Corrective Action Plans

Finding 45687 (2022-003)

Significant Deficiency 2022

Blackburn University Dba Blackburn College

IL

Questioned Costs Student Financial Aid Cash Management

Condition: Two of the 40 student files (5%) we examined, we noted the students were not properly awarded Direct loans. Further, we noted two of the 40 students (5%) were not properly awarded Pell. Corrective Action Plan: It is important to note that the entire 2021/2022 award year was processed by 3...

Condition: Two of the 40 student files (5%) we examined, we noted the students were not properly awarded Direct loans. Further, we noted two of the 40 students (5%) were not properly awarded Pell. Corrective Action Plan: It is important to note that the entire 2021/2022 award year was processed by 3rd party servicer, Fully Disbursed. The current Financial Aid staff at Blackburn College started in October of 2021 but the processing was conducted by Fully Disbursed as they were under contract with Blackburn College for all 2021-2022 processing and packaging until August 2022 at the completion of the summer semester. The Financial Aid Office at Blackburn has evaluated and revised policies and procedures to ensure students receive the proper amount of Title IV Aid. Reconciling each month is necessary to ensure we catch any and all discrepancies that may occur. We will continue to utilize all available software to assist with packaging and that will allow all financial aid, including Title IV funds, to be reviewed frequently by both the Director of Financial Aid and the Assistant Director of Financial Aid. Responsible Person for Correction Action Plan: Alexis Brown, Director of Financial Aid Implementation Date for Corrective Action Plan: April 2023

View Audit 40629 Questioned Costs: $1

Finding 45683 (2022-009)

Significant Deficiency 2022

Community College of Beaver County

PA

Student Financial Aid Eligibility Significant Deficiency

Finding 2022-009: Eligibility-Significant Deficiency and Noncompliance Condition: For three of the twenty-five students selected for testing, the Pell Award calculation was not correctly performed, and the students did not receive an adequate amount of Pell Award for the period under audit. Responsi...

Finding 2022-009: Eligibility-Significant Deficiency and Noncompliance Condition: For three of the twenty-five students selected for testing, the Pell Award calculation was not correctly performed, and the students did not receive an adequate amount of Pell Award for the period under audit. Responsible for the Plan: Janet Davidson, Director of Financial Aid Planned completion date: June 30, 2023 Corrective Action Plan: To ensure compliance with eligibility requirements the college will adopt the following procedure: ? The Financial Aid Assistant/Loan Officer will review the daily registration changes report to determine the students enrollment status for each term and then set the appropriate class load in Powerfaids in the POE screen. ? Powerfaids uses that class load screen and the Pell payment schedules to determine the students pell grant award. ? The Director of Financial Aid will work with IT/IR to create a report that details the pell load in Powerfaids to match it against current credit load in Jenzabar to ensure that the student has the appropriate credit load in Powerfaids and the appropriate Pell awards are disbursed.

View Audit 52943

Finding 45645 (2022-001)

Significant Deficiency 2022

The Carmelite System, Inc.

NY

Internal Control / Segregation of Duties Procurement, Suspension & Debarment Eligibility

Management agrees that they submitted the same invoice twice. The amount of the invoice was $700. They also believe that there were many expenses incurred of which they could have submitted and therefore have not used the grant monies inappropriately. We agree that a more in-depth review could be do...

Management agrees that they submitted the same invoice twice. The amount of the invoice was $700. They also believe that there were many expenses incurred of which they could have submitted and therefore have not used the grant monies inappropriately. We agree that a more in-depth review could be done for future submissions.

View Audit 51311

Finding 45638 (2022-001)

Significant Deficiency 2022

Community Housing Ii, Inc. the Maples II Apartments

OR

HUD Housing Programs Eligibility

Finding 2022-001 ? Federal Assistance Listing Number 14.157 Statement of Condition: In connection with our lease file review, we noted: 1. One instance of one tenant tested where management did not maintain move-out inspection forms in the lease file. 2. One out of one tenant tested income verifi...

Finding 2022-001 ? Federal Assistance Listing Number 14.157 Statement of Condition: In connection with our lease file review, we noted: 1. One instance of one tenant tested where management did not maintain move-out inspection forms in the lease file. 2. One out of one tenant tested income verification was not performed with the use of the HUD enterprise Income Verification ("EIV") or other verification methods. 3. One out of two tenants tested recertification was not performed timely. Corrective Action: Due to either tenant non-compliance or challenges with scheduling meetings with tenants or obtaining verifications, some recertifications were completed late. REACH has policies in place to complete recertifications timely, and will be providing ongoing training and guidance to staff to make sure the policies are being followed. Management has a policy for conducting move-out inspections and completing the move-out form, and will review this policy and procedure with staff to make sure it?s followed on all move-outs.

View Audit 47415

Finding 45630 (2022-003)

Significant Deficiency 2022

Marion Street Apartments, Inc.

OR

HUD Housing Programs Eligibility

Finding No. 2022-003; Federal Assistance Listing Number 99.999 Statement of Condition: In connection with our lease file review we noted that one out of two tenants tested did not have income verification in connection with the preparation of the recertification. Corrective Action: Due to either ten...

Finding No. 2022-003; Federal Assistance Listing Number 99.999 Statement of Condition: In connection with our lease file review we noted that one out of two tenants tested did not have income verification in connection with the preparation of the recertification. Corrective Action: Due to either tenant non-compliance or challenges with scheduling meetings with tenants or obtaining verifications, some recertifications were completed late. REACH has policies in place to complete recertifications timely, and will be providing ongoing training and guidance to staff to make sure the policies are being followed.

View Audit 47410

Finding 45615 (2022-004)

None 2022

Wingate University

NC

Student Financial Aid Eligibility Internal Control / Segregation of Duties

Name of Responsible Individual: Jenn Hall, Director of Financial Planning Corrective Action: The Financial Planning Office has reviewed its policies surrounding FSEOG awarding and added additional quality control measures for the 2022-2023 award cycle so that FSEOG funding is provided solely to PE...

Name of Responsible Individual: Jenn Hall, Director of Financial Planning Corrective Action: The Financial Planning Office has reviewed its policies surrounding FSEOG awarding and added additional quality control measures for the 2022-2023 award cycle so that FSEOG funding is provided solely to PELL recipients. Anticipated Completion Date: December 31, 2022

View Audit 44558

Finding 45583 (2022-007)

Material Weakness 2022

Department of Human Services

HI

Questioned Costs Eligibility HUD Housing Programs

Finding No. 2022 007: Special Tests and Provisions (Material Weakness) Federal Agency: U.S. Department of Agriculture AL Number and Title: 10.551, 10.561, and COVID 19 ? 10.561 ? Supplemental Nutrition and Assistance (?SNAP?) Cluster Award Number and Award Year: 7HI4004HI, 7HI400HI4, 7HI430HI4, 7...

Finding No. 2022 007: Special Tests and Provisions (Material Weakness) Federal Agency: U.S. Department of Agriculture AL Number and Title: 10.551, 10.561, and COVID 19 ? 10.561 ? Supplemental Nutrition and Assistance (?SNAP?) Cluster Award Number and Award Year: 7HI4004HI, 7HI400HI4, 7HI430HI4, 7HI400HI5, 7HI430HI5, 7HI460HI6, 227HIHI7F1003 Condition During our audit, we selected a non statistical sample of 60 participant files which approximated $50,000 in monthly payments, out of a population of approximately 195,000 participant files which approximated $986 million in total annual benefit payments, for testing and noted exceptions in three case files as follows: ? One case file where manually entered unearned income and medical expense deduction amounts did not agree with the documentation retained in the participant?s case file. ? Two case files where manually entered income information did not agree with the documentation retained in the respective participant?s case files. Views of Responding Officials: The Department agrees with the finding and will implement corrective action. Corrective Action Taken of Planned: Remind eligibility staff to ensure that verification submitted by the household and filed in household?s electronic case folder (ECF) along with documentation on cases through DHS 1006 and/or case notes are consistent with what is processed and recorded in the eligibility system - HAWI, and that processing is completed according to Supplemental Nutrition and Assistance Program (SNAP) policy to ensure that households are receiving the maximum amount of benefits they are eligible to receive. The SNAP office would also coordinate with the Staff Development Office to put an extra emphasis on this area when conducting SNAP basic training for new eligibility workers. Expected Completion Date: September 30, 2023 Responding Official: Manuel Banasihan, Benefit, Employment, and Support Services Division Supplemental Nutrition and Assistance Program Administrator

View Audit 51705 Questioned Costs: $1

Finding 45576 (2022-002)

Material Weakness 2022

Department of Human Services

HI

Questioned Costs Eligibility

Finding No. 2022 002: Special Tests and Provisions (Material Weakness) Federal Agency: Department of Health and Human Services AL Number and Title: 93.777, 93.778, and COVID 19 ? 93.778 ? Medicaid Cluster Award Number and Award Year: 2105HIMAP, 2205HIMAP, 2105HIADM, 2205HIADMN Condition During our ...

Finding No. 2022 002: Special Tests and Provisions (Material Weakness) Federal Agency: Department of Health and Human Services AL Number and Title: 93.777, 93.778, and COVID 19 ? 93.778 ? Medicaid Cluster Award Number and Award Year: 2105HIMAP, 2205HIMAP, 2105HIADM, 2205HIADMN Condition During our audit, we selected a non statistical sample of 60 providers for testing out of a population of approximately 1,800 providers. The providers selected for testing represented approximately $21 million of payments out of a total payment population of $223 million. The results of our testing were as follows: ? Four providers where the DHS Form 1139 was not maintained. ? Eight providers where the DHS Form 1139 did not support revalidation within the most recent five year period. Views of Responding Officials The Department agrees with the finding and will implement corrective action. Corrective Action Taken or Planned The conversion to the HOKU online provider enrollment system in 2020, the staffing and workload impacts of the COVID 19 public health emergency and the inability to fill key provider enrollment section positions have combined to tax the ability of the Department to come into compliance with the stated criteria. These factors have created backlogs in the processing turnaround time for new provider enrollment applications that have been submitted by providers and are waiting to be processed by the Department. These factors have also hampered the Department?s efforts to timely outreach with providers who are at/over the five-year revalidation threshold. The Department was able to fill the section administrator over the provider enrollment section in June 2022, and also fill a key contract specialist position in August 2022. The Department entered into a new provider enrollment staff augmentation contract with Maximus effective January 1, 2023, and initial vendor performance has been promising. New provider enrollment processing time has been reduced to no more than ten days for certain provider types, and Maximus is on track to eliminate the existing provider enrollment application backlog by the third quarter of 2023. The Department is expecting these changes to result in full compliance with the stated criteria by the end of 2023. Expected Completion Date December 31, 2023 Responding Officials Jon Fujii, MED Quest Division Health Care Services Branch Administrator

View Audit 51705 Questioned Costs: $1

Finding 45552 (2022-001)

Significant Deficiency 2022

Mountaineer Community Health Center, INC

WV

Special Tests & Provisions Eligibility HUD Housing Programs

#2022-001 Sliding Fee Discounts Documentation U.S. Department of Health and Human Services Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) AL #93.224 Grants for New and Expanded Se...

#2022-001 Sliding Fee Discounts Documentation U.S. Department of Health and Human Services Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) AL #93.224 Grants for New and Expanded Services Under the Health Center Program AL #93.527 Recommendation: We recommend the Center provide training to employees to ensure that the sliding fee discounts are being properly applied, supported, and documented. In addition, we recommend the employees administering the sliding fee discounts be properly monitored and supervised to ensure compliance with program documentation. Action Taken: The Mountaineer Community Health Center, Inc.'s management will take the necessary steps to ensure that the sliding fee discounts are being properly applied and documented to support the determination of adjustments to patient charges. Ciro Grassi, Chief Executive Officer is responsible for implementing these procedures by December 31, 2022.

View Audit 46213

Finding 45528 (2022-011)

Material Weakness 2022

Department of Human Services

HI

Questioned Costs Eligibility

Finding No. 2022 011: Eligibility (Material Weakness) Federal Agency: U.S. Department of Health and Human Services AL Number and Title: 93.558 and COVID 19 ? 93.558 ? Temporary Assistance for Needy Families Award Number and Award Year: 1601HITAN3, 2001HITANF, 2101HITANF, 2201HITANF, 2021G990228 Co...

Finding No. 2022 011: Eligibility (Material Weakness) Federal Agency: U.S. Department of Health and Human Services AL Number and Title: 93.558 and COVID 19 ? 93.558 ? Temporary Assistance for Needy Families Award Number and Award Year: 1601HITAN3, 2001HITANF, 2101HITANF, 2201HITANF, 2021G990228 Condition We selected a non statistical sample of 60 participant files, representing approximately $39,000 of benefit payments, out of a population of approximately 8,700 cases, representing approximately $17.8 million of benefit payments, for testing and noted exceptions in 17 case files as follows: ? Nine case files where eligibility redeterminations were not completed in the timeframe required by the State Plan. ? Seven case files where there was no evidence of a TANF case worker?s signature on the eligibility redetermination form. ? One case file where the interview process was not conducted within the forty-five (45) day timeframe required by the State Plan. Views of Responding Officials: The Department agrees with the finding and will implement corrective action. Corrective Action Taken or Planned: Administration for Children and Families (?ACF?) will be notified in writing, within the required timeframe, if additional amendments will be or are made to the current Temporary Assistance for Needy Families State Plan. Expected Completion Date: On-going Responding Official: Catherine Scardino, Benefit, Employment, and Support Services Division Temporary Assistance for Needy Families Program Administrator

View Audit 51705 Questioned Costs: $1

Finding 45527 (2022-010)

Material Weakness 2022

Department of Human Services

HI

Questioned Costs Eligibility

Finding No. 2022 010: Special Tests and Provisions (Material Weakness) Federal Agency: U.S. Department of Health and Human Services AL Number and Title: 93.558 and COVID 19 ? 93.558 ? Temporary Assistance for Needy Families Award Number and Award Year: 1601HITAN3, 2001HITANF, 2101HITANF, 2201HITA...

Finding No. 2022 010: Special Tests and Provisions (Material Weakness) Federal Agency: U.S. Department of Health and Human Services AL Number and Title: 93.558 and COVID 19 ? 93.558 ? Temporary Assistance for Needy Families Award Number and Award Year: 1601HITAN3, 2001HITANF, 2101HITANF, 2201HITANF, 2021G990228 Condition We selected a non statistical sample of 60 case files for testing and noted 11 instances where the Department?s records did not support the use of the income information obtained through Income Eligibility and Verification System (?IEVS?) to evaluate or re-evaluate the benefit calculation. Views of Responding Officials: The Department agrees with the finding and will implement corrective action. Corrective Action Taken of Planned: It was noted in the Corrective Action Plan, in response to the State fiscal year 2021 audit finding, the DHS 1006 form, ?Eligibility Documentation? (formerly titled ?Interview Documentation?), was revised to require the eligibility of staff to notate the date the Income Eligibility and Verification System (IEVS) query was completed, the findings, and what information was used for eligibility determinations. However, for most of the State fiscal year 2022, the interview requirement for new applicants and annual recertifications for recipients were waived; therefore, the DHS 1006 form was not utilized. Form DHS 1006 will be revised further to create IEVS query fields specifically under Section IX ? Temporary Assistance for Needy Families (TANF) Requirements, and a policy clarification will be issued to remind staff of the IEVS query requirement and instructions on how to complete the DHS 1006 form. Expected Completion Date: September 30, 2023 Responding Official: Catherine Scardino, Benefit, Employment, and Support Services Division Temporary Assistance for Needy Families Program Administrator

View Audit 51705 Questioned Costs: $1

Finding 45525 (2022-004)

Material Weakness 2022

Department of Human Services

HI

Questioned Costs Eligibility

Finding No. 2022 004: Special Tests and Provisions (Material Weakness) Federal Agency: Department of Health and Human Services AL Number and Title: 93.767 ? State Children?s Health Insurance Program Award Number and Award Year: 2105HI5022 Condition During our audit, we selected a non statistical s...

Finding No. 2022 004: Special Tests and Provisions (Material Weakness) Federal Agency: Department of Health and Human Services AL Number and Title: 93.767 ? State Children?s Health Insurance Program Award Number and Award Year: 2105HI5022 Condition During our audit, we selected a non statistical sample of 60 providers for testing out of a population of approximately 1,800 providers. The providers selected for testing represented approximately $240,000 of payments out of a total payment population of $7.2 million. The results of our testing were as follows: ? Four providers where the DHS Form 1139 was not maintained. ? Eight providers where the DHS Form 1139 did not support revalidation within the most recent five year period. Views of Responding Officials The Department agrees with the finding and will implement corrective action. Corrective Action Taken or Planned The conversion to the HOKU online provider enrollment system in 2020, the staffing and workload impacts of the COVID 19 public health emergency and the inability to fill key provider enrollment section positions have combined to tax the ability of the Department to come into compliance with the stated criteria. These factors have created backlogs in the processing turnaround time for new provider enrollment applications that have been submitted by providers and are waiting to be processed by the Department. These factors have also hampered the Department?s efforts to timely outreach with providers who are at/over the five-year revalidation threshold. The Department was able to fill the section administrator over the provider enrollment section in June 2022, and also fill a key contract specialist position in August 2022. The Department entered into a new provider enrollment staff augmentation contract with Maximus effective January 1, 2023, and initial vendor performance has been promising. New provider enrollment processing time has been reduced to no more than ten days for certain provider types, and Maximus is on track to eliminate the existing provider enrollment application backlog by the third quarter of 2023. The Department is expecting these changes to result in full compliance with the stated criteria by the end of 2023. Expected Completion Date December 31, 2023 Responding Officials Jon Fujii, MED Quest Division Health Care Services Branch Administrator

View Audit 51705 Questioned Costs: $1

Finding 45522 (2022-002)

Material Weakness 2022

Urban Redevelopment Authority of Pittsburgh

PA

Eligibility HUD Housing Programs Internal Control / Segregation of Duties

Finding 2022-002: HOME Investment Partnerships Program ? Eligibility Requirements U.S. Department of Housing and Urban Development, Passed through the City of Pittsburgh ? Assistance Listing Number 14.239, Grant #MC-42-0501 Questioned Costs: Unknown Condition: During 2022, the URA did not have in...

Finding 2022-002: HOME Investment Partnerships Program ? Eligibility Requirements U.S. Department of Housing and Urban Development, Passed through the City of Pittsburgh ? Assistance Listing Number 14.239, Grant #MC-42-0501 Questioned Costs: Unknown Condition: During 2022, the URA did not have internal controls in place to ensure all Tenant Income Certification forms were reviewed for existing HOME projects. The URA?s current process is supposed to be that external property managers prepare the forms and the URA obtains the forms from the external property managers to review the forms to ensure the HOME projects are in compliance with the eligibility requirements. We reviewed a sample of Tenant Income Certification forms and noted that for one existing HOME project the Tenant Income Certification forms were not obtained by the URA during 2022 and for one HOME project the forms were obtained and in compliance but not signed. In conjunction with the audit, the URA obtained the forms from the one HOME project from the external property managers, and we noted that the forms reviewed were in compliance with the eligibility requirements. Action: The URA is updating its policies and procedures for its annual certification of tenant income and rent compliance for HOME-assisted projects. With the revamped policies and procedures and updated project information, we will be able to complete the annual compliance in a more timely and efficient manner. The URA will complete the remaining tenant income certifications before the end of the calendar year.

View Audit 51169

Finding 45505 (2022-002)

Material Weakness 2022

Detroit Housing Commission

MI

Questioned Costs HUD Housing Programs Subrecipient Monitoring

Finding Number: 2022-002 Condition: Participant files selected for testing did not include complete information to support participant eligibility Planned Corrective Action: Staff will be retrained on the compliance requirements under the standards of the HCV Program through the oversight of the Ren...

Finding Number: 2022-002 Condition: Participant files selected for testing did not include complete information to support participant eligibility Planned Corrective Action: Staff will be retrained on the compliance requirements under the standards of the HCV Program through the oversight of the Rental Assistance Department Manager and Continued Occupancy Supervisor. The Department Manager and Supervisor will continue to utilize all Yardi monitoring reports to ensure the Department is operating in accordance with industry standards. Reporting will be done and monitored monthly to meet set goals. We know and maintain we will work in accordance with HUD rules and regulations where Annual Recertification processes are concerned. Weekly, Department Manager will review the certification pipeline to ensure compliance and follow up with the Housing Specialist to ensure compliance and meeting set weekly and monthly goals and metrics. Contact person responsible for corrective action: Felicia Burris, HCV Program Manager Anticipated Completion Date: 6/30/2023

View Audit 45566 Questioned Costs: $1

Finding 45504 (2022-001)

Material Weakness 2022

Detroit Housing Commission

MI

HUD Housing Programs Subrecipient Monitoring Eligibility

Finding Number: 2022-001 Condition: DHC did not complete fiscal year 2022 recertification. Planned Corrective Action: Staff will be retrained on the compliance requirements under the standards of the HCV Program through the oversight of the Rental Assistance Department Manager and Continued Occupanc...

Finding Number: 2022-001 Condition: DHC did not complete fiscal year 2022 recertification. Planned Corrective Action: Staff will be retrained on the compliance requirements under the standards of the HCV Program through the oversight of the Rental Assistance Department Manager and Continued Occupancy Supervisor. The Department Manager and Supervisor will continue to utilize all Yardi monitoring reports to ensure the Department is operating in accordance with industry standards. Reporting will be done and monitored monthly to meet set goals. We know and maintain we will work in accordance with HUD rules and regulations where Annual Recertification processes are concerned. Weekly, Department Manager will review the certification pipeline to ensure compliance and follow up with the Housing Specialist to ensure compliance and meeting set weekly and monthly goals and metrics. Contact person responsible for corrective action: Felicia Burris, HCV Program Manager Anticipated Completion Date: 6/30/2023

View Audit 45566

Finding 45502 (2022-004)

Significant Deficiency 2022

Detroit Housing Commission

MI

Questioned Costs HUD Housing Programs Cash Management

Finding Number: 2022-004 Condition: Participant files selected for testing did not include complete information to support participant eligibility Planned Corrective Action: While the Detroit Housing Commission works towards implementing Rent Cafe, an electronic platform to allow applicants, residen...

Finding Number: 2022-004 Condition: Participant files selected for testing did not include complete information to support participant eligibility Planned Corrective Action: While the Detroit Housing Commission works towards implementing Rent Cafe, an electronic platform to allow applicants, residents, and Management the ability to streamline the continued occupancy and eligibility process, DHC will continue to utilize the manual application process with the following controls in place: 1. There will be ongoing training to support staff in Public Housing Rent Calculation. Within the designated training, Housing Specialists, Property Managers, Assistant Property Managers and Compliance Specialists will focus on correctly calculating subsidy for applicants and residents. Trainings will include but are not limited to properly identifying and verifying income, expenses, allowances, adjusted income, total tenant payment (TTP), utility standards, PHA payment and subsidy standards. 2. Regional Managers will conduct the first line of quality control file reviews. Upon Housing Specialist, Property Manager and Assistant Property Manager's completing Initial Eligibility, Annual and Interim recertifications, Regional Managers will review the proposed certification against the certification's checklist for approval. 3. The Compliance Department will conduct ongoing Quality Control File Reviews on a 10% sample selection of households to ensure timely completion and accuracy of ongoing participant rent determination. a. When deficiencies are identified during a Quality Control review, site staff will have 7 days to cure and upload the corrective file to SharePoint. b. The final quality control review will also include reconciliation for acceptance of the electronic file to PIC. 4 . To address the incorrect utility allowance amounts being utilized to calculate tenant rent, the following will occur: a. DHC's REM Department will work with DHC's IT Department of update the Utility Allowance tables in the housing's Yardi Software. Current utility allowances will be entered in the software's utility allowance table and will prepopulate based on the action type and effective date of the recertification. b. Site staff will include the printed utility allowance chart within the certification with the allowance amount provided clearly identified for review by the Regional Manager when conducting the first line of quality control file review. Contact person responsible for corrective action: Scharre Leslie, Operations Analyst & Compliance Manager Anticipated Completion Date: 6/30/2023

View Audit 45566 Questioned Costs: $1

Finding 45444 (2022-002)

None 2022

Health Opportunities for the People of East Texas, Inc.

TX

Eligibility HUD Housing Programs

Item 2022-002: Compliance with Client Placement on the Sliding Fee Scale for the Health Center Cluster Program Implementation of Phreesia software will flag any placement discrepancies. Front Desk Staff has completed and signed off of an intensive two-week training. All front desk has been properly ...

Item 2022-002: Compliance with Client Placement on the Sliding Fee Scale for the Health Center Cluster Program Implementation of Phreesia software will flag any placement discrepancies. Front Desk Staff has completed and signed off of an intensive two-week training. All front desk has been properly trained and will have ongoing and refresher training as needed. Front Desk Staff are required to check their work at the end of the day. We have a dedicated staff member who double checks each SFS registration. The corrected registration packet is returned to the corresponding Office Manager who reviews the corrections with the Front Desk staff member. The Front Desk staff member will make the noted corrections themselves. Front Desk will experience disciplinary action for continued incorrect placements such as write ups, or termination. We conduct an Eligibility Audit on a monthly basis. A report consisting of errors by facility as well as the employee responsible for the errors will be given to office managers and key administrative staff. The information collected is reported during our monthly CPI Committee meetings. Estimated Completion Date: Ongoing Responsible Party Contact Information: Jolene Busby Jbusby@hcmtx.org 936-591-8380 Ext 109

View Audit 50067

Finding 45368 (2022-003)

Significant Deficiency 2022

Madonna University

MI

Student Financial Aid Eligibility Significant Deficiency

Finding Number: 2022-003 Condition: The University could not provide records to substantiate that the relevant criteria was complied with by the University in all cases. Planned Corrective Action: Train faculty to preserve and provide documentation related to reported last dates of attendance. This ...

Finding Number: 2022-003 Condition: The University could not provide records to substantiate that the relevant criteria was complied with by the University in all cases. Planned Corrective Action: Train faculty to preserve and provide documentation related to reported last dates of attendance. This will be stored in the university?s enterprise document management system. Contact person responsible for corrective action: Dina DuBuis, Ann Elinski Anticipated Completion Date: February 15, 2023

View Audit 50091

Finding 45349 (2022-002)

Significant Deficiency 2022

The Chidlren's Clinic, Serving Children and Their Families

CA

Questioned Costs Allowable Costs / Cost Principles Eligibility

Response to 2022-002 We agree there were errors in the calculation of lost revenue. The PRF guidance on reporting changed/updated several times over the course of 2 years and some requirements were missed right before the reporting was due. However, the organization?s eligibility did not change an...

Response to 2022-002 We agree there were errors in the calculation of lost revenue. The PRF guidance on reporting changed/updated several times over the course of 2 years and some requirements were missed right before the reporting was due. However, the organization?s eligibility did not change and the funded amount was fully supported by the actual loss of revenue calculation required by DHHS. Management will closely monitor future grant reporting. Contact person responsible for corrective action: Eden Ballatan, CFO Anticipated Completion Date: 3/31/2023

View Audit 46929 Questioned Costs: $1

Finding 45343 (2022-002)

None 2022

County of Cumberland

NC

Questioned Costs Subrecipient Monitoring Cash Management

Finding 2022-002 Name of contact person: Vivian Tookes, DSS Division Director for Economic Services and DSS Director when appointed. Corrective Action: All cases will utilize guidance provided by Treasury to determine eligibility and will clearly document and store all copies of evidence to support ...

Finding 2022-002 Name of contact person: Vivian Tookes, DSS Division Director for Economic Services and DSS Director when appointed. Corrective Action: All cases will utilize guidance provided by Treasury to determine eligibility and will clearly document and store all copies of evidence to support the elig1ibility determination to issue payments. This will also be clearly documented as to the evidence gathered in the case file for each determination. Proposed Completion Date: February 28, 2023.

View Audit 44675 Questioned Costs: $1

Finding 45342 (2022-001)

Material Weakness 2022

County of Cumberland

NC

Subrecipient Monitoring Eligibility Material Weakness

Finding 2022-001 Name of Contact Person: Vivian Tookes, DSS Division Director for Economic Services and DSS Director when appointed. Corrective Action: After approval of the disbursement, a 2nd party QA check will be completed and documented in the file by a lead or supervisor. This review will sati...

Finding 2022-001 Name of Contact Person: Vivian Tookes, DSS Division Director for Economic Services and DSS Director when appointed. Corrective Action: After approval of the disbursement, a 2nd party QA check will be completed and documented in the file by a lead or supervisor. This review will satisfy the requirement in the control documents that every case will have a 2nd party review prior to monies being distributed. Proposed Completion Date: February 28, 2023

View Audit 44675

Finding 45262 (2022-001)

None 2022

Seton Hill University

PA

Student Financial Aid Eligibility Material Weakness § 200.516

Corrective Action Plan The University will update written procedures to include an additional manual process, which identifies and updates withdrawals within the National Student Clearinghouse with a higher frequency. These procedures are targeted for the summer term, in which the current year lapse...

Corrective Action Plan The University will update written procedures to include an additional manual process, which identifies and updates withdrawals within the National Student Clearinghouse with a higher frequency. These procedures are targeted for the summer term, in which the current year lapse was identified. This will ensure that no one is reported outside of the 60 day window.

View Audit 47217

Finding 45247 (2022-003)

Material Weakness 2022

Wayland Baptist University

TX

Reporting Student Financial Aid Eligibility

Incorrect Enrollment Reporting to National Student Loan Data System (NSLDS) Planned Corrective Action: In late June 2022, known settings and data required by the baseline report were in place, and a small sample of test records passed a basic test. In July 2022, full-term data generated by the Pow...

Incorrect Enrollment Reporting to National Student Loan Data System (NSLDS) Planned Corrective Action: In late June 2022, known settings and data required by the baseline report were in place, and a small sample of test records passed a basic test. In July 2022, full-term data generated by the PowerCAMPUS baseline tool was submitted to NSCH as a more extensive test for Summer 2022. Due to the discovery of a significant number of SIS data errors for at least two major categories and a quickly approaching deadline, the previous tool was used for that end-of-term enrollment data. In addition, the previous tool was used for earlier registration reporting within the Fall 2022 term. The PowerCAMPUS baseline tool is being updated and tested again during the Fall 2022 term with anticipation that the baseline tool will be used for reporting the final end-of-term enrollment data reported in January 2023. Person Responsible for Corrective Action Plan: Cagan Cummings, CIO and Christy Miller, Executive Director of Financial Aid Anticipated Date of Completion: January 2023

View Audit 40639

Finding 45175 (2022-002)

Significant Deficiency 2022

Tabor College, Inc.

KS

Eligibility Reporting Significant Deficiency

2022-002 Eligibility and Certification Approval Report (ECAR) Award Period: July 1, 2021 to June 30, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance; Other Matters Recommendation: We recommend the College review its reporting procedures surrounding updating the ECAR ...

2022-002 Eligibility and Certification Approval Report (ECAR) Award Period: July 1, 2021 to June 30, 2022 Type of Finding: Significant Deficiency in Internal Control over Compliance; Other Matters Recommendation: We recommend the College review its reporting procedures surrounding updating the ECAR to ensure reporting is accurate and completed. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Tabor College will ensure that ECAR is updated in a timely manner when there is a change in a position of an official for the institution. Name(s) of the contact person(s) responsible for corrective action: Scott Franz, Interim Financial Aid Director Planned completion date for corrective action plan: April 2, 2023

View Audit 44253

Finding 44896 (2022-001)

Significant Deficiency 2022

Housing Authority of the City of Raleigh

NC

HUD Housing Programs Eligibility Significant Deficiency

Fiscal Year Ending (?FYE?) 2022 Audit Response Corrective Action Plan Finding 2022-001 ?Housing Choice Voucher Program Tenant Files ?Eligibility-Internal Control over Tenant Files-Noncompliance and Significant Deficiency? RHA Response The Raleigh Housing Authority and Leased Housing Department ack...

Fiscal Year Ending (?FYE?) 2022 Audit Response Corrective Action Plan Finding 2022-001 ?Housing Choice Voucher Program Tenant Files ?Eligibility-Internal Control over Tenant Files-Noncompliance and Significant Deficiency? RHA Response The Raleigh Housing Authority and Leased Housing Department acknowledge and accept that there were a significant number (27 files of 120 reviewed) of past due annual recertifications during the FYE 2022 review period. The abundance of outstanding annual re-exams started mid-2020. During the height of the Coronavirus pandemic, we changed our process for in-person appointments for completing the Annual Re-exam paperwork to mailing the packets to the families. This caused us problems with obtaining the necessary documentation for processing the recertifications. Also, other agencies that provided the required income/household verifications were closed and families were unable to obtain the required information. The Leased Housing Department modified its procedures and accepted what was minimally allowable based on HUD?s guidance. The staff worked diligently with the families that had outstanding documents to avoid terminating the families which would have likely resulted in homelessness during a national pandemic. There was a moratorium in place that prevented evictions of tenants during that time also. The Leased Housing Department also had a number of vacant positions during this review period. The Client Manager worked a large portion of the previous review period FYE 2021 with two full-time staff person and 2 temporary employees during part of that time. In a department that normally worked with 4 full-time trained employees, this staff reduction and having to train temporary employees slowed the process down. The Leased Housing staff has put the following plan in place to catch up on our annual recertifications and to complete timely moving forward: ? Additional Staffing positions to hire and train o one (1) client specialist ? this team gathers all the required documents and confirms completed properly o two (2) account specialist ? this team calculates the annual recertification income and generates the 50058s transmitted to HUD ? Current staffing positions reassigned to assist including: o 2 Temporary employees o Compliance Officer o Contract Specialist o 2 File Review Specialist ? from Finance Compliance team o Client Manager ? Contract with an outside service provider to help with the volume - We have received quotes from both Nan McKay and Quadel and will look to procure within the next few weeks to help us move through the volume of past due files ? A new tracking system for Annual recertification has been implemented to ensure the number of Annual Re-exams that need to be processed weekly are meet to meet our monthly goals. ? The Client Manager and the Assistant Director of Leased Housing will meet weekly to discuss the progress and work together to meet the monthly lease-up goal. ? Voucher families will be scheduled to come-into the office to pick-up the annual recertification packet and speak to their assigned specialist if needed. ? Voucher families are notified 90-days prior to their annual recertification date and given a time and date to submit the requested documents. If requested documents are not received, the voucher family will receive a pre-term letter with a scheduled appointment to come into the office and meet with the assigned Client Specialist. They will only be given 7-business days to return requested documents after this meeting. If not received the family will be issued a letter of termination. Anticipated Completion: 12/31/22 Person Responsible: Liz Edgerton Respectfully, Liz Edgerton Interim Director

View Audit 46840

Corrective Action Plans

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