Corrective Action Plans

Finding 1160191 (2024-017)

Material Weakness 2024

Town of Jonesboro

LA

Questioned Costs Allowable Costs / Cost Principles

The Town of Jonesboro acknowledges this audit finding and concurs with the conclusion that a duplicate payment occurred in connection with the use of $53,786 in funds from the Coronavirus State and Local Fiscal Recovery Funds (SLFRF) program. The duplicate payment resulted from the same expenditure ...

The Town of Jonesboro acknowledges this audit finding and concurs with the conclusion that a duplicate payment occurred in connection with the use of $53,786 in funds from the Coronavirus State and Local Fiscal Recovery Funds (SLFRF) program. The duplicate payment resulted from the same expenditure being reimbursed by a second federal program that was not designated as a major program. While this incident was unintentional and due to a lack of centralized grant tracking at the time, the Town has taken corrective action to prevent such issues from occurring in the future. Specifically: 1. Implementation of a Grant Award Management System: The Town is currently deploying a formal grant tracking and reconciliation system that will provide centralized oversight of all grant awards, expenditures, and reimbursements. This system is designed to prevent overlapping or duplicative claims across funding sources and will be supported by enhanced documentation and review protocols. 2. Internal Controls and Policy Enhancements: In response to this finding, the Town has updated its grant management policies and internal accounting procedures to include specific verification steps prior to submitting reimbursement requests. These policies now require: o Cross-checking all grant reimbursements against prior or pending claims, o Documenting funding source allocation for each expenditure, o Requiring dual review by finance and grants administration staff. 3. Staff Training and Grant Oversight: Personnel involved in grant administration and finance have received and will continue to receive training on federal allowable cost principles under 2 CFR Part 200, Subpart E. The Town is committed to maintaining compliance with all federal funding requirements and is actively working to reinforce accountability and transparency in its use of public funds. The Town will coordinate with the appropriate federal and state authorities to resolve any remaining discrepancies and, if necessary, return funds that have been deemed ineligible or duplicated.

View Audit 370560 Questioned Costs: $1

Finding 1160189 (2024-015)

Material Weakness 2024

Town of Jonesboro

LA

Questioned Costs Subrecipient Monitoring Cash Management

The Town of Jonesboro respectfully disagrees with this finding as presented. While the audit notes delays between the receipt of federal funds and their disbursement, the Town asserts that it is not responsible for managing or operating the federal financial system that governs the authorization, di...

The Town of Jonesboro respectfully disagrees with this finding as presented. While the audit notes delays between the receipt of federal funds and their disbursement, the Town asserts that it is not responsible for managing or operating the federal financial system that governs the authorization, disbursement, or scheduling of funds related to the referenced grant. The Louisiana Department of Environmental Quality (LDEQ) and other relevant governmental entities manage the disbursement platform used for this grant, and Town personnel do not have direct administrative control over its structure or scheduling capabilities. Furthermore, Town staff have not received adequate training or guidance from state or federal administrators regarding the procedural requirements or compliance timelines for the Clear Water State Revolving Fund (CWSRF) program. Despite these limitations, the Town remains fully committed to compliance with federal cash management standards and the Uniform Guidance (2 CFR § 200.305), which requires recipients to minimize the time elapsing between the receipt and disbursement of federal funds. To that end, the Town will take the following corrective actions: 1. Formal Communication with Program Administrators: The Town will engage the appropriate contacts at the Louisiana Department of Environmental Quality and relevant federal partners to clarify disbursement protocols, timelines, and responsibilities under the CWSRF program. 2. Staff Training and Coordination: The Town will coordinate with the LDEQ and/or EPA to request or arrange formal training for municipal staff involved in the administration of federal grant funds, with a focus on cash management and financial compliance procedures. 3. Procedure Development: Following training and clarification from the funding agencies, the Town will develop internal procedures and documentation protocols to ensure that federal funds are disbursed as promptly as administratively possible upon receipt. The Town of Jonesboro affirms its commitment to fiscal transparency, accountability, and compliance with all applicable state and federal grant management requirements. We look forward to working collaboratively with our state and federal partners to improve administrative performance in all future program years.

View Audit 370560 Questioned Costs: $1

Finding 1160123 (2024-002)

Material Weakness 2024

Tuscan Brotherhood Homes Ii, Inc.

CT

Questioned Costs HUD Housing Programs

Major Federal Award Programs Audit:Mortgage Insurance Rental Housing, Federal Assistance Listing Number 14.134 Comments on the Finding and Recommendation During lhe year ended December 31, 2024, the p-oject paid payroll expenses in the amount of $4,342: on behalf of an affiliate from project cash wi...

Major Federal Award Programs Audit:Mortgage Insurance Rental Housing, Federal Assistance Listing Number 14.134 Comments on the Finding and Recommendation During lhe year ended December 31, 2024, the p-oject paid payroll expenses in the amount of $4,342: on behalf of an affiliate from project cash without HUD approval. The amount due to the project as of December 31, 2024 is $4,342. Action(s) Taken or Planned on the Finding The amount of $4,342 was located and the affiliate property has returned the amount paid in error lo Tuscan as of February 28, 2025. Plans were put in to place to have the approval process go through a two-step verification process.

View Audit 370521 Questioned Costs: $1

Finding 1159894 (2024-002)

Material Weakness 2024

City of Nashua

NH

Questioned Costs Period of Performance Subrecipient Monitoring § 200.308 § 200.309 § 200.403

Corrective Action Plan – Federal Funds Review and Processing Audit Finding Reference: Response to Finding 2024-002: Improvement Control Over Period of Performance for Federal Awards Name of Contact Person and Completion Date: Krystal De Gray, COO of Nashua School District 09-22-2025 Planned Correcti...

Corrective Action Plan – Federal Funds Review and Processing Audit Finding Reference: Response to Finding 2024-002: Improvement Control Over Period of Performance for Federal Awards Name of Contact Person and Completion Date: Krystal De Gray, COO of Nashua School District 09-22-2025 Planned Corrective Action: The Nashua School District acknowledges the finding related to the control over the period of performance for federal awards (Finding 2024-002). In response, the district will develop and implement a formal internal procedure to ensure that all purchases funded by federal awards are both placed and received within the established period of performance. This procedure will include appropriate review, documentation, and oversight to maintain compliance with federal grant regulations. To further strengthen internal controls, the Nashua School District will implement a procedure limiting purchases to occur no later than 15 days prior to the grant’s end date. Additionally, all necessary services must be received and completed prior to the expiration of the grant period. Mario Andrade Krystal De Gray Superintendent Chief Operating Officer

View Audit 370436 Questioned Costs: $1

Finding 1159877 (2024-002)

Material Weakness 2024

Lubbock County Hospital District D/b/a University Medical Center

TX

Questioned Costs Allowable Costs / Cost Principles

Finding 2024-002 Information on the federal program: Federal Program Name: Mental and Behavioral Health Education and Training Grants Federal Agency: U.S. Department of Health and Human Services Federal Assistant Listing and Title Number: 93.732 Award Year: January 1, 2024 to December 31, 2024 Crite...

Finding 2024-002 Information on the federal program: Federal Program Name: Mental and Behavioral Health Education and Training Grants Federal Agency: U.S. Department of Health and Human Services Federal Assistant Listing and Title Number: 93.732 Award Year: January 1, 2024 to December 31, 2024 Criteria or Specific Requirement: Activities Allowed/Unallowed and Allowable Costs/Cost Principles (Pub. L. No. 116-136, 134 Stat. 563 and Pub. L. No. 116-139, 134 Stat. 622 and 623) Condition: The District should only charge and be reimbursed by the grant for allowable expenditures based on the grant agreement. Correction Action Planned: We were using verbal guidance around meals, specifically page 84 of HHS Grants Policy Statement which states as follows under Consumer/ Provider Board Participation: “Allowable in accordance with applicable program regulations. When not specifically authorized by program regulations, only the following costs are allowable with OPDIV prior approval: The reasonable costs of necessary meals furnished by the recipient to consumer or provider participants during scheduled meetings if not reimbursed to participants as per diem or otherwise.” The conference in question was held outside some participants shift time so light refreshments were provided. However, in order to ensure compliance with the Notice of Award Terms and Conditions Grant Specific Term #5, the University Medical Center will not submit unallowable meal costs and provide refresher for existing grant Program Managers to ensure they understand the terms and conditions to avoid unallowable costs and discuss the terms and conditions with the HRSA Grants Management Specialist and Project Officer if questions arise. Contact Person (s) Responsible for Corrective Action: Aaron Davis, VP & Chief Experience Officer Anticipated Completion Date: The Corrective Action will be implemented by October 31, 2025 in response to the auditors’ recommendation.

View Audit 370418 Questioned Costs: $1

Finding 1159876 (2024-001)

Material Weakness 2024

Lubbock County Hospital District D/b/a University Medical Center

TX

Questioned Costs Procurement, Suspension & Debarment § 200.317 § 200.327

Federal Program Name: Mental and Behavioral Health Education and Training Grants Federal Agency: U.S. Department of Health and Human Services Federal Assistant Listing and Title Number: 93.732 Award Year: January 1, 2024 to December 31, 2024 Criteria or Specific Requirement: Procurement, Suspension ...

Federal Program Name: Mental and Behavioral Health Education and Training Grants Federal Agency: U.S. Department of Health and Human Services Federal Assistant Listing and Title Number: 93.732 Award Year: January 1, 2024 to December 31, 2024 Criteria or Specific Requirement: Procurement, Suspension and Debarment Condition: The District is required to follow their own documented procurement procedures which conform to the Uniform Guidance procurement standards. Correction Action Planned: The first contract in question was for a vendor (Healthsource Solutions) already under contract with Lubbock County Hospital District dba University Medical Center prior to the grant application. The vendor in question had been used since at least 2010, with the most recent contract for the current wellness portal (Wellness +) beginning in 2017. Because of the success of the wellness portal and established relationship with the vendor, University Medical Center included expansion of existing platforms and additional services provided by Healthsource Solutions as a large component of the Methodology/Approach in the proposed activities of the grant narrative submitted. Use of this vendor and its applications were specifically outlined in the grant project narrative and a critical component of meeting grant objectives. The second contract in question was for the Evaluation Group which provided specific services around grant program evaluation. This vendor was included in the original grant application and selected via the grant consultant used during the grant application process. University Medical Center follows the Lubbock County Purchasing Guidelines, which conform to the Uniform Guidance procurement standards. University Medical Center has reviewed the specified requirements of the Office of Management and Budget Uniform Guidance for procurement standards, specifically related to noncompetitive procurement and concurs that formal procurement methods were not used for expansion of new services with this existing vendor or adequate documentation was provided for noncompetitive procurement. In order to ensure compliance with the Uniform Guidance, the University Medical Center will provide training to existing grant Program Managers on Uniform Guidance procurement standards. Additionally, if a new grant is being pursued the grant committee should receive training on Uniform Guidance procurement standards before completing grant applications. On existing or future grants, any potential contracts or purchases over $75,000 should be reviewed by the grant Program Manager (or Grant Committee lead if a Program Manager has yet been assigned) to ensure all procurement guidelines are followed and sufficient documentation is obtained prior to purchase or contract execution. Contact Person (s) Responsible for Corrective Action: Aaron Davis, VP & Chief Experience Officer Anticipated Completion Date: The Corrective Action will be immediately implemented in response to the auditors’ recommendation.

View Audit 370418 Questioned Costs: $1

Finding 1159865 (2024-001)

Material Weakness 2024

Allenstown School District

NH

Questioned Costs Matching / Level of Effort / Earmarking

The LEA funding that was budgeted and expended was consistent with expectations, as a worksheet was completed and submitted to the State for approval of the original allotment. The issued identified in the finding appears to relate specifically to the ARP IDEA funding an additional allocation provid...

The LEA funding that was budgeted and expended was consistent with expectations, as a worksheet was completed and submitted to the State for approval of the original allotment. The issued identified in the finding appears to relate specifically to the ARP IDEA funding an additional allocation provided to the district well after the FY23/24 IDEA award. At no point did the State require our district to revise the MOE or resubmit the worksheet, which is why a revised version was not submitted. The district continued to receive grant approval without the ARP IDEA portion included in the worksheet. This was not due to staff inexperience or lack of training, but rather the direct result of the State’s guidance and approval process. In fact, the District has received multiple commendations from the State for the effective management of the IDEA funds. Moving forward, if additional funding is allocated, we will proactively submit a revised worksheet, regardless of whether the State requests it, to ensure full compliance with audit requirements and all grant fund related funding is captured.

View Audit 370405 Questioned Costs: $1

Finding 1159850 (2024-004)

Material Weakness 2024

Second Harvest Northern Lakes Food Bank

MN

Questioned Costs Procurement, Suspension & Debarment § 200.320

SHN will draft a “Federal Grants Management Policy Manual” and implements related procedures which will be in compliance with Uniform Guidance (2 CFR 200.320) for micro-purchases. As of April 2025, there is a Procurement Policy in place and contracted vendors and staff are required to follow the pol...

SHN will draft a “Federal Grants Management Policy Manual” and implements related procedures which will be in compliance with Uniform Guidance (2 CFR 200.320) for micro-purchases. As of April 2025, there is a Procurement Policy in place and contracted vendors and staff are required to follow the policy. For food purchases that are in relation to federal funding, due to multiple smaller purchases, the requester must obtain 3 quotes and complete a spreadsheet indicating why the vendor was selected. It is then approved by the Director of Operations to move forward with the purchase.

View Audit 370389 Questioned Costs: $1

Finding 1159800 (2024-003)

Material Weakness 2024

City of Akron, Ohio

OH

Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles § 200.308 § 200.309 § 200.403

2024-003 The City charged costs that were incurred prior to the beginning of the period of performance of the grant. Helen Tomic, Long Range Planning Manager December 31, 2025 The City will implement control procedure to prevent the charging of costs before the period of performance.

View Audit 370339 Questioned Costs: $1

Finding 1159690 (2024-003)

Material Weakness 2024

The Family Conservancy, INC

KS

Questioned Costs Allowable Costs / Cost Principles § 200.403

Corrective Action Plan Identifying Number: 2024-003 Finding: The Agency did not properly allocate indirect costs during the fiscal period in which the corresponding direct costs were incurred, resulting in an indirect cost rate exceeding the de minimis rate for a portion of the 2024 fiscal period. C...

Corrective Action Plan Identifying Number: 2024-003 Finding: The Agency did not properly allocate indirect costs during the fiscal period in which the corresponding direct costs were incurred, resulting in an indirect cost rate exceeding the de minimis rate for a portion of the 2024 fiscal period. Corrective Actions Taken or Planned: The Agency concurs with the finding. To correct the cause and ensure compliance with Uniform Guidance requirements for indirect costs, the following actions will be implemented: 1. Establish Written Indirect Cost Procedures – Develop and document procedures to ensure indirect costs are consistently calculated at the approved de minimis rate per the federal grant award on total direct costs during the performance period. 2. Implement Pre-Posting Review – Require a supervisory review of indirect cost calculations before charges are recorded to the general ledger and before grant reimbursements are submitted. We have implemented new procedures to ensure that indirect costs are included in each invoice for reimbursement. 3. Staff Training – Provide training for grants and finance staff on indirect cost requirements, the proper application of the de minimis rate, and reconciliation processes in accordance with 2 CFR 200.414(f). 4. Quarterly Reconciliations – Implement quarterly reconciliations of indirect costs applied to grants to confirm rates are applied correctly and consistently throughout the fiscal year. 5. Continuity Controls – Assign responsibility for indirect cost oversight to both a primary and a backup staff member to ensure consistency during periods of management turnover. Contact Person Responsible for Corrective Action: Fred Timberlake, Vice President of Finance Isha Martin, Controller/Grant Finance Manager Anticipated Completion Date: • New procedures: June 15, 2025 • Written procedures in place: December 31, 2025 • Staff training completed: January 31, 2026 • Supervisory review and reconciliations implemented: Beginning with January 2026 close

View Audit 370280 Questioned Costs: $1

Finding 1159688 (2024-001)

Material Weakness 2024

The Family Conservancy, INC

KS

Questioned Costs Allowable Costs / Cost Principles § 200.403

Corrective Action Plan Identifying Number: 2024-001 Finding: Expenditure was identified for one invoice with a 2023 service period that was improperly recorded, and reimbursed, as an expenditure in 2024, indicating improper expense recognition in accordance with US GAAP. Corrective Actions Taken or ...

Corrective Action Plan Identifying Number: 2024-001 Finding: Expenditure was identified for one invoice with a 2023 service period that was improperly recorded, and reimbursed, as an expenditure in 2024, indicating improper expense recognition in accordance with US GAAP. Corrective Actions Taken or Planned: The Agency concurs with the finding. To correct the cause and ensure compliance with 2 CFR 200.403(e), the following actions will be implemented: 1. Establish Written Cutoff Procedures – Formal written procedures will be developed for reviewing service dates and supporting documentation prior to posting expenditures in the general ledger. These procedures will specifically address Uniform Guidance period-of-performance requirements. 2. Implement Supervisory Review – All expenditures charged to federal awards will undergo supervisory review at period-end. The review will confirm that expenses are recorded in the proper performance period before submission for reimbursement. Effective June 2025, the Vice President of Finance and the Controller performed a retrospective review of 2024 expenses to confirm that they were allocated to the correct reporting period. This supervisory review has continued into the current reporting period with no exceptions noted. 3. Staff Training – Grants and finance staff will receive focused training on Uniform Guidance cost principles, proper expenditure cutoff, and documentation standards to ensure consistent application. Staff training will include review of the finding and leadership will highlight the importance of verifying the correct reporting period for each entry. 4. Continuity Controls – To address turnover risk, responsibility for cutoff procedures will be assigned to both a primary and a backup staff member to provide coverage and reduce errors caused by staff changes. 5. Ongoing Monitoring – The VP of Finance will review quarterly grant compliance checklists and provide updates to senior leadership and the Finance Committee. Contact Person Responsible for Corrective Action: Fred Timberlake, Vice President of Finance Isha Martin, Controller/Grant Finance Manager Anticipated Completion Date: • Management supervisory review procedures: June 15, 2025 • Written cutoff procedures in place: December 31, 2025 • Staff training completed: January 31, 2026

View Audit 370280 Questioned Costs: $1

Finding 1159584 (2024-001)

Material Weakness 2024

Franklin County Technical School District

MA

Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles § 200.308 § 200.309 § 200.403

Audit Finding Reference: 2024-001 Description of Finding: The audit revealed that grant expenditures were incurred outside the authorized performance period, resulting in non-compliance with grant regulations and potential cost disallowance. Planned Corrective Action • Conduct a comprehensive assess...

Audit Finding Reference: 2024-001 Description of Finding: The audit revealed that grant expenditures were incurred outside the authorized performance period, resulting in non-compliance with grant regulations and potential cost disallowance. Planned Corrective Action • Conduct a comprehensive assessment of existing procedures to identify gaps that led to noncompliance with grant regulations. • Ensure timely submission of grant applications. • Implement enhanced oversight and monitoring processes for all grant-related expenditures to ensure alignment with policy 2 CFR 200.1. • Maintain detailed documentation of all award dates and expenditures to provide a clear compliance record. • Ensure all documentation is easily accessible and systematically organized for audit purposes. • Ensure pre-award costs are allowable only to the extent they would have been allowable if incurred after the effective date and only with written approval from the Federal awarding agency (as per 2 CFR 200.458). • Establish a process for obtaining and documenting written approval for pre-award costs. • Provide comprehensive training on compliance with Uniform Grant Guidance to all relevant staff. • Review and update policies and procedures related to grant expenditures regularly to ensure they are current and compliant with federal regulations. • Assign accountability for monitoring and reporting compliance to specific roles within the organization. The Business Manager, Elizabeth Bouchard, will be responsible for implementing this plan beginning with the Fiscal Year 2026 grant cycle. As of September 2025, non-compliance issues have been identified and addressed, documentation has been maintained to track award dates, and training has been provided to designated roles within the District. In addition, procedures to maintain detailed documentation of all award dates and expenditures to ensure a clear compliance record have been shared with all District Administrators utilizing grant funds.

View Audit 370226 Questioned Costs: $1

Finding 1159428 (2024-002)

Material Weakness 2024

Mhub

IL

Questioned Costs Procurement, Suspension & Debarment § 200.318 § 200.319 § 200.320

Condition: The Organization did not have controls to retain documentation that the procurement process was followed to ensure more than one vendor was reviewed for pricing before selecting the vendor chosen (as required under 2 CFR 320(a)(2)(i)). Planned Corrective Action: Management will implement ...

Condition: The Organization did not have controls to retain documentation that the procurement process was followed to ensure more than one vendor was reviewed for pricing before selecting the vendor chosen (as required under 2 CFR 320(a)(2)(i)). Planned Corrective Action: Management will implement controls to ensure proper support of the procurement process is retained. Contact person responsible for corrective action: Manas Mehandru, COO Anticipated Completion Date: December 31, 2025

View Audit 370163 Questioned Costs: $1

Finding 1159426 (2024-003)

Material Weakness 2024

Capital Region Minority Supplier Development Council

MD

Questioned Costs Matching / Level of Effort / Earmarking § 200.306

Thank you for your review and the findings shared in the recent audit. We appreciate the thorough assessment and the opportunity to strengthen our processes. We acknowledge the findings; however we respectfully disagree with [Finding Reference 2024-003, Insufficient Non-Federal Share]. Based on the ...

Thank you for your review and the findings shared in the recent audit. We appreciate the thorough assessment and the opportunity to strengthen our processes. We acknowledge the findings; however we respectfully disagree with [Finding Reference 2024-003, Insufficient Non-Federal Share]. Based on the support and documentation we provided we captured $191,000 (25% non-federal match) of in-kind to meet our obligation of $189,250 for grant award Year 1, 2023. And although we met our in-kind obligation, we experienced several delays which were recognized by our grantee, MBDA. The delay in funding the grant award took place from July 2023 to September 2023 and subsequently after funding was released an additional black-out period from September 2023 to October 2023 was experienced due to a system transition from BAS to GEMS/era Commons. Acknowledgement of these delays was addressed by an official during an MBDA All Equities call on October 18, 2023. During that call awardees were advised to continue focusing on our program activities and clients as the situation was being addressed. To account for the delays, we later submitted a budget revision request through the new system, eRA Commons on 12.09.2024 asking for a budget carryover of $337,825.00 which also outlines how the funds will be expended. Additionally, it is noted in your finding that the allowable in-kind contribution is being reduced given that budget categories were not met by line item. However, our interpretation of MBDA Capital Readiness NOFO (pg.14), we are directed to Section CFR200.306 [https://www.ecfr.gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-D/section-200.306] which does not cap in-kind by line-item. Lastly, the MBDA organization has changed dramatically since the inception of the Capital Readiness grant in 2023, yet we have been in communication with an MBDA government official who acknowledges the delays during the time outlined above and ask that flexibility for this non-federal share requirement be re-considered. Supporting documentation has been sent to support the statements. Name of the contact person responsible for corrective action: Sharon R. Pinder, President, 301.593.5861 Planned completion date for corrective action plan: We plan to continue to seek validation of our position from our grantor and grant management entity – 4th Quarter 2025.

View Audit 370152 Questioned Costs: $1

Finding 1159424 (2024-003)

Material Weakness 2024

Social & Environmental Entrepreneurs, Inc.

CA

Questioned Costs Allowable Costs / Cost Principles

Single Audit Finding: 2024-003 Allowable Costs and Allowable Activities (Material Weakness in Internal Controls over Compliance) Condition: The auditors identified an instance of material noncompliance; for transactions sampled under ALN 21.027, timesheets did not adequately support the charges to g...

Single Audit Finding: 2024-003 Allowable Costs and Allowable Activities (Material Weakness in Internal Controls over Compliance) Condition: The auditors identified an instance of material noncompliance; for transactions sampled under ALN 21.027, timesheets did not adequately support the charges to grants. Additionally, in the transactions tested for ALN 66.615, there was no sufficient documentation to support the total fringe benefit amounts charged to the grants. Repeat Finding: Yes, similar deficiencies noted in 2023‐003. Views of Responsible Officials: There was a finding that was noted related to the tracking of personnel costs to the federally funded contract. SEE Accounting and Administration, which includes HR, has established and implemented uniform timekeeping procedures requiring all employees, both exempt and non-exempt, whose salaries are charged to federal contracts to submit accurate and complete timecards that reflect the actual hours worked. These formal procedures are monitored, reviewed, and reconciled on a monthly basis. Official Responsible for Ensuring CAP: Jennifer Hoffman, CEO; Anna Zaricki, CFO; Trevis Bird, COO; Monique Gutierrez, Sr-HRD; Arthur Doi, Controller; and Justin Yamashiro, Audit Manager are responsible for ensuring corrective action is implemented. Planned Completion Date for CAP: December 31, 2026

View Audit 370147 Questioned Costs: $1

Finding 1159416 (2024-002)

Material Weakness 2024

Gowest Foundation

WA

Questioned Costs Eligibility Matching / Level of Effort / Earmarking § 200.303 § 200.518

It should be noted that distribution of funds under this program terminated on December 31, 2024; no new loans will be originated. The Foundation will implement the recommended actions as appropriate in future programs that may be similar to this one.

View Audit 370140 Questioned Costs: $1

Finding 1159415 (2024-001)

Material Weakness 2024

Gowest Foundation

WA

Questioned Costs Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties § 200.303

It should be noted that distribution of funds under this program terminated on December 31, 2024; no new loans will be originated. The Foundation will implement the recommended actions as appropriate in future programs that may be similar to this one.

View Audit 370140 Questioned Costs: $1

Finding 1159406 (2024-008)

Material Weakness 2024

Mount Sinai Health System, Inc.

NY

Questioned Costs Procurement, Suspension & Debarment Subrecipient Monitoring

Finding 2024-008 I. Procurement and Suspension and Debarment Information on the federal program: Grantor: Grantor: Department of Agriculture, Department of Defense, Department of Labor, National Aeronautics and Space Administration, Promotion of the Arts Grants to Organizations and Individuals, Nati...

Finding 2024-008 I. Procurement and Suspension and Debarment Information on the federal program: Grantor: Grantor: Department of Agriculture, Department of Defense, Department of Labor, National Aeronautics and Space Administration, Promotion of the Arts Grants to Organizations and Individuals, National Science Foundation, Department of Veteran Affairs, Environment Protection Agency, Department of Energy, Department of Health and Human Services, U.S. Agency for International Development Program Name: Research and Development Cluster Assistance Listing No.: Various Views of responsible officials and planned corrective actions: Management agrees with the finding described above. Due to a system failure, vendor payment files from January through September 2024 were not transmitted to Mount Sinai’s sanction screening vendor. Mount Sinai has taken corrective actions to address this issue. All current vendors in our vendor master file, as well as all new vendors added through our new vendor credentialing process, are now processed through our sanction screening vendor on a monthly basis. In addition, a new manual control has been implemented to review, confirm, and reconcile to ensure that the vendor master file has been transmitted successfully, and all vendors are screened for sanctions, and a report thereof is provided each month. Our process will also document and maintain evidence that unverified vendors or those that were indicated as excluded were investigated and evaluated by the Health System. We will also periodically perform independent sanction screening checks on a sample of our vendors to validate the accuracy of the results of our third-party sanction screening vendor. Name of responsible official: Franco Sagliocca Corporate Director, Supply Chain Franco.sagliocca@mountsinai.org Projected completion date: Our vendor credentialing process was establishing with our ERP implementation on October 7, 2024. Our enhanced procedures to reconcile our file transmissions to our independent third-party and perform screening checks on samples of vendors verified by our independent third-party is expected to be implemented by December 31, 2025.

View Audit 370128 Questioned Costs: $1

Finding 1158856 (2024-007)

Material Weakness 2024

Mount Sinai Health System, Inc.

NY

Questioned Costs Procurement, Suspension & Debarment

Finding 2024-007 I. Procurement and Suspension and Debarment Information on the federal program: Grantor: Grantor: Department of Agriculture, Department of Defense, Department of Labor, National Aeronautics and Space Administration, Promotion of the Arts Grants to Organizations and Individuals, Nati...

Finding 2024-007 I. Procurement and Suspension and Debarment Information on the federal program: Grantor: Grantor: Department of Agriculture, Department of Defense, Department of Labor, National Aeronautics and Space Administration, Promotion of the Arts Grants to Organizations and Individuals, National Science Foundation, Department of Veteran Affairs, Environment Protection Agency, Department of Energy, Department of Health and Human Services, U.S. Agency for International Development Program Name: Research and Development Cluster Assistance Listing No.: Various Views of responsible officials and planned corrective actions: Management agrees with the finding described above. In October 2024, Mount Sinai transitioned to Oracle Cloud for its Enterprise Resource Planning (ERP) and general ledger system. During this transition, Deputy Buyer transactions of $10,000 and above were not routed to the Purchasing Team for review, allowing purchase orders to be completed without the required documentation, including Sole Source Justifications, Directed Source Justifications, or multiple quotes as required under Uniform Guidance. Corrective actions, including a system enhancement, have been implemented to remediate this issue. Mount Sinai’s enhanced process ensures Deputy Buyer transactions of $10,000 and above are routed appropriately to the Purchasing Team for validation and documentation review. In addition, a quarterly manual review process, supported by reports developed in partnership with Mount Sinai’s technology team, will be fully implemented as a compensating control in the fourth quarter of 2025. Name of responsible official: Franco Sagliocca Corporate Director, Supply Chain Franco.sagliocca@mountsinai.org Projected completion date: Our enhanced procedures for ensuring the necessary documentation is completed on Deputy Buyer transactions of $10,000 and above is expected to be implemented by December 31, 2025.

View Audit 370128 Questioned Costs: $1

Finding 1158231 (2024-002)

Material Weakness 2024

New York College of Traditional Chinese Medicine

NY

Questioned Costs Student Financial Aid Special Tests & Provisions

Finding 2025-002: Untimely Paid Credit Balance Comments on Finding and Recommendation: Statement of Concurrence: We concur with the finding of Untimely Paid Credit Balance The delay in issuing the credit balance was due to a timing oversight related to the award year dates. Although the Credit Balan...

Finding 2025-002: Untimely Paid Credit Balance Comments on Finding and Recommendation: Statement of Concurrence: We concur with the finding of Untimely Paid Credit Balance The delay in issuing the credit balance was due to a timing oversight related to the award year dates. Although the Credit Balance Authorization Form was on file, the refund was processed after the award year had ended, rather than within the required timeframe. In the past, students were always allowed to keep funds in their Populi accounts for future use regardless of the loan award year, and it had not previously been indicated that this practice was not allowed. Actions Taken or Planned: We have reviewed our internal procedures and will strengthen oversight of award year deadlines to ensure that all credit balances are refunded within the required timeframe. Moving forward, the financial aid and accounting teams will implement a compliance checklist and establish calendar reminders to prevent similar delays. Additionally, we will revise the wording on our Credit Balance Authorization Form to read: “Leave the funds in my account and any remaining funds from the current award year in my account up to the end of the loan period.” Completion Date: Ongoing 9/26/2025 Dong-Hua Yang MD, PhD Date Title: Administrative Dean Telephone: 516-739-1545 Email: administrative_dean@nyctcm.edu

View Audit 370123 Questioned Costs: $1

Finding 1158225 (2024-004)

Material Weakness 2024

St Bernard Parish Government

LA

Questioned Costs Procurement, Suspension & Debarment

Name of contact person responsible for corrective action plan: Justin Frank Corrective action planned: The Parish will review all policies and procedures to ensure that proper internal controls are in place, with an emphasis on Federal procurement guidelines. Anticipated Completion Date: December 31...

Name of contact person responsible for corrective action plan: Justin Frank Corrective action planned: The Parish will review all policies and procedures to ensure that proper internal controls are in place, with an emphasis on Federal procurement guidelines. Anticipated Completion Date: December 31, 2025

View Audit 370116 Questioned Costs: $1

Finding 1158144 (2024-001)

Material Weakness 2024

YMCA of Metropolitan Fort Worth

TX

Questioned Costs Procurement, Suspension & Debarment

Response: The YMCA of Metropolitan Fort Worth created and implemented a new Procurement, Suspension, and Debarment Policy in April 2025. This policy was distributed to all impacted parties and outlines the requirements for ensuring that all vendors procured under federal awards comply with Uniform G...

Response: The YMCA of Metropolitan Fort Worth created and implemented a new Procurement, Suspension, and Debarment Policy in April 2025. This policy was distributed to all impacted parties and outlines the requirements for ensuring that all vendors procured under federal awards comply with Uniform Guidance. Training and communication were provided to ensure consistent application. Date of Completion: April 2025 Person Responsible to Ensure Completion: Kristen Lee, Chief Finance & Administration Officer

View Audit 370064 Questioned Costs: $1

Finding 1158085 (2024-004)

Material Weakness 2024

Native Village of Point Hope

AK

Questioned Costs Cash Management Material Weakness § 200.305

Finding 2024-004 Lack of Internal Control over Cash Management Type of Finding: Material weakness in internal control over compliance and material noncompliance. Name of Contact: Adela Lane, Executive Director. Corrective Action Plan: 1. Strengthen the payment review process: • Action: Enforce and d...

Finding 2024-004 Lack of Internal Control over Cash Management Type of Finding: Material weakness in internal control over compliance and material noncompliance. Name of Contact: Adela Lane, Executive Director. Corrective Action Plan: 1. Strengthen the payment review process: • Action: Enforce and document a stricter segregation of duties in the payment process. This will ensure the individual requesting a payment is not the same person who authorizes the payment. • Details: All payment requests must be cross-referenced with a corresponding invoice or receipt and reviewed and approved by an authorized department head. This Department Head must not be the one who submitted the initial request. 2. Implement a two-tiered review for cash receipts: • Action: Establish a formal two-tiered cash receipts process to enhance accountability and accuracy. • Details: o Tier 1: The individual receiving and logging cash receipts will immediately perform a preliminary count and documentation. o Tier 2: A separate, authorized staff member will perform a second, independent review of the cash receipt records and verify the funds against the deposit slip before the funds are deposited. 3. Standardize training and onboarding for all staff: • Action: Develop a standardized training curriculum on financial management policies and procedures, including a dedicated section on cash management best practices. • Details: o All new permanent and staff members will undergo mandatory training on the updated policies. o Training will cover the importance of internal controls, specifically emphasizing segregation of duties in cash handling. o The Executive Director will meet with all new finance and administrative staff within their first two weeks to review proper protocols and emphasize the organization's commitment to financial controls. 4. Introduce periodic, surprise cash audits: • Action: Conduct unannounced cash counts and reconciliations to ensure compliance with procedures. • Details: An authorized, independent party will perform these surprise audits quarterly to check cash on hand and compare records against financial systems. 5. Enhance oversight and reporting: • Action: The Executive Director will provide regular updates on the implementation of these corrective actions to the Native Village of Point Hope Tribal Council. • Details: A formal report will be presented quarterly, outlining the progress of the corrective actions and any findings from the new oversight procedures. This provides a clear accountability mechanism. Proposed Completion Date: Ongoing, Starting Early 2026.

View Audit 370023 Questioned Costs: $1

Finding 1158056 (2024-001)

Material Weakness 2024

Caap Housing, Inc. Dba Emma O. Johnson Homes 073-11685

IN

Questioned Costs HUD Housing Programs

Auditee: CAAP Housing, Inc. HUD Project Number: 073-11685 Audit Firm: Agresta, Storms & O’Leary PC Audit Period Ended December 31, 2024 Corrective Action Plan Prepared by: Name: Cynthia Norris Position: Housing Asset and Tenant Service Director (Community Action of Greater Indianapolis, Inc.) A. Cur...

Auditee: CAAP Housing, Inc. HUD Project Number: 073-11685 Audit Firm: Agresta, Storms & O’Leary PC Audit Period Ended December 31, 2024 Corrective Action Plan Prepared by: Name: Cynthia Norris Position: Housing Asset and Tenant Service Director (Community Action of Greater Indianapolis, Inc.) A. Current Findings on the Schedule of Findings, Questioned Costs, and Recommendations Finding No. 2024-001 A. Comments on the Finding and Each Recommendation: Management agrees with the finding that the security deposit cash account was underfunded at December 31, 2024. B. Action Taken or Planned on the Finding: Management will transfer the required funds to the security deposit cash account when the funds are available. B. Status of Corrective Actions on Findings Reported in the Prior Audit Schedule of Findings, Questioned Costs, and Recommendations See Finding No. 2024-001 for status of Finding No. 2023-001. Respectfully Submitted, Terrence White Executive Director/CEO Community Action of Greater Indianapolis, Inc.

View Audit 370008 Questioned Costs: $1

Finding 1158055 (2024-001)

Material Weakness 2024

St Barnabas Hospital

NY

Questioned Costs Procurement, Suspension & Debarment

Finding 2024-001 Material Weakness regarding Procurement Information on the federal program: Grantor: Department of Health and Human Services Program Name: Congressional Directives Assistance Listing No.: 93.493 Views of responsible officials and planned corrective actions: Management acknowledges t...

Finding 2024-001 Material Weakness regarding Procurement Information on the federal program: Grantor: Department of Health and Human Services Program Name: Congressional Directives Assistance Listing No.: 93.493 Views of responsible officials and planned corrective actions: Management acknowledges the finding related to procurement documentation for the installation of equipment purchased under the grant. We recognize the importance of maintaining effective internal controls to ensure compliance with procurement requirements under the Uniform Guidance. The hospital has reviewed the circumstances surrounding this transaction and agrees that documentation supporting either (i) the competitive bidding process or (ii) the justification for noncompetitive procurement was not adequately retained. While the cost was included in the approved budget and was an allowable expense under the grant agreement, we understand that the absence of contemporaneous documentation represents a material weakness in our internal control framework. Subsequent to the procurement in question, the Hospital solicited and obtained an additional bid from another qualified source to validate that the original vendor’s pricing was reasonable and consistent with market expectations. Although this does not substitute for obtaining bids prior to procurement, it provides assurance that the transaction was consistent with the principles of fair and open competition. Management has prepared a Corrective Action Plan to strengthen procurement controls, improve documentation retention, and provide staff training to ensure future compliance with Uniform Guidance requirements. Corrective Action Plan: 1. Policy Enhancement: The hospital is revising its procurement policy to more clearly define documentation requirements for purchases made with federal funds, particularly those exceeding the micro-purchase threshold. 2. Pre-Procurement Checklist: A standardized checklist will be implemented for all federally funded purchases to verify compliance with procurement methods outlined in 2 CFR §200.320, including competitive bidding or justification for noncompetitive procurement. 3. Documentation Retention: Procurement staff will be required to upload and retain all competitive quotes or sole-source justifications in the centralized procurement system prior to final approval. 4. Training: Targeted training will be provided to procurement and grants management staff to reinforce Uniform Guidance requirements and the hospital’s updated procurement policies. 5. Monitoring: The compliance department will conduct quarterly reviews of federally funded procurements above the micro-purchase threshold to ensure adherence to policies and to promptly address any gaps. Name of responsible official: William DiBitetto, Senior Vice President, Finance Projected completion date: The updated policies and procedures will be implemented within 90 days of this response. Staff training and compliance monitoring will begin immediately thereafter.

View Audit 370005 Questioned Costs: $1

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