Corrective Action Plans

Finding 1173239 (2022-004)

Material Weakness 2022

New Space Nexus

NM

Reporting

Response: Management concurs with the finding. Corrective Action Plan: Management will implement documented reporting procedures that clearly define all required financial, technical, and annual reports; assign preparation and review responsibilities; and establish an internal review and approval pr...

Response: Management concurs with the finding. Corrective Action Plan: Management will implement documented reporting procedures that clearly define all required financial, technical, and annual reports; assign preparation and review responsibilities; and establish an internal review and approval process prior to submission. The Financial Analyst and Executive Director will review reports for accuracy and timeliness. Management will conduct periodic monitoring to ensure reports are submitted in accordance with award requirements. SF-425 reports will be submitted to AFRL at the same time as the Part 2 invoice for the last month of each quarter. Designation of Employee Position Responsible for Meeting Deadline: Financial Analyst — by March 31, 2023.

View Audit 386730

Finding 1173237 (2022-002)

Material Weakness 2022

New Space Nexus

NM

Reporting § 200.502

2022‐002—PREPARATION OF SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) Response: Management concurs with the finding. Corrective Action Plan: Management will implement a documented SEFA preparation process that derives the SEFA directly from the general ledger and supporting grant schedules. A li...

2022‐002—PREPARATION OF SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) Response: Management concurs with the finding. Corrective Action Plan: Management will implement a documented SEFA preparation process that derives the SEFA directly from the general ledger and supporting grant schedules. A line-by-line reconciliation will be performed by the financial advisor and independently reviewed prior to finalization by the Executive Director. Documentation supporting the reconciliation and final SEFA will be retained to demonstrate accuracy and completeness. Designation of Employee Position Responsible for Meeting Deadline: Financial Analyst — by December 31, 2023.

View Audit 386730

Finding 1173236 (2022-001)

Material Weakness 2022

New Space Nexus

NM

Eligibility Reporting Significant Deficiency

Response: Management concurs with the finding. Corrective Action Plan: Management will implement and document a formal employee onboarding procedure that requires timely completion and retention of Form I-9 for all new hires. Existing personnel files will be reviewed for completeness and missing I-9...

Response: Management concurs with the finding. Corrective Action Plan: Management will implement and document a formal employee onboarding procedure that requires timely completion and retention of Form I-9 for all new hires. Existing personnel files will be reviewed for completeness and missing I-9 forms will be remediated where permissible. Management will retain evidence of completion and conduct periodic compliance reviews to ensure ongoing adherence. Designation of Employee Position Responsible for Meeting Deadline: Financial Analyst — by January 31, 2023.

View Audit 386730

Finding 1172706 (2022-008)

Material Weakness 2022

Northwest Indian College

WA

Eligibility Reporting Significant Deficiency § 200.303 § 200.328 § 200.329

Recommendation: We recommend the College review the reporting requirements and implement procedures to ensure that all required reports are issued/posted in an accurate and timely manner. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in...

Recommendation: We recommend the College review the reporting requirements and implement procedures to ensure that all required reports are issued/posted in an accurate and timely manner. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Collaborative workflow was developed between Grant PI's and IS department personnel to ensure that all reports are posted to the website in a timely manner. Name of the contact person responsible for corrective action: Clarissa Salhus, Finance Manager, Duane VanderGriend, CFO Planned completion date for corrective action plan: Completed as of January 14, 2026

View Audit 385956

Finding 1172556 (2022-008)

Material Weakness 2022

City of Senatobia

MS

Reporting Internal Control / Segregation of Duties

The City will implement control procedures over receipts and transfers to ensure that all cash transactions are properly recorded and classified in the City's accounting system, in a timely manner. The City staff has since reviewed the situation to have a better understanding of how the procedures s...

The City will implement control procedures over receipts and transfers to ensure that all cash transactions are properly recorded and classified in the City's accounting system, in a timely manner. The City staff has since reviewed the situation to have a better understanding of how the procedures should be handled.

View Audit 385854

Finding 1171695 (2022-012)

Material Weakness 2022

Osage County

OK

Procurement, Suspension & Debarment Subrecipient Monitoring Allowable Costs / Cost Principles § 200.303

Chairman of the Board of County Commissioners: The lack of cooperation and oversight during the prior County Clerk’s administration left significant gaps that required immediate attention. The current leadership has made addressing these gaps a top priority. Together, we are: • meeting monthly to up...

Chairman of the Board of County Commissioners: The lack of cooperation and oversight during the prior County Clerk’s administration left significant gaps that required immediate attention. The current leadership has made addressing these gaps a top priority. Together, we are: • meeting monthly to update procedures and build stronger internal controls, • developing and formalizing policies to ensure full compliance with federal grant requirements, • and improving communication between offices to ensure federal reporting is accurate and timely. Our collective commitment is to put permanent measures in place to prevent these issues from recurring and to uphold the highest level of compliance for all federal programs. County Clerk: I was not the County Clerk in office at this time. The County will comply with all aspects of grant reporting and requirements. The Officials will work together to put policies and procedures in place to ensure more accurate reporting. County Treasurer: The County Officers will work on better communication to more accurately report the SEFA funds.

View Audit 384725

Finding 1171694 (2022-011)

Material Weakness 2022

Osage County

OK

Reporting Internal Control / Segregation of Duties Subrecipient Monitoring

Chairman of the Board of County Commissioners: These findings trace back to gaps under the prior Clerk’s administration and her lack of cooperation with the Board of County Commissioners, but our focus is on fixing the problems, not dwelling on them. Under the current leadership, the Board of County...

Chairman of the Board of County Commissioners: These findings trace back to gaps under the prior Clerk’s administration and her lack of cooperation with the Board of County Commissioners, but our focus is on fixing the problems, not dwelling on them. Under the current leadership, the Board of County Commissioners, the new County Clerk and the other elected officials have made addressing these control weaknesses a priority. Together, we are: • strengthening county-wide policies and procedures to meet federal compliance requirements • improving communication and oversight to ensure accurate and timely federal reporting • and establishing clear standards and training for all reporting officers to prevent inaccurate or untimely reporting. Our collective goal is to build a stronger, more accountable system that ensures federal programs are managed with the highest level of integrity. County Clerk: I was not the County Clerk in office at this time. Ensure that the County has standards in place that will deter inaccurate and untimely reporting. In addition, those reporting have the knowledge and understanding to properly report. County Treasurer: The County Officers will work on better communication to more accurately report the Schedule of Expenditures of Federal Awards (SEFA) funds.

View Audit 384725

Finding 1171105 (2022-002)

Material Weakness 2022

WESTERN WISCONSIN WORKFORCE DEVELOPMENT BOARD, INC.

WI

Reporting

Western Wisconsin Workforce Development Board, Inc. did not submit the data collection form and reporting package to the Federal Audit Clearinghouse within the required timeframe. This delay occurred due to staffing transitions and limited fiscal capacity during the audit period, which resulted in c...

Western Wisconsin Workforce Development Board, Inc. did not submit the data collection form and reporting package to the Federal Audit Clearinghouse within the required timeframe. This delay occurred due to staffing transitions and limited fiscal capacity during the audit period, which resulted in challenges completing financial reporting and coordinating the final submission. To address the issue, WWWDB has hired a dedicated accountant and established clearer internal roles for managing the annual audit and Federal Audit Clearinghouse submission process. The organization has also created an internal audit calendar that outlines all required federal deadlines, including the due date for the data collection form and reporting package. Going forward, WWWDB will implement a formal checklist to ensure all components of the Single Audit are completed, reviewed, and submitted on time. WWWDB is also strengthening communication and coordination with its external auditors to ensure that all required documents are prepared in alignment with federal deadlines. Staff involved in the audit process will receive additional training on the Federal Audit Clearinghouse submission requirements. The Interim Executive Director and the Accountant will be responsible for monitoring compliance with all federal reporting deadlines. WWWDB anticipates full implementation of these corrective actions prior to the next reporting cycle to prevent recurrence of this issue.

View Audit 384512

Finding 1170706 (2022-011)

Material Weakness 2022

Hope the Mission

CA

Reporting Subrecipient Monitoring Internal Control / Segregation of Duties § 200.510

The Schedule of Expenditures of Federal Awards (SEFA) provided to the audit firm was incomplete due to two primary factors: (1) insufficient understanding by staff regarding the requirement to include federally funded capital expenditures, and (2) improper recording of property acquisitions. Managem...

The Schedule of Expenditures of Federal Awards (SEFA) provided to the audit firm was incomplete due to two primary factors: (1) insufficient understanding by staff regarding the requirement to include federally funded capital expenditures, and (2) improper recording of property acquisitions. Management acknowledges this oversight, which occurred during the implementation of a new program and at a time when staff were not fully aware that such expenditures must be reflected on the SEFA. Furthermore, certain capital expenditures paid directly through escrow were not recorded in the organization's accounting records. To remediate these issues, management has taken the following corrective actions: - Delivered targeted training to staff on the proper treatment and reporting of federally funded capital expenditures; - Updated internal closing and reporting procedures to incorporate a formal review of balance sheet activity; and - Updated internal closing and reporting procedures to incorporate a reconciliation to settlement statements when recording new property acquisitions; and - Strengthened internal controls to ensure all federally funded capital items are accurately captured in future SEFA submissions. Management is committed to maintaining compliance with federal reporting requirements and ensuring the completeness and accuracy of future SEFA filings.

View Audit 383904

Finding 1170482 (2022-002)

Material Weakness 2022

Alameda County Deputy Sheriff's Activities League Inc.

CA

Material Weakness Reporting

Management's Response: DSAL will attempt to meet the annual filing requirements. Estimated Completion Date: May 2025 Responsible Party: Sara Sherman, Contract Finance Manager

View Audit 383671

Finding 1170423 (2022-002)

Material Weakness 2022

Baltimore Medical System, Inc.

MD

Subrecipient Monitoring Allowable Costs / Cost Principles Reporting § 200.510

Finding: During the audit of the auditee's SEFA for the year ended December 31, 2022, we noted discrepancies related to incorrect identification of Assistance Listing Numbers for certain grants, as well as difficulty providing initial supporting detail for balances of expenditures for certain Federa...

Finding: During the audit of the auditee's SEFA for the year ended December 31, 2022, we noted discrepancies related to incorrect identification of Assistance Listing Numbers for certain grants, as well as difficulty providing initial supporting detail for balances of expenditures for certain Federal programs. The auditee lacks sufficient internal controls over the preparation and review of the SEFA. Specifically, there is no established process to reconcile federal expenditures reported on the SEFA to the auditee's underlying accounting records. A formal review process involving an individual independent of the preparation was not conducted to ensure the SEFA was complete and accurate before submission to the auditors. Views of responsible officials and planned corrective actions: Management agrees with the recommendation to establish and document a formal, multilevel review process for the preparation of the SEFA. Baltimore Medical System recently hired a new grant accountant who will be responsible for the preparation of the SEFA. • The Controller will perform a detailed reconciliation of the SEFA’s data to the general ledger and supporting grant documents. • The Grant Accountant will develop a central repository that includes all grant contracts/awards and a summary document which contains the grant name, grantee, award amount and period, Assistance Listing Numbers, pass-through entity and subrecipient information. • Train relevant staff on the SEFA requirements governed by the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for the Federal Awards (2 CFR Part 200, 200.510(b)). Anticipated date of completion: December 31, 2025 Contact person responsible – Tammy Grinnan, Controller and Margaret Boemmel, CFO

View Audit 383596

Finding 1169155 (2022-001)

Material Weakness 2022

City of Tahlequah

OK

Reporting Internal Control / Segregation of Duties

Finding 2022-001 - Accurate Reporting of Federal Expenditures Condition: Internal controls over financial reporting lacked oversight and thorough review, as federal expenditures were excluded from the SEFA during fiscal year 2022. Additionally, accurate SF-425 federal reporting did not reflect the e...

Finding 2022-001 - Accurate Reporting of Federal Expenditures Condition: Internal controls over financial reporting lacked oversight and thorough review, as federal expenditures were excluded from the SEFA during fiscal year 2022. Additionally, accurate SF-425 federal reporting did not reflect the expenditures incurred for the appropriate reporting period. Lastly, the City did not submit its audit report to the federal audit clearinghouse within nine months from the year ending June 30, 2022. In conjunction with our FY2022 single audit, please see the City’s corrective action plan below: We have reviewed our current procedures related to SEFA reporting and have increased our training to ensure accurate reporting of financial information on the SEFA. We have established procedures to ensure timely reconciliation of federal expenses. We have internal controls in place to ensure that future filings are completed within the established deadlines. Expected completion date: 7/1/2024 Party Responsible: Michele Collins, Finance Director Contact Information: mcollins@tahlequah.gov

View Audit 382013

Finding 1169143 (2022-001)

Material Weakness 2022

Olympic Medical Center

WA

Reporting § 200.512

November 10,2025 Clallam County Public Hospital District No. 2, dba Olympic Medical Center (OMC) Corrective Action Plan Year Ended December 31,2022 Finding 2022-001 Responsible Official: Dennis Stillman, Interim CFO Conection Action and Timing: With the volume of COVID-19 federal programs and the re...

November 10,2025 Clallam County Public Hospital District No. 2, dba Olympic Medical Center (OMC) Corrective Action Plan Year Ended December 31,2022 Finding 2022-001 Responsible Official: Dennis Stillman, Interim CFO Conection Action and Timing: With the volume of COVID-19 federal programs and the related complexities associated with the evolving guidance, it was challenging to prepare the Schedule of Expenditures of Federal Awards (SEFA) and related support completely and accurately for the single audit by the required due dates. Before the COVID-19 pandemic, grant expenditures related to federal programs rarely surpassed the single audit threshold, and the single audit threshold for OMC is unlikely to be surpassed in the future. To prepare for the possibility of future federal grant awards, all applications and contracts for federal awards will require review and approval by OMC's Contracts department. All applications for federal awards will be forwarded to the Chief Financial Officer for evaluation, acceptance, and record-keeping for Schedule of Expenditure of Federal Awards, SEFA. The recordkeeping for SEFA will be for accuracy, completeness, and reconciliation with accounting records. These records will support the performance of the single audit. OMC will implement this Corrective Action Plan effective November 1,2025 S Stillman Interim CFO Contracts Manager Controller cc:

View Audit 381986

Finding 1169021 (2022-008)

Material Weakness 2022

City of Hollister

CA

Reporting

The City recognizes that full implementation of this corrective action cannot be achieved until the City becomes current with all outstanding audits. Completion of prior-year audits is necessary to establish accurate beginning balances, finalize prior-year reconciliations, and allow future audits to...

The City recognizes that full implementation of this corrective action cannot be achieved until the City becomes current with all outstanding audits. Completion of prior-year audits is necessary to establish accurate beginning balances, finalize prior-year reconciliations, and allow future audits to begin on schedule. In the meantime, the City is actively improving its internal processes to support more timely financial reporting going forward. The City has strengthened year-end closing procedures, enhanced reconciliation processes, and increased staff capacity within the Finance Division, including the addition of two full-time Accountants dedicated to bank reconciliations, grant reconciliation, and other core accounting functions. Internal deadlines for year-end close and audit preparation have also been established to create a more efficient workflow once the City is current. These improvements, combined with updated procedures and enhanced staffing, will help ensure smoother and more timely audit preparation in future years once prior-year audits are completed.

View Audit 381688

Finding 1169019 (2022-006)

Material Weakness 2022

City of Hollister

CA

Reporting

The City will strengthen its internal controls over the preparation of the Schedule of Expenditures of Federal Awards (SEFA) by implementing the improvements outlined in the corrective action for Finding 2022-002. The City’s updated Grants Administration Policy, standardized grant packet requirement...

The City will strengthen its internal controls over the preparation of the Schedule of Expenditures of Federal Awards (SEFA) by implementing the improvements outlined in the corrective action for Finding 2022-002. The City’s updated Grants Administration Policy, standardized grant packet requirements, and the addition of a full-time Accountant responsible for grant reconciliation will provide the structure and oversight necessary to ensure accurate reporting of federal expenditures. The Accountant will perform year-end SEFA preparation in coordination with departmental grant managers and Finance staff to verify that expenditures reported on the SEFA reconcile to the general ledger and represent allowable costs under each federal award. This enhanced oversight will help ensure that the SEFA is prepared accurately, consistently, and in compliance with federal reporting requirements. The Accountant will also coordinate communication between department grant managers and the Finance Division to ensure that grant agreements, budgets, amendments, reports, and supporting documentation are complete and properly recorded. The updated Grants Administration Policy will reflect these strengthened processes and the centralized oversight provided through this position.

View Audit 381688

Finding 1168941 (2022-001)

Material Weakness 2022

New Directions, Inc.

CA

Internal Control / Segregation of Duties Subrecipient Monitoring Reporting

Management concurs that there were staffing and turnover challenges for the Organization. Adequate policies and procedures are in place to ensure timeliness of data requested. Additionally, we will establish milestones to ensure future audits progress within the Uniform Guidance timeline.

View Audit 381458

Finding 1168915 (2022-002)

Material Weakness 2022

Weld Seattle

WA

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Cash Management § 200.514

Management agrees with the finding presented by the audit. Management has taken corrective actions to meet this standard. The Organization has taken corrective actions to meet this standard for FY23. These actions include the Organization implementing a grant reimbursement approval system with three...

Management agrees with the finding presented by the audit. Management has taken corrective actions to meet this standard. The Organization has taken corrective actions to meet this standard for FY23. These actions include the Organization implementing a grant reimbursement approval system with three levels of review. The controls include segregation of duties between the employee who process the data and the employees who review in order to ensure any errors are identified and remediated prior to submission to the grantor. The Staff Accountant and Shared Services team process data for reimbursement and provides the data to the Finance Manager to review and create the grant filing. Once the grant filing is prepared, the Grant Administrator reviews the grant filing and provides the completed filing to the Operations Director to review and approve prior to submission to the grantor.

View Audit 381373

Finding 1168524 (2022-002)

Material Weakness 2022

The County of Butler

MO

Subrecipient Monitoring Allowable Costs / Cost Principles Material Weakness

U.S. Department of Treasury - Coronavirus State and Local Fiscal Recovery Effort Recommendation: We recommend the County review federal guidelines to ensure that reports are identified to allow proper and timely submission. Explanation of disagreement with audit finding: There is no disagreement wit...

U.S. Department of Treasury - Coronavirus State and Local Fiscal Recovery Effort Recommendation: We recommend the County review federal guidelines to ensure that reports are identified to allow proper and timely submission. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County agrees and is developing a process to ensure reports are prepared and submitted. Name(s) of the contact person(s) responsible for corrective action: Donna Hillis, County Clerk Planned completion date for corrective action plan: December 31, 2025

View Audit 380345

Finding 1168467 (2022-005)

Material Weakness 2022

Wyola School District No. 29

MT

Reporting

Finding 2022 – 005: Reporting – Late Data Collection Form Submission Response: For the audit period and subsequent audit periods the District will not be in compliance with this finding until the FY 2022-23, FY 2023-24 and FY 2024-25 audits are completed.

View Audit 380260

Finding 1168465 (2022-003)

Material Weakness 2022

Wyola School District No. 29

MT

Reporting § 200.510

Finding 2022 – 003: Reporting: Preparation of the Schedule of Expenditures of Federal Awards (SEFA) Response: For the audit period and subsequent audit periods the employee responsible for the SEFA did not prepare the SEFA for the audit. For future audit periods the SEFA will be prepared by the Fina...

Finding 2022 – 003: Reporting: Preparation of the Schedule of Expenditures of Federal Awards (SEFA) Response: For the audit period and subsequent audit periods the employee responsible for the SEFA did not prepare the SEFA for the audit. For future audit periods the SEFA will be prepared by the Financial Consultant.

View Audit 380260

Finding 1167401 (2022-002)

Material Weakness 2022

Compañia de Turismo de Puerto Rico

PR

Reporting

Views of responsible officials: The Company will establish a clear and organized calendar for the submission of all required reports. This calendar will serve as a reference to ensure that all deadlines are met, helping to improve overall efficiency. By outlining specific dates for each report will ...

Views of responsible officials: The Company will establish a clear and organized calendar for the submission of all required reports. This calendar will serve as a reference to ensure that all deadlines are met, helping to improve overall efficiency. By outlining specific dates for each report will avoid delays and ensure that all required reports and documentation are submitted on time, contributing to a more effective report delivery process.

View Audit 378469

Finding 1167400 (2022-001)

Material Weakness 2022

Compañia de Turismo de Puerto Rico

PR

Reporting

The Chief Financial Officer (CFO) is responsible for this task. The overview includes reviewing and submitting the information and data collected during the month. To ensure timely compliance, the CFO has implemented a shared calendar system with the administrative personnel that establishes clear d...

The Chief Financial Officer (CFO) is responsible for this task. The overview includes reviewing and submitting the information and data collected during the month. To ensure timely compliance, the CFO has implemented a shared calendar system with the administrative personnel that establishes clear deadlines and reminders to prevent delays and improve efficiency, ensuring all submissions are received within the required timeframe. In addition to timeliness, the CFO will implement enhanced internal controls and quality assurance measures to guarantee that all data submitted is accurate, complete, and in full compliance with federal reporting requirements. This process will include: • Conducting a pre-submission review of all documents by the finance and compliance team to verify accuracy and consistency. • Establish a checklist of federal regulatory requirements to be applied before final submission of reporting packages. • Assigning a secondary reviewer independent of the preparer to ensure an additional level of oversight. • Documenting all reviews and approvals to create an audit trail that supports transparency and accountability. • Holding monthly coordination meetings with responsible personnel to address potential delays, clarify requirements, and provide corrective guidance in real time. By combining timely submission mechanisms with strengthened review and compliance controls, the CFO ensures that reporting packages meet the highest standards of accuracy, reliability, and federal regulatory compliance.

View Audit 378469

Finding 1167143 (2022-003)

Material Weakness 2022

Pulaski Memorial Hospital

IN

Reporting

Corrective action: Management has implemented internal controls over compliance in place to assist with the timely preparation of the SEFA.

View Audit 378192

Finding 1167142 (2022-002)

Material Weakness 2022

Pulaski Memorial Hospital

IN

Allowable Costs / Cost Principles Reporting

Corrective action: Management understands the due date for single audit reporting package submission to the Federal Audit Clearinghouse and filed as soon as possible

View Audit 378192

Finding 1166292 (2022-006)

Material Weakness 2022

Rehoboth McKinley Christian Health Care Services, Inc.

NM

Reporting Significant Deficiency

All required PRF reporting has been submitted. Will comply should new or additional reporting requirements be added in the future.

View Audit 377383

Corrective Action Plans

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