Corrective Action Plans

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Planned Corrective Action: SC-OR Management will implement enhanced procedures requiring all journal entries to be reviewed by an individual with the appropriate skills, knowledge, and experience. The review will include verification of supporting documentation, confirmation of accurate account codi...
Planned Corrective Action: SC-OR Management will implement enhanced procedures requiring all journal entries to be reviewed by an individual with the appropriate skills, knowledge, and experience. The review will include verification of supporting documentation, confirmation of accurate account coding, and an assessment of the impact on the financial statements. Additionally, the SC-OR's outsourced accounting firm, CliftonLarsonAllen LLP, will be involved with the review and ongoing monitoring. Name(s) of Contact Person(s) Responsible for Corrective Action: SC-OR's outsourced accounting team from CliftonLarsonAllen LLP will collaborate with SC-OR's Administrative Assistant, Christina Neads, for ensuring the corrective action plan is implemented and maintained. Oversight will be provided by the General Manager, Glen Sturdevant. Anticipated Completion Date: Effective immediately, the new review and approval procedures are in place and will be fully operational by January 31, 2026.
Highway Planning and Construction - Assistance Listing No. 20.205 Recommendation: We recommend that the City evaluate its procedures and implement an additional control to ensure verifications checks are occurring prior to entering into contracts with a vendor. Explanation of disagreement with audit...
Highway Planning and Construction - Assistance Listing No. 20.205 Recommendation: We recommend that the City evaluate its procedures and implement an additional control to ensure verifications checks are occurring prior to entering into contracts with a vendor. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: With the recent filling of open positions and the execution of contracts with engineering firms, additional controls have been implemented to strengthen project review processes. Specifically, the hiring of a City Administrator and an Economic Development Director will enhance controls over new established process. Name(s) of the contact person(s) responsible for corrective action: Kim Barfield Planned completion date for corrective action plan: 12/29/25
Paris Junior College management will ensure that a standardized procedure including internal controls is established and implemented to ensure the R2T4 process is timely and accurate.
Paris Junior College management will ensure that a standardized procedure including internal controls is established and implemented to ensure the R2T4 process is timely and accurate.
CORRECTIVE ACTION PLAN Finding 2025-001 – Allowable Costs The District concurs with the finding 2025-001. Corrective Action: The District will implement the following corrective actions to be completed by September 30, 2025: 1.The District will develop and implement new written policies and procedur...
CORRECTIVE ACTION PLAN Finding 2025-001 – Allowable Costs The District concurs with the finding 2025-001. Corrective Action: The District will implement the following corrective actions to be completed by September 30, 2025: 1.The District will develop and implement new written policies and procedures for time and effort reporting. 2.All grant-funded employees will receive training on the new procedures. 3.The District will implement a new system to track and certify employee time. Contact Person: Lou D’Ambro, School Business Administrator (315) 822-2826 ldambro@mmcsd.org
2025 –002 Reporting Program: Homeowner Assistance Fund Assistance Listing Number 21.026 Name of Contact Person: Lisa Coleman, Senior Vice President of Federal Grants Corrective Action: Management will implement procedures to ensure the timely and accurate submission of Homeowner Assistance Fund (HAF...
2025 –002 Reporting Program: Homeowner Assistance Fund Assistance Listing Number 21.026 Name of Contact Person: Lisa Coleman, Senior Vice President of Federal Grants Corrective Action: Management will implement procedures to ensure the timely and accurate submission of Homeowner Assistance Fund (HAF) Quarterly and Annual Performance Reports. Reporting deadlines are tracked on the Corporation’s federal reporting and compliance calendar, with oversight by the AVP of Grants Compliance and Reporting, who actively monitors reporting progress and coordinates reconciliation of financial data between the HAF Program Manager and Accounting. The AVP of Grants Compliance and Reporting reviews each completed report for accuracy and completeness, signs and dates the report, and submits it to the SVP of Federal Grants for final review and approval. The HAF Program Manager provides confirmation of successful submission through the U.S. Treasury portal. These procedures will be incorporated into the HAF Program Manual. Anticipated Completion Date: March 31, 2026
Finding 2025-001, Significant Deficiency – Reporting - ERA Corrective Action Plan: Goal: To ensure required reporting to grantors has a defined review process including a preparer, reviewer and an approver to validate accuracy and compliance with data and information submitted to maintain compliance...
Finding 2025-001, Significant Deficiency – Reporting - ERA Corrective Action Plan: Goal: To ensure required reporting to grantors has a defined review process including a preparer, reviewer and an approver to validate accuracy and compliance with data and information submitted to maintain compliance with federal requirements. Plan: Staff is finalizing a formal written review policy which includes compliance components such as timely draft circulation, an independent review, checklists and documented approvals. Once the policy is finalized, training will be provided to staff on the new requirements to ensure consistent application across all grantor reporting cycles. Responsible Party: Housing and Community Development Timeframe: All elements of the Corrective Action Plan will be implemented by March 31, 2026.
The Director of Business Services will review bank reconciliations on a monthly basis to ensure everything is accurate and appropriate. On a weekly basis the Director of Business Services holds business office meetings with his staff to review opportunities for continuous improvement within the busi...
The Director of Business Services will review bank reconciliations on a monthly basis to ensure everything is accurate and appropriate. On a weekly basis the Director of Business Services holds business office meetings with his staff to review opportunities for continuous improvement within the business office. The Director of Business Services also reviews financial activity on a monthly basis for any material discrepancies in the accounts. After the checks are approved, they are mailed out. In prior years, the Board Finance Committee randomly pulled checks for review. Current practice is that all Board members get a copy of the check register for the period between board meetings and ask questions about any expenditures they want additional information for. All expense reports are currently being countersigned. The budget to actual comparisons are reviewed by the Board at least annually, but it is not on based on a set schedule. The Director of Business Services provides financial updates to the Board of Education on a monthly basis. The Director of Business Services reviews employee contracts (professional staff) and rates of pay (non-professional staff) to ensure the correct rate is being paid to each employee. District is willing to accept the risk.
In response, the District agrees and intends to continue to provide supervision and monitor accounting information and operations including obtaining explanations for variances from unexpected results and work to increase segregation of duties. In addition to monthly review and Board approval of the...
In response, the District agrees and intends to continue to provide supervision and monitor accounting information and operations including obtaining explanations for variances from unexpected results and work to increase segregation of duties. In addition to monthly review and Board approval of the voucher list, detailed check register, and itemized revenue and expenditure statements relative to the yearly approved district budget, the Administrator will also review the monthly bank reconciliations, payroll records, and accounting information to determine if expectations are being met, as well as to obtain explanations for any variances.
Monitoring of federal compliance information by management and the Board of Education will continue at the District. The District will conduct a documented review of monthly claim reports.
Monitoring of federal compliance information by management and the Board of Education will continue at the District. The District will conduct a documented review of monthly claim reports.
FINDING 2025-001 Information on the federal program: Subject: Child Nutrition Cluster - Internal Controls over Eligibility Federal Agency: Department of Agriculture Federal Program: School Breakfast Program, National School Lunch Program Assistance Listing Number: 10.553, 10.555 Federal Award Number...
FINDING 2025-001 Information on the federal program: Subject: Child Nutrition Cluster - Internal Controls over Eligibility Federal Agency: Department of Agriculture Federal Program: School Breakfast Program, National School Lunch Program Assistance Listing Number: 10.553, 10.555 Federal Award Numbers and Years (or Other Identifying Numbers): FY2024, FY2025 Pass-Through Entity: Indiana Department of Education Compliance Requirement: Eligibility Audit Finding: Material Weakness Context: During the testing of internal controls over eligibility determinations for free and reduced meals, we noted there was no formal, documented review control in place. There is no documented, secondary review for the applications entered in the food service software which determines eligibility. Additionally, there was no documented review by School Corporation personnel of the Income Eligibility Guidelines used by the food service software which are updated on annual basis Contact Person Responsible for Corrective Action: Amber Swinehart, Food Services Director Contact Phone Number: 765-759-2592 Views of Responsible Official: We concur with the finding. Description of Corrective Action Plan: The Food Services Director will provide evidence of review for the eligibility parameters from Titan at least once a year prior to the start of the school year Anticipated Completion Date: 6/30/2026
Recommendation: Management should reinforce the requirement for supervisor approval of all timecards prior to payroll processing. This should include training for supervisors and payroll staff on federal timekeeping requirements and implementation of system controls or checklists to ensure approvals...
Recommendation: Management should reinforce the requirement for supervisor approval of all timecards prior to payroll processing. This should include training for supervisors and payroll staff on federal timekeeping requirements and implementation of system controls or checklists to ensure approvals are documented. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Reinforce supervisor approval of all timecards prior to payroll processing. Name(s) of the contact person(s) responsible for corrective action: Judy Thomas, CFO Planned completion date for corrective action plan: June 2026
Adjusting Journal Entries and Required Disclosures to the Financial Statements. Year Ended June 30, 2025. Auditors Recommendation: Although auditors may continue to provide such assistance both now and in the future, under the new pronouncement, the District should continue to review and accept both...
Adjusting Journal Entries and Required Disclosures to the Financial Statements. Year Ended June 30, 2025. Auditors Recommendation: Although auditors may continue to provide such assistance both now and in the future, under the new pronouncement, the District should continue to review and accept both proposed adjusting journal entries and footnote disclosures, along with the draft financial statements. School District's Response: The District has received, reviewed and approved all journal entries, footnote disclosures and draft financial statements proposed for the current year audit and will continue to review similar information in future years. Further, the District believes it has a thorough understanding of these financial statements and the ability to make informed judgements based on these financial statements.
Views of Responsible Officials and Planned Corrective Actions Clearinghouse reports are from the college’s student information system (SIS). During FY24, the finding stems from a student’s withdrawal, which was promptly processed and entered in the SIS. However, the system categorized the student as...
Views of Responsible Officials and Planned Corrective Actions Clearinghouse reports are from the college’s student information system (SIS). During FY24, the finding stems from a student’s withdrawal, which was promptly processed and entered in the SIS. However, the system categorized the student as "less than half-time” because the student received a passing grade in a course for which the student was exempted after passing a proficiency test. The SIS did not update the student status to 'withdrawn' until the semester ended, which was more than 60 days after the withdrawal date. To remedy this issue, the college’s Business Office now maintains an online spreadsheet listing withdrawn students outside the SIS that is updated whenever a student withdraws from the college. The list has been shared with the personnel responsible for the Clearinghouse reports and the Financial Aid Coordinator. Personnel will monitor the withdrawal listing and verify that all withdrawn students are accurately categorized in the Clearinghouse report from the SIS before completing the submission. After reviewing the FY25 finding, we discovered that the student attended in the spring 2025 semester but withdrew during the college’s drop/add period. By default, the SIS removes students who withdraw during drop/add from the Clearinghouse report.We have confirmed that Welch is unable to modify data or correct errors in the SIS report submitted to the Clearinghouse.Action Taken/Planned To address these problems, which ultimately stemmed from the limitations of Clearinghouse reporting by the college’s SIS, Welch has taken the following steps: 1. Clearinghouse reporting responsibilities have transitioned to a full-time, onsite employee in the Provost’s Office. 2. When preparing Clearinghouse reports and to help with identifying any errors before submitting the report, the employee will continue to monitor the withdrawn students listing maintained by the college’s Business Office, as outlined in the steps taken with the FY24 finding. 3. Welch plans to engage with its SIS and explain the reporting issues and limitations to determine if the SIS can help the college resolve the reporting limitations with its system. 4. To minimize the possibility of students being omitted from any Clearinghouse report, the employee responsible for the Clearinghouse report will submit an initial report to Clearinghouse on the first day of each term (fall, winter, spring, summer), followed by submitting reports on the mandatory reporting dates, as given by Clearinghouse. 5. The employee responsible for Clearinghouse reporting and the college’s Financial Aid Coordinator will collaborate before and after each Clearinghouse submission, and once the submission data is reported to NSLDS by Clearinghouse, the Financial Aid Coordinator will review all withdrawn students to confirm their NSLDS status is correct. If not, she will manually update the student’s NSLDS status to ensure accuracy. Anticipated Completion Date/Date Completed: November 6, 2025
Corrective Action Planned: The Organization has updated its policies and procedures to ensure proper approvals are performed and documented. Anticipated Completion Date: Continuous. Responsible Parties: Management and the Board of Directors.
Corrective Action Planned: The Organization has updated its policies and procedures to ensure proper approvals are performed and documented. Anticipated Completion Date: Continuous. Responsible Parties: Management and the Board of Directors.
Finding Number: 2025-006 Federal Program, Assistance Listing Number and Name: ALN 10.557, United States Department of Agriculture, WIC Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Condition: Original Finding Description: The City applied indirect costs to the program...
Finding Number: 2025-006 Federal Program, Assistance Listing Number and Name: ALN 10.557, United States Department of Agriculture, WIC Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Condition: Original Finding Description: The City applied indirect costs to the programs in a manner that did not align with the allocation methodology outlined in the 2022–2023 cost allocation plan submitted to MDHHS. Furthermore, the plan lacked explicit certification and contained minor errors and omissions. Contact Person Responsible for Corrective Action / Anticipated Completion Date: Regina Greear Terri Daniels Anticipated completion date: July 2026 Planned Corrective Action: Upon identification, the City worked with the Michigan Department of Health and Human Services (MDHHS) and obtained approval and acceptance of the indirect cost calculation. The City will continue to work with MDHHS to ensure full compliance. The City has initiated a review of its indirect cost allocation methodology to ensure compliance. Management is updating the cost allocation calculation to document the approved allocation method and ensure the method is in accordance with the approved plan. The City will also provide training to staff involved in the preparation, submission, and calculation of the indirect costs to ensure understanding requirements. The City will also provide training to staff involved in the preparation, submission, and calculation of the indirect costs to ensure understanding requirements.
Finding Number 2025-004 Federal Program, Assistance Listing Number and Name: ALN 14.239, Department of Housing and Urban Development, Home Investment Partnerships Program Condition: Original Finding Description: The City lacked adequate controls to ensure annual reviews were conducted in accordance ...
Finding Number 2025-004 Federal Program, Assistance Listing Number and Name: ALN 14.239, Department of Housing and Urban Development, Home Investment Partnerships Program Condition: Original Finding Description: The City lacked adequate controls to ensure annual reviews were conducted in accordance with its policy, limiting its ability to exercise proper oversight of eligibility determinations performed by the program’s contractor. Contact Person Responsible for Corrective Action / Anticipated Completion Date: Julie Schneider Anticipated completion date: July 2025 Planned Corrective Action: This finding is timing related and was resolved by the City during fiscal year. The City reviewed and updated its policies and procedures to help ensure proper segregation of duties and proper oversight of eligibility determination. Additional processes now have independent review of inspections after the program’s contractor to further support program compliance. Review responsibilities were put in place to help ensure determinations receive an independent secondary review by City staff. These changes were in place by year-end. The City will continue to monitor the program and review procedures to ensure continued compliance and to prevent the recurrence of similar timing-related issues. The City will continue to monitor the program and review procedures to ensure continued compliance and to prevent the recurrence of similar timing-related issues.
Finding Number: 2025-003 Federal Program, Assistance Listing Number and Name: ALN 14.239, Department of Housing and Urban Development (HUD), Home Investment Partnerships Program Condition: Original Finding Description: The requirements mandate that units be inspected, deficiencies communicated, and ...
Finding Number: 2025-003 Federal Program, Assistance Listing Number and Name: ALN 14.239, Department of Housing and Urban Development (HUD), Home Investment Partnerships Program Condition: Original Finding Description: The requirements mandate that units be inspected, deficiencies communicated, and corrective actions taken promptly. However, controls over housing quality standards are not effectively designed, reflecting a persistent lack of segregation of duties necessary to ensure compliance. Furthermore, existing controls were insufficient to guarantee that HQS inspection requirements were met and that identified deficiencies were addressed in a timely manner. Contact Person Responsible for Corrective Action / Anticipated Completion Date: Julie Schneider Anticipated completion date: July 2025 Planned Corrective Action: During the fiscal year, the City reviewed and enhanced its internal controls over HQS inspections to strengthen oversight and segregation of duties. Process changes were implemented to ensure that inspections, documentation of deficiencies, follow-up actions, and certifications of completion have independent review and approval. In addition, management implemented monitoring procedures to track inspection schedules to help ensure HQS requirements are met in a timely manner.While corrective actions were initiated during the fiscal year, they were not fully implemented throughout the entire period. By year-end, the controls were in place. The City will continue to monitor these controls to ensure ongoing compliance and to prevent similar issues from recurring.
The District will continue procedures to provide oversight to the bookkeeper and treasurer positions, including oversight of bank reconciliations.
The District will continue procedures to provide oversight to the bookkeeper and treasurer positions, including oversight of bank reconciliations.
Federal Agency Name: Department of Agriculture Assistance Listing Number: #10.766 Program Nome: Community Facilities Loans andGrants Finding Summary: There was no formal review separate from the preparer performed over reconciliations of the program reserve fund. Corrective Action Plan: Management w...
Federal Agency Name: Department of Agriculture Assistance Listing Number: #10.766 Program Nome: Community Facilities Loans andGrants Finding Summary: There was no formal review separate from the preparer performed over reconciliations of the program reserve fund. Corrective Action Plan: Management will ensure a review separate from the preparer of the reconciliationfor the program's reserve fund is completed with formal documentation notingthe review. The CFO will reconcile the bank statement and will sign off on the bank statement, alongwith the CEO for the reserve accounts. Responsible Individuals: Tammy Larson, CFO Anticipated Completion Date: January 1, 2026
Inadequate Segregation of Duties Actions Planned - The District has implemented a plan to mitigate this finding for federal programs by distiributing duties, and adding additional oversight. Program managers have been assigned to monitor and give oversight approval for federal fund expenses and budg...
Inadequate Segregation of Duties Actions Planned - The District has implemented a plan to mitigate this finding for federal programs by distiributing duties, and adding additional oversight. Program managers have been assigned to monitor and give oversight approval for federal fund expenses and budgets. Program managers sign off on all receipts and disbursements. A principal will act as a program manager for Title funds, and the Superintendent will act as program manager for all other federal funds. Request for reimbursement and receipting will be completed by the Business Manager with oversight by the Superintendent. The key action to eliminate inadequate segregation of duties is developing strong contols over the review and approval of adjusting journal entries. This will involve detailed review by the program manager and the Superintendent. Adjusting journal entries are discussed and signed off on each month to timely detect misstatements. Official Responsible - Business Manager and Superintendent of Schools. Planned Completion date - Discussed with School Board December 29, 2025. This is considered ongoing to to current staffing available. Disagreement with Finding - None. ISD #695 - Chisholm concurs with the finding. Plan to Monitor - The Distirct is aware of the situation and will monitor, as it deems appropriate. Monitoring will include educating program managers to provide additional oversight for the interim and year end reporting.
The entity's Board continually evaluates the distribution of duties to employees and closely monitors all accounting functions. The School District has implemented controls within its accounting functions to mitigate the lack of segregation of duties but recognizes that this should still be a concer...
The entity's Board continually evaluates the distribution of duties to employees and closely monitors all accounting functions. The School District has implemented controls within its accounting functions to mitigate the lack of segregation of duties but recognizes that this should still be a concern for the School District and the Board.
CIF grew substantially in FY 24 following execution of the Federal award. This finding reflects the learning phase as CIF came into compliance with the Uniform Guidance. Beginning in FY 26, CIF implemented a system for documenting time and effort in a manner that complies with Federal requirements w...
CIF grew substantially in FY 24 following execution of the Federal award. This finding reflects the learning phase as CIF came into compliance with the Uniform Guidance. Beginning in FY 26, CIF implemented a system for documenting time and effort in a manner that complies with Federal requirements which involves timesheets that record actual time spent on a funding source and are accompanied by supervisory approvals. This system has been formally documented in the FY 26 update to the CIF Financial Policy and includes annual training for staff responsible for managing payroll allocations and Federal reporting. Charges to Federal awards for salaries and wages are now based on records that accurately reflect the work performed. The records are supported by a system of internal control that provides reasonable assurance that the charges are accurate, allowable, and properly allocated. The records support the distribution of the employee's salary or wages among specific activities or cost objectives if the employee works on more than one Federal award; a Federal award and non-Federal award; an indirect cost activity and a direct cost activity; two or more indirect activities allocated using different allocation bases; or an unallowable activity and a direct or indirect cost activity.
Significant Deficiency Item 2025-006 - Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Notice of Award Number 6 HB0CS00505-23-04, 6 H2ECS45602-02-04, 1 HBLCS50772-01-00 and 6 HBHCS46163-03-01 During ...
Significant Deficiency Item 2025-006 - Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Notice of Award Number 6 HB0CS00505-23-04, 6 H2ECS45602-02-04, 1 HBLCS50772-01-00 and 6 HBHCS46163-03-01 During our audit, we noted that LBUCC conducted quarterly internal audit reviews of fifty (50) samples self-pay patients to review for sliding fee discount determination. However, we noted that the findings or exceptions identified in the quarterly internal audit review remained uncorrected. Recommendation: We recommend that LBUCC establish a process for communicating, investigating and correcting all internal audit findings or exceptions on a timely manner. Additionally, we recommend that management identify the potential cause of such findings or exceptions and that necessary corrective actions be taken to address such cause. For example, LBUCC may conduct periodic training of all employees involved in the patient intake and screening process. Action Taken: The internal audit process has been redesigned and expanded to include weekly reviews and all exceptions/errors will be corrected and the cause determined. Additional training will be provided with the expectation that the exceptions/errors will reduce going forward. Effectivity Date: This will be fully implemented by 1/31/2026
Material Weakness Item 2025-002 - Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Notice of Award Number 6 H80CS00505-23-04, 6 H2ECS45602-02-04, 1 H8LCS50772-01-00 and 6 H8HCS46163-03-01 During our a...
Material Weakness Item 2025-002 - Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Notice of Award Number 6 H80CS00505-23-04, 6 H2ECS45602-02-04, 1 H8LCS50772-01-00 and 6 H8HCS46163-03-01 During our audit, we noted that LBUCC did not properly determine the sliding fee discount provided to certain eligible patients based on information provided during the patient registration process. Additionally, we could not ascertain if the sliding fee discount provided to certain eligible patients were correct as LBUCC did not maintain documentation of the proof of income of those eligible patients. Recommendation: We recommend that LBUCC conduct training of all of its personnel who are involved in determining and applying the sliding fee scale of patients. We also recommend LBUCC to maintain complete and auditable documentation supporting each patient's eligibility for sliding fee discount. Action Taken: Eligibility was provided additional training which included training on a tool to assist them in determining the proper sliding fee discount. Effectivity Date: Training was held on October 28, 2025, and the tool to assist them was reviewed and provided at that time and implemented immediately thereafter.
Inadequate Segregation of Duties Actions Planned - The school district has implemented a process for federal programs by distributing duties, and adding additional oversight. Program managers are assigned to monitor and give oversight approval for federal fund expenses and budgets. Program managers ...
Inadequate Segregation of Duties Actions Planned - The school district has implemented a process for federal programs by distributing duties, and adding additional oversight. Program managers are assigned to monitor and give oversight approval for federal fund expenses and budgets. Program managers sign off on all receipts and disbursements. Monthly reports given to program managers to assist in the oversight. The Special Education Director acts as a program manager for special ed funds, a Principal acts as a program manager for Title funds, and the Superintendent acts as program manager for all other federal funds. Request for reimbursement and receipting is completed by the Administrative Assistant with oversight by the Business Manager and Superintendent. The key action to eliminate inadequate segregation of duties is developing strong controls over the review and approval of adjusting journal entires. This involves detailed review by the program manager and the Superintendent. Adjusting journal entries are discussed and signed off on each month to timely detect misstatements. Official Responsible - Business Manager and Superintendent of Schools Planned Completion Date - December 31, 2025 Disagreement with Finding - None - ISD #701 - Hibbing concurs with the finding. Plan to monitor - The District is aware of the situation and will monitor, as it deems appropriate. Monitoring will include educating program managers to provide additional oversight fo the interim and year end reportin. This finding will like be ongoing due to limited resources.
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