Corrective Action Plans

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MANAGEMENT WILL ENSURE THAT ALL FUTURE GRANT DRAWDOWNS ARE RETAINED IN THE BANK UNTIL SPENT ON ALLOWABLE GRANT EXPENSES.
MANAGEMENT WILL ENSURE THAT ALL FUTURE GRANT DRAWDOWNS ARE RETAINED IN THE BANK UNTIL SPENT ON ALLOWABLE GRANT EXPENSES.
There is now a new Clerk/Treasurer in place who is aware of the federal reimbursement requirements and will not allow reimbursement requests be made prior to the vendor receiving payment.
There is now a new Clerk/Treasurer in place who is aware of the federal reimbursement requirements and will not allow reimbursement requests be made prior to the vendor receiving payment.
The City will implement formal review and approval process for reimbursement requests within grant management policy; and require documentation (signatures/dates) to evidence compliance. Responsible Officials: Michael Elizalde, Grants & Strategic Initiatives Director / Vidal Roman, Finance Director ...
The City will implement formal review and approval process for reimbursement requests within grant management policy; and require documentation (signatures/dates) to evidence compliance. Responsible Officials: Michael Elizalde, Grants & Strategic Initiatives Director / Vidal Roman, Finance Director Timeline to Complete: Estimated June 2026
H. Period of Performance Timely Payment of Financial Obligations Assistance Listing 93.959: Block Grants for Substance Use Prevention, Treatment, and Recovery Services Federal Agency: Department of Health and Human Services Recommendation: As the grant period has ended, we recommend that the Corpora...
H. Period of Performance Timely Payment of Financial Obligations Assistance Listing 93.959: Block Grants for Substance Use Prevention, Treatment, and Recovery Services Federal Agency: Department of Health and Human Services Recommendation: As the grant period has ended, we recommend that the Corporation works with the funding agency to remedy the period of performance noncompliance. In addition, we recommend that the Corporation reassess the design of its period of performance controls to identify where enhancement or additional controls are needed over liquidation of financial obligations subsequent to the end of a grant award. Explanation of disagreement with audit finding: There is no disagreement with the finding and recommendation. Action planned/taken in response to finding: The Corporation went live on its new ERP system in April 2024. Since go-live, management has continued to optimize the system and find ways to strengthen our internal controls, including automating certain processes. Management will continue to educate all grant managers on (1) the reporting capabilities within the system that can be utilized in the execution of monitoring payment status on individual invoices that have been submitted to granting agencies for reimbursement, and (2) the requirement to use their grant specific general ledger coding when orders are placed with vendors that are set up under the Corporation’s group purchasing process. For the specific vendor noted in Finding 2024-003, a grant number input field has been added to the group purchasing orders to allow for enhanced tracking and review of expenditures associated with grants and the monitoring of payment of those expenditures. The use of the accurate grant general ledger coding by grant managers when orders are placed will reduce the time between placement of order and payment of the invoice. The grant manager responsible for oversight of BHSB grants will work with BHSB to remedy the period of performance noncompliance noted in Finding 2024-003. Anticipated Completion Date – June 30, 2026 Name(s) of the contact person(s) responsible for corrective action: Jeff Chadwick, Financial Reporting Director, jeff.chadwick@umm.edu
C. Cash Management; L. Reporting Evidence and Review and Approval of the Reported Expenditures and Timely Report Submission Assistance Listing 93.959: Block Grants for Substance Use Prevention, Treatment, and Recovery Services Federal Agency: Department of Health and Human Services Recommendation: M...
C. Cash Management; L. Reporting Evidence and Review and Approval of the Reported Expenditures and Timely Report Submission Assistance Listing 93.959: Block Grants for Substance Use Prevention, Treatment, and Recovery Services Federal Agency: Department of Health and Human Services Recommendation: Management should reassess the design of its controls to ensure submissions to BHSB are made timely within the required 15-day period and that documentation is retained that evidences the review and approval of expenditures submitted to BHSB for reimbursement. Explanation of disagreement with audit finding: There is no disagreement with the finding and recommendation. Action planned/taken in response to finding: The Corporation went live on its new ERP system in April 2024. Since go-live, management has continued to optimize the system and find ways to strengthen our internal controls, including automating certain processes. Management will continue educating grant managers on capabilities within the system that can be utilized in the execution of review and approval of grant expenditures prior to timely submission to the relevant granting agencies for reimbursement. Centralized repositories have been set up for grant managers to extract specific monthly financial reports for use in the execution of their controls, as well as to retain their review and approval evidence. Additionally, management is developing standard operating procedures and policies that include the requirements for compliance and internal controls for federal grants. The policies will acknowledge that for controls to be designed and operate effectively, there must always be a segregation of duties between the preparer of the control vs. reviewer and that clear documentation must be retained to evidence the execution of the controls. Anticipated Completion Date – June 30, 2027 Name(s) of the contact person(s) responsible for corrective action: Jeff Chadwick, Financial Reporting Director, jeff.chadwick@umm.edu
Finding 2024-04 Schedule of Expenditures of Federal Awards. Management concurs with the finding. IHS will be working with the new outside CPA firm to develop a grant bridging report beginning FY2025/26.
Finding 2024-04 Schedule of Expenditures of Federal Awards. Management concurs with the finding. IHS will be working with the new outside CPA firm to develop a grant bridging report beginning FY2025/26.
Finding 2024-03 Filing of Single Audit Reports. Management concurs with the finding. Beginning July 1, 2025, IHS will be transitioning some of its financial reporting and audit support functions to an outside CPA firm specializing in nonprofit services. It is anticipated that this transition will he...
Finding 2024-03 Filing of Single Audit Reports. Management concurs with the finding. Beginning July 1, 2025, IHS will be transitioning some of its financial reporting and audit support functions to an outside CPA firm specializing in nonprofit services. It is anticipated that this transition will help assist in meeting the single audit filing deadline.
Finding reference: 2024-004 - 93.137 – Community Programs to Improve Minority Health Grant Program Significant Deficiency and Noncompliance over Cash Management Recommendation: We recommend that the City review policies, procedures and practices in place to ensure drawdowns are reconciled to the gen...
Finding reference: 2024-004 - 93.137 – Community Programs to Improve Minority Health Grant Program Significant Deficiency and Noncompliance over Cash Management Recommendation: We recommend that the City review policies, procedures and practices in place to ensure drawdowns are reconciled to the general ledger, and reviewed and approved before requests have been submitted. Action taken: With the hiring of our grant accountant, the policy is that all drawdowns are to be reconciled to general ledger prior to submitting.
Finding reference: 2024-009 - 93.224, 93.527 – Health Center Program Cluster Material Weakness and Noncompliance over Cash Management Recommendation: We recommend that the City review policies, procedures and practices in place to ensure drawdowns are reconciled to the general ledger, and reviewed a...
Finding reference: 2024-009 - 93.224, 93.527 – Health Center Program Cluster Material Weakness and Noncompliance over Cash Management Recommendation: We recommend that the City review policies, procedures and practices in place to ensure drawdowns are reconciled to the general ledger, and reviewed and approved before requests have been submitted. Action taken: With the hiring of our grant accountant, the policy is that all drawdowns are to be reconciled to general ledger prior to submitting.
United States Environmental Protection Agency Capitalization Grants for Clean Water Revolving Funds ALN: 66.458 Condition: The Village has not updated its existing policies and written procedures to conform to Uniform Guidance requirements. Planned Corrective Action: The Village’s Treasurer will wor...
United States Environmental Protection Agency Capitalization Grants for Clean Water Revolving Funds ALN: 66.458 Condition: The Village has not updated its existing policies and written procedures to conform to Uniform Guidance requirements. Planned Corrective Action: The Village’s Treasurer will work on updating all policies and procedures relating to the U.S. Office of Management and Budget Uniform Guidance to ensure the Village policies are in compliance with these guidelines. Responsible Contact Person: Linda M. Morrisey Village Treasurer Village of Ocean Beach Bay & Cottage Walks, P.O. Box 457 Ocean Beach, NY 11770 Anticipation completion date: March 31, 2026
As part of the proposal negotiations for the federal program, initial discussions with the sponsoring office of the federal program included a limitation for allowable compensation for employees that were not the Executive Director. Although the limitation was intended to be removed from the final a...
As part of the proposal negotiations for the federal program, initial discussions with the sponsoring office of the federal program included a limitation for allowable compensation for employees that were not the Executive Director. Although the limitation was intended to be removed from the final agreement, the budgeted requested salaries were not updated. The Assistance Agreement has been modified to remove any such limitation prospectively beginning with Modification 0015 in April 2024. Implementation Date – April 2025
As is touched upon in the Cause, the Organization was unaware of audit requirements which resulted in delays for both the audit of the period ending December 31, 2023 and the audit of the year ending December 31, 2024. The Organization has engaged our current auditors to perform the 2025 audit, and ...
As is touched upon in the Cause, the Organization was unaware of audit requirements which resulted in delays for both the audit of the period ending December 31, 2023 and the audit of the year ending December 31, 2024. The Organization has engaged our current auditors to perform the 2025 audit, and it is expected to be completed by the September 30, 2026 deadline. Implementation Date – January 2026
2024-001– Allowable Costs – Internal Control over Payroll and Non-Payroll Costs Programs 64.024 Veteran Affairs Homeless Providers Grant and Per Diem Program 64.055 Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Responsible Officials Stephanie Marchetti, Executive Director Cynthia...
2024-001– Allowable Costs – Internal Control over Payroll and Non-Payroll Costs Programs 64.024 Veteran Affairs Homeless Providers Grant and Per Diem Program 64.055 Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program Responsible Officials Stephanie Marchetti, Executive Director Cynthia Newsham, Director of Finance Plan Detail Based on the on the findings, the Executive Director and Director of Finance will review the organizational policies and procedures and create a cost allocation plan based on employment status. Once finalized the cost allocation plan will be reviewed and approved by the board of directors, who approve any policy changes before they are implemented. Anticipated Completion Date June 30, 2025
Finding Number: 2024-006 Finding Title: Financial Policies and Procedures Federal Program Information: • Federal Agency: Department of Housing and Urban Development; Department of the Treasury • Assistance Listing Numbers (ALN): 14.251 and 21.027 • Federal Program Names: Economic Development Initiat...
Finding Number: 2024-006 Finding Title: Financial Policies and Procedures Federal Program Information: • Federal Agency: Department of Housing and Urban Development; Department of the Treasury • Assistance Listing Numbers (ALN): 14.251 and 21.027 • Federal Program Names: Economic Development Initiatives—Special Project, Neighborhood Initiative and Neighborhood Stabilization Program; Coronavirus State and Local Fiscal Recovery Funds Compliance Requirement: Financial Management and Standards of Financial Management Systems (2 CFR §200.302(b)); Allowable Costs (2 CFR §200.403-405); Procurement (2 CFR §200.317-327); Cash Management (2 CFR §200.305); Travel Costs (2 CFR §200.475) Note: Organization has existing Conflict of Interest policy in compliance with 2 CFR §200.318(c)(1). Questioned Costs: $0 Repeat Finding: No Management's Response: The Board of Directors of Restoration Christian Ministries agrees with the finding. The Organization will establish formalized accounting policies and procedures that adhere to the requirements of the Uniform Guidance. Corrective Action Plan: Corrective Action #1: Comprehensive Policy Manual Development • Action: Engage consultant or work with Contract Accountant to develop comprehensive written financial policies and procedures manual addressing all Uniform Guidance requirements, including: (a) Allowable costs (2 CFR §200.403-405); (b) Procurement (2 CFR §200.317-327); (c) Cash management (2 CFR §200.305); (d) Travel costs (2 CFR §200.475); (e) Time and effort documentation; (f) Equipment management; (g) Subrecipient monitoring; (h) Financial reporting; and (i) Record retention. Ensure policies address financial management system requirements under 2 CFR §200.302. Tailor policies to Organization's all-volunteer structure. [Note: Organization already has Conflict of Interest policy complying with 2 CFR §200.318(c)(1).] • Responsible Person/Title: Board Treasurer with Contract Accountant • Anticipated Completion Date: April 30, 2026 Corrective Action #2: Board Approval and Adoption • Action: Present draft policies to full Board of Directors for review and input. Board will formally adopt policies by resolution. Document approval in Board meeting minutes. • Responsible Person/Title: Board President • Anticipated Completion Date: May 31, 2026 Corrective Action #3: Dissemination and Training • Action: Distribute approved policies to all Board members and Contract Accountant. Conduct training session for Board members and Contract Accountant on new policies and procedures. Board members and Contract Accountant will sign acknowledgment of receipt and understanding. Make policies readily accessible (e.g., shared drive, Board portal). • Responsible Person/Title: Board President • Anticipated Completion Date: June 30, 2026 Corrective Action #4: Implementation Tools and Support • Action: Develop templates, forms, and tools to support policy implementation. Create workflow diagrams and checklists for common transactions. Establish Board Treasurer as primary resource for policy implementation questions. • Responsible Person/Title: Board Treasurer and Contract Accountant • Anticipated Completion Date: July 31, 2026 Corrective Action #5: Annual Policy Review Process • Action: Schedule annual review of policies to ensure continued Uniform Guidance compliance. Update policies as needed for regulatory or organizational changes. Submit material policy changes to full Board for approval. • Responsible Person/Title: Board Treasurer • Anticipated Completion Date: Annually, beginning June 2027 Corrective Action #6: Governance Structure Assessment • Action: Board will evaluate establishing Audit Committee or combined Finance/Audit Committee to provide enhanced oversight of financial management, internal controls, and federal compliance. If Board size prohibits separate committee, designate at least two Board members with specific oversight responsibilities. • Responsible Person/Title: Board President • Anticipated Completion Date: June 30, 2026
Management has established separate bank accounts for the security deposits, residual receipts, and replacement reserve, and required deposits to the replacement reserve have been made.
Management has established separate bank accounts for the security deposits, residual receipts, and replacement reserve, and required deposits to the replacement reserve have been made.
The District Office has established a separate bank account for its Cafeteria Fund in fiscal year 25. The District is also in the process of implementing procedures to ensure cafeteria funds are used exclusively for allowable food service purposes and are properly monitored and reconciled.
The District Office has established a separate bank account for its Cafeteria Fund in fiscal year 25. The District is also in the process of implementing procedures to ensure cafeteria funds are used exclusively for allowable food service purposes and are properly monitored and reconciled.
The District Office will work directly with the Federal Programs Coordinator to ensure more timely submissions of Reconciliation of Cash on Hand Quarterly Reports and Final Expenditure Reports are prepared accurately and submitted timely in accordance with grant requirements. The Business Manager wi...
The District Office will work directly with the Federal Programs Coordinator to ensure more timely submissions of Reconciliation of Cash on Hand Quarterly Reports and Final Expenditure Reports are prepared accurately and submitted timely in accordance with grant requirements. The Business Manager will do this by creating reminders on the Business Manager’s calendar that include due dates each quarter and reminding the Federal Programs Coordinator when their respective reports are due. The District will implement and form a review and monitoring process and provide any necessary training to staff responsible for grant reporting to ensure ongoing compliance.
The City will ensure that all future expenditures are tracked and reported to the proper periods and recorded appropriately.
The City will ensure that all future expenditures are tracked and reported to the proper periods and recorded appropriately.
Management will implement standardized cash drawdown procedures to ensure federal funds are requested only for immediate cash needs in accordance with Uniform Guidance. A consistent drawdown calculation template will be used, supported by incurred and allowable expenditures. Monthly reconciliations ...
Management will implement standardized cash drawdown procedures to ensure federal funds are requested only for immediate cash needs in accordance with Uniform Guidance. A consistent drawdown calculation template will be used, supported by incurred and allowable expenditures. Monthly reconciliations of drawdowns to actual expenses will be performed, and staff involved in federal fund management will receive training on federal cash management requirements.
Management Response: We acknowledge that some 1571 reports were submitted after the required deadline due to internal staffing transitions and competing reporting priorities. Planned Corrective Action: Management has implemented a compliance calendar with automated reminders and a secondary review p...
Management Response: We acknowledge that some 1571 reports were submitted after the required deadline due to internal staffing transitions and competing reporting priorities. Planned Corrective Action: Management has implemented a compliance calendar with automated reminders and a secondary review process to ensure timely submission of all DSS-1571 forms. Cross-training has been completed to ensure adequate coverage during staff absences. In addition, a formal procedure is now in place to request extensions when a reimbursement cannot be submitted by the 10th of the month. Name of Contact Person: Anna Eaton, Executive Director
Management Response: Management acknowledges that certain expense and salary allocations were not fully aligned with the approved grant budgets, primarily due to staffing transitions and evolving program priorities. These changes temporarily impacted the consistency of allocation methods and review ...
Management Response: Management acknowledges that certain expense and salary allocations were not fully aligned with the approved grant budgets, primarily due to staffing transitions and evolving program priorities. These changes temporarily impacted the consistency of allocation methods and review processes. methods and review processes. Planned Corrective Action: Management has implemented monthly reconciliations between expense allocations and the approved budgets to ensure ongoing accuracy and compliance. An ORR tracking sheet is now used to verify expenditure allocations against current budgeted amounts prior to each reimbursement submission, ensuring that all costs are allowable, properly supported, and aligned with approved grant budgets. Name of Contact Person: Anna Eaton, Executive Director
2024-007: Material Weakness and Noncompliance – Written Policies Required by the Uniform Guidance Statement of Condition/Criteria: Delta County does not have written policies and procedures to implement the requirements of 2 CFR section 200 for the administration of federal awards. 2 CFR 200.303(a) ...
2024-007: Material Weakness and Noncompliance – Written Policies Required by the Uniform Guidance Statement of Condition/Criteria: Delta County does not have written policies and procedures to implement the requirements of 2 CFR section 200 for the administration of federal awards. 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal controls over the federal awards that provide assurance that the entity is managing the federal awards in compliance with federal statutes, regulations, and the conditions of the federal award. Planned Corrective Action: County management will develop written policies and procedures for grants. Contact person responsible for corrective action: Emily DeSalvo, County Administrator Anticipated Completion Date: March 2026
FINDING NUMBER 2024-002 Reporting views of responsible officials: The Company will monitor cash balances or monitor the bank ratings. Concur or do not concur with the finding: Concur with the finding Auditors' summary of auditee's comments on the findings and recommendations: The Company should moni...
FINDING NUMBER 2024-002 Reporting views of responsible officials: The Company will monitor cash balances or monitor the bank ratings. Concur or do not concur with the finding: Concur with the finding Auditors' summary of auditee's comments on the findings and recommendations: The Company should monitor the investments held by these financial institutions to ensure that HUD’s requirements are met. Response indicator: Agree. Response: The Company should monitor the investments held by these financial institutions to ensure that HUD’s requirements are met. Completion date: December 31, 2025
Corrective Action Plan Year Ended September 30, 2024 Finding 2024-002 AL Numbers: 97.036 Program: Disaster Grants – Public Assistance (Presidentially Declared Disasters) Correction Action: Brown Health management asserts that the methodology applied to estimate and avoid duplication of benefits was ...
Corrective Action Plan Year Ended September 30, 2024 Finding 2024-002 AL Numbers: 97.036 Program: Disaster Grants – Public Assistance (Presidentially Declared Disasters) Correction Action: Brown Health management asserts that the methodology applied to estimate and avoid duplication of benefits was reasonable, allowable, and consistent with FEMA guidance. The projects were previously reviewed, approved, obligated, funded, and closed or in pending close status by FEMA. Formal appeals of FEMA’s subsequent recommended reduction for Bradley Hospital and Newport Hospital were filed. Management continues to cooperate with FEMA and RIEMA during the appeal process. Accordingly, corrective action is contingent upon FEMA’s final determination. Contacts: Stephen Almonte, VP of Finance and Corporate Controller Salmonte3@brownhealth.org Mark Adelman, Director Public Policy and Federal Advocacy Madelman@brownhealth.org Planned Completion Date: Not applicable. Management will evaluate the need for any corrective action plan upon receipt of FEMA’s final determination on the pending appeals.
Management Response: Management concurs with the auditor’s finding and recommendation. For audit years ending on December 31, 2020, to 2024, HTHA recognizes that former Finance Director failed to timely reconcile some general ledger balances. We recognize that timely and effective account reconcilia...
Management Response: Management concurs with the auditor’s finding and recommendation. For audit years ending on December 31, 2020, to 2024, HTHA recognizes that former Finance Director failed to timely reconcile some general ledger balances. We recognize that timely and effective account reconciliations are a critical component of internal control over financial reporting to prevent and detect material weaknesses. Anticipated Completion Date: To address the root causes of this material weakness, HTHA hired a Chief Financial Officer who will now implement the following corrective actions:  Standardized Operating Procedures: We will develop and implement a formal Standard Operating Procedure (SOP) by Spring 2026, to document the required frequency, format, and supporting documentation for all material reconciliations.  Staff Training: Mandatory training on the new reconciliation protocols will be conducted for all accounting personnel by June 2026, to reinforce accountability and technical proficiency. Responsible Party: Finance Director (responsible party for financial internal control during the audit year ending on December 31, 2024); and Chief Financial Officer (CFO) (responsible for internal control implementation starting in the year ending on December 31, 2025).
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