Corrective Action Plans

Quarterly Reporting The State concurs in part with the condition and recommendation. A unique challenge with ERA reporting has been changes in the U.S. Treasury portal for that program, which have impacted the State?s ability to download and provide copies of past reports that have been submitted. In addition, this issue in the reporting portal has been inconsistent, as some previously submitted reports were made accessible by Treasury, while others were not, which resulted in the State being able to access some requisite materials but not others. The State did not have documented procedures to ?pull down? copies of reports it had submitted to Treasury because the State has otherwise been able to rely on access to its previously submitted reports within reporting portals in order to enable the testing required during audit for the relevant periods. Meaning, in the State?s experience with COVID-19 related federal funds reporting, it has been able to access and download past reports for purposes of audit. However, also noted above is that the Treasury portal was recently revised and updated to allow for accessing previously submitted ERA reports that were not otherwise available (the communication from Treasury acknowledging this change was provided by the State). However, the reporting portal change did not take place in time for the State?s auditors to reasonably conduct the necessary testing. The State did provide the data and materials it reported to Treasury for the relevant periods, but auditors were unable to test and validate that data because the State could not access and provide a copy of what was actually uploaded into the portal. Nevertheless, to avoid any such potential issues in the future, the State has already implemented a procedure that involves downloading copies of reports as soon as they are submitted and taking screenshots of portions of the portal where perceived necessary to support what the State has submitted to Treasury. This updated procedure will be memorialized in the program?s transaction processing memo during its next update. Monthly Reporting The State concurs in part but has already implemented related corrective action in line with the recommendation above. The State would also like to note that as part of the ERA reallocation process U.S. Treasury has relied on both quarterly and monthly reporting, and that the State has continued to engage in thorough monitoring of its subrecipient and receives regular reports from that subrecipient, including weekly, biweekly, and quarterly data, which also includes quality control reports. This is inclusive of the monthly reports that were required by U.S. Treasury at one time but no longer are. The State reviews and then discusses reports received at standing, calendared, weekly meetings with the subrecipient and often engages in e-mail correspondence concerning those reports, especially if any questions concerning the data provided arise. However, the State has acknowledged that its documentation of those weekly conversations needed to be more formally memorialized. During the current fiscal year, the State began providing agendas and summaries of topics discussed during the weekly check-ins and will ensure that the program?s transaction processing memo adequately documents this requirement and procedure. The very nature of this program and U.S. Treasury?s facilitation of it has required the State and its subrecipient to stay in close contact, make regular decisions on strategies and policies within the program, and closely consider data relative to it. Anticipated Completion Date Quarterly reporting - Corrective action relative to acquisition of submitted federal reports has already been implemented and this revised procedure will be memorialized in the transaction processing memo for the program during its next update in Q1 2023. Monthly Repotting - Corrective action relative to documentation of weekly meetings was already complete as of the State?s response to this finding, and the State will ensure that the transaction processing memo for the program reflects these measures during its next update in Q1 2023. Contact Person Chase Hagaman, Lisa Cota-Robles, and Emily Larson

Vendor?s eligibility was reviewed but not formally documented. A spreadsheet will be documented when vendor?s eligibility are reviewed. Babette L. Donlon District Treasurer 1/23

Finding 2022-002, Special Tests and Provisions a. Program Information: Foster Grandparent Program ? ALN 94.011, Senior Companion Program ? ALN 94.016 b. Criteria: The NSCHC must be conducted, reviewed, and an eligibility determination made by the grant recipient or subrecipient based on the results of the NSCHC no later than the day before a person begins to work or serve on a NSCHC-required grant. The grant recipient must maintain adequate documentation of individual NSCHC grant records to include evidence that all required components (NSOPW, State(s), and FBI checks) were completed and on file (45 CFR ?2540.206). c. Condition: CSE did not have completed NSOPW documentation on file for two individuals before they began working or serving on the grant. Response: The CSE Director of Human Resources and project management will review and update existing policy as necessary and ensure that all required components of the NSCHC are completed by requiring the NSCHC Documentation Checklist to be: 1) completed at least one day prior to the person working or serving on the grant and 2) retained at the program and/or personnel level as appropriate. Contact person(s) responsible for corrective action: 1. Vance Kelly, Director of Finance and Accounting 2. Michele Flowerdew, Director of Sponsored Programs Administration Anticipated completion date: December 31, 2022

Finding 2022-002:Section 8 Project-Based Cluster Federal Assistance Number: 14.182 and 14.195 U.S. Department of Housing and Urban Development Compliance Requirements: Cash Management, Eligibility, Reporting 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 administrative staff allowing the administrator to act in a more supervisory position. Action Taken: This is not a "non-compliance" finding, however, management and the Board understand that internal controls and best management practices need to be strengthened. Management will review job descriptions and evaluate the number of staff needed to strengthen internal controls. Policies and procedures will be reviewed and adopted to segregate duties for best management practices in internal controls given the size of the organization we are. If the U.S. Department of Housing and Urban Development have questions regarding this plan, please call the responsible party at (719) 852-5778. Sincerely yours, Karla Shriver Managing Board Member Tri-County Senior Citizens and Housing, Inc.

U.S. Department of Education Alcorn State University (ASU) respectfully submits the following corrective action plan for the year ended June 30, 2022. Audit period: July 1, 2021 ? June 30, 2022 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS?FEDERAL AWARD PROGRAMS AUDITS 2022-003: Eligibility of Participants (ASU) TRIO Cluster - Assistance Listing No. 84.047 Recommendation: We recommend the institution maintain proper documentation in accordance with federal grantor requirements and ensure that the documents are readily available for review upon request. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To identify the possibility of noncompliance, the Office of Grants and Contracts staff reviewed prior emails. It was noted that we inadvertently did not respond to the updated testing (follow-up) email of April 26, 2023. Inherently, under the assumption it was duplicate request previously fulfilled, the email was disregarded. As a preventive measure, we will ensure that all federal grantor requests and requirements are thoroughly examined and submitted in a reasonable and timely manner. Name of contact person responsible for corrective action: Sabrena Johnson Planned completion date for corrective action plan is May 18, 2023. If the Department of Education has questions regarding this plan, please call Sabrena Johnson at 601-877-4711.

DEPARTMENT OF AGRICULTURE Assistance Listing 10.558 Child and Adult Care Food Program, Year Ended September 30, 2022. Compliance Recommendation: The Organization should implement a policy of requesting secondary review of payment requests for meals served by a responsible individual as a means of reducing the likelihood of error. Action Taken: The CACFP administrator will process the eligibility status of the families based on the CACFP intake forms. The Finance Manager will review the categorization of the families for accuracy. The Director will use the categorization of families, Free Meals, Reduced Meals and Paid Meals, to process the monthly reimbursement claim.

DEPARTMENT OF AGRICULTURE Assistance Listing 10.558 Child and Adult Care Food Program, Year Ended September 30, 2022. Significant Deficiency Recommendation: An individual knowledgeable of the Federal program requirements should be assigned the responsibility of reviewing the periodic request for payment prior to submission. Action Taken: The Director and the Finance Manager will attend the CACFP conference in April 2023 to become more knowledgeable in the program's requirements. The Finance Manager will review the monthly reimbursement claim and sign off on its accuracy before the Director finalizes the submission.

2022-001: Section 202, Assistance Listing No. 14.157 Two tenant files were selected for testing and the required documentation to determine eligibility, as required by the HUD Regulatory Agreement, could not be located as follows: ? 2 files were missing Form HUD-50059, Owner?s Certification of Compliance ? 2 files were missing the move-in and move-out inspection forms Recommendation: We recommend the Corporation establish procedures for maintaining tenant files to comply with HUD requirements for verification of tenant information, as required. Action Taken: Management agrees with the recommendation and will establish procedures with the managing agent to ensure all tenant files are maintained in accordance with HUD regulations.

During the 2022 grant year for the Temporary Assistance for Needy Families Grant # 93.558, the grantor implemented a new reporting tool, the SAFE Program Client Agreement Form (PCAF). The effective date of this new form requirement was on or about April 1, 2022. In April and May, while the PCAF process was in its infancy, two small assistance expenditures were charged to a Catholic Charities credit card. In our accounts payable file supporting the payment of these charges, one charge was supported by a PCAF, but the PCAF lacked an approval signature from an authorized supervisor. The second charge was not supported by a PCAF. In both instances, the credit card package was approved in total by an authorized supervisor and the grantor approved the drawdown package that included these expenditures without comment. We believe that these two instances were start up exceptions and not reflective of our compliance with the procedure on an ongoing basis. The procedures for processing charges to this grant have been fully implemented and the team that administers the TANF grant has been fully trained in the proper documentation procedures regarding documenting the PCAF. We are confident that this training is sufficient to ensure compliance with the documentation requirements of the grantor and that our training procedures for any future documentation changes will help ensure a smooth incorporation of new requirements.

Finding: An Administrative Review for Dierks School District was completed by the Arkansas Division of Elementary and Secondary Education, Child Nutrition Unit (DESE, CNU) in February 2022. The review noted the high school meal counts for breakfast and lunch were not consolidated and daily rosters for lunch at the elementary school were inaccurately counted on the January 2022 claim for reimbursement. This resulted in an under claim of $3,354 for breakfast and $12,494 for lunch. In addition, the review noted the District was talking lunch counts in the classroom prior to the lunch service rather than at the point of service. During our examination of the March and May 2022 claims for reimbursement, we noted the number of meals reported was overstated by 34 for breakfast and 42 for lunch resulting in a combined over claim of $280. The District will thoroughly review the data during the posting of monthly account eligibility reports and daily record forms to the monthly claim for reimbursement. Person responsible for the Corrective Action Plan: Kayla Jones Business Manager, Federal Programs Manager 870-286-2191, 227 Kayla.jones@dierksschools.org

2022-001: Missing Exit Counseling Documentation - Student Financial Aid Cluster - Assistance Listing #s 84.033, 84.007, 84.063, 84.268, 84.038 - Grant Period - Year Ended August 31, 2022 Condition: During our student file testing, we noted one student out of 40 did not have documentation in their file that exit counseling was sent thirty days after the student withdrew. We consider the missing exit counseling to be an instance of non-compliance with the Eligibility Compliance Requirement. Corrective Action Plan: Our office has updated the document letter template to automatically input the date of creation. The office will also ensure that the letters are generated promptly when informed of student withdrawal. The office will also periodically review withdrawn students to verify exit notification was sent. Responsible Person for Corrective Action Plan: Director- Marc Yambao Assistant Director- Josie Extrom Implementation Date of Corrective Action Plan: 10/27/2022

2. Finding 2022-002 a. Comments on the Finding and Each Recommendation The auditee is to provide a statement of concurrence or nonconcurrence with each finding. The auditee is also to provide a statement of agreement or disagreement with each recommendation in the finding. Management concurs that the move-in EIV was not run within 90 days of move in and that this is no in compliance with the requirement to maintain HUD tenant lease files per the HUD Handbook 4350.3. b. Action(s) Taken or Planned on the Finding The auditee should detail actions taken or planned to correct each finding identified in the report. Appropriate documentation should be submitted for actions taken. For planned actions, the auditee should provide the projected date for completion of all required action. The auditee should provide information on the task(s), subtask(s) and projected completion date(s) for the correction of the deficient condition and repayment of funds if appropriate. Officials responsible for completing the proposed task(s) and subtask(s) should also be identified. If the auditee believes a corrective action is not required, a statement describing the reasons should be included. Management staff have been trained on the requirements to run EIV reports in accordance with the HUD Handbook. Staff have included a note to file explaining the deficiency in the tenant file and will ensure that EIV reports are ran as required moving forward.

FINDING 2022-004 COMMENT: Under Uniform Guidance requirements, the County may charge only allowable costs incurred during the approved budget period of a federal award's period of performance and any costs incurred before the federal awarding agency or pass-through entity made the federal award that were authorized by the federal awarding agency or pass-through entity. Each individual project under this program has a specified work deadline, which may be extended at the discretion of FEMA. RESPONSE: The County has requested an extension related to the FEMA work, but as of the date of the report, the extension has not been approved. Effective June 26, 2023, Rett Daniels, Deputy County Administrator, and Sarah Sun, Budget Director, will continue to seek and obtain the proper extensions needed for the FEMA project in question.

Corrective Action Plan For the year ended September 30, 2022 U.S. Department of Housing and Urban Development: Housing Authority of the City of Salem respectfully submits the following corrective action plan for the year ended September 30, 2022. Auditor: Novogradac and Company, LLP Certified Public Accountants 1144 Hooper Avenue Suite 203 Toms River, New Jersey 08753 The findings from the September 30, 2022 schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. Federal Award Findings and Questioned Costs Finding 2022-001: Federal Agency: U.S. Department of Housing and Urban Development Federal Program Titles: Section 8 Housing Choice Vouchers Program Federal Catalog Numbers: 14.871 Noncompliance ? E. Eligibility ? Tenant Files Non Compliance Material to the Financial Statements: No Significant Deficiency in Internal Control over Compliance for Eligibility Criteria:Tenant Files. The PHA must do the following: As a condition of admission or continued occupancy, require the tenant and other family member to provide necessary information, documentation, and releases for the PHA to verify income eligibility (24 CFR sections 5.230, 5.609, and 982.516). These files are required to be maintained and available for examination at the time of audit. Condition: Based upon inspection of the Authority?s files and on discussion with management, there were documents that were unavailable for examination at the time of audit. Context: There are approximately 2,723 Section 8 Housing Choice Vouchers units and 123 Mainstream Vouchers units. Of a sample size of forty-seven (47) tenant files, the following was noted: ? Lead based paint form was missing in 14 files ? Annual inspection report was missing in 1 file Our sample size is statistically valid. Cause: There is a significant deficiency in internal controls over the compliance for the eligibility type of compliance related to the maintenance of tenant files. The Authority has not properly considered, designed, implemented, maintained and monitored a system of internal controls that assures the program is in compliance. Effect: The Section 8 Housing Choice Vouchers Program is in non-compliance with the eligibility type of compliance related to the maintenance of tenant files. Recommendation:We recommend the Authority design and implement internal control procedures that will assure compliance with the Uniform Guidance and the compliance supplement. Authority Response: The Authority accepts the recommendations of the auditor and has issued the following directives to staff in order to prevent future recurrence of similar issues: ? Administrative Advisory 2023-02 ? This Administrative Advisory requires staff, effective June 12, 2023, to obtain the Lead Based Paint (LBP) Disclosure form for any new leases / moves related to units built before 1978, as well as requiring staff to review files at annual recertification and request the LBP Disclosure form for those units built prior to 1978 as part of the recertification process. Using this method, all LBP disclosures shall be present in tenant files by the end of calendar year 2025 (SHA is moving to biennial recertifications as part of its Moving to Work Initiative). ? Administrative Advisory 2023-03 ? This Administrative Advisory directs staff to ensure that original applications and initial eligibility documentation are scanned when files are archived, or new volumes are created. Additionally, staff have been advised to pull the original application and initial eligibility forward into new volumes. If the original application and initial eligibility information are found to be incomplete or missing at the time the file is archived, staff have been instructed to document the file and replace the missing information with the best available documentation to demonstrate date of original application and that initial eligibility criteria were met. Due to the conditions of the COVID-19 pandemic, SHA was unable to contract a third party inspector to conduct inspections of units that it owns and operates, as required by HUD regulations. This led to a gap of more than 24 months between an initial inspection and a biennial inspection for a resident living in a SHA-owned unit. Inspections of SHA-owned units have since been completed under an agreement with a neighboring housing authority and will continue to be completed in accordance with HUD regulations and requirements going forward. Melanie Fletcher will be responsible to implement this corrective action by September 30, 2023.

2022-002 Internal Controls over Documentation in Tenant Files We will implement controls and procedures to ensure proper verification of tenant information and rent calculations are performed. We will also implement a review process to detect errors timely. Date of completion: Ongoing

Corrective Action Plan For the Year Ended September 30, 2022 Section II - Financial Statement Findings: None Reported Section III - Federal Award Findings and Questioned Costs Finding 2022-001 Name of Contact Person: Michael Best Executive Director Corrective Action: We will implement proper internal control procedures for the Public and Indian Housing program eligibility requirements. Proposed Completion Date: Immediately

Finding 2022-001 ? Special Tests and Provisions ? Enrollment Reporting (Student Financial Assistance Cluster) Contact Persons: Diana Dimas, Registrar?s Office Cristen Alecia, Office of Financial Assistance Current Status: Correction of this finding is in-progress. Anticipated Completion Date: December 31, 2023 Condition: The University of the Incarnate Word did not accurately or timely report student status changes to the NSLDS for 6 out of 60 students selected for testing. Identification of Repeat Finding: 2021-001, 2020-001, 2019-002 While the condition reported above is considered a repeat finding, it is important to note that the errors are different this year and that these findings are not a reflection of the university ignoring previous findings or failing to make changes, but rather a reflection of the complexity of enrollment reporting. There were no inaccurate or untimely attendance level changes, and the official withdrawals were reported accurately and timely. In this year?s errors, we had a student who graduated outside of a normal conferral date, causing them not to be reported during our normal degree conferral report to NSC. The Registrar?s Office is putting changes in place to either eliminate out-of-cycle conferrals, or increase the number of conferral and reporting dates to effectively capture all graduates. We know that only 6 students were caught up in this out-of-cycle graduation, as it was a specific exception for the School of Osteopathic Medicine, and is not a wide-spread issue. We had two unofficial withdrawals reported later than 60 days ? at 69 and 70 days. While the withdrawal and the changes were processed timely, the timing of the roster from NSLDS compared to the submission to NSC caused the report not to be acknowledged until after the 60 days had passed. The Office of Financial Assistance is researching the option of manually reporting unofficial withdrawals outside of the monthly reporting cycle in order to eliminate this problem. The Registrar?s Office will review the roster and NSC submission schedules to see if changes need to be made in order to better align reporting dates. We had three students inaccurately reported as withdrawn for the summer semester. These students were at least half-time in the preceding Spring and the following Fall, and therefore were not required to be reported as withdrawn. The Office of Financial Assistance and the Registrar?s Office will work together to research options in Banner and with NSC. It may be necessary to create a separate withdrawal code to identify summer withdrawals that should not be reported as withdrawn, and create a report to monitor the fall enrollment for these students in case they later withdraw from Fall and transition to a withdrawal which must be reported. The Banner system alone does not allow for the complicated logic mandated for summer reporting in the NSLDS Enrollment Reporting Guide. Our offices will continue to work in partnership to resolve these enrollment reporting issues. Cristen Alicea Director Office of Financial Assistance 210.805.1238 gimenez@uiwtx.ed www.uiw.edu/finaid Diana Dimas Associate Registrar Registration and Technology Office of the Registrar 210.832.5484 dimasd@uiwtx.edu www.uiw.edu

CORRECTIVE ACTION PLAN Project Legal Name: Catherine Booth Towers Orlando, FL (? Project of Catherine Booth Residence, Inc., a Florida Corporation) HUD Project No.: 067-EE054-WAH Audit Firm: CohnReznick LLP Period covered by the audit: 10/1/2021-9/30/2022 Corrective Action Plan prepared by: Name: Sriparna Mitra Position: HUD Specialist, THQ (Legal) Telephone Number: 404-728-6700 A. Current Findings on the Schedule of Findings, Questioned Costs and Recommendations 1. Finding 2022-001 a. Comments on the Finding and Each Recommendation The auditee agrees with the finding. The late completion of the audits for fiscal years 2020 and 2021 has contributed to management not getting the budgets for the new fiscal years submitted and approved by HUD timely. As a result, management did not have access to the EIV system for a period of time so that they could verify income. This issue is anticipated again in fiscal year 2023 because of the late submission of the fiscal year 2022 budget which required the fiscal year 2021 actual data. b. Action(s) Taken or Planned on the Finding The late completion of our audits for fiscal years 2020 and 2021 has contributed to our not getting our budgets for the new fiscal years submitted and approved timely. Therefore, Management did not have access to the Enterprise Income Verification (EIV) system [the system used to access Social Security information and Health and Human Service information] for a period of time so that they could verify income. This issue is anticipated again in fiscal year 2023 because of the late submission of the fiscal year 2022 budget which required the fiscal year 2021 actual data. Steps are being taken to have the fiscal year 2022 audit completed in a reasonable timeframe, and we do not anticipate the same problem going forward. B. Status of Corrective Actions on Findings Reported in the Schedule of the Status of Prior Year Findings, Questioned Costs and Recommendations 1. 2021-001 In process. See finding 2022-001. 2. 2021-002 Cleared.

Findings: 2022-001 MISSISSIPPI FOOD NETWORK Name of Responsible Official: Theodora Ann Rowan, Director of Accounting/Information Technology Anticipation Completion Date: 06/30/2023 Network's Response: The Network plans to enhance an existing internal control to ensure the agency files are complete with all the required documentation. The Accounting Department will perform a quarterly review of the files on a rotation basis. Subsequent to June 30, 2022, the Network hired a new Director of Accounting/Information Technology who will be responsible for this internal control.

Finding No. 2022-002 Enrollment reporting Cluster: Student Financial Assistance Cluster Grantor: Department of Education Award Name: Federal Direct Student Loans Award Year: July 1, 2021 ? June 30, 2022 Award Number: Not applicable Assistance Listing Number: 84.268 The College agrees with the finding noting that this exception is an unusual occurrence as a result of improper recording of the leave status in Colleague, the student information system. The record in Colleague should have had hiatus data entered on April 11, 2022, the date in which the College was aware of the student?s enrollment change, which would allow the change in enrollment information to be queried and transmitted to the National Student Clearinghouse (?NSC?) in in the May 17, 2022 submission. As this hiatus data was not updated, the student?s enrollment record was reported as enrolled at that time, which is attributed to an error in data entry of the multiple fields required in Colleague to reflect a leave from the College. The student?s transcript was correctly marked as ?W? as of April 8, 2022. However, the effective date was not correctly reported to the NSLDS. Management is in the process of correcting the effective date reporting to the NSLDS. The College has since implemented Workday Student, the College?s new student information system, in August of 2022. New business processes for entering student leaves have been documented and staff have been trained. The Office of Student Affairs initiates the leave process and a system process prompts records, financial aid, and billing to review the student record. The leave is updated within the student information system once all of the relevant offices have completed their processing. Training was done as a part of the implementation and testing process. The NSC enrollment reporting in Workday is automated. Jesse Barba, Director of Institutional Research and Registrar Services, is responsible for the implemented corrective action plan.

CORRECTIVE ACTION PLAN Volunteer Homes for Elderly, Inc. respectfully submits the following corrective action plan for the year ended September 30, 2022. Purkey, Carter, Compton, Swann, & Carter, PLLC PO. Box 727 Morristown, Tennessee 37815 Audit period: October 1, 2021 - September 30, 2022 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. Section A of the schedule, Summary of Audit Results, does not include findings and is not addressed. FINDINGS-FINANCIAL STATEMENT AUDIT None Finding No. 2022 ? 003: Ineffective oversight and operation of internal controls over compliance by management Volunteer Homes for Elderly, Inc's managers did not follow all HUD requirements when going through the tenant recertification process. The tenant files tested for internal controls over compliance contained multiple deficiencies including missing copy of social security card in order to verify social security number; missing income verification; missing Ethnic and Racial Data conformation; incorrect calculation of tenant assets; incorrect income used on HUD Form 50059, and missing tenant signature and date on Resident Rights and Responsibilities acknowledgment. Criteria: According to HUD Handbook 4350.3: 1. All applicant and tenant household members must disclose and provide verification of the complete and accurate social security number assigned to them except for those individuals who do not contend eligible immigration status. Owners must include verification documentation in the tenant file. Owners must gather data about the race and ethnicity of applicants and tenants so that HUD can easily spot possible discrimination, track racial or ethnic concentrations, and focus enforcement actions on owners with racially or ethnically identifiable properties. 4. Owners must verify all income assets, expenses, deductions, family characteristics, and circumstances that affect family eligibility or level of assistance: for savings accounts, use the current balance and for checking accounts. use the average balance for the last six months. 5. Annual income is defined as all amounts anticipated to be received from a source outside the family during the 12?month period following admission or annual recertification and owner calculates projected annual income by annualizing current income. 6. Owners must provide applicants and tenants with a copy of the Resident Rights and Responsibilities brochure at move-in and annual recertification and all family members at least 18 years of age must acknowledge receipt of brochure by signing and dating the acknowledgement. Cause of Condition: The management agent did not have systems in place to ensure managers know of and are complying with ail HUD requirements pursuant to the HUD Handbook 4350.3. Recommendation: Auditor recommends management review HUD Handbook 4350.3 and put proper procedures in place to ensure managers know of applicable HUD requirements and are complying with HUD requirements. Action Taken: Management agent will provide additional training on HUD requirements to managers during their annual manager's training and implement procedures to ensure managers are complying with requirements pursuant to' HUD Handbook 4350.3.

B J ENTERPRISES, INC. CORRECTIVE ACTION PLAN SEPTEMBER 30, 2022 REFERENCE: 2022-101 REPEAT FINDING REFERENCE: 2021-001 CFDA NUMBER: 10.558 ? CHILD AND ADULT CARE FOOD PROGRAM U.S. DEPARTMENT OF AGRICULTURE - FOOD AND NUTRITION - 2022 PASSED THROUGH ARIZONA STATE DEPARTMENT OF EDUCATION GRANT NUMBER 6AZ300003 CLIENT RESPONSE AND CORRECTIVE ACTION PLAN We concur with the condition. 1. Name of the contact person responsible for corrective action: Katie O'Neill, Director 2. Corrective action planned: a. For 2 of 40 providers files tested, menus were clerically inaccurate and did not support the meals claimed. The Area Coordinators will be retrained to double check their meal counting on their menus at least once before they submit their meal counts and one time after they submit their meal counts. See BJ Enterprises Procedures for Reading Menus, Section D, #6. b. For 1 of 40 provider files tested, meals were claimed for the provider's own child, when the provider was not eligible for free/reduced price meals. The menu reader must use the most current "Claiming Own" report while they are menu reading. The income applications have to be approved by the Assistant Director or Director prior to the menus being read. The menu reader will use this list, as well as the Master List when reading the menus. The Area Coordinators will be retrained to ensure that the provider who is claiming their own children qualify to do so. See BJ Enterprises Procedures for Reading Menus, Section C, #5. c. For 2 of 40 provider files tested meals were claimed when the provider's children were the only children present. This occurred when the day care children were disallowed. The Area Coordinators will be re-trained to disallow the day care providers own children when meals are disallowed for all of the day care children. See BJ Enterprises Procedures for Reading Menus, Section C, #5. d. For 1 of 40 provider files tested, meals were claimed outside of the current claim month. The Area Coordinators will be re-trained to disallow meals on the front end or the back end of the month. See BJ Enterprises Procedures for Reading Menus, Section B, #2. e. For 1 of 40 provider files tested, meals were claimed when the child was not indicated as being present for the meal. The times in and out were not on the day that was claimed. The Area Coordinators will be re-trained to disallow meals when the time in and outs are not written on the menu. See 8 J Enterprises Procedures for Reading Menus, Section C, #4. f. For 1 of 40 provider files tested, meals were claimed when no menu components were listed on the menu. The Area Coordinators will be re-trained to disallow meals when thy have no components listed on the menu. See BJ Enterprises Procedures for Reading Menus, Section B, #3. All of the menu mistakes were on paper menus. We are encouraging everyone to start claiming on computerized menus (KidKare) because there are less or no mistakes on those menus. 3. Anticipated completion date: June 30, 2023

Finding 2022-1 a. Comments on the Finding and Each Recommendation Management agrees with the finding. b. Action(s) Taken or Planned on the Finding In 2022 we hired additional oversight staff at the corporate level and changed the procedure for reviewing and approving annual certifications as well as monitoring EIV reporting. We have implanted new EIV procedures to ensure

Action taken in response to finding: After management was re-notified of the reporting errors in the HEERF reports on the college website, management has decided to completely reorganize the college webpage for HEERF reports. This will allow management and the reader to better understand the spending history of institutional and student portions of these grants. When the website is reorganized, quarterly reports will be reviewed and verified that student data is verified and reported correctly in the narrative of the reports. Name(s) of the contact person(s) responsible for corrective action: Ms. Karen Pelton, Mr. Timothy League and Mr. John Gay. Planned completion date for corrective action plan: Adjustments to the website and the review and correction of these reports, if needed, is currently in process and is expected to be completed no later than January 31, 2023.

2022-001 Sufficient documentation of eligibility not maintained for all items selected for testing. Contact Person Trisha Braswell Anticipated Completion Date 12/31/2023 Action Plan: Due to large turnover in staff at the front desk , we were not able to fully correct this finding this year. The Clinic Manager will ensure all new staff are trained and that it is part of the of the orientation.