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Corrective Action Plans

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Finding 554574 (2024-002)
Significant Deficiency 2024
Okc Charter Santa Fe South Schools No. G-021
OK
Equipment & Real Property Management Questioned Costs Procurement, Suspension & Debarment § 200.313
Amend the property records invenotry procedures to follow 2 CFR Section 200.313 (3 through (2); see the criteria of the finding for the detailed list of requirements.
Amend the property records invenotry procedures to follow 2 CFR Section 200.313 (3 through (2); see the criteria of the finding for the detailed list of requirements.
View Audit 353277
Finding 554572 (2024-003)
Significant Deficiency 2024
Trinity Services, Inc.
IL
Questioned Costs Allowable Costs / Cost Principles
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are a...
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are accurately stated.
View Audit 353273 Questioned Costs: $1
Finding 554571 (2024-002)
Significant Deficiency 2024
Trinity Services, Inc.
IL
Allowable Costs / Cost Principles Questioned Costs Reporting
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are a...
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are accurately stated.
View Audit 353273 Questioned Costs: $1
Finding 554570 (2024-001)
Significant Deficiency 2024
Trinity Services, Inc.
IL
Allowable Costs / Cost Principles Questioned Costs Reporting
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are a...
The Organization will enhance its procedures and internal controls with respect to preparation and requests of funds. Grant agreements will be reviewed to confirm if expenditures being requested are allowed. The Organization will add a secondary level of review to ensure reimbursement requests are accurately stated.
View Audit 353273 Questioned Costs: $1
Finding 554541 (2024-004)
Significant Deficiency 2024
Falmouth Housing Authority
MA
HUD Housing Programs Internal Control / Segregation of Duties Questioned Costs
2024-004 - REPORTING Significant Deficiency Auditee’s Response and Planned Corrective Action As with 2024-001, this finding was based on a HUD system error that prevented submission on the due date. FHA experienced transition in the fiscal department and is cross-training backup personnel. A 10-day ...
2024-004 - REPORTING Significant Deficiency Auditee’s Response and Planned Corrective Action As with 2024-001, this finding was based on a HUD system error that prevented submission on the due date. FHA experienced transition in the fiscal department and is cross-training backup personnel. A 10-day buffer will be applied internally to submission deadlines to ensure on-time filing regardless of staff changes and absences. Planned Implementation Date of Corrective Action: Immediate Person Responsible for Corrective Action: Bobbi Richards, Executive Director
View Audit 353264
Finding 554530 (2024-005)
Material Weakness 2024
Inner City Health Center
CO
Questioned Costs Allowable Costs / Cost Principles Period of Performance § 200.1 § 200.303
Recommendation: Our auditors recommended the Organization update their method of allocating expenditures to federal awards based on invoice date to ensure the incurred date is within the proper period of performance. Explanation of disagreement with audit finding: There is no disagreement with the ...
Recommendation: Our auditors recommended the Organization update their method of allocating expenditures to federal awards based on invoice date to ensure the incurred date is within the proper period of performance. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Organization will review grant requirements and make sure that allowable costs are incurred and allocated to the grant within the grant period.
View Audit 353251 Questioned Costs: $1
Freeport Union Free School District
NY
Subrecipient Monitoring Questioned Costs Cash Management § 200.344
Significant Deficiency Other Matter – Non-Major Federal Award Program 2024-002. Questioned Costs United States Department of Education, Passed Through New York State, Department of Education: Special Education Cluster Special Education Grants to States: IDEA Part B ALN: 84.027 Pass-through Entity Nu...
Significant Deficiency Other Matter – Non-Major Federal Award Program 2024-002. Questioned Costs United States Department of Education, Passed Through New York State, Department of Education: Special Education Cluster Special Education Grants to States: IDEA Part B ALN: 84.027 Pass-through Entity Number: 0032-23-0415 Condition: The District received total reimbursement for its 2022-2023 IDEA, Part B (Section 611) Federal grant award that exceeded the program’s final total expenditures, but did not notify the pass-through entity of the overpayment to refund the overpayment. Planned Corrective Action: The District’s Assistant Business Administrator will contact the NYSED for instructions to submit a corrected final expenditure report, and begin the overpayment refund process. Responsible Contact Person: Mr. Ivono Stintug Assistant Business Administrator Freeport Union Free School District 235 North Ocean Avenue Freeport, New York 11520 Tel: (516) 867-5235 Email: istintug@freeportschools.org Anticipated Completion Date: April 30, 2025.
View Audit 353213 Questioned Costs: $1
Finding 554520 (2024-001)
Significant Deficiency 2024
Lupus Foundation of America, Inc.
DC
Questioned Costs Special Tests & Provisions Significant Deficiency
LUPUS FOUNDATION OF AMERICA, INC. CORRECTIVE ACTION PLAN For the Year Ended September 30, 2024 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Lupus Foundation of America, Inc. (the Foundation) submits the following corrective action plan for the year ended September 30, 2024. Independent Public Ac...
LUPUS FOUNDATION OF AMERICA, INC. CORRECTIVE ACTION PLAN For the Year Ended September 30, 2024 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Lupus Foundation of America, Inc. (the Foundation) submits the following corrective action plan for the year ended September 30, 2024. Independent Public Accounting Firm: CBIZ CPAs P.C. 1899 L Street NW, Suite 850 Washington, DC 20036 Audit Period: The finding from the September 30, 2024 schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FEDERAL AWARD FINDINGS AND QUESTIONED COSTS Finding No. 2024-001: Special Tests and Provisions – Significant Deficiency – Internal Control and Compliance Finding ALN 93.068 – Chronic Diseases: Research, Control, and Prevention, Grant Number 5NU58DP006907-04-00, Grant Period: September 30, 2020 to September 29, 2025 Condition The Foundation did not have adequate internal control procedures in place to ensure that certain disclaimers required by the grant agreements are included in written conference materials or publications. Context One of two conference materials we reviewed did not include the required disclaimer. Recommendation It was recommended that management enhance current internal control procedures to ensure that the Foundation is in compliance with the grant’s special provisions that requires certain disclaimers in written conference materials or publications. Action Taken PULSE Team Check-Ins: • Incorporate disclaimer compliance as a standing agenda item during bi-weekly PULSE team meetings to review upcoming materials and confirm adherence to requirements. • The Directors (Content and Federal Grants and Public Health Programs) Program Manager will be assigned to monitor and track the inclusion of disclaimers. Quarterly Compliance Review: • Implement a quarterly review process to assess all conference materials and publications for the inclusion of required disclaimers. • Document review findings and corrective actions, if applicable, to ensure consistent compliance. Executive Leadership Reporting: • Provide updates to executive leadership on all conference materials and publications produced and disclaimer compliance status, including any identified issues and corrective actions taken. • Share compliance trends and recommendations for ongoing improvement to reinforce accountability and oversight. Contact Person Responsible for Corrective Action: Dr. Melicent R. Miller, Director, Federal Grants and Public Health Programs If the US Department of Health and Human Services has questions regarding this plan, please call Cynthia R. Meekins, Chief Financial Officer at 202.349.1141 or meekins@lupus.org Sincerely, Cynthia R. Meekins, MBA Chief Financial Officer Lupus Foundation of America
View Audit 353210
Sycamore Square Housing Corporation
CA
HUD Housing Programs Questioned Costs Matching / Level of Effort / Earmarking
A. Current Findings on the Schedule of Findings, Questioned Costs and Recommendations 1. Finding 2024-001 a. Comments on the Finding and Each Recommendation Management concurs that the Project paid expenses in the amount of $14,215 on behalf of an affiliate from project cash without HUD approval. ...
A. Current Findings on the Schedule of Findings, Questioned Costs and Recommendations 1. Finding 2024-001 a. Comments on the Finding and Each Recommendation Management concurs that the Project paid expenses in the amount of $14,215 on behalf of an affiliate from project cash without HUD approval. b. Action(s) Taken or Planned on the Finding Management has retrained staff, reaffirmed the review and approval processes to ensure accuracy and existence of each transaction to ensure no cash disbursements are made on behalf of affiliates without HUD approval. Management will continue to reinforce its internal processes to prevent and detect unauthorized cash disbursements from project assets. It has requested reimbursement from the affiliated project, and the funds have been reimbursed.
View Audit 353197 Questioned Costs: $1
Finding 554518 (2024-002)
Material Weakness 2024
Bassett Creek Senior Housing 092-Ee037
MN
Questioned Costs Eligibility HUD Housing Programs
Corrective Action: The Organization agrees with the finding. Currently, management plans to transition 50% of its real estate portfolio to new property management in 2025. Management is working with the new property managers to ensure they have procedures in place to document and maintain tenant fil...
Corrective Action: The Organization agrees with the finding. Currently, management plans to transition 50% of its real estate portfolio to new property management in 2025. Management is working with the new property managers to ensure they have procedures in place to document and maintain tenant files in accordance with HUD and will have routine internal audits of tenant files to ensure compliance with HUD regulations. For properties not transitioning to new property management, management believes the reduced volume of properties at one property manager will reduce staff turnover and more efficiently provide the proper training to existing staff to improve compliance with tenant files. Proposed completion date: Management has begun the corrective action and is expected to have additional internal controls in place by December 31, 2025. Name of contact person: Jennifer Anderson, Interim CFO
View Audit 353189
Finding 554517 (2024-001)
Material Weakness 2024
Bassett Creek Senior Housing 092-Ee037
MN
HUD Housing Programs Questioned Costs Eligibility
Corrective Action: The Organization agrees with the finding and has continued to implement strategies to address the finding. To address this finding, management has assembled and deployed a team of external consultants and temporary workers to assist site staff in completing tenant recertifications...
Corrective Action: The Organization agrees with the finding and has continued to implement strategies to address the finding. To address this finding, management has assembled and deployed a team of external consultants and temporary workers to assist site staff in completing tenant recertifications and hired a team of additional roving property management/compliance teams to cover open property management positions and to support site staff in completing tenant recertifications. Currently, management plans to transition 50% of its real estate portfolio to new property management in 2025. Proposed completion date: Management has begun the corrective action and is expected to have additional internal controls in place by December 31, 2025. Name of contact person: Jennifer Anderson, Interim CFO
View Audit 353189
Finding 554511 (2024-006)
Material Weakness 2024
Sandhills Medical Foundation, Inc.
SC
Questioned Costs Cash Management
In Finding 2024-006, The Organization made several draws of federal funds for which expenditures were not documented at the time of the draw. The Organization is required to identify related expenditures prior to the transfer of funds to the Organization from the U.S. Treasury. Management recognize...
In Finding 2024-006, The Organization made several draws of federal funds for which expenditures were not documented at the time of the draw. The Organization is required to identify related expenditures prior to the transfer of funds to the Organization from the U.S. Treasury. Management recognizes the importance of the requirements to disburse federal funds in a timely manner. In response to Finding 2024-006, procedures. will be established to document these expenditures prior to transferring the from the U.S. Treasury to ensure that advance draws of federal funds do not occur.
View Audit 353175
Finding 554508 (2024-005)
Material Weakness 2024
Sandhills Medical Foundation, Inc.
SC
Questioned Costs Allowable Costs / Cost Principles
In Finding 2024-005, it was reported that time and activity reports are not maintained for salaried employees. The Organization’s operating processes in place do not require salaried employees to certify time and efforts on a monthly basis. In response to Finding 2024-005, procedures will be establ...
In Finding 2024-005, it was reported that time and activity reports are not maintained for salaried employees. The Organization’s operating processes in place do not require salaried employees to certify time and efforts on a monthly basis. In response to Finding 2024-005, procedures will be established to maintain time and effort certifications by all salaried employees. Procedures will be established to ensure that salaried employees certify time and effort that coincide with the Organization’s payroll cycle (at least on a monthly basis).
View Audit 353175
Realife of Columbus
NE
Questioned Costs HUD Housing Programs
The final approved budget will be used in determining funding requirements. Monthly deposits into the reserve have been restarted and the reserve is scheduled to reach the 25% funding threshold in the upcoming fiscal year.
The final approved budget will be used in determining funding requirements. Monthly deposits into the reserve have been restarted and the reserve is scheduled to reach the 25% funding threshold in the upcoming fiscal year.
View Audit 353124 Questioned Costs: $1
Finding 554475 (2024-002)
Significant Deficiency 2024
Tri-County Community Action Partnership, Inc.
MN
Questioned Costs Cash Management Significant Deficiency § 200.303
Head Start - AL #93.6000 Recommendation: The Organization should establish a backup signatory process to ensure that there is always an available individual to provide necessary signatures, even during periods of unavailability. Explanation of disagreement with audit finding: There is no disagreemen...
Head Start - AL #93.6000 Recommendation: The Organization should establish a backup signatory process to ensure that there is always an available individual to provide necessary signatures, even during periods of unavailability. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to the findings: We implement a policy to ensure there is someone available to provide signatures. Name(s) of the contact person(s) responsible for corrective action: Penny Paul Planned completion date for corrective action plan: September 30, 2025
View Audit 353111
Finding 554458 (2024-002)
Material Weakness 2024
Northeast Metropolitan Intermediate School District No. 916
MN
Internal Control / Segregation of Duties Questioned Costs Special Tests & Provisions
MATERIAL WEAKNESS IN INTERNAL CONTROL OVER COMPLIANCE AND MATERIAL NONCOMPLIANCE – U.S. DEPARTMENT OF EDUCATION, PASSED THROUGH MINNESOTA DEPARTMENT OF EDUCATION, COVID-19 – EDUATION STABILIZATION FUND – FEDERAL ALN 84.425 2024-002 Internal Control Over Compliance and Material Noncompliance With S...
MATERIAL WEAKNESS IN INTERNAL CONTROL OVER COMPLIANCE AND MATERIAL NONCOMPLIANCE – U.S. DEPARTMENT OF EDUCATION, PASSED THROUGH MINNESOTA DEPARTMENT OF EDUCATION, COVID-19 – EDUATION STABILIZATION FUND – FEDERAL ALN 84.425 2024-002 Internal Control Over Compliance and Material Noncompliance With Special Tests and Provisions Over Wage Rate Requirements Finding Summary 29 CFR part 5 requires the District to establish and maintain effective internal control over compliance with requirements applicable to federal program expenditures, including wage rate requirements applicable to the education stabilization fund. During our audit, we noted the District did not have sufficient controls in place resulting in material noncompliance within its education stabilization funds federal program to ensure compliance with wage rate requirements related to minor remodeling, renovation, or construction contracts that are over $2,000 that use laborers and mechanics that are required to meet Davis-Bacon Act prevailing wage rate requirements. Corrective Action Plan Actions Planned – The District is in the process of reviewing and updating its policies and procedures relating to wage rate requirements for its federal programs to ensure compliance with the Uniform Guidance in the future. The review of procedures will also include steps to ensure that district personnel are following the requirements of the Uniform Guidance related to wage rate requiremetns and maintaining appropriate documentation. Official Responsible – The District’s Director of Finance and Operations, Mark Kumlien. Planned Completion Date – June 30, 2025. Disagreement With or Explanation of Finding – The District is in agreement with this finding. Plan to Monitor – The District’s Director of Finance and Operations, Mark Kumlien, will assure appropriate internal controls and procedures are updated and in place to ensure compliance with wage rate requirements.
View Audit 353092
Northwest Estates 811
WA
Questioned Costs HUD Housing Programs Matching / Level of Effort / Earmarking
Agent will be diligent in practicing procedures already in place. The agent will obtain HUD approval of any replace from HUD controlled reserves prior to releasing funds.
Agent will be diligent in practicing procedures already in place. The agent will obtain HUD approval of any replace from HUD controlled reserves prior to releasing funds.
View Audit 353089 Questioned Costs: $1
Finding 554452 (2024-001)
Significant Deficiency 2024
Northwest Estates 811
WA
Questioned Costs HUD Housing Programs Internal Control / Segregation of Duties
Agent will be diligent in practicing procedures already in place. The agent will obtain HUD approval of any replace from HUD controlled reserves prior to releasing funds.
Agent will be diligent in practicing procedures already in place. The agent will obtain HUD approval of any replace from HUD controlled reserves prior to releasing funds.
View Audit 353089 Questioned Costs: $1
Finding 554416 (2024-003)
Significant Deficiency 2024
City of Edinburg
TX
Questioned Costs Reporting Significant Deficiency
Recommendation: We recommend that the City adhere to the Compliance and Reporting Guidance for the SLFRF program and establish internal controls to ensure the City submits required reports when they are due. Views of Responsible Officials: The City has changed the process to submit their Quarterly r...
Recommendation: We recommend that the City adhere to the Compliance and Reporting Guidance for the SLFRF program and establish internal controls to ensure the City submits required reports when they are due. Views of Responsible Officials: The City has changed the process to submit their Quarterly reports. Reports are reviewed by the Grants Administration Department and Finance Department before they are submitted. The Finance Department has implemented procedures to ensure that all reports are processed and submitted timely. Proposed Completion Date: Fiscal Year 2024-2025 Contact Person: Ascencion Alonzo, Director of Finance, City of Edinburg
View Audit 353076
Finding 554347 (2024-001)
Significant Deficiency 2024
Barry County
MI
Questioned Costs Significant Deficiency Internal Control / Segregation of Duties
March 25, 2025 CORRECTIVE ACTION PLAN Pursuant to federal regulations, Uniform Administrative Requirements Section 200.511, the following are the findings, as noted in the Barry County Transit’s Single Audit report for the year ended September 30, 2024, and corrective actions to be completed. Fin...
March 25, 2025 CORRECTIVE ACTION PLAN Pursuant to federal regulations, Uniform Administrative Requirements Section 200.511, the following are the findings, as noted in the Barry County Transit’s Single Audit report for the year ended September 30, 2024, and corrective actions to be completed. Finding: 2024-001 – Internal Control Over Federal Awards – Allowability of Costs and Allowable Activities Auditor Description of Condition and Effect: Costs must meet certain general criteria to be allowable under federal awards. One criterion is that the costs be adequately documented. Several of the payroll expenses that were selected for testing did not have employee timecards with evidence that they were reviewed and authorized for payment by their immediate supervisor. As a result of this condition, the Transit does not have adequate documentation demonstrating that an individual with appropriate knowledge of the transaction has reviewed that the transaction is allowable, free of error, and necessary and reasonable for the performance of the federal award. Auditor Recommendation: We recommend that the Transit ensures policies and procedures are followed to provide documented proof of review by management over key transactions such as payroll. Corrective Action: We concur with the finding and management will work to show documented review over payroll transactions. Responsible Person: Mary Bassett – Director Signature Anticipated Completion Date: September 30, 2025
View Audit 352956
Finding 554333 (2024-001)
Significant Deficiency 2024
Chestnut Ferry Court, Inc. Dba Chestnut Ferry Court 054-Hd059
SC
Questioned Costs Subrecipient Monitoring HUD Housing Programs
Finding #2024-001: Comments on the Finding and Each Recommendation: During the year ended December 31, 2024, the Corporation did not make the HUD required number of deposits to the reserve for replacements. Management should transfer $6,000 from the operating account to the reserve for replacements ...
Finding #2024-001: Comments on the Finding and Each Recommendation: During the year ended December 31, 2024, the Corporation did not make the HUD required number of deposits to the reserve for replacements. Management should transfer $6,000 from the operating account to the reserve for replacements account. Action(s) taken or planned on the finding: Management concurs with the finding and recommendation. Management deposited $6,000 to the reserve for replacements account on February 27, 2025. No further action is required.
View Audit 352926 Questioned Costs: $1
Finding 554307 (2024-005)
Material Weakness 2024
YWCA West Central Michigan
MI
Questioned Costs Allowable Costs / Cost Principles § 200.405
Percentages used for allocations will be reviewed annually across all grants/programs and updated during the budget process. These allocations will be reviewed by the CFO.
Percentages used for allocations will be reviewed annually across all grants/programs and updated during the budget process. These allocations will be reviewed by the CFO.
View Audit 352907 Questioned Costs: $1
Finding 554306 (2024-004)
Material Weakness 2024
YWCA West Central Michigan
MI
Period of Performance Questioned Costs Allowable Costs / Cost Principles
The YWCA will implement the following changes in its accounting procedures. 1. The Staff Accountant will review the period each expenditure is related to and record the invoice to the appropriate period when entering it into accounts payable. The month and year will be noted on the invoice. 2. The C...
The YWCA will implement the following changes in its accounting procedures. 1. The Staff Accountant will review the period each expenditure is related to and record the invoice to the appropriate period when entering it into accounts payable. The month and year will be noted on the invoice. 2. The CFO will review the month and year noted by the Staff Accountant prior to entry into accounts payable.
View Audit 352907 Questioned Costs: $1
Finding 554301 (2024-001)
Material Weakness 2024
Western Illinois Area Agency on Aging
IL
Internal Control / Segregation of Duties Questioned Costs Material Weakness
Aging Cluster – Assistance Listing Numbers: 93.044, 93.045, and 93.053 Recommendation: We recommend the Agency implement an internal control to have a documented review of the reports by a person independent of the preparer of the report Explanation of disagreement with audit finding: There is no di...
Aging Cluster – Assistance Listing Numbers: 93.044, 93.045, and 93.053 Recommendation: We recommend the Agency implement an internal control to have a documented review of the reports by a person independent of the preparer of the report Explanation of disagreement with audit finding: There is no disagreement with the finding. Action taken in response to finding: The Agency will review its processes to ensure an internal control is implemented. Name of the contact person responsible for corrective action: Tony Vermazen, Fiscal Manager Planned completion date for corrective action plan: Fiscal Year 2025
View Audit 352904
Finding 554300 (2024-002)
Significant Deficiency 2024
City of San Bruno
CA
Questioned Costs Allowable Costs / Cost Principles Reporting
The City will develop, document, and implement formal grant summary requirements review process and audit preparedness policy and procedures. The responsibilities, deliverables, and deadlines will be clearly outlined and communicated to all staff members. The City will remedy the customer account cr...
The City will develop, document, and implement formal grant summary requirements review process and audit preparedness policy and procedures. The responsibilities, deliverables, and deadlines will be clearly outlined and communicated to all staff members. The City will remedy the customer account credit balances by October 2025. Management intends to review and adjust the customer account balances.
View Audit 352902 Questioned Costs: $1
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