Corrective Action Plans

Finding 1217310 (2025-002)

Material Weakness 2025

Arisa Health INC

AR

Procurement, Suspension & Debarment Subrecipient Monitoring Questioned Costs

Contacts: Brian Lutz, VP of Accounting; Rob Busteed, Director of Accounting Contact Phone Numbers: 479-967-5570 Ext. 2013; 479-725-5117 Audit Period Ending: June 30, 2025 2025-002: The Corporation did not perform procedures to ensure vendors used in covered transactions were not suspended, debarred,...

Contacts: Brian Lutz, VP of Accounting; Rob Busteed, Director of Accounting Contact Phone Numbers: 479-967-5570 Ext. 2013; 479-725-5117 Audit Period Ending: June 30, 2025 2025-002: The Corporation did not perform procedures to ensure vendors used in covered transactions were not suspended, debarred, or otherwise excluded. Management concurs with the finding. Arisa has subsequently received a signed certification from the subcontractor dated 4/20/2026 indicating that the vendor was not debarred, suspended, or otherwise excluded from participation in federal assistance programs. For future federal awards, Arisa will collect a certification from the subcontractor/vendor indicating compliance with this requirement. Completion date: Beginning with May 2026 invoices, certifications are required to be included.

View Audit 403483

Finding 1217309 (2025-001)

Material Weakness 2025

Arisa Health INC

AR

Matching / Level of Effort / Earmarking Questioned Costs Reporting § 200.430

Contacts: Brian Lutz, VP of Accounting; Rob Busteed, Director of Accounting Contact Phone Numbers: 479-967-5570 Ext. 2013; 479-725-5117 Audit Period Ending: June 30, 2025 2025-001: The Corporation failed to meet the 80% level of effort requirements as stipulated in the grant agreements. Management c...

Contacts: Brian Lutz, VP of Accounting; Rob Busteed, Director of Accounting Contact Phone Numbers: 479-967-5570 Ext. 2013; 479-725-5117 Audit Period Ending: June 30, 2025 2025-001: The Corporation failed to meet the 80% level of effort requirements as stipulated in the grant agreements. Management concurs with the finding. Arisa’s time-keeping application is designed to meet FLSA recordkeeping requirements. This system does not contain a solution to subdivide hours worked by project in a manner that would satisfy level of effort reporting. Arisa will require employees in positions that are partially or fully funded through a federal contract containing level of effort requirements to complete and submit a separate paper timesheet documenting time worked on the federal contract. In addition, subcontractors will be required to include a certification on their invoices that applicable level of effort requirements were met. Program Staff were alerted of the deficiencies in April 2026. Completion date: May 2026.

View Audit 403483

Finding 1217302 (2025-002)

Material Weakness 2025

Alexander County Housing Authority

IL

Questioned Costs HUD Housing Programs Internal Control / Segregation of Duties

Tenant Files. 2025-001. Tenant Files Corrective action planned: The Corrective Action plan for this Audit Finding 2025-002 is that the Alexander County Housing Authority is under new management. The Housing Authority of Pulaski County was contracted on February 2, 2025, to manage this housing author...

Tenant Files. 2025-001. Tenant Files Corrective action planned: The Corrective Action plan for this Audit Finding 2025-002 is that the Alexander County Housing Authority is under new management. The Housing Authority of Pulaski County was contracted on February 2, 2025, to manage this housing authority. On this date, all HUD guidelines followed at Pulaski County were implemented at Alexander County Housing Authority. Contact person: JoAnn Pink, Executive Director. Anticipated completion date: September 30, 2026.

View Audit 403467

Finding 1217300 (2025-002)

Material Weakness 2025

Palm Beach County Housing Authority

FL

Questioned Costs Subrecipient Monitoring HUD Housing Programs

Housing Voucher Cluster – Assistance Listing No. 14.871 and 14.879 Recommendation: We recommend the Authority strengthen internal controls over HQS enforcement by implementing procedures to track and monitor HQS deficiencies and required correction timelines. Explanation of disagreement with audit f...

Housing Voucher Cluster – Assistance Listing No. 14.871 and 14.879 Recommendation: We recommend the Authority strengthen internal controls over HQS enforcement by implementing procedures to track and monitor HQS deficiencies and required correction timelines. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: PBCHA has made significant improvements in inspection compliance and will continue to monitor its third-party inspection vendor to ensure timely submission of inspection reports. The agency will utilize Yardi and other centralized tracking systems to monitor inspection due dates and follow-up activities, ensuring inspections are completed in accordance with HUD requirements. PBCHA will also provide ongoing staff training to reinforce NSPIRE requirements and compliance expectations. Name(s) of the contact person(s) responsible for corrective action: Yvette Bembry Planned completion date for corrective action plan: December 31, 2026

View Audit 403465

Finding 1217294 (2025-003)

Material Weakness 2025

Safehaven of Tarrant County

TX

Questioned Costs Period of Performance Significant Deficiency

Finding 2025-003: Period of Performance – Significant deficiency in internal controls over compliance and compliance finding. Management Response The agency has added another level of review for Requests for Reimbursement (RFRs) to improve internal controls. Effective 10.01.2025, grant expense charg...

Finding 2025-003: Period of Performance – Significant deficiency in internal controls over compliance and compliance finding. Management Response The agency has added another level of review for Requests for Reimbursement (RFRs) to improve internal controls. Effective 10.01.2025, grant expense charges are processed as follows: 1. Finance Assistant creates grant Request for Reimbursement (RFR). Upon completion of the RFR, theAssistant signs the RFR as completed, then submits completed RFR along with supportingdocumentation to the EVP of Finance. Formerly, the creation of the RFR was being done by the EVP of Finance, with the addition of staff, we were able to relocate those duties to Finance Assistance in the Fall of 2025. 2. The EVP of Finance reviews the RFR for correct calculations and if the appropriate supportingdocumentation is attached. The EVP of Finance signs the RFR, then presents it to the ChiefOperating Officer for final approval. 3. Chief Operating Officer receives RFR from EVP of Finance, reviews RFR and approves for submissionto the Grantor or sends back for corrections. Adding a staff member in the Finance department allowed us to add another level of approval. In addition, notations have been made on all internal grant tracking documents, as to the start of each grant period. A payroll pay calendar is accessible to verify the exact dates covered on a pay period.

View Audit 403455

Finding 1217291 (2025-001)

Material Weakness 2025

Safehaven of Tarrant County

TX

Internal Control / Segregation of Duties Questioned Costs Subrecipient Monitoring

Finding 2025-001: Reporting – Material weakness in internal controls over compliance and compliance finding. Management Response Effective May 12, 2026, the agency enhanced its performance reporting oversight by requiring the Chief of Mission and the Executive Vice President of Victim Services to re...

Finding 2025-001: Reporting – Material weakness in internal controls over compliance and compliance finding. Management Response Effective May 12, 2026, the agency enhanced its performance reporting oversight by requiring the Chief of Mission and the Executive Vice President of Victim Services to review and approve preliminary reports to funding entities drafted by the compliance department, prior to submission. The agency’s compliance department, which consists of a Database Manager, Compliance Manager, and Executive Vice President of Compliance, is tasked with ensuring reliability and validity of client-level database entered in the client database. Monthly, the agency’s compliance department reconciles the number of new and unduplicated participants served by the agency as a whole and within each grant-funded program. The compliance department’s report originator will save the source data electronically, ensuring it matches the official figures submitted to the funding entity. Source data reports will be available upon request by agency staff and/or funders.

View Audit 403455

Finding 1217267 (2025-002)

Material Weakness 2025

PRESERVATION TRUST OF VERMONT, INC.

VT

Questioned Costs Allowable Costs / Cost Principles Significant Deficiency § 200.303 § 200.508

The Organization acknowledges and concurs with the auditor’s finding as discussed within the Schedule of Findings and Questioned Costs for the year-ended September 30, 2025. During the audit for PTV’s fiscal year 2025, it was determined that we should add an additional layer of confirmation to our a...

The Organization acknowledges and concurs with the auditor’s finding as discussed within the Schedule of Findings and Questioned Costs for the year-ended September 30, 2025. During the audit for PTV’s fiscal year 2025, it was determined that we should add an additional layer of confirmation to our approval process. Currently, the President reviews invoices prior to signing the checks, thereby signaling approval. Moving forward, in addition to this review, the President will also confirm approval by initialing the invoice itself. Beyond this initial next step, PTV will also review its current Fiscal Policy to consider implementation of an approval process that allows other authorized approvers the authority to review expenses up to certain thresholds. Policy development at this level requires Finance Committee involvement and full Board approval, so it may take several months to fully implement a new process. We appreciate the opportunity to continue to strengthen PTV’s internal controls and financial operations.

View Audit 403427

Finding 1217260 (2025-002)

Material Weakness 2025

Cabrini of Westchester

NY

Questioned Costs HUD Housing Programs Significant Deficiency

Federal Agency: U.S. Department of Housing and Urban Development Federal Program Title: Supportive Housing for the Elderly Section 232 ALN Number: 14.129 Award Period: Year Ended December 31, 2025 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matters Criteria ...

Federal Agency: U.S. Department of Housing and Urban Development Federal Program Title: Supportive Housing for the Elderly Section 232 ALN Number: 14.129 Award Period: Year Ended December 31, 2025 Type of Finding: • Significant Deficiency in Internal Control over Compliance • Other Matters Criteria or specific requirement: HUD requires a signed management fee agreement when such transactions take place. Condition: Unallowed related party transactions were identified in 2025. Context: Affiliate dues were booked to the Home's cash clearing account as a credit for $400,000 with the understanding that these fees would qualify as a service contract rather than a management fee. However, due to the cash infused into the program by The Carmelite System, the $400,000 will not be noted as questioned costs needing to be repaid into the project. Recommendation: The Home should adhere to the Regulatory Agreement and obtain HUD’s approval prior to taking any actions specifically precluded in the Regulatory Agreement. Action taken in response to finding: There is no disagreement with the audit finding. Management will work to obtain proper approval going forward. If the U.S. Department of Housing and Urban Development has questions regarding this schedule, please call Corrinne Schindler at 518-537-7500 or CSchindler@CarmeliteSystem.org.

View Audit 403406

Finding 1217259 (2025-001)

Material Weakness 2025

Cabrini of Westchester

NY

Questioned Costs HUD Housing Programs Material Weakness

Federal Agency: U.S. Department of Housing and Urban Development Federal Program Title: Supportive Housing for the Elderly Section 232 ALN Number: 14.129 Award Period: Year Ended December 31, 2025 Type of Finding: • Material Weakness in Internal Control over Compliance • Other Matters Criteria or sp...

Federal Agency: U.S. Department of Housing and Urban Development Federal Program Title: Supportive Housing for the Elderly Section 232 ALN Number: 14.129 Award Period: Year Ended December 31, 2025 Type of Finding: • Material Weakness in Internal Control over Compliance • Other Matters Criteria or specific requirement: The Home was required to obtain written approval for the member substitution transaction with The Carmelite System, Inc. prior to closing. Condition: Membership transfer agreements must be in place and signed by HUD during the transition of Ownership / Governance. Context: Formal HUD approval was not obtained in relation the Member Substitution in which the Carmelite System, Inc. became the sole member and sponsor of the Home. Recommendation: The Home should adhere to the Regulatory Agreement and obtain HUD’s approval prior to taking any actions specifically precluded in the Regulatory Agreement. Action taken in response to finding: There is no disagreement with the audit finding. Management is working to obtain the necessary HUD approvals.

View Audit 403406

Finding 1217240 (2025-005)

Material Weakness 2025

Community Health Improvement Center, Inc. D/b/a Crossing Healthcare

IL

Questioned Costs Reporting Internal Control / Segregation of Duties § 200.329

Finding summary – The Organization’s annual UDS report was selected for testing. Of the ten inputs tested, four exceptions were noted as the Organization was unable to provide supporting documentation that agreed to the line items tested on the report. Corrective Action Planned - Management has enga...

Finding summary – The Organization’s annual UDS report was selected for testing. Of the ten inputs tested, four exceptions were noted as the Organization was unable to provide supporting documentation that agreed to the line items tested on the report. Corrective Action Planned - Management has engaged with an independent 3rd party accounting firm to review current processes, assist with strengthening internal controls and month-end/year-end closing procedures, and provide assistance in completing the Organization’s annual UDS report. Anticipated Completion Date – Completed 1/1/2026 Responsible Contact Person – Margret Guy, Director of Revenue; Julie Brilley, CEO Management Response - Management concurs with the auditor's finding. The Organization acknowledges that a mistake was made on Table 9E-Other Revenue, where grant income, from the Early Childhood Development (ECD) grant, was listed in the incorrect location. The ECD grant should have been listed under Federal Grants: UHI Grant Revenue. Additionally, the Organization’s UDS preparer, completed a transposition error when entering a salary amount in Table 8A.

View Audit 403385

Finding 1217239 (2025-004)

Material Weakness 2025

Community Health Improvement Center, Inc. D/b/a Crossing Healthcare

IL

Questioned Costs Special Tests & Provisions Subrecipient Monitoring

Finding summary – Patients received sliding fee discounts that were inconsistent with the stated sliding fee discount categories under the Organization’s policy. Corrective Action Planned – 1. Crossing has implemented a billing workflow to automatically apply sliding fee scale discounts to all eligi...

Finding summary – Patients received sliding fee discounts that were inconsistent with the stated sliding fee discount categories under the Organization’s policy. Corrective Action Planned – 1. Crossing has implemented a billing workflow to automatically apply sliding fee scale discounts to all eligible self-pay accounts during the billing process, eliminating manual charge adjustments and improving consistency with established guidelines. 2. All billing staff have received retraining on the correct manual posting procedures for sliding fee scale adjustments after insurance payment, ensuring compliance with patient income verification and applicable percentage guidelines. 3. We will continue ongoing monitoring and review of accounts receiving sliding fee scale adjustments to ensure accurate and compliant application of the approved discount and percentages. Anticipated Completion Date – Completed 4/1/2026 Responsible Contact Person – Margret Guy, Director of Revenue; Julie Brilley, CEO Management Response - Management concurs with the auditor's finding. The Organization acknowledges that patients received sliding fee discounts that were inconsistent with the stated sliding fee discount categories under the Organization’s policy. The corrective action plan has been successfully implemented and will be monitored regularly to ensure compliance.

View Audit 403385

Finding 1217233 (2025-004)

Material Weakness 2025

CITY OF DAYTON

MN

Questioned Costs Material Weakness Internal Control / Segregation of Duties

Community Project Funding (CFP) Program – Assistance Listing No. 14.251 Recommendation: We recommend the City ensure environmental review requirements are completed and documented prior to incurring any project-related expenditures for the Community Project Funding program. The City should continue ...

Community Project Funding (CFP) Program – Assistance Listing No. 14.251 Recommendation: We recommend the City ensure environmental review requirements are completed and documented prior to incurring any project-related expenditures for the Community Project Funding program. The City should continue to maintain procedures designed to prevent project activities from beginning before environmental review requirements are satisfied. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: City management noted that procedures have been implemented for this grant, including a memorandum of understanding that is annually reaffirmed by the City Council, to ensure environmental review requirements are completed prior to incurring project expenditures and to prevent similar occurrences in the future.. Name of the contact person responsible for corrective action: Zach Doug Planned completion date for corrective action plan: December 31, 2026

View Audit 403370

Finding 1217232 (2025-003)

Material Weakness 2025

CITY OF DAYTON

MN

Internal Control / Segregation of Duties Questioned Costs Material Weakness § 200.303

Community Project Funding (CFP) Program – Assistance Listing No. 14.251 Recommendation: We recommend the City implement procedures to ensure appropriate internal controls over compliance related to reporting, including documentation of review and approval of all required reports by someone other tha...

Community Project Funding (CFP) Program – Assistance Listing No. 14.251 Recommendation: We recommend the City implement procedures to ensure appropriate internal controls over compliance related to reporting, including documentation of review and approval of all required reports by someone other than the preparer prior to submission. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: City management acknowledges that limited staffing and experience constrain segregation of duties; however, the City will evaluate and implement procedures to improve documentation of review and approval of required reports for the Community Project Funding program. Name of the contact person responsible for corrective action: Zach Doug Planned completion date for corrective action plan: December 31, 2026

View Audit 403370

Finding 1217223 (2025-003)

Material Weakness 2025

School Board City of Richmond

VA

Questioned Costs Significant Deficiency Internal Control / Segregation of Duties

Views of Responsible Officials and Planned Corrective Action: Responsible officials acknowledge the finding and agree that documentation supporting student removals from the adjusted cohort was not maintained timely in all instances. Management stated that it will implement enhanced procedures and s...

Views of Responsible Officials and Planned Corrective Action: Responsible officials acknowledge the finding and agree that documentation supporting student removals from the adjusted cohort was not maintained timely in all instances. Management stated that it will implement enhanced procedures and supervisory review processes to ensure required documentation is obtained and retained timely for all applicable students going forward.

View Audit 403361

Finding 1217212 (2025-002)

Material Weakness 2025

South Seven Senior Village

WA

Eligibility Significant Deficiency Questioned Costs

Management Response: Management concurs with the findings. OlyCAP recognizes the importance of maintaining complete and accurate tenant eligibility documentation to demonstrate compliance with HUD program requirements. The missing background verification documentation identified during the audit app...

Management Response: Management concurs with the findings. OlyCAP recognizes the importance of maintaining complete and accurate tenant eligibility documentation to demonstrate compliance with HUD program requirements. The missing background verification documentation identified during the audit appears to be the result of incomplete lease up processes at project inception in 2005. While management believes eligibility determinations were appropriately made, supporting documentation was not obtained in the early period of the project. Corrective Action Plan: 1. OlyCAP has implemented a standardized tenant file checklist identifying all required eligibility and compliance documentation, including background verification records, income documentation, lease agreements, and other required tenant file components. 2. Housing program staff has been trained on file documentation requirements, records retention standards, and file review procedures. 3. Management conducted a comprehensive review in 2024 of all current tenant files to identify missing documentation. 4. Supervisory file reviews are conducted on all tenant files at lease up using the standardized checklist to verify that required documentation is complete and maintained in accordance with program requirements. These corrective actions are intended to strengthen internal controls over tenant eligibility documentation and ensure ongoing compliance with HUD requirements. Anticipated Completion Date: July 1, 2026 Responsible officials: .Executive Director .Housing Director .Housing Program Managers .Compliance and Quality Assurance Staff

View Audit 403348

Finding 1217195 (2025-001)

Material Weakness 2025

Dowagiac Housing Commission

MI

HUD Housing Programs Questioned Costs Eligibility

Housing Choice Vouchers – CFDA 14.871 Recommendation: The Commission should consider reviewing its current policy regarding rent certifications. The Commission should ensure all persons involved in the certification process are properly trained and understand regulations in order to accurately ident...

Housing Choice Vouchers – CFDA 14.871 Recommendation: The Commission should consider reviewing its current policy regarding rent certifications. The Commission should ensure all persons involved in the certification process are properly trained and understand regulations in order to accurately identify errors. Additionally, the Commission should implement a thorough second party review of annual certifications to verify accuracy. Action Taken: Management will implement stronger controls over tenant files including a more thorough second party review. Anticipated Completion Date of Action: August 31, 2025

View Audit 403316

Finding 1217192 (2025-004)

Material Weakness 2025

Johnston County

NC

Eligibility Internal Control / Segregation of Duties Questioned Costs

Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Q...

Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Question Costs Darren Phillips, Quality Assurance and Program Integrity Supervisor We are building a training slideshow presentation to provide tenured caseworkers refresher training for all of the Internal Error findings. This will cover Incorrect Resources, Incorrect Income, Incorrect HH and Residency issues. The SSI expartes that were in error have been completed as of 12/10/2025. We will cover the use of NCFAST reports to ensure that they are worked in a timely manner. A greater emphasis will be placed during training of new hires in the areas of the errors found. Supervisors will provide policy updates and review the income and recertification policies in the Monthly Unit Meetings. The Medicaid Division Director will meet with the Medicaid supervisors to address the untimely reviews and put a plan into place to work them in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. Training will be provided by 2/28/2026 for all Medicaid personnel. Darren Phillips, Quality Assurance and Program Integrity Supervisor We are currenty building a training slideshow presentation to provide tenured caseworkers refresher training on how to update income on cases. The training will cover Self-Employment, the use of pay stubs and pulling income from OVS and TWN. The training will cover both error findings, Incorrect Income and Inadequate Request for Income. A greater emphasis will be placed on the training of new hires for the areas of the errors found. A Desk Reference will be created to assist caseworkers with their duties. Supervisors will provide policy updates and review the income and recertification policies in their Monthly Unit Meetings. The Medicaid Director will meet with the Medicaid Supervisors to discuss the Untimely Reviews to ensure that cases are completed in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. 230

View Audit 403310

Finding 1217191 (2025-003)

Material Weakness 2025

Johnston County

NC

Eligibility Internal Control / Segregation of Duties Questioned Costs

Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Q...

Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Question Costs Darren Phillips, Quality Assurance and Program Integrity Supervisor We are building a training slideshow presentation to provide tenured caseworkers refresher training for all of the Internal Error findings. This will cover Incorrect Resources, Incorrect Income, Incorrect HH and Residency issues. The SSI expartes that were in error have been completed as of 12/10/2025. We will cover the use of NCFAST reports to ensure that they are worked in a timely manner. A greater emphasis will be placed during training of new hires in the areas of the errors found. Supervisors will provide policy updates and review the income and recertification policies in the Monthly Unit Meetings. The Medicaid Division Director will meet with the Medicaid supervisors to address the untimely reviews and put a plan into place to work them in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. Training will be provided by 2/28/2026 for all Medicaid personnel. Darren Phillips, Quality Assurance and Program Integrity Supervisor We are currenty building a training slideshow presentation to provide tenured caseworkers refresher training on how to update income on cases. The training will cover Self-Employment, the use of pay stubs and pulling income from OVS and TWN. The training will cover both error findings, Incorrect Income and Inadequate Request for Income. A greater emphasis will be placed on the training of new hires for the areas of the errors found. A Desk Reference will be created to assist caseworkers with their duties. Supervisors will provide policy updates and review the income and recertification policies in their Monthly Unit Meetings. The Medicaid Director will meet with the Medicaid Supervisors to discuss the Untimely Reviews to ensure that cases are completed in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. 230

View Audit 403310

Finding 1216984 (2025-002)

Material Weakness 2025

The Village at Oasis Park - Phase Ii, Inc.

AZ

Questioned Costs HUD Housing Programs

Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner, therefore HUD is un...

Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner, therefore HUD is unable to track subsidies and ultimately pay for 2025 amounts timely. Context: The Organization hired an outside consultant and it was unclear who was responsible for filing the monthly vouchers. Vouchers were not filed timely but were filed and amounts were received subsequent to year end. Response: The Organization will ensure access to systems and reports are submitted timely. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.

View Audit 403291

Finding 1216982 (2025-001)

Material Weakness 2025

The Village at Oasis Park - Phase Ii, Inc.

AZ

Questioned Costs

Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Requi...

Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Required deposits were made but they were not made monthly due to cash flow restraint. Response: The Organization will make the required deposits monthly if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.

View Audit 403291

Finding 1216980 (2025-003)

Material Weakness 2025

The Village at Oasis Park - Phase I, Inc.

AZ

Questioned Costs HUD Housing Programs

Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner. Context: The Organi...

Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner. Context: The Organization hired an outside consultant and it was unclear who was responsible for filing the monthly vouchers. Vouchers were not filed timely but were filed and amounts were received subsequent to year end. Response: The Organization will review policies and procedures to verify reports are submitted timely. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.

View Audit 403290

Finding 1216978 (2025-002)

Material Weakness 2025

The Village at Oasis Park - Phase I, Inc.

AZ

Questioned Costs HUD Housing Programs

Security Deposit Account Does Not Cover Liability Criteria: The amount of the segregated, interest-bearing account maintained by The Village at Oasis Park - Phase I, Inc. for security deposits must at all times equal the total amount collected from the families then in occupancy plus any accrued int...

Security Deposit Account Does Not Cover Liability Criteria: The amount of the segregated, interest-bearing account maintained by The Village at Oasis Park - Phase I, Inc. for security deposits must at all times equal the total amount collected from the families then in occupancy plus any accrued interest and less allowable administrative costs adjustments. Condition: The amount within the segregated, interest-bearing security deposits account was less than security deposits liability. Context: A separate, interest-bearing account is maintained, but did not total an amount equal or greater than the security deposit liability due to cash flow restraint. Response: The Organization will make a deposit to security deposit account if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.

View Audit 403290

Finding 1216976 (2025-001)

Material Weakness 2025

The Village at Oasis Park - Phase I, Inc.

AZ

Questioned Costs

Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Requi...

Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Required deposits were made but they were not made monthly due to cash flow restraint. Response: The Organization will make the required deposits monthly if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.

View Audit 403290

Finding 1216961 (2025-002)

Material Weakness 2025

Clinica Sierra Vista

CA

Cash Management Questioned Costs Subrecipient Monitoring § 200.305

2025-002 Cash Management Corrective action planned: Management will implement controls over all draws from the Payment Management System to minimize the time elapsed between the drawdown of funds from PMS and the payment for expenditures. The controls will incorporate the following: Prepare a detail...

2025-002 Cash Management Corrective action planned: Management will implement controls over all draws from the Payment Management System to minimize the time elapsed between the drawdown of funds from PMS and the payment for expenditures. The controls will incorporate the following: Prepare a detailed listing of expenditures claimed for reimbursement for each drawdown request. The expenditures listing will be reviewed by appropriate personnel to ensure cash payments for the expenditure are made before the date of the draw or within a reasonable time after the draw. Drawdowns are authorized and approved by the appropriate personnel before the drawdown is made and will be tracked and summarized in a ledger. Anticipated completion date: June 2026 Contact person responsible for corrective action: Harjeet Sidhu, Chief Financial Officer

View Audit 403260

Finding 1216764 (2025-002)

Material Weakness 2025

Planned Parenthood North Central States

MN

Internal Control / Segregation of Duties Questioned Costs Eligibility

Title X – Assistance Listing No. 93.217 Recommendation: We recommend management review its patient intake process to ensure income and household size is properly verified, the control is adequately documented and retained in accordance with organizational policies and program requirements. Explanati...

Title X – Assistance Listing No. 93.217 Recommendation: We recommend management review its patient intake process to ensure income and household size is properly verified, the control is adequately documented and retained in accordance with organizational policies and program requirements. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: With our recent transition from NextGen to Epic, PPNCS is establishing a new process to ensure patient income and household size are accurately identified and documented in our medical records system. With the enhanced functionalities available in Epic, patients now have the ability to pre-register for appointments via e-Check In. This eliminates reliance on the formerly manual process of patients documenting their income and household size on the registration form (B209) which staff would then enter into the medical records system. In addition, PPNCS will continue to perform internal audits, ensuring that the information provided via e-Check In is accurately reflected in the medical records system. PPNCS’s Standard Operating Procedure will be updated to reflect these changes by July 1, 2026. Name of the contact person responsible for corrective action: Randy Drager, CFO Planned completion date for corrective action plan: July 1, 2026

View Audit 403225

Corrective Action Plans

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