schafer, Wildland Fire & Fuels Division Chief, Tahoe Douglas Fire Protection District Carrie Nolting, Finance Manager, Tahoe Douglas Fire Protection District Corrective Action Plan: Chief Schafer, who reviews the personnel cost charged to grants for fuels reduction, will not only review informally as he currently does but the district will implement a sign off for this review. Anticipated Completion Date: Ongoing

View Audit 352768

Finding 554110 (2024-008)

Material Weakness 2024

Tahoe Douglas Fire Protection District

NV

Allowable Costs / Cost Principles Material Weakness Reporting § 200.303

Finding 2024-008 U.S. Department of Interior Direct award and pass-through Tahoe Resource Conservation District Southern Nevada Public Land Management, 15.235 Finding Summary: The personnel costs charged to grant awards were underbilled due to using an average rate for a quarter of reporting. In add...

Finding 2024-008 U.S. Department of Interior Direct award and pass-through Tahoe Resource Conservation District Southern Nevada Public Land Management, 15.235 Finding Summary: The personnel costs charged to grant awards were underbilled due to using an average rate for a quarter of reporting. In addition, an annual burdened crew rate spreadsheet was used that was not updated when individuals received salary increases. Responsible Individuals: Scott Lindgren, Fire Chief, Tahoe Douglas Fire Protection District Keegan Schafer, Wildland Fire & Fuels Division Chief, Tahoe Douglas Fire Protection District Carrie Nolting, Finance Manager, Tahoe Douglas Fire Protection District Corrective Action Plan: The district is planning to find a solution utilizing the UKG payroll software to pull up to date salary information to be utilized in conjunction with the burdened crew rate schedule to make sure the appropriate rates are being billed to the grant. Anticipated Completion Date: Ongoing

View Audit 352768

Finding 554089 (2024-001)

Material Weakness 2024

Town of Brunswick Maine

ME

Questioned Costs Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking § 200.430

Management Response/Corrective Action Plan: The School Department completed the necessary time and effort documents for expense reimbursement that were approved by the Department of Education. The time and effort was not specific to actual time worked for those split among multiple grants or funds. ...

Management Response/Corrective Action Plan: The School Department completed the necessary time and effort documents for expense reimbursement that were approved by the Department of Education. The time and effort was not specific to actual time worked for those split among multiple grants or funds. Moving forward, any employee who has time split between multiple grants or Federal and non-Federal activities will be expected to complete a personnel activity report. This report will record actual time spent working on eligible activities for each fund. If the employee has a regular schedule, the employee’s schedule will suffice as their personnel activity report, as long as it follows the guidelines. The personnel activity reports will be requested each month during the reimbursement request process and will be signed by the employee and their supervisor.

View Audit 352733 Questioned Costs: $1

Finding 554086 (2024-004)

None 2024

Town of Brunswick Maine

ME

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

Management Response/Corrective Action Plan: We have had a lot of turnover in the business office with a new finance director, payroll coordinator, and finance accounts coordinator (bookkeeper). Since being notified of the issue, we have put procedures in place to ensure issues related to MainePERS ...

Management Response/Corrective Action Plan: We have had a lot of turnover in the business office with a new finance director, payroll coordinator, and finance accounts coordinator (bookkeeper). Since being notified of the issue, we have put procedures in place to ensure issues related to MainePERS contributions do not occur and/or are resolved in a timely manner. As employees are hired, or change funding accounts, the payroll coordinator now has procedures in place to check the appropriate deductions for each account. We also are up to date with MainePERS reconciliation, which includes reviewing contributions for federally funded employees. If an error occurs, the process will cause us to review the issue and reconcile the accounts as necessary.

View Audit 352733 Questioned Costs: $1

Finding 554080 (2024-002)

Significant Deficiency 2024

Town of Brunswick Maine

ME

Questioned Costs Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking § 200.430

Management Response/Corrective Action Plan: The School Department completed the necessary time and effort documents for expense reimbursement that were approved by the Department of Education. The time and effort was not specific to actual time worked for those split among multiple grants or funds. ...

Management Response/Corrective Action Plan: The School Department completed the necessary time and effort documents for expense reimbursement that were approved by the Department of Education. The time and effort was not specific to actual time worked for those split among multiple grants or funds. Moving forward, any employee who has time split between multiple grants or Federal and non-Federal activities will be expected to complete a personnel activity report. This report will record actual time spent working on eligible activities for each fund. If the employee has a regular schedule, the employee’s schedule will suffice as their personnel activity report, as long as it follows the guidelines. The personnel activity reports will be requested each month during the reimbursement request process and will be signed by the employee and their supervisor.

View Audit 352733 Questioned Costs: $1

Finding 554078 (2024-001)

Significant Deficiency 2024

M.s.a.d. No 70

ME

Allowable Costs / Cost Principles § 200.303 § 200.430

CORRECTIVE ACTION PLAN (Concerning Finding 2024-001) Contact Person Responsible for Corrective Action: Catrina Kemp, Business Manager Corrective Action: The Regional School Unit No. 70 will take the following actions to address finding 2024-001. Managerment will review standards and requirements ann...

CORRECTIVE ACTION PLAN (Concerning Finding 2024-001) Contact Person Responsible for Corrective Action: Catrina Kemp, Business Manager Corrective Action: The Regional School Unit No. 70 will take the following actions to address finding 2024-001. Managerment will review standards and requirements annually to ensure that the district is following federal guidelines. Management will also employ a signature and date on all federal grant disbursements to ensure that all criteria and requirements are met. Allowable costs will be assesed monthly before submission for allowability. Management will implement a two step review process for contracts and payroll. Anticipated Completions Date: July 1, 2025

View Audit 352732

Finding 554051 (2024-002)

Significant Deficiency 2024

Heart of Iowa Regional Transit Agency

IA

Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking Subrecipient Monitoring

We will update our Accounting Policy Manual, and create formal time tracking procedures for staff.

View Audit 352712

Finding 554040 (2024-003)

Material Weakness 2024

St. Joseph County Transportation Authority

MI

Allowable Costs / Cost Principles Material Weakness

March 31, 2025 CORRECTIVE ACTION PLAN Pursuant to federal regulations, Uniform Administrative Requirements Section 200.511, the following are the findings, as noted in the St. Joseph County Transportation Authority (the “Authority”), Single Audit report for the year ended September 30, 2024, and c...

March 31, 2025 CORRECTIVE ACTION PLAN Pursuant to federal regulations, Uniform Administrative Requirements Section 200.511, the following are the findings, as noted in the St. Joseph County Transportation Authority (the “Authority”), Single Audit report for the year ended September 30, 2024, and corrective actions to be completed. Finding 2024-003 - Supporting Documentation and Review and Approval for Federal Expenditures Auditor Description of Condition and Effect. Management is responsible for verifying that federal expenditures are in compliance with allowable costs and allowable activities. The Authority had instances during Accounts Payable, Payroll, and Journal Entry testing where documentation of expenditures lacked evidence of review by senior management. As a result of this condition, the Authority is exposed to an increased risk of errors or misstatements in financial records related to the federal funds. Auditor Recommendation. The Authority should implement procedures for the independent review and approval by management over all journal entries, accounts payable, and payroll, related to federal funds. Corrective Action. We concur with the recommendation and will continue to seek out possibilities to further strengthen our internal control. Responsible Person: Allen Balog, Executive Director Anticipated Completion Date: September 30, 2025

View Audit 352668

Finding 554027 (2024-007)

Material Weakness 2024

Inglewood Unified School District

CA

Questioned Costs Allowable Costs / Cost Principles Internal Control / Segregation of Duties § 200.303 § 200.430

The District acknowledges this finding and is committed to strengthening internal controls to ensure compliance with federal time accounting requirements. The State and Federal Programs Department has received training on Time and Effort procedures, and additionally training is being provided to sch...

The District acknowledges this finding and is committed to strengthening internal controls to ensure compliance with federal time accounting requirements. The State and Federal Programs Department has received training on Time and Effort procedures, and additionally training is being provided to school sites to reinforce accurate time certification and documentation for federal fund expenditures. To address the deficiencies, the district will shift from an annual to a monthly reconciliation process, ensuring that employee salaries charged to Title I accurately reflect actual work performed. The State and Federal Programs Department will collaborate with the Budget Department to systematically track employees funded through Title I and verify that all required PARs are completed and maintained.

View Audit 352638 Questioned Costs: $1

Finding 554022 (2024-005)

Significant Deficiency 2024

Eagle Academy Public Charter School

DC

Allowable Costs / Cost Principles Subrecipient Monitoring § 200.430

U.S. Department of Education AL 84.010A Title I, Basic Grants to Local Education Agencies AL 84.010A Title I, Part A - Investment in Schools 2 AL 84.367A Title II: Improving Teacher Quality State Grants AL 84.424A Title IV: Student Support and Academic Enrichment Grants Type of Finding – Noncomplian...

U.S. Department of Education AL 84.010A Title I, Basic Grants to Local Education Agencies AL 84.010A Title I, Part A - Investment in Schools 2 AL 84.367A Title II: Improving Teacher Quality State Grants AL 84.424A Title IV: Student Support and Academic Enrichment Grants Type of Finding – Noncompliance and Significant Deficiency over Activities Allowed or Unallowed and Allowable Costs/Cost Principles (Payroll) Repeat Finding: No Auditee’s Corrective Action Plan: The School recognizes the importance of maintaining records and ensuring adequate internal controls over activities allowed and allowable costs/costs/principles. To strengthen internal controls in this area, in July 2024, the school introduced EdOps to work on payroll and to conduct an additional layer of review in addition to the HR Manager and the CEO. The School recognizes that its documentation and record-keeping requires improvement. Should the School resume operations, it will assess review and record-keeping processes to ensure the integrity and accuracy of payroll and related documents. Contact Person: Aaron Lentner

View Audit 352637

Finding 554000 (2024-004)

Significant Deficiency 2024

Family Guidance Center of Alabama, Inc.

AL

Reporting Allowable Costs / Cost Principles Significant Deficiency

Each grant's financial report will be reviewed and approved each month, whether or not it is submitted to a funder. Individual Responsible Debbie Pinnock Completion Date Plan to be implemented as soon as possible.

View Audit 352634

Finding 553975 (2024-003)

Material Weakness 2024

Desert Aids Project, Inc.

CA

Allowable Costs / Cost Principles Material Weakness Reporting

Department of Housing and Urban Development Federal Financial Assistance Listing #93.224 and #93.527 Community Health Center Cluster Reporting – Material Weakness in Internal Control over Compliance Finding Summary Certain tables within the Universal Data System (UDS) Report did not reconcile to DAP...

Department of Housing and Urban Development Federal Financial Assistance Listing #93.224 and #93.527 Community Health Center Cluster Reporting – Material Weakness in Internal Control over Compliance Finding Summary Certain tables within the Universal Data System (UDS) Report did not reconcile to DAP Health, Inc. supporting information. The tables that did not reconcile to the supporting information include Table 4, Selected Patient Characteristics, and Table 5, Staffing and Utilization. Table 4 reports the total number of patients seen while Table 5 reports the number of clinic visits by the various types of providers. The primary causes of the differences were due to DAP Health, Inc. acquiring a large entity during the year which used a different Electronic Health Record System. The combination of bringing together information from two different systems caused the reporting to be more complicated. In addition, certain supporting documentation used to prepare the UDS report was not maintained. The review process for the UDS report was also not functioning properly. Responsible Individuals Rigo Garcia, Analytics Manager and Bill Lee, Director of Information Management Status Management of DAP Health, Inc. has already converted the 25 acquired clinics to the DAP Health, Inc. Electronic Health System, which streamlined the process for the preparation of the UDS Report for the calendar year ending December 31, 2024. In addition, management has implemented new procedures requiring supporting documentation to be maintained. Management has also implemented a formalized review procedure for the UDS Report prior to submission. Anticipated Completion Date March 31, 2025

View Audit 352630

Finding 553805 (2024-002)

Material Weakness 2024

Wisconsin Literacy, INC

WI

Subrecipient Monitoring Allowable Costs / Cost Principles Cash Management

The organization will update policies and procedures to obtain and review evidence for all cost reimbursement requests from subrecipient organizations.

View Audit 352443

Finding 553803 (2024-002)

Material Weakness 2024

City of Milano

TX

Allowable Costs / Cost Principles

The City is in the process of establishing written policies for federal awards.

View Audit 352434

Corrective Action Plans

Filters