Corrective Action Plans

Finding 498338 (2023-001)

Significant Deficiency 2023

Golden Triangle Resource Conservation and Development Area INC

GA

Internal Control / Segregation of Duties Cash Management Reporting

2019-01: Segregation of Duties Name of contact person: Rhonda Gordon, Program Coordinator Corrective Action: Duties and functions will be reviewed to determine where segregation needs to occur. The duties will be separated as much as possible and alternative controls will be implemented to com...

2019-01: Segregation of Duties Name of contact person: Rhonda Gordon, Program Coordinator Corrective Action: Duties and functions will be reviewed to determine where segregation needs to occur. The duties will be separated as much as possible and alternative controls will be implemented to compensate for lack of segregation. However, the risk of not segregating certain duties is not worth the additional costs. Nonfinancial employees will be trained and provide some assistance. Proposed completion date: The Board will implement the above procedure immediately.

View Audit 321079

Finding 498333 (2023-002)

Significant Deficiency 2023

Farmworker Justice

DC

Reporting Allowable Costs / Cost Principles Significant Deficiency § 200.508

Views of Responsible Officials: Management concurs with the recommendation. See the corrective action plan.

View Audit 321069

Finding 498309 (2023-002)

Significant Deficiency 2023

National Council for the Traditional Arts, Inc.

MD

Reporting

Views of Responsible Officials: Management agrees with the finding and will implement changes to its accounting system to comply with the auditor’s recommendation. This change will be implemented for any drawdowns that are submitted for CY2024. Management will use a sub-ledger In QuickBooks to more ...

Views of Responsible Officials: Management agrees with the finding and will implement changes to its accounting system to comply with the auditor’s recommendation. This change will be implemented for any drawdowns that are submitted for CY2024. Management will use a sub-ledger In QuickBooks to more accurately generate reports that provide detail of the expenses that are being charged to and reimbursed by the federal government. With each drawdown, the finance manager will generate reports from the sub-ledger and the executive director will confirm that the sub-ledger ties to expenses that should be charged to the corresponding federal award before submission.

View Audit 321060

Finding 498297 (2023-001)

Material Weakness 2023

Cottage Health

CA

Allowable Costs / Cost Principles Internal Control / Segregation of Duties Special Tests & Provisions

Finding 2023-001 – Internal control deficiency over Activities Allowed or Unallowed, Allowable Costs/Cost Principles, Period of Performance, Reporting, and Special Tests and Provisions. Condition: Management did not design effective internal controls to retain documentation to evidence the operati...

Finding 2023-001 – Internal control deficiency over Activities Allowed or Unallowed, Allowable Costs/Cost Principles, Period of Performance, Reporting, and Special Tests and Provisions. Condition: Management did not design effective internal controls to retain documentation to evidence the operating effectiveness of the internal controls over the projects and related expenses submitted to FEMA for reimbursement. Current Status: In progress. Resolution: Management will develop and implement additional internal controls to ensure documentation is retained to evidence the operating effectiveness of the internal controls. These internal controls will ensure expenses included in FEMA grant applications are reported completely and accurately. The additional internal controls will include a reconciliation of application expense detail to final paid invoices along with a notation that each expense is allowed to be included in the FEMA submission. The reconciliation will be reviewed and approved by the Cottage Health Director of Finance prior to final FEMA submission and evidence of the review will be retained. Contact Person: Lawrence Thomas, Director of Corporate Finance Anticipated Completion Date: November 29, 2024

View Audit 321051

Finding 498294 (2023-006)

Significant Deficiency 2023

City of Seattle

WA

Subrecipient Monitoring Internal Control / Segregation of Duties Allowable Costs / Cost Principles

City staff will contact all Community Based Organizations (CBOs) that received Emergency Rental Assistance 2 funding to determine if they were required to complete a Single Audit per the Single Audit Act. This communication will include, if applicable, a request that they submit the organizations mo...

City staff will contact all Community Based Organizations (CBOs) that received Emergency Rental Assistance 2 funding to determine if they were required to complete a Single Audit per the Single Audit Act. This communication will include, if applicable, a request that they submit the organizations most recent audit for review by staff. Should a Single Audit identify any findings or other deficiencies, staff will ask the CBO to provide an update as to the status of the deficiency and if it has been appropriately addressed. Staff will document this communication in the electronic file of the CBO who was required to complete a Single Audit.

View Audit 321037

Finding 498276 (2023-004)

None 2023

City of Seattle

WA

Questioned Costs Subrecipient Monitoring Allowable Costs / Cost Principles

The Human Services Department The Human Services Department has acknowledged the issue identified regarding timesheet pre-approvals and will take immediate steps to address the issue. HSD will ensure that proxy timesheet approvers are properly assigned in cases where the primary supervisor is unavai...

The Human Services Department The Human Services Department has acknowledged the issue identified regarding timesheet pre-approvals and will take immediate steps to address the issue. HSD will ensure that proxy timesheet approvers are properly assigned in cases where the primary supervisor is unavailable on the day payroll approval is due. HSD will maintain compliance with payroll policies and ensure the accuracy of timesheet approvals. Office of Housing The Office of Housing has acknowledged the finding regarding timesheet pre-approvals and will take immediate steps to address the issue. Office of Housing will ensure that proxy timesheet approvers are properly assigned in cases where the primary supervisor is unavailable on the day payroll approval is due. This adjustment will be incorporated into the previous improved practices, eliminating the need for pre-approving timesheets. By ensuring that proxy approvers are in place, the department will maintain compliance with payroll policies and ensure the accuracy of timesheet approvals. Parks and Recreation Department The Parks and Recreation Department acknowledges the finding regarding timesheet preapprovals and will ensure that proxy timesheet approvers are assigned moving forward as part of the department's ongoing commitment to improved practices. In addition, the department would like to clarify that the pre-approval noted occurred before the implementation of the current corrective action plan, which addressed the prior year's finding. The department reassures the State Auditor's Office (SAO) that the newly adopted practices, which prevent preapprovals, will continue to be strictly followed, ensuring compliance and accuracy in payroll processing, even during pay periods that coincide with holidays.

View Audit 321037 Questioned Costs: $1

Finding 498271 (2023-003)

Significant Deficiency 2023

City of Seattle

WA

Subrecipient Monitoring Allowable Costs / Cost Principles Cash Management

HSD acknowledges the identified weakness and implemented an updated Accounts Payable control procedure in 2024, that includes an additional standard monthly report and review process to ensure that reimbursements are processed with the required 30-day period.

View Audit 321037

Finding 498262 (2023-001)

Significant Deficiency 2023

Sunflower Diversified Services, Inc.

KS

HUD Housing Programs Procurement, Suspension & Debarment Reporting

14.155 – Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects Condition During testing, we identified that certain tenants had an improper amount of rent calculated and applied to their rental agreement or paid an incorrect amount. Recommendation Procedures sho...

14.155 – Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects Condition During testing, we identified that certain tenants had an improper amount of rent calculated and applied to their rental agreement or paid an incorrect amount. Recommendation Procedures should be reviewed to ensure that all tenants pay an accurate amount for their rental agreements. Comments on the Finding The Organization is aware of the oversight and will strive to improve the process in the future. Action Taken As of the date of this notice, processes have been implemented for the Fiscal Manager or Executive Director to complete a review of all rent calculations prior to sending them to the third party HUD contractor for inclusion on form HUD-50059. Additionally, all applicable staff have been trained on the timelines associated with implementing rent increases.

View Audit 321023

Finding 498252 (2023-001)

Significant Deficiency 2023

West Hennepin Affordable Housing Land Trust Dba Homes Within Reach

MN

Reporting Significant Deficiency § 200.512

Name of contact person: Brenda Lano, Executive Director Corrective Action: The Organization continues to work with the various cities and counties to obtain grant agreements and document if there is not an agreement. The Organization is also actively working with their auditor to improve communicat...

Name of contact person: Brenda Lano, Executive Director Corrective Action: The Organization continues to work with the various cities and counties to obtain grant agreements and document if there is not an agreement. The Organization is also actively working with their auditor to improve communication during the audit so a late filing does not occur again. We expect the issue will be mitigated for the 2023 audit. Completion Date: The Organization has already adopted this corrective action.

View Audit 321018

Finding 498251 (2023-003)

Significant Deficiency 2023

Greater Bethlehem

LA

HUD Housing Programs Reporting

We will ensure that going forward, processes are in place to allow for the timely submission of the financial reporting requirements. Further, we request that this finding be removed as the late filing occurred in 2024 and should be given in 2024 pursuant to AU-C 935.

View Audit 321015

Finding 498244 (2023-006)

Significant Deficiency 2023

City of Denison

IA

Reporting Internal Control / Segregation of Duties

The City will develop policies and procedures to ensure that all federal reporting is done timely and accurately. Also, those policies and procedures should ensure that these reports are independently reviewed before submission.

View Audit 320993

Finding 498243 (2023-001)

Significant Deficiency 2023

Northland Counseling Center, INC

MN

Internal Control / Segregation of Duties Reporting

Lack of segregation of duties. Recommendation: The Center's governing board should be cognizant of the issue and provide appropriate oversight. Management should provide reasonable oversight to accounting functions including accounts payable di...

Lack of segregation of duties. Recommendation: The Center's governing board should be cognizant of the issue and provide appropriate oversight. Management should provide reasonable oversight to accounting functions including accounts payable disbursements, reconciliations, and reporting including journal entry preparation. Action taken: The Center agrees with recommendations. The Center recongizes this deficiency due to the size of the financial department and limted resources to adequately divide duties or hire enough additional staff to completely segregate duties. The Center hired an account payable staff to the team in December 2021 to assist with work load and help create better division of duties. The Center also hired a part-time employee in August 2023 to assist with financial preparation. In May 2024 Northland hired an additional part-time employee to assist with billing data analysis. This is an ongoing process.

View Audit 320984

Finding 498240 (2023-003)

Significant Deficiency 2023

Joshua Manor

LA

HUD Housing Programs Reporting

We will ensure that going forward, processes are in place to allow for the timely submission of the financial reporting requirements. Further, we request that this finding be removed as the late filing occurred in 2024 and should be given in 2024 pursuant to AU-C 935.

View Audit 320977

Finding 498204 (2023-002)

Significant Deficiency 2023

Mt. Sinai Manor

LA

HUD Housing Programs Reporting

We will ensure that going forward, processes are in place to allow for the timely submission of the financial reporting requirements. Further, we request that this finding be removed as the late filing occurred in 2024 and should be given in 2024 pursuant to AU-C 935.

View Audit 320969

Finding 498202 (2023-005)

Significant Deficiency 2023

Rev. Dr. Clay Evans Manor

LA

HUD Housing Programs Reporting

We will ensure that going forward, processes are in place to allow for the timely submission of the financial reporting requirements. Further, we request that this finding be removed as the late filing occurred in 2024 and should be given in 2024 pursuant to AU-C 935.

View Audit 320968

Finding 498196 (2023-004)

Material Weakness 2023

Osceola Electric Cooperative, Inc.

IA

Reporting Material Weakness

Federal Agency Name: Department of Homeland Security Pass-Through Entity: State of Iowa Homeland Security & Emergency Management Federal Financial Assistance Listing #97 .039 Program Name: Hazard Mitigation Grant Program Finding Summary: The Cooperative does not have an internal control system desi...

Federal Agency Name: Department of Homeland Security Pass-Through Entity: State of Iowa Homeland Security & Emergency Management Federal Financial Assistance Listing #97 .039 Program Name: Hazard Mitigation Grant Program Finding Summary: The Cooperative does not have an internal control system designed to provide for a complete and accurate schedule of federal expenditures of federal awards (the schedule) being audited. We requested our auditors to assist with the preparation of the schedule and the accompanying notes to the schedule. Corrective Action Plan: It is not cost effective to have an internal control system designed to provide for the preparation of the schedule of federal expenditures of federal awards and the accompanying notes to the schedule. We requested that our auditors, Eide Bailly, LLP, prepare the schedule and accompanying notes. We have designated a member of management to review the drafted schedule and accompanying notes to the schedule. Responsible Individuals: Mark Vander Pol, Office Manager and Jeff TenNapel, General Manager Anticipated Completion Date: Ongoing

View Audit 320953

Finding 498195 (2023-003)

Material Weakness 2023

Osceola Electric Cooperative, Inc.

IA

Material Weakness Reporting Internal Control / Segregation of Duties § 200.303

Federal Agency Name: Department of Homeland Security Pass-Through Entity: State of Iowa Homeland Security & Emergency Management Federal Financial Assistance Listing #97.039 Program Name: Hazard Mitigation Grant Program Finding Summary: In three of three quarterly reports tested, the Cooperative im...

Federal Agency Name: Department of Homeland Security Pass-Through Entity: State of Iowa Homeland Security & Emergency Management Federal Financial Assistance Listing #97.039 Program Name: Hazard Mitigation Grant Program Finding Summary: In three of three quarterly reports tested, the Cooperative improperly excluded information on the total funds expended to date lines for the federal, state, local and total categories. Corrective Action Plan: Future quarterly reporting will include reporting of total funds expended for applicable line items. General Manager will review quarterly submissions before submitting to Homeland Security. Responsible Individuals: Mark Vander Pol, Office Manager and JeffTenNapel, General Manager Anticipated Completion Date: October 2024

View Audit 320953

Finding 498187 (2023-002)

Significant Deficiency 2023

Westward Heights

WY

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.327

Effective immediately, our management company changed the process that office managers get invoices submitted and paid, which will guarantee the Chief Financial Analyst gets financial statements out before the 15th of each month. This will allow time to get the quarterly reports completed and sent t...

Effective immediately, our management company changed the process that office managers get invoices submitted and paid, which will guarantee the Chief Financial Analyst gets financial statements out before the 15th of each month. This will allow time to get the quarterly reports completed and sent to the USDA.

View Audit 320940

Finding 498184 (2023-001)

None 2023

Columbus Regional Hospital

IN

Questioned Costs Reporting Internal Control / Segregation of Duties

Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Even if lost revenues for the January 1, 2023 through June 30, 2023 time period are appropriately reduced ...

Views of Responsible Officials and Planned Corrective Action: We concur. Management continues to evaluate the current controls related to reporting to ensure amounts are appropriately stated. Even if lost revenues for the January 1, 2023 through June 30, 2023 time period are appropriately reduced to zero, the Hospital had $7,855,000 of unused lost revenues following submission #4, well in excess of the $1,326,000 of funding received in Period 5 requiring substantiation.

View Audit 320933 Questioned Costs: $1

Finding 498182 (2023-005)

Material Weakness 2023

YMCA of Southern Arizona

AZ

Material Weakness Reporting Internal Control / Segregation of Duties

Finding Reference Number: 2023-005 Description of Finding: The organization does not have a control requiring internal review with signature approval of the Schedule of Expenditures of Federal Awards before submitting to external auditors. Statement of Concurrence or Nonconcurrence: The organization...

Finding Reference Number: 2023-005 Description of Finding: The organization does not have a control requiring internal review with signature approval of the Schedule of Expenditures of Federal Awards before submitting to external auditors. Statement of Concurrence or Nonconcurrence: The organization concurs with the audit finding. Corrective Action: The organization’s procedures regarding the Schedule of Expenditures of Federal Awards included the CFO create it and the CEO review it; however, it did not include a signature approval by CFO and CEO before submitting to external auditors. The organization has now included the signature approval in its procedures. Name of Contact Person: Cathy Scheirman CFO 520.623.5511 x248 cathys@tucsonymca.org Projected Completion Date: The corrective action plan has been completed.

View Audit 320927

Finding 498181 (2023-004)

Material Weakness 2023

YMCA of Southern Arizona

AZ

Reporting Material Weakness

Finding Reference Number: 2023-004 Description of Finding: The organization did not submit all reports required by the program. Statement of Concurrence or Nonconcurrence: The organization concurs with the audit finding. Corrective Action: The organization has submitted all late reports required by ...

Finding Reference Number: 2023-004 Description of Finding: The organization did not submit all reports required by the program. Statement of Concurrence or Nonconcurrence: The organization concurs with the audit finding. Corrective Action: The organization has submitted all late reports required by the program. All reports were not submitted as required by the program due to staffing changes within the organization and these reports did not get reassigned. The organization has assigned tasks regarding the submitting and reviewing of reports in a timely manner to multiple staff in order to prevent this from occurring in the future. Name of Contact Person: Cathy Scheirman CFO 520.623.5511 x248 cathys@tucsonymca.org Projected Completion Date: The corrective action plan has been completed.

View Audit 320927

Finding 498176 (2023-001)

Significant Deficiency 2023

Gateway Accessible Housing Iii, Inc.

MO

Subrecipient Monitoring Reporting Internal Control / Segregation of Duties § 200.512

Finding 2023-001: Comments on the Finding and Each Recommendation: Statement of condition 2023-001: The Corporation did not file the data collection form SF-SAC for the audited financial statements for the year ended December 31, 2022, with the federal audit clearing house in a timely manner, as r...

Finding 2023-001: Comments on the Finding and Each Recommendation: Statement of condition 2023-001: The Corporation did not file the data collection form SF-SAC for the audited financial statements for the year ended December 31, 2022, with the federal audit clearing house in a timely manner, as required by 2 CFR 200.512. Recommendation: Management should submit data collection form SF-SAC as required by 2 CFR 200.512. Action(s) taken or planned on the finding: Management filed form SF-SAC on January 4, 2024.

View Audit 320918

Finding 498164 (2023-001)

Material Weakness 2023

St. Joseph's Health, Inc.

NJ

Procurement, Suspension & Debarment Reporting § 200.318 § 200.319 § 200.320 § 200.326 § 200.327

Management will strengthen its processes and internal control to ensure that report of expenditures is reviewed by Finance prior to submission and only includes expenditures incurred in the period. In addition, Management will amend its procurement policy to ensure the policy includes the required ...

Management will strengthen its processes and internal control to ensure that report of expenditures is reviewed by Finance prior to submission and only includes expenditures incurred in the period. In addition, Management will amend its procurement policy to ensure the policy includes the required regulations as outlined in the Code of Federal Regulations in relation to Federal Awards and that all relevant documentation will be retained. Christopher Caulfield, Executive Director of Financial Operations, will effectuate the corrective action plan, which is anticipated to be completed by December 31, 2024. caulfieldc@sjhmc.org 973-754-2016

View Audit 320895

Finding 498162 (2023-006)

Material Weakness 2023

Town of Frankton

IN

Reporting Allowable Costs / Cost Principles Material Weakness § 200.303

Title of result and comment:: Frankton FINDING 2023‐006 Contact person Responsible for Corrective Action: First Name: Timothy Last Name: Detrick Contact’s Phone Number:: (765) 754‐7285 Contact’s Email Address:: tdetrickct@gmail.com Views of Responsible Official: We concur with the finding Descriptio...

Title of result and comment:: Frankton FINDING 2023‐006 Contact person Responsible for Corrective Action: First Name: Timothy Last Name: Detrick Contact’s Phone Number:: (765) 754‐7285 Contact’s Email Address:: tdetrickct@gmail.com Views of Responsible Official: We concur with the finding Description of Corrective Action Plan:: We have started a ledger that will keep track of all funds/grants that may not appear on our bank Rec. They will be check every month by the board to make sure they are accurate. Anticipated Completion Date: Year: 2024 Month: 6 Day: 14 If applicable: Document reason issue will NOT be corrected within 6 months::

View Audit 320891

Finding 498154 (2023-004)

Material Weakness 2023

Shelby County

IN

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Material Weakness § 200.1 § 200.303

FINDING 2023-04 Finding Subject: COVID-19 Coronavirus State and Local Fiscal Recovery Funds – Reporting Summary of Finding: Reports were incorrectly completed, excluded amounts for the report period. Contact Person Responsible for Corrective Action: Amy L. Glackman Contact Phone Number: 317-392-6310...

FINDING 2023-04 Finding Subject: COVID-19 Coronavirus State and Local Fiscal Recovery Funds – Reporting Summary of Finding: Reports were incorrectly completed, excluded amounts for the report period. Contact Person Responsible for Corrective Action: Amy L. Glackman Contact Phone Number: 317-392-6310 Views of Responsible Official: We concur with the finding. Description of Corrective Action Plan: Control procedures will be put into place effective immediately. The Auditor will have the Deputy Auditor start signing off on all reports to verify the dates are correct for the reporting period. Anticipated Completion Date: August 30, 2024

View Audit 320882

Corrective Action Plans

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