Corrective Action Plans

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2023-007. SEMAP Supporting Documentation Corrective action planned: QC on all indicators is now being completed as required. Contact person: Matt Brady, Executive Director. Anticipated completion date: September 30, 2024
2023-007. SEMAP Supporting Documentation Corrective action planned: QC on all indicators is now being completed as required. Contact person: Matt Brady, Executive Director. Anticipated completion date: September 30, 2024
2023-006. Significant Audit Adjustments Corrective action planned: I have spoken with Lindsey and Company and will better communicate. Contact person: Matt Brady, Executive Director. Anticipated completion date: September 30, 2024
2023-006. Significant Audit Adjustments Corrective action planned: I have spoken with Lindsey and Company and will better communicate. Contact person: Matt Brady, Executive Director. Anticipated completion date: September 30, 2024
U.S. Department of Health and Human Services Washington County Memorial Hospital (“Hospital”) respectfully submits the following corrective action plan for the year ended August 31, 2023. Audit period: September 1, 2022 – August 31, 2023 The findings from the schedule of findings and questioned cos...
U.S. Department of Health and Human Services Washington County Memorial Hospital (“Hospital”) respectfully submits the following corrective action plan for the year ended August 31, 2023. Audit period: September 1, 2022 – August 31, 2023 The findings from the schedule of findings and questioned costs are discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS— FINDINGS AND QUESTIONED COSTS – MAJOR FEDERAL PROGRAMS DEPARTMENT OF HEALTH AND HUMAN SERVICES 2023 – 001 COVID-19 Provider Relief Fund and American Rescue Plan Rural Distribution Recommendation: We recommend the Hospital design controls to ensure that reporting is completing in accordance with latest HHS guidelines. Action taken in response to finding: The Hospital will ensure that they use the appropriate method of reporting lost revenue calculations in the future reporting periods. Name of the contact person responsible for corrective action: Debra Pratt, CFO. Planned completion date for corrective action plan: September 1, 2024 If the Department of Health and Human Services has questions regarding this plan, please call Debra Pratt, CFO at (573) 438 5451 Ext 771.
Segregation of Duties Auditors’ Recommendation: The Fire District should continue to obtain involvement from the Board of Fire Commissioners in reviewing monthly financial reports and approving expenditures. In addition, the Fire District should consider having a Board member prepare or review bank ...
Segregation of Duties Auditors’ Recommendation: The Fire District should continue to obtain involvement from the Board of Fire Commissioners in reviewing monthly financial reports and approving expenditures. In addition, the Fire District should consider having a Board member prepare or review bank reconciliations for each of its bank accounts. Fire District Response: Meghan Nagel, Treasurer, and Brian Engels, Board chairman, understand the importance of having strong segregation of duties and will attempt to separate certain responsibilities as outline above for the year ending December 31, 2024, but does prove difficult in a small district with minimal employees. The Fire District will continue to have the Board review monthly reports and approve expenditures. Further, the Fire District will continue to print the operating account reconciliation and will have that reviewed by a board member. The Fire District will start printing the reconciliation for all other accounts for them to be reviewed by a board member, as well continuing to print each bank statement to be reviewed.
Finding 400882 (2023-001)
Significant Deficiency 2023
The City agrees with the finding. The City will improve internal controls over the Performance and Expenditure report review process and ensure this review addresses all aspects of the reports and is completed prior to submission. Corrective action was taken in spring of 2024 when the issue was iden...
The City agrees with the finding. The City will improve internal controls over the Performance and Expenditure report review process and ensure this review addresses all aspects of the reports and is completed prior to submission. Corrective action was taken in spring of 2024 when the issue was identified during the 2023 audit. Responsible Official: Catrina Asher, Finance Director Planned completion date for corrective action plan: March 31, 2024.
Management is currently confident with the abilities of the accounting staff to prepare interim financial statements. The District has also accepted the additional risk associated with the auditor drafting year-end financial statements including the notes to the financial statements. Management wi...
Management is currently confident with the abilities of the accounting staff to prepare interim financial statements. The District has also accepted the additional risk associated with the auditor drafting year-end financial statements including the notes to the financial statements. Management will review, approve, and take responsibility for the financial statements.
Finding # 2023-001 Material Weakness over Preparation of Schedule of Federal Expenditures (SEFA) The Organization did not identify all federal expenditures and significant adjustments were required to the SEFA prepared by management. Corrective Action: The Organization agrees with and independent...
Finding # 2023-001 Material Weakness over Preparation of Schedule of Federal Expenditures (SEFA) The Organization did not identify all federal expenditures and significant adjustments were required to the SEFA prepared by management. Corrective Action: The Organization agrees with and independently identified this issue and proactively implemented a new payroll process as of January 2024 in order to address this issue. This will ensure all expenses are tracked in one system for all purposes. In addition the Organization created a new grant tracking field in the chart of accounts which tracks the Assistance Listing numbers of all grants, allowing for the automated creation of the SEFA, as well as providing an internal control to ensure that revenue recognition policies and relevant federal guidelines are correctly applied to all funding sources. Anticipated Completion Date: January 2024
Name of the contact person responsible for corrective action: Glenn Seagraves, CFO Corrective Action Plan: The delay in filing was the result of significant staff turnover in Liberty Resources Inc.’s finance department producing the Organization's financial statements and the limited availability ...
Name of the contact person responsible for corrective action: Glenn Seagraves, CFO Corrective Action Plan: The delay in filing was the result of significant staff turnover in Liberty Resources Inc.’s finance department producing the Organization's financial statements and the limited availability of other resources to assist in the preparation of the financial statements. The Organization has developed and implemented a staffing plan that has adjusted the responsibilities of existing staff and has also hired new additional staff since the end of the June 30, 2023 fiscal year. Anticipated completion date: The plan has been implemented and will continue to be monitored to ensure the Organization’s ability to complete the Single Audit financial statements in a timely manner and that the data collection form can be submitted in compliance with the Single Audit requirements.
2023-003 Compliance of Special Tests and Provisions – National Service Criminal History Checks: Management Response: Management will ensure an individual who does not perform the adjudication will review and document whether information was entered correctly and whether the adjudications are proper ...
2023-003 Compliance of Special Tests and Provisions – National Service Criminal History Checks: Management Response: Management will ensure an individual who does not perform the adjudication will review and document whether information was entered correctly and whether the adjudications are proper and documented prior to a member’s start date. Responsible Person: Lisa Moore, Executive Director Anticipated Remediation Date: Fiscal year ending August 31, 2024
2023-002 Approval of Living Allowance Payments: Management Response: Management will include others on correspondence regarding approval of payroll, which will help detect when an approval of payroll is not made timely. If payroll is not approved before paid, then Management will perform a documente...
2023-002 Approval of Living Allowance Payments: Management Response: Management will include others on correspondence regarding approval of payroll, which will help detect when an approval of payroll is not made timely. If payroll is not approved before paid, then Management will perform a documented review to ensure payroll payments are proper. Management will also develop a policy to stop living allowance payments timely when a member will not meet their service hour obligation. Responsible Person: Lisa Moore, Executive Director Anticipated Remediation Date: Fiscal year ending August 31, 2024
2023-001 Segregation of Duties: Management Response: Due to the size of LDSC’s administrative staff, complete segregation of duties is not economically feasible. However, during the 2023 fiscal year, LDSC created a financial policies handbook that outlines controls and responsibilities in the financ...
2023-001 Segregation of Duties: Management Response: Due to the size of LDSC’s administrative staff, complete segregation of duties is not economically feasible. However, during the 2023 fiscal year, LDSC created a financial policies handbook that outlines controls and responsibilities in the financial reporting cycle. We will ensure the areas recommended above are added to our current policy to the extent it is economically feasible. Responsible Person: Lisa Moore, Executive Director Anticipated Remediation Date: Fiscal year ending August 31, 2024
Planned Corrective Action: ARPA Grant Funds are now being approved by the Controller before submitting to the Treasury Website. Responsible officials: Luis Barrera, Controller, will be responsible for approvals before submitting the expenditures Planned completion date: The approval process was impl...
Planned Corrective Action: ARPA Grant Funds are now being approved by the Controller before submitting to the Treasury Website. Responsible officials: Luis Barrera, Controller, will be responsible for approvals before submitting the expenditures Planned completion date: The approval process was implemented on October 31, 2023
Finding: 2023-002 Lack of Proper Review – Eligibility, Reporting, and Special Provisions Federal agency: U.S. Department of Housing and Urban Development Federal program Title: Housing Choice Voucher Program Assistance Listing Number: 14.871 and 14.879 Federal Award Identification Number and Year: ...
Finding: 2023-002 Lack of Proper Review – Eligibility, Reporting, and Special Provisions Federal agency: U.S. Department of Housing and Urban Development Federal program Title: Housing Choice Voucher Program Assistance Listing Number: 14.871 and 14.879 Federal Award Identification Number and Year: N/A Pass-Through Agency: N/A Pass-Through Number(s): N/A Award Period: December 31, 2023 Type of Finding: Material Weakness in Internal Control Over Compliance Recommendation: We recommend the HRA implement controls over all areas of the federal program so that controls are in place and working. Views of Responsible Officials: There is no disagreement with the audit finding. Action Taken in Response to Finding: The HRA will assess the controls over the federal program and make changes as deemed necessary. Name of the Contact Person Responsible for Corrective Action Plan: Rhonda Moen, Finance Manager Planned Completion Date for Corrective Action Plan: December 31, 2024.
Management Response: CLUES’ financial management detected an oversight in billing a specific unallowable cost to certain grants that fund our Behavioral Health (“BH”) clinics. The oversight was promptly investigated, and we immediately remedied the situation with the affected funders. CLUES has take...
Management Response: CLUES’ financial management detected an oversight in billing a specific unallowable cost to certain grants that fund our Behavioral Health (“BH”) clinics. The oversight was promptly investigated, and we immediately remedied the situation with the affected funders. CLUES has taken action to prevent similar potential errors in the future. Two of our grants account for the majority of the improper billing total. The funders agreed that we can charge other billable expenses not previously covered. CLUES expended all funds with the funder’s approval. This matter was resolved and reported to the funder’s satisfaction. Action taken in response to finding: Management immediately identified the scope of the billing discrepancy, contacted the funders to resolve it, and have incorporated training and monitoring procedures internally to ensure we do not inadvertently bill such unallowable costs again. Proper review processes have been implemented to detect and prevent similar findings in the future. Name of the contact person responsible for corrective action: Ryan Robinson (VP of Finance & Administration) Planned completion date for corrective action plan: This matter was resolved in May 2024.
Finding 400835 (2023-006)
Significant Deficiency 2023
Company-wide reports are submitted monthly to the Board of Directors for approval. Reports that are submitted are separated by grant, so that the Board of Directors can see the activity in each grant for each month during the fiscal year. The reports submitted to the funders by Marlon Mitchell are t...
Company-wide reports are submitted monthly to the Board of Directors for approval. Reports that are submitted are separated by grant, so that the Board of Directors can see the activity in each grant for each month during the fiscal year. The reports submitted to the funders by Marlon Mitchell are taken from the financial reports that are approved by the Board of Directors. In addition, Marlon does not enter the financial information, nor does he prepare the monthly reports submitted to the Board. He serves as a fourth set of eyes on the information before the reports are submitted to the funders. Khayriyah Mitchell enters all of the revenue and expenditures into the accounting system, Shanelle Herman reconciles the bank and credit card accounts and runs the reports for the Board of Directors, the Board reviews and approves the financial statements, and Marlon Mitchell uses the approved financial information to create the reports to the grant funding agencies.
USD #250 has implemented new procedures to ensure that information provided to the Food Service Director is correct. Personnel have been trained in the poper way to run reports under the District's accounting system. In addition, the Director of Business Operations will review the annual food serv...
USD #250 has implemented new procedures to ensure that information provided to the Food Service Director is correct. Personnel have been trained in the poper way to run reports under the District's accounting system. In addition, the Director of Business Operations will review the annual food service report prepared by the Food Service Director before it is submitted to the Kansas Department of Education.
Finding No. Name of Responsible Official Management’s Response to Findings Description of Corrective Action 2023-001 John Proni, Director of Finance_x0002_Hospital Division Management agrees with the finding for CFDA 93.498 where Period 5 Provider Relief Funds (PRF) were excluded on the original SE...
Finding No. Name of Responsible Official Management’s Response to Findings Description of Corrective Action 2023-001 John Proni, Director of Finance_x0002_Hospital Division Management agrees with the finding for CFDA 93.498 where Period 5 Provider Relief Funds (PRF) were excluded on the original SEFA and an adjustment of $9,234,533 was required. 2023-001 John Proni, Director of Finance_x0002_Hospital Division Management agrees with the finding and the corrected amount on the federal SEFA. On the original draft of the SEFA, for CFDA 93.914 expenses were included from February 2024 dates of service. An adjustment of $152,329 was required Management will ensure that in preparation of the SEFA, (1) a team member will assemble the initial reconciliation, (2) management will review the initial reconciliation and review the consolidation from all BayCare entities to the combined SEFA, (3) A final review will be conducted by the Director. Sign-off from each preparer/reviewer shall be required. Meetings will be conducted as needed with departments outside of Hospital Finance to ensure completeness and accuracy of data. Anticipated Completion Date Completion of SEFA for Fiscal Year 2024 will be completed in first quarter 2025.
Management acknowledges the delay in completing the FYE 2023 audit and filing the Data Collection Form (SF-SAC) on time. We have since completed the audit and submitted the required documentation to the Federal Audit Clearinghouse. To prevent recurrence of this issue the following corrective actio...
Management acknowledges the delay in completing the FYE 2023 audit and filing the Data Collection Form (SF-SAC) on time. We have since completed the audit and submitted the required documentation to the Federal Audit Clearinghouse. To prevent recurrence of this issue the following corrective actions will be implemented: -Establish a detailed timeline for the audit process, including key milestones and deadlines -Conduct regular progress review to ensure adherence to the timeline -Allocate additional resources to the finance departments as needed during critical periods to ensure timely completion of tasks -Improve communication between the audit team and mangement to promptly address any issues that may cause delays. Responsible Party: Ed Gonzalez, CFO, will be responsible for overseeing the implementation and execution of this corrective action plan. Estimated Completion Date: The corrective actions outlined above are expected to be fully implemented by May 31, 2024. We are committed to ensuring compliance with all financial reporting obligations and will take the necessary steps to prevent future occurrences of such delays.
Late Filing of Required Reporting of Federal Awards/Grant. CAL-PEP Inc.’s Data Collection Form and Reporting Package was not submitted to the Federal Clearinghouse within extended due date. Corrective Action Plan: Policy and Procedures on the submittal of Data Collection Form and Reporting Package t...
Late Filing of Required Reporting of Federal Awards/Grant. CAL-PEP Inc.’s Data Collection Form and Reporting Package was not submitted to the Federal Clearinghouse within extended due date. Corrective Action Plan: Policy and Procedures on the submittal of Data Collection Form and Reporting Package to the Federal Clearing House within extended due date had been established. Policy is shown below: The reporting package for the Federal clearing house must be submitted 30 days after receipt of auditor's report, or 9 months after end of the fiscal year whichever comes first, (February). In order to meet the deadline, a request to start the company audit will be arrange at the earliest, by August every year. In case an Audit Report is expected not to be receive within 9 months after fiscal year, a written extension must be submitted by the Finance Manager.
Finding 2023-002: Reporting - Significant Deficiency in Internal Control over Compliance Management agrees with the finding and the auditor's recommendation. Contact Person responsible for corrective action: Patrick Williams Deputy Finance Director pwilliams@clackamas.us 971-325-5392 Corrective Acti...
Finding 2023-002: Reporting - Significant Deficiency in Internal Control over Compliance Management agrees with the finding and the auditor's recommendation. Contact Person responsible for corrective action: Patrick Williams Deputy Finance Director pwilliams@clackamas.us 971-325-5392 Corrective Action Planned: Procedures will be incorporated into the County workflow to provide additional monitoring, oversight, and record retention related to reporting. These will include: -Compiling a comprehensive inventory of grants and reporting deadlines, including for reporting submitted by departments -Timely monitoring for the status of reporting and tracking of extensions. -Obtain copies of all grant reports and documentation of extensions -Report status of pending and/or delinquent reports due to funding sources at quarterly Finance/Performance Clackamas Check-in meetings with Health, Housing, & Human Services Director's Office. Anticipated Completion Date: September 30th, 2024
The Executive Director and Senior Director of Finance will work with the Controller to update the procedures for the SEFA incorporating additional steps that share the responsibility for recording Federal Expenses and Revenue in line with the needs of the SEFA report.
The Executive Director and Senior Director of Finance will work with the Controller to update the procedures for the SEFA incorporating additional steps that share the responsibility for recording Federal Expenses and Revenue in line with the needs of the SEFA report.
Finding 2023-001: Allowable costs – significant deficiency in internal controls over compliance and compliance finding. Management Response CCGD was issued monitoring findings by HHSC for the monitoring period October 2021 (FY 21) -November 2022 (FY 22) in April 2023. As a result of that finding, CC...
Finding 2023-001: Allowable costs – significant deficiency in internal controls over compliance and compliance finding. Management Response CCGD was issued monitoring findings by HHSC for the monitoring period October 2021 (FY 21) -November 2022 (FY 22) in April 2023. As a result of that finding, CCGD received a finding in its 2022 audit. Because of the timing of the findings, as noted in the 2023 audit report, there was not time to resolve the issue before 2023. Therefore, even though the below described plan was implemented in 2023, immediately upon receipt of the initial finding, CCGD was still issued a finding in its FY2023 audit. The notification was received in the 7th month of fiscal year 2023, the following plan has been implemented. o Timesheet and GL mismatch i. Management Response: 1. Perform an audit of existing setup of HRIS-Paycom system to determinecause of mismatch 2. If needed, reimplement Paycom with required setup or change vendors 3. All departments along with respective service categories werereestablished in Paycom to only display employees applicable servicecategories based their respective grants. 4. Conduct quarterly audits of timesheets and GL to ensure there are nomismatches. 5. Time study was performed on quarterly basis to ensure individualperformance complies with funders mandate. ii. Progress Update - GL and Timesheet Mismatch: 1. Audit of existing setup to review the following: a. Department(s) - revised department names/descriptions i. Made changes to all applicable employees’ setup. b. Home Allocation(s) – revised home allocation(s)i. Revised/edited the default home allocation description ii. Assigned correct default home allocation to employees c. Service Categories i. Revised/edited service categories assigned to each department 2. Observations: a. Following Paycom updates, CCGD experienced technical challenges due to software glitches which continued to result in timesheet and GL mismatches. CCGD is continuing to work with Paycom to identify and eliminate the problem. b. CCGD subsequently sought assistance from Paycom in the troubleshooting process. 3. Departmental training of timekeeping process a. Personalized standard operating procedures used b. Real-time examples/instruction provided to staff in training session(s) 4. Post-training audits conducted to include: a. Timecard/sheet review b. GL review and comparison of timecards and sheetsiii. Future Steps and Anticipated Timeline: 1. Continuation of post-training audits to include: a. Timecard/sheet review b. GL review and comparison of timecards and sheets 2. With an anticipated deadline completion date of December 31, 2023, for adherence of full compliance, CCGD effectively implemented system updates prior to this deadline to ensure payroll processing is now based on the actual time and effort performed. iv. Progress Update – Performance Activity Report 1. To provide further back up to time and effort, an additional option in Paycom was enabled for staff to enter notes on day-to-day activity. 2. Departmental training on this goal was performed and completed as of March 31, 2024. 3. Continuation of post-training audits to include: a. Timecard/sheet review b. GL review and comparison of timecards and sheets v. Post implementation plan and observation: CCGD is fully committed to complying with funders and audit standards. Furthermore, CCGD will continue to monitor and identify any potential errors in its payroll reporting to bring a timely solution if required. Furthermore, minor reporting errors occur in payroll GL reports on a random basis. The errors appear to be technical, and as such, we are currently working with Paycom to resolve this issue. Additionally, CCGD will continue to perform time study to ensure that all salary expenses and allocations are adhered to the respective program budget. Parties Responsible: Chief Executive Officer, Chief Financial Officer, and Director - Human Resources
LATE FILING OF 2022 DATA COLLECTION FORM; PROBLEM - THE ANNUAL REPORTING REQUIREMENTS OF THE FEDERAL AUDIT CLEARINGHOUSE WERE NOT MET IN RELATION TO THE CERTIFICATION OF THE 2022 DATA COLLECTION FORM.; CORRECTIVE ACTION - OUR YMCA MANAGEMENT TEAM WILL WORK CLOSELY WITH OUR AUDIT FIRM TO FILE AND CER...
LATE FILING OF 2022 DATA COLLECTION FORM; PROBLEM - THE ANNUAL REPORTING REQUIREMENTS OF THE FEDERAL AUDIT CLEARINGHOUSE WERE NOT MET IN RELATION TO THE CERTIFICATION OF THE 2022 DATA COLLECTION FORM.; CORRECTIVE ACTION - OUR YMCA MANAGEMENT TEAM WILL WORK CLOSELY WITH OUR AUDIT FIRM TO FILE AND CERTIFY THE 2022 DATA COLLECTION FORM ALONGSIDE THE FILING AND CERTIFICATION OF THE 2023 DATA COLLECTION FORM TO ENSURE COMPLIANCE WITH THE REPORTING REQUIREMENTS OF THE UNIFORM GUIDANCE.; TIMELINE - THE 2022 DATA COLLECTION FORM WILL BE FILED AND CERTIFIED NO LATER THAN 30 DAYS AFTER THE RELEASE OF THE AUDITED FINANCIAL STATEMENTS. IN THIS CASE, THE FORM WILL BE FILED BY JULY 5, 2024.; MONITORING FOR FUTURE COMPLIANCE - OUR YMCA MANAGEMENT TEAM WILL ENSURE THAT PROCESSES ARE IN PLACE TO WORK WITH OUR AUDIT FIRM EACH YEAR SUBSEQUENT TO 2024 TO ENSURE THAT THE DATA COLLECTION FORM IS FILED AND CERTIFIED TIMELY AND IN ACCORDANCE WITH REQUIREMENTS OF THE UNIFORM GUIDANCE.
Finding 2023-008: Compliance with Federal Wage Requirements Finding: The District did not include federal wage rate requirements in construction contracts which were partially funded with federal grant funds. Additionally, the District did not require the contractors in those agreements to submit we...
Finding 2023-008: Compliance with Federal Wage Requirements Finding: The District did not include federal wage rate requirements in construction contracts which were partially funded with federal grant funds. Additionally, the District did not require the contractors in those agreements to submit weekly certified payrolls. Corrective Actions Planned: The District will update the language used for construction contracts and develop an internal process for the collection and retention of the required weekly certified payrolls. Expected Implementation Date: June 30, 2024 Contact Person: Dr. Frank Williams
View Audit 308771 Questioned Costs: $1
Finding 2023-009: Untimely Data Collection Form Submittance Finding: The District submitted its data collection form more than nine months after the end of the fiscal year 2023 audit period. Corrective Actions Planned: The District will work with its auditors to ensure timely completion of the singl...
Finding 2023-009: Untimely Data Collection Form Submittance Finding: The District submitted its data collection form more than nine months after the end of the fiscal year 2023 audit period. Corrective Actions Planned: The District will work with its auditors to ensure timely completion of the single audit in the future. Expected Implementation Date: December 31, 2024 Contact Person: Dr. Frank Williams
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