Corrective Action Plans

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Finding 555180 (2023-002)
Significant Deficiency 2023
We will utilize new software to automate the preparation and compilation of audit reports and compliance reports, streamlining the entire process and reducing the likelihood of delays. We will establish a centralized document management system with robust retention protocols. This system will ensure...
We will utilize new software to automate the preparation and compilation of audit reports and compliance reports, streamlining the entire process and reducing the likelihood of delays. We will establish a centralized document management system with robust retention protocols. This system will ensure that all relevant documents and information required for the reports are readily accessible and properly maintained, minimizing delays caused by searching for necessary materials. We will institute a schedule for regular reviews and monitoring of the reporting process. This will involve conducting periodic assessments to identify any bottlenecks or potential issues that could lead to delays, allowing for proactive intervention and resolution. By implementing these measures, we aim to mitigate the risk of late filing of the audit report, thereby enhancing compliance with regulatory requirements and ensuring timely and accurate reporting.
Finding 555151 (2023-008)
Significant Deficiency 2023
Views of Responsible Officials: Based on this audit finding, SAMU agreed addressing the following: 1. Implement a formal review and approval process for program reports, including documentation of reviewer's name and date. 2. Establish a system to retain internal documentation of report submission d...
Views of Responsible Officials: Based on this audit finding, SAMU agreed addressing the following: 1. Implement a formal review and approval process for program reports, including documentation of reviewer's name and date. 2. Establish a system to retain internal documentation of report submission dates. 3. Develop a reporting calendar with internal deadlines for report preparation and review. 4. Designate specific individuals responsible for report preparation, review, and submission.
Finding 555110 (2023-001)
Material Weakness 2023
Effective October 1, 2023, management implemented extensive accounting and documentation controls to ensure full accounting and reporting compliance on direct costs incurred for all federal grants and expenditures. These controls are reviewed and monitored for compliance by management on a periodic ...
Effective October 1, 2023, management implemented extensive accounting and documentation controls to ensure full accounting and reporting compliance on direct costs incurred for all federal grants and expenditures. These controls are reviewed and monitored for compliance by management on a periodic basis during the year.
View Audit 353705 Questioned Costs: $1
Finding 554894 (2023-002)
Material Weakness 2023
Finding Number: 2023-002 Closing Process – (Material Weakness) Planned Corrective Action: The auditors noted issues related to the timeliness of the financial statement close process, the quantity of entries to close the books, the reconciliation of the beginning trial balance to the prior year aud...
Finding Number: 2023-002 Closing Process – (Material Weakness) Planned Corrective Action: The auditors noted issues related to the timeliness of the financial statement close process, the quantity of entries to close the books, the reconciliation of the beginning trial balance to the prior year audited trial balance, and a lack of segregation of duties which led to journal entries being prepared, reviewed and posted by the same person in the general ledger system. The issues noted were largely the result of significant turnover within the Finance Department, including the departure of the former head of the department without a proper transfer of institutional knowledge to remaining staff or incoming leadership. Since that time, oversight has improved considerably, and key processes have been reviewed, updated, and formally documented. While the current size of the Finance Team necessitates that the same individual generally enters and posts journal entries, we have implemented compensating controls that we believe are appropriate given the assessed levels of risk and materiality. These controls include role-specific responsibilities for journal entries and reconciliations. For example, with respect to cash activity, different team members handle cash receipts, disbursements, and inter-account transfers. A fourth team member is responsible for preparing the monthly bank reconciliations, which are then formally reviewed and signed off by Fiscal Department management, including the CFO. Management remains committed to strengthening internal controls, maintaining adequate segregation of duties to the extent practicable, and continuing to enhance the overall financial close and reporting process. Person Responsible: The Executive Director and Chief Financial Officer Completion Date: April 30, 2025
Finding 554521 (2023-005)
Significant Deficiency 2023
The County will ensure future reports are completed on time.
The County will ensure future reports are completed on time.
2023-002 - Reporting Auditee’s Response and Planned Corrective Action The Authority is now under the management of the Quincy Housing Authority and all controls and processes have been updated to account for the needs of the Holbrook Housing Authority, including internal controls over financial re...
2023-002 - Reporting Auditee’s Response and Planned Corrective Action The Authority is now under the management of the Quincy Housing Authority and all controls and processes have been updated to account for the needs of the Holbrook Housing Authority, including internal controls over financial reporting, documentation retention, and timeliness of reporting. Planned Implementation Date of Corrective Action: June 30, 2024 Person Responsible for Corrective Action: James Marathas, Executive Director
Views of Responsible Officials and Planned Corrective Actions: See Comment 2023-001 and 002. Date to be implemented: See Comment 2023-001 and 002. Persons responsible: See Comment 2023-001 and 002
Views of Responsible Officials and Planned Corrective Actions: See Comment 2023-001 and 002. Date to be implemented: See Comment 2023-001 and 002. Persons responsible: See Comment 2023-001 and 002
The Department has ramped up recruiting efforts by advertising positions on external websites such as indeed. The accounting department has recently increased the wages of existing staff and the starting wages of all positions in an effort to attract and retain qualified staff.
The Department has ramped up recruiting efforts by advertising positions on external websites such as indeed. The accounting department has recently increased the wages of existing staff and the starting wages of all positions in an effort to attract and retain qualified staff.
The Department has hired a new audit firm that specializes in the audits of Tribes. Our new audit firm has demonstrated a commitment to allocating the necessary resources to complete our audits in a timely manner.
The Department has hired a new audit firm that specializes in the audits of Tribes. Our new audit firm has demonstrated a commitment to allocating the necessary resources to complete our audits in a timely manner.
The College is in the process of establishing journal entry controls including an independent review and approval process for all entries and ensuring sufficient documentation is maintained for each entry.
The College is in the process of establishing journal entry controls including an independent review and approval process for all entries and ensuring sufficient documentation is maintained for each entry.
The College has spent a significant amount of time in FY 2025 evaluating their IT controls and policies and procedures. New internal controls are expected to be implemented to address these findings.
The College has spent a significant amount of time in FY 2025 evaluating their IT controls and policies and procedures. New internal controls are expected to be implemented to address these findings.
Material Weakness in Compliance and Internal Control over Compliance Recommendation: CLA recommends that additional emphasis of documentary evidence of approvals be made, and such evidence is retained by ICEDC as proof of oversight of expenditure of federal funds. Additionally, we recommend adding ...
Material Weakness in Compliance and Internal Control over Compliance Recommendation: CLA recommends that additional emphasis of documentary evidence of approvals be made, and such evidence is retained by ICEDC as proof of oversight of expenditure of federal funds. Additionally, we recommend adding a review and approval process for the ED’s timesheets. There is no disagreement with the audit finding. Action taken in response to finding: ICEDC appreciates CLA’s recommendation to enhance processes concerning the retention of documentary evidence of approvals and importance of maintaining strong oversight of expenditures, especially when handling federal funds. ICEDC will place greater emphasis on obtaining and retaining documentation of approvals related to the expenditure of funds. This documentation will serve as proof of oversight, ensuring compliance with federal regulations and enhancing transparency in fund management. A formal review and approval process will be established for the Executive Director's (ED’s) timesheets. This process will involve periodic reviews by a designated authority and documentation will be retained to maintain a clear audit trail. Name(s) of the contact person(s) responsible for corrective action: Kristina Hines Planned completion date for corrective action plan: 8/31/2025
View Audit 353072 Questioned Costs: $1
Housing Authority of the City of Conway respectfully submits the following corrective action plan for the year ended September 30, 2023. Responsible Official: Catherine Lamberg, Executive Director Name and address of independent public accounting firm: Miller & Rose, PA 1309 East Race Searcy, ...
Housing Authority of the City of Conway respectfully submits the following corrective action plan for the year ended September 30, 2023. Responsible Official: Catherine Lamberg, Executive Director Name and address of independent public accounting firm: Miller & Rose, PA 1309 East Race Searcy, AR 72143 Audit period: Year ended September 30, 2023 Oversight Agency: U.S. Department of Housing and Urban Development The findings from the September 30, 2023, audit are discussed below. The findings are numbered to correspond to the auditing findings disclosed in the Schedule of Findings and Questioned Costs. MATERIAL WEAKNESSES Finding 2023-001 – Material Misclassifications • Criteria: A control deficiency exists when the design or operation of a control does not allow management or employees, in the normal course of performing their assigned functions to prevent or detect misstatements of the financial statements on a timely basis. AU-C Section 265 Communication Internal Control Related Matters Identified in an Audit, identifies deficiencies in controls over the period-end financial reporting process, including controls over procedures used to enter transactions and journal entries into the general ledger and to record recurring and nonrecurring adjustments to the financial statements that was not initially identified by the entity’s internal controls even if management subsequently corrects the misstatement. • Condition: Material misclassifications in the financial statements under audit. Multiple accounts were not reconciled on a regular basis. In addition, deposits were not recorded on a timely basis resulting in material errors on the financial data schedule that was submitted to REAC. • Context: Several items were discovered that were misclassified. More specifically, assets, liabilities, revenues and expenses were not able to be verified or reconciled. • Effect: The financial statements of Housing Authority of the City of Conway were not materially correct. • Recommendation: Review procedures for proper classification of expenditures and reconcile accounts on a regular basis. • Planned Corrective Actions: We are working with our accountant to resolve the issue. During the current fiscal year, our accountant was not able to access our financial records on a timely basis which resulted in multiple items not being recorded or reconciled. We anticipate these issues being resolved prior to completion of the next audit.
Federal Program Education Stabilization Fund - Passed through the Pennsylvania Department of Education COVID-19 - Elementary and Secondary School Emergency Relief Fund (ARP ESSER) ALN 84.425U; Contract #223-21-0141; Grant Period 03/13/20 - 09/30/24 COVID-19 - ARP ESSER Learning Loss Set Aside ALN 84...
Federal Program Education Stabilization Fund - Passed through the Pennsylvania Department of Education COVID-19 - Elementary and Secondary School Emergency Relief Fund (ARP ESSER) ALN 84.425U; Contract #223-21-0141; Grant Period 03/13/20 - 09/30/24 COVID-19 - ARP ESSER Learning Loss Set Aside ALN 84.425U; Contract #225-21-0141; Grant Period 03/13/20 - 09/30/24 Criteria In accordance with Uniform Guidance Post Federal Award Requirements, the District must establish, document, and maintain effective internal control over the Federal award that provides reasonable assurance that the recipient is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. Condition The District did not maintain effective internal controls over the Federal awards. Two invoices were coded to the grants that were paid without documented approval. Cause The District did not follow documented internal control procedures which require all disbursements to have an approved purchase order or invoice signed by an administrator. Effect By paying invoices coded to Federal grants without approval, the District is not verifying the allowability of invoices. This increases the risk that unallowable activities and costs can be charged to the Federal grants and go undetected. Questioned Costs None. Context The Education Stabilization Fund grant nonpayroll costs were made up of 23 invoices. We tested three individually significant and five sampled invoices. Of the five sampled invoices, we found that two invoices were paid without approval. However, no discrepancies were identified in the allowability of the invoices. Repeat Finding No. Recommendation We recommend the District follow documented internal control procedures requiring all disbursements have an approved purchase order or signed invoice. This will ensure that invoices coded to Federal grants are reviewed for allowability before they are applied to the grants. Management Response This has been rectified. The district had a vacancy in the Federal Program Coordinator. Either the new Federal program Coordinator or the Business Administrator will approve and initial the invoices prior to payment.
Corrective Action: The Organization is working with their financial institution to see if statement closing dates can better align with the reporting period. The Organization will perform the reconciliation if no changes can be made with the bank
Corrective Action: The Organization is working with their financial institution to see if statement closing dates can better align with the reporting period. The Organization will perform the reconciliation if no changes can be made with the bank
Finding 554151 (2023-019)
Significant Deficiency 2023
The CDSS’ Disability Determination Services Division (DDSD) has implemented corrective measures to address inaccuracies in the Modernized Integrated Disability Adjudicative System (MIDAS) and Disability Case Processing System (DCPS) invoice review processes. This includes an internal quality control...
The CDSS’ Disability Determination Services Division (DDSD) has implemented corrective measures to address inaccuracies in the Modernized Integrated Disability Adjudicative System (MIDAS) and Disability Case Processing System (DCPS) invoice review processes. This includes an internal quality control process to monitor and review additional invoice samples from Branches after they have been processed and reviewed by Branch Program Technicians and Branch Auditors. Additionally, the DDSD Central Support Services Branch implemented a secondary audit process and created a new Auditor role to routinely sample additional Medical Evidence of Record (MER) and Consultative Examination (CE) contracts. Findings are provided to branches to reinforce accuracy and assure compliance. The DDSD, also transitioned from MIDAS to DCPS, which provides more sophisticated fiscal controls. To remediate any inaccuracies, DDSD’s centralized auditor will assess findings and develop an action plan to prevent erroneous invoices. The CDSS ensures that all necessary controls are in place to verify the accuracy and proper documentation of invoices. The CDSS concludes that the sample size of 15 MER cases does not provide sufficient audit evidence that controls are not operating effectively resulting in a calculated $54,398 in potential costs. However, CDSS agrees with the finding and is committed to the control and mitigation of risk related to the audit recommendation. Estimated Implementation Date: Implemented Contact: Bernice Stanfield, Fiscal and Procurement Section Chief Central Support Services Branch Disability Determination Service Division California Department of Social Services
View Audit 352774 Questioned Costs: $1
CDPH is addressing the findings of the audit through a combination of outreach and training for internal stakeholders, updated internal policies, and data verification to ensure proper review and approval of the Form CMS-1539. Estimated Implementation Date: April 2025 Contact: Nate Gilmore, Branch ...
CDPH is addressing the findings of the audit through a combination of outreach and training for internal stakeholders, updated internal policies, and data verification to ensure proper review and approval of the Form CMS-1539. Estimated Implementation Date: April 2025 Contact: Nate Gilmore, Branch Chief Center for Health Care Quality California Department of Public Health
The CDSS disagrees with the finding. California’s subsidized child care system is locally operated. The CDSS relies on hundreds of local county offices and nonprofit agencies to administer child care and development programs at the local level, rather than having the State pay subsidized providers d...
The CDSS disagrees with the finding. California’s subsidized child care system is locally operated. The CDSS relies on hundreds of local county offices and nonprofit agencies to administer child care and development programs at the local level, rather than having the State pay subsidized providers directly. As a result, CDSS required Alternative Payment Programs, direct-service contractors that administer Family Child Care Home Education Networks, and fiscal partners to track survey completion as a prerequisite for awarding American Rescue Plan Act (ARPA) subgrants. This local infrastructure and the size of California’s subsidized child care and development system separates California from other states. As a result, CDSS worked very closely with the federal grantor, the Administration for Children and Families, to ensure that the ARPA survey methodology met federal monitoring requirements and tracked data elements required by the federal government. For this reason, CDSS believes it has fulfilled its responsibility and does not need to further establish a monitoring program. Estimated Implementation Date: Will not implement Contact: Jeff Fowler, Staff Services Manager III Child Care and Development Program California Department of Social Services
View Audit 352774 Questioned Costs: $1
Finding 554135 (2023-018)
Significant Deficiency 2023
DHCS recently implemented and instructed all staff on an improved leave management and timesheet submission process, effective November 20, 2024, beginning with the December 2024 pay period. The change addresses the recommendations from CSA by streamlining the submission, review, and storage of empl...
DHCS recently implemented and instructed all staff on an improved leave management and timesheet submission process, effective November 20, 2024, beginning with the December 2024 pay period. The change addresses the recommendations from CSA by streamlining the submission, review, and storage of employee timesheets, ensuring efficient and transparent management of time-related data across DHCS. Furthermore, the new process ensures a manager or supervisor reviews and approves all timesheets before submission. Estimated Implementation Date: November 20, 2024 Contact: California Department of Health Care Services • Primary – Erika Cristo Assistant Deputy Director, Behavioral Health • Secondary – Wendy Rasmussen, Chief, Office of Compliance - Internal Audits
Finding 554133 (2023-017)
Significant Deficiency 2023
Public Health’s Office of AIDS (OA) agrees with the finding and recommendation. OA introduced and fully implemented an internal Secondary Review (SR) process for all AIDS Drug Assistance Program (ADAP) applications in March 2018. This SR process enables ADAP staff to verify that contracted and certi...
Public Health’s Office of AIDS (OA) agrees with the finding and recommendation. OA introduced and fully implemented an internal Secondary Review (SR) process for all AIDS Drug Assistance Program (ADAP) applications in March 2018. This SR process enables ADAP staff to verify that contracted and certified enrollment workers across California are consistently adhering to eligibility and documentation requirements. However, due to staffing challenges caused by the redirection of staff during the state of emergency declared for the COVID-19 pandemic, ADAP faced significant workforce shortages from March 2020 through much of 2023. This caused a backlog in SR processing, which delayed tasks, including the review of this client’s application. The client’s eligibility lapsed after 130 days, before SR could be conducted. The Eligibility Operations Section (EOS) of ADAP which conducts SR, is now fully staffed and has successfully addressed the backlog. As of early 2024, SR processing has returned to normal operations and is current. Estimated Implementation Date: Already implemented as of April 2024 Contact: Joseph Lagrama, ADAP Branch Chief California Department of Public Health
DHCS implemented a process to impose payment withholds for significantly late cost reports, which addresses CSA’s recommendations. As of January 1, 2025, DHCS has issued 26 Notices of Delinquency to contracted counties of Short-Doyle funding (two notices for FY 2015-16, four notices for FY 2016-17, ...
DHCS implemented a process to impose payment withholds for significantly late cost reports, which addresses CSA’s recommendations. As of January 1, 2025, DHCS has issued 26 Notices of Delinquency to contracted counties of Short-Doyle funding (two notices for FY 2015-16, four notices for FY 2016-17, one notice for FY 2018-19, three notices for FY 2019-20, six notices for FY 2020-21, and ten notices for FY 2021-22). DHCS has received positive responses from some of the delinquent counties, stating the cost reports should be submitted shortly. If the counties do not submit their cost reports within 30 calendar days of the delinquency notice, DHCS will send a Notice of Intent to Impose Temporary Withhold of Funds with an option to meet and confer. If a county still has not submitted its cost report within 30 calendar days after Notice of Intent to Impose Temporary Withhold of Funds, the county will be put on Final Notice of Intent to Impose Temporary Withhold of Funds with an effective date of 30 days, at which time a withhold of funds will be processed. Estimated Implementation Date: January 1, 2025 Contact: California Department of Health Care Services • Primary – Ryan Whalen, Behavioral Health Interim Settlement, Section Chief, Audit & Investigations (A&I) Financial Review Outpatient and Behavioral Health Division (FROBHD) • Secondary – Lisa Alder, Behavioral Health Financial Review, Branch Chief, A&I FROBHD • Tertiary – Charles Anders, Behavioral Health Financing Branch, Chief, Local Governmental Financing Division (LGFD)
Finding 554122 (2023-005)
Significant Deficiency 2023
As reported in the prior year’s response, since fiscal year 2020-21, the Employment Development Department (EDD) has implemented dozens of strict anti-fraud measures and has continued to evaluate and enhance its fraud detection. EDD has also developed internal fraud working groups and a multiagency ...
As reported in the prior year’s response, since fiscal year 2020-21, the Employment Development Department (EDD) has implemented dozens of strict anti-fraud measures and has continued to evaluate and enhance its fraud detection. EDD has also developed internal fraud working groups and a multiagency fraud task force that reviews fraud data and fraud reports on a continual basis and recommends adjustments to filters and tools as necessary. EDD has successfully halted two large fraud scheme attempts over the previous two years and continues to work towards immediate detection and prevention of fraud attempts. EDD will continue to analyze and assess our processes to stay ahead of the ever-evolving fraud landscape. As previously described, EDD implemented the following measures to address the nationwide fraud attempts perpetrated against the new emergency federal benefit programs in 2020-21: • Implemented additional cross-matches in September 2020 to detect multiple claims per address. • Ceased automatically backdating PUA claims under federal rules in September 2020. • Strengthened identity verification procedures in October 2020 by implementing ID.me. • Implemented additional cross-matches in November 2020 against state inmate information. • Vetted applications against law enforcement databases and other tools provided by Thomson Reuters in December 2020 to further curb identity and non-identity fraud. • Established a 1099-G call center to help victims of identity theft deal with any tax-related questions. • Ceased printing Social Security numbers on mailed documents to reduce identity theft risk. • Enhanced benefit card security with Bank of America. • Partnered with state, local and federal law enforcement agencies to support thousands of criminal investigations, arrests, prosecutions and convictions. Estimated Implementation Date: Completed September 2024 Contact: Diane Underwood, Division Chief Unemployment Insurance Branch California Employment Development Department
View Audit 352774 Questioned Costs: $1
As reported in the prior year’s response, given the unprecedented volume of unemployment insurance claims during the federal disaster—approximately 20 million claims compared to 3.8 million during the Great Recession—EDD took action to speed payments to eligible claimants whenever possible. For exam...
As reported in the prior year’s response, given the unprecedented volume of unemployment insurance claims during the federal disaster—approximately 20 million claims compared to 3.8 million during the Great Recession—EDD took action to speed payments to eligible claimants whenever possible. For example, EDD launched in July 2021 a Conditional Payment Program to speed payments to claimants who certified for benefits and already received at least one week of benefits in the past but whose payments were later pending for more than two weeks. EDD also boosted its capacity to process workloads, prioritized timely payments, and employed automation among other measures. EDD began automatically cross-matching EDD wage records and Franchise Tax Board records in November 2020 to assist in verifying the income of PUA claimants who could not be automatically verified through these procedures. Such claimants were required to submit additional documentation to EDD for a manual review. Regarding the manual processing of the income documents to substantiate the PUA weekly benefit amounts that have been increased above the minimum California WBA of $167, and the verification of employment or self-employment substantiation (known in California as “Self-employment/Employment Substantiation” or “SEES”), based on the U.S. Department of Labor’s (DOL) guidance in Unemployment Insurance Program Letter 05 24, EDD notified DOL on February 6, 2024, that California Unemployment Insurance Code (CUIC) section 1376 bars EDD from resolving the wage verification and self-employment verification items. Section 1376 provides that EDD cannot establish overpayments more than one year after the close of the benefit year in which the overpayment was made unless the overpayment is found to be a result of fraud, misrepresentation, or willful nondisclosure. Given that there is no fraud in creating these overpayments on the part of the individuals identified in these populations, EDD is no longer able to establish overpayments for these populations. On May 31, 2024, DOL notified EDD that the February 6, 2024, submission regarding how California’s finality laws affect the actions required to correct the wage verification and self-employment findings is sufficient to close these findings. Estimated Implementation Date: Completed May 2024 Contact: Diane Underwood, Division Chief Unemployment Insurance Branch California Employment Development Department
View Audit 352774 Questioned Costs: $1
The purchase in question is related to the LSC Disaster funding. One of the primary purposes of this funding was to purchase a vehicle to enable OILS to provide quick response to disasters in Oklahoma. Due to LSC guidelines, OILS was required to receive prior approval from LSC for the purchase, whic...
The purchase in question is related to the LSC Disaster funding. One of the primary purposes of this funding was to purchase a vehicle to enable OILS to provide quick response to disasters in Oklahoma. Due to LSC guidelines, OILS was required to receive prior approval from LSC for the purchase, which OILS did request and receive. Additionally, the purchase of the vehicle was included in the annual budget approved by the Board of Directors. Clarifying language will be added to the Finance Manual under Section 6.1 Purchases to indicate that the Executive Director is authorized to execute all purchases in any amount, wherein the Board of Directors has provided prior approval and/or the funds for the activity have been appropriated in the adopted annual budget, including any contingency budget. Additionally, the management team collectively will work to ensure that purchases within the policy approval limits are brought to the Board for review and approval and that the approval is reflected in the meeting minutes. Anticipated Date of Conpletion: Revisions to teh Finance Manual, including the clarifying language in Section 6.1, will be submitted to the Board of Directors for adoption no later than the November 12, board meeting.
A meeting is held prior to audit with all accountants, Controller and CFO prior to audit to review total amount of grants awarded and/or funds received or spent. Responsible Contact Person - Mary Lou Tate, CFO Anctipated Completion Date - June 2024
A meeting is held prior to audit with all accountants, Controller and CFO prior to audit to review total amount of grants awarded and/or funds received or spent. Responsible Contact Person - Mary Lou Tate, CFO Anctipated Completion Date - June 2024
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