Corrective Action Plans

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Federal Agency Name: Legal Services Corporation Program Name: Legal Services Corporation – Basic Field Grant FFAL#: 09-542026 Finding Summary: The Organization did not perform an annual IT risk assessment during 2024 and did not test an emergency disaster prevention and recovery plan as required in...
Federal Agency Name: Legal Services Corporation Program Name: Legal Services Corporation – Basic Field Grant FFAL#: 09-542026 Finding Summary: The Organization did not perform an annual IT risk assessment during 2024 and did not test an emergency disaster prevention and recovery plan as required in Section 2.5.3 of the LSC Financial Guide. Responsible Individuals: Lea Wroblewski, Executive Director Corrective Action Plan: The Executive Director shared the risk assessment guidelines with the 3rd party IT consultants, CMIT Solutions of Sioux Falls, who is familiar with technology utilized by ERLS. CMIT Solutions will conduct an annual risk assessment, help create an emergency disaster prevention and recovery plan, and help ensure that risk assessment guidelines are followed. At the regularly scheduled annual review with CMIT, ERLS will review the necessity of additional technology improvements following the completion of the 2022 Technology Assessment. Completion Date: July 2025
Finding Number: 2024‐002 Program Name/Assistance Listing Title: COVID‐19 Education Stabilization Fund Assistance Listing Numbers: 84.425D, 84.425U Contact Person: Cliff Wadhams, Business Manager Anticipated Completion Date: August 31, 2025 Planned Corrective Action: The District will be r...
Finding Number: 2024‐002 Program Name/Assistance Listing Title: COVID‐19 Education Stabilization Fund Assistance Listing Numbers: 84.425D, 84.425U Contact Person: Cliff Wadhams, Business Manager Anticipated Completion Date: August 31, 2025 Planned Corrective Action: The District will be requiring all District LEAs to take the necessary training through  the  Arizona  Department  of  Education  web  portal  and  related  classes  as  necessary  to  be  better informed on ESSER reporting and supporting documentation.
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2024 Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart F, Section 511 – Audit Findings Follow-up requires the auditee t...
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2024 Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart F, Section 511 – Audit Findings Follow-up requires the auditee to prepare a corrective action plan to address each audit finding included in the current year auditor’s reports. The Corrective Action Plan for Current Year Findings present our corrective action plan for the Financial Statement and/or Federal Award Findings described in the accompanying Schedule of Findings and Questioned Costs for the period ended December 31, 2024. Finding 2024-001 Responsible Party: Name: Rodney Potter Position: Assistant Executive Director Telephone Number: (816) 364-3827 Federal Agency U.S. Department of Housing and Urban Development Federal Program Supportive Housing for Persons with Disabilities – Section 811 Compliance Requirements N – Special Tests and Provisions Finding Type Federal Awards Auditee’s Comments on Finding The Maples Housing Corporation agrees with the auditors’ finding and recommendation. Corrective Action(s) We will ensure tenants requesting maintenance of property via work orders are being maintained properly and in a timely manner and review the accuracy / completeness of the documentation being processed in the work order system on a quarterly basis. Anticipated Completion Date July 31, 2025
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2023 Finding 2024-002 Responsible Party: Name: Rodney Potter Position: Assistant Executive Director Telephone Number: (816) 364-3827 Federal Agency U.S. Department of Housing and Urban Development Federal Program Supportive Housing for Persons w...
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2023 Finding 2024-002 Responsible Party: Name: Rodney Potter Position: Assistant Executive Director Telephone Number: (816) 364-3827 Federal Agency U.S. Department of Housing and Urban Development Federal Program Supportive Housing for Persons with Disabilities – Section 811 Compliance Requirements N – Special Tests and Provisions Finding Type Financial Statements and Federal Awards Auditee’s Comments on Finding Keystone Place agrees with the auditors’ finding and recommendation. Corrective Action(s) We will ensure a current and approved HUD Form 9839-B is on file. The form was submitted to HUD for approval on March 22, 2023, however HUD requested additional documentation from the Organization regarding the operation and management of the property before granting approval. The additional documentation (a Management Agreement) and an updated Form 9839-B request was submitted to HUD in October 2024; however, approval has not been granted by HUD to-date. Anticipated Completion Date July 31, 2025
View Audit 358319 Questioned Costs: $1
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2024 Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart F, Section 511 – Audit Findings Follow-up requires the auditee t...
CORRECTIVE ACTION PLAN FOR THE YEAR ENDED DECEMBER 31, 2024 Title 2, U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), Subpart F, Section 511 – Audit Findings Follow-up requires the auditee to prepare a corrective action plan to address each audit finding included in the current year auditor’s reports. The Corrective Action Plan for Current Year Findings present our corrective action plan for the Financial Statement and/or Federal Award Findings described in the accompanying Schedule of Findings and Questioned Costs for the period ended December 31, 2024. Finding 2024-001 Responsible Party: Name: Rodney Potter Position: Assistant Executive Director Telephone Number: (816) 364-3827 Federal Agency U.S. Department of Housing and Urban Development Federal Program Supportive Housing for Persons with Disabilities – Section 811 Compliance Requirements N – Special Tests and Provisions Finding Type Federal Awards Auditee’s Comments on Finding Keystone Place agrees with the auditors’ finding and recommendation. Corrective Action(s) We will ensure tenants requesting maintenance of property via work orders are being maintained properly and in a timely manner and we will review the accuracy / completeness of the documentation being processed in the work order system on a quarterly basis. Anticipated Completion Date July 31, 2025
Finding 564126 (2024-001)
Significant Deficiency 2024
Finding #2024-001 – Significant Deficiency and Other Noncompliance. Applicable federal programs: U. S. Department of Housing and Urban Development, Economic Development Initiative, Community Project Funding, and Miscellaneous Grants, Assistance Listing #14.251, Contract Number: В-23-СР-TX-1411, Co...
Finding #2024-001 – Significant Deficiency and Other Noncompliance. Applicable federal programs: U. S. Department of Housing and Urban Development, Economic Development Initiative, Community Project Funding, and Miscellaneous Grants, Assistance Listing #14.251, Contract Number: В-23-СР-TX-1411, Contract Year: 02/15/24 – 08/31/31, Harris County, Passed through The Houston Food Bank, COVID-19 Coronavirus State and Local Fiscal Recovery Funds, Assistance Listing #21.027, Contract Number: N/A, Contract Year: 02/08/23 – 12/31/24. Recommendation: Develop a formal procurement policy and provide training to staff responsible for procurement. Planned corrective action: Target Hunger will develop and implement a procurement policy in accordance with the Uniform Guidance Procurement standards and will provide training to those responsible for procurement activities. Responsible officer: Sandra Wicoff, Chief Executive Officer. Estimated completion date: July 2025.
Finding #2024-004 – Significant Deficiency and Other Noncompliance. Applicable federal program: U. S. Department of Health and Human Services, 93.576, Refugee and Entrant Assistance Discretionary Grants, Passed through U. S. Committee for Refugees and Immigrants: 09/30/24 – 09/29/25, GPK5RHKAEUGS, ...
Finding #2024-004 – Significant Deficiency and Other Noncompliance. Applicable federal program: U. S. Department of Health and Human Services, 93.576, Refugee and Entrant Assistance Discretionary Grants, Passed through U. S. Committee for Refugees and Immigrants: 09/30/24 – 09/29/25, GPK5RHKAEUGS, 09/30/23 – 09/29/24, 90RP0119, 09/30/22 – 09/29/23, 90RP0119-01-01, 09/30/24 – 09/29/25, 90RP0119, 09/30/22 – 09/29/23, 90RP0119, 09/30/23 – 09/29/24, 90RP0119-02-04. Condition and context: During our testing of the accuracy and timeliness of financial and programmatic programming for the major programs selected for testing, we identified the following exception: Documentation of the submission and review of the one semi-annual narrative and one semi-annual data reports tested for the Refugee and Entrant Assistance Discretionary Grants was not evidenced on the copy of the reported provided. Recommendation: Provide additional training and emphasize adherence to established policies and procedures to ensure maintenance of documentation of submission of reports and timely submission of reports. Management’s response: Management agrees with the finding. While these reports were submitted as required, proof of submission and review were not available. We will reinforce the importance of documentation and retention thereof with staff assigned to all grant-funded programs. We will also improve our documentation tracking system to ensure this information is available in our internal records and will incorporate into our internal control system procedures to address staff turnover and personnel changes. Responsible officer: Jennifer Garcia, Chief Financial Officer. Estimated completion date: June 2025.
The person responsible for the correcting the finding and timeline are as follows: The Director of Veterans Programs, Alyssa Carion, Due Date: May 1, 2025. Regarding finding #2024-001, all items identified have been addressed and the due date has been met. All missing program agreements noted in the...
The person responsible for the correcting the finding and timeline are as follows: The Director of Veterans Programs, Alyssa Carion, Due Date: May 1, 2025. Regarding finding #2024-001, all items identified have been addressed and the due date has been met. All missing program agreements noted in the SSG Fox audit have been loaded to participant files. Policy and procedures have been updated to state that the patient health questionnaire must be completed by a staff member and a policy for releasing program participants has been added. Tracking participants outside of the online portal is in place and includes enrollment date, disenrollment date for all clients form program inception. In addition, a monthly control is in place to review the spreadsheet o ensure all documents are included.
Finding 563976 (2024-003)
Significant Deficiency 2024
Block Grants for Prevention and Treatment of Substance Abuse – Assistance Listing No. 93.959 Recommendation: We recommend the County to conduct training with its various departments to instruct them on how to compile expenditures based on the accrual basis of accounting (when the expenditures were i...
Block Grants for Prevention and Treatment of Substance Abuse – Assistance Listing No. 93.959 Recommendation: We recommend the County to conduct training with its various departments to instruct them on how to compile expenditures based on the accrual basis of accounting (when the expenditures were incurred). Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Auditor’s Controllers office provides training on accrual basis of accounting at year-end training. All personnel related to recording the expenditures related to this program will be required to attend the meeting. In addition, the Auditor’s office will require all department heads and chief fiscal officers to sign off on the accuracy and completeness of their revenue and expenditures prior to closing each fiscal year going forward. Names of the contact persons responsible for corrective action: Aimee Espinoza, Auditor-Controller and Alonzo Solis, AC Senior Accountant. Planned completion date for corrective action plan: June 30, 2025, is not feasible due to the issuance date so expected completion date to June 30, 2026.
Finding 563974 (2024-002)
Significant Deficiency 2024
Block Grants for Community Mental Health Services - Assistance Listing No. 93.958 Recommendation: We recommend the County to conduct training with its various departments to instruct them on how to compile expenditures based on the accrual basis of accounting (when the expenditures were incurred). ...
Block Grants for Community Mental Health Services - Assistance Listing No. 93.958 Recommendation: We recommend the County to conduct training with its various departments to instruct them on how to compile expenditures based on the accrual basis of accounting (when the expenditures were incurred). Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Auditor’s Controllers office provides training on accrual basis of accounting at year-end training. All personnel related to recording the expenditures related to this program will be required to attend the meeting. In addition, the Auditor’s office will require all department heads and chief fiscal officers to sign off on the accuracy and completeness of their revenue and expenditures prior to closing each fiscal year going forward. Names of the contact persons responsible for corrective action: Aimee Espinoza, Auditor-Controller and Alonzo Solis, AC Senior Accountant. Planned completion date for corrective action plan: June 30, 2025, is not feasible due to the issuance date so expected completion date to June 30, 2026.
Finding 2024-002: Internal Control Over Financial Reporting– Significant Deficiency Audit Finding: Management is responsible for the design and implementation of internal controls over year-end financial reporting, including controls over procedures used to enter transaction in the general ledge...
Finding 2024-002: Internal Control Over Financial Reporting– Significant Deficiency Audit Finding: Management is responsible for the design and implementation of internal controls over year-end financial reporting, including controls over procedures used to enter transaction in the general ledger and record recurring and nonrecurring adjustments to the financial statements on an accrual basis. During the course of the audit, journal entries were required to reconcile accounts receivable, accrued expenses, and accrued PTO from a cash basis to an accrual basis, which indicate a lack of operating effectiveness of internal controls over the financial reporting process. Audit Recommendation: We recommend School District 12 Education Foundation (dba Five Star Education Foundation) review policies and procedures related to the year-end financial reporting process and controls should be implemented to ensure accrual basis financial reporting can be achieved. Management’s Response and Corrective Action Plan: School District 12 Education Foundation (dba Five Star Education Foundation) agrees with the finding and recommendation. These transactions were proactively shared with the auditor at the commencement of the audit and discussed. Actions were already taken to fix these processes. In 2023 an outside professional was hired to mitigate these circumstances and ensure adherence to GAAP accounting. Management is hiring new accountants to alleviate future issues in this space. Management is in the process of implementing enhanced processes and procedures to achieve the proper recording of transactions on an accrual basis. A year-end checklist will be used to ensure that all accruals are booked in accounts receivable and payables. Contact and Completion Date: Shannon Hancock, 720-972-4342, shannon.hancock@5starfoundation.org, is the primary contact, and the Executive Director at School District 12 Education Foundation (dba Five Star Education Foundation). The corrective action is expected to be resolved before the end of the next fiscal year-end of December 31, 2025.
Federal Agency Name: US Department of Housing and Urban Development Program Name: Section 8 Housing Choice Vouchers Federal Financial Assistance Listing Number: 14.871 Finding Summary: The commission is required to calculate the tenant's rent payment using documentation from third party verification...
Federal Agency Name: US Department of Housing and Urban Development Program Name: Section 8 Housing Choice Vouchers Federal Financial Assistance Listing Number: 14.871 Finding Summary: The commission is required to calculate the tenant's rent payment using documentation from third party verification used to calculate payment of assistance; in one of the 40 tenant files tested, the tenant's payment amounts were calculated incorrectly. Responsible Individuals: Mary Goldade, Executive Director Corrective Action Plan: Continued training and additional review of calculations by an individual not performing the original calculation will be done to ensure accurate calculations going forward. Anticipated Completion Date: June 30, 2025
Finding 563807 (2024-001)
Significant Deficiency 2024
Finding 2024-001: Cash Management Federal Grant – ALN 93.788 and ALN 93.959 Condition – During testing, it was noted that cash was requested prior to disbursement of funds by a month or more. Corrective Action –HealthWest finance management will conduct a mandatory staff training session for all r...
Finding 2024-001: Cash Management Federal Grant – ALN 93.788 and ALN 93.959 Condition – During testing, it was noted that cash was requested prior to disbursement of funds by a month or more. Corrective Action –HealthWest finance management will conduct a mandatory staff training session for all relevant staff on cash management requirements, including timing of cash requests, documentation of expenditures, and consequences of non-compliance. Refresher grant compliance and cash management policy review and training will be incorporated into annual training for all grant management personnel. HealthWest will update grant pre-draw process to require a documented review and approval of all cash draw requests by finance leadership or designee ensuring drawdowns are supported by general ledger expenditure activity reports. Contract Person – Brandy Carlson, Chief Financial Officer Anticipated Completion Date – June 30, 2025
Taylor Regional Hospital (Hospital) respectfully submits the following corrective action plan for the year ended March 31, 2024. The findings from the March 31, 2024 Schedule of Findings and Questioned Costs is discussed below. The findings are numbered consistently with the numbers assigned in the ...
Taylor Regional Hospital (Hospital) respectfully submits the following corrective action plan for the year ended March 31, 2024. The findings from the March 31, 2024 Schedule of Findings and Questioned Costs is discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FEDERAL AWARD PROGRAMS AUDIT FINDINGS Significant Deficiency (2024-002) Planned Corrective Action: The hospital agrees with this finding. See 2024-001.
Finding Reference Number: 2024-004 Reporting Description of Finding: During the fiscal year ended June 30, 2024, the Authority's internal controls over the submission of VMS to HUD did not include a review or reconciliation of the information submitted to supporting documentation. As a result, hous...
Finding Reference Number: 2024-004 Reporting Description of Finding: During the fiscal year ended June 30, 2024, the Authority's internal controls over the submission of VMS to HUD did not include a review or reconciliation of the information submitted to supporting documentation. As a result, housing assistance payments for Mainstream Port-out vouchers were not reported in VMS. Statement of Concurrence or Nonconcurrence: The Wallingford Housing Authority agrees and accepts the above reference findings. Corrective Action Plan: Maintaining a properly staffed and trained staff will ensure that each montky VMS report will be reconciled prior to being submitted by the third-party fee accountant. A schedule or reconciliations will be created and implemented.
Finding Reference Number: 2024-003 Reporting Description of Finding: The selection of a sample of 12 annual reexaminations, which is approximately 10% of the population, for participants in the Housing Voucher Cluster. For 3 out of the 12 re-examinations, the annual reexamination was not conducted ...
Finding Reference Number: 2024-003 Reporting Description of Finding: The selection of a sample of 12 annual reexaminations, which is approximately 10% of the population, for participants in the Housing Voucher Cluster. For 3 out of the 12 re-examinations, the annual reexamination was not conducted timely. Documented delays in receiveing informatuon from participants caused the re-examinations to not bt conducted on an annual basis. Statement of Concurrence or Noncurrence: The Wallingford Housing Authority agrees and accepts the above referenced findings: Correction Action: Maintaining a properly staffed and trained management team who will create and maintain a schedule of annual reexaminations to be held in compliance within the guidelines of HUD and to be completed in a timely manner.
Finding 563657 (2024-002)
Significant Deficiency 2024
Preparation of Financial Statements and Related Footnotes
Preparation of Financial Statements and Related Footnotes
Finding 563657 (2024-002)
Significant Deficiency 2024
Recommendation: This control deficiency is not unusual in a small city. However, it is the responsibility of management and the Council to decide whether to accept the degree of risk associated with this condition based on the cost of correction and other considerations.
Recommendation: This control deficiency is not unusual in a small city. However, it is the responsibility of management and the Council to decide whether to accept the degree of risk associated with this condition based on the cost of correction and other considerations.
Finding 563657 (2024-002)
Significant Deficiency 2024
Management’s Response and Actions Planned: The City’s management is aware of this significant deficiency. Management reviews and approves the draft annual audited financial statements and distributes them to the users. For entities of this size, it generally is not practical to obtain the internal e...
Management’s Response and Actions Planned: The City’s management is aware of this significant deficiency. Management reviews and approves the draft annual audited financial statements and distributes them to the users. For entities of this size, it generally is not practical to obtain the internal expertise needed to handle all aspects of the external financial reporting. Management recognizes this and feels it is effectively handling its reporting responsibilities with the procedures described above.
Internal Control Over Compliance Recommendation: We recommend that the organization implement additional review process over the rate determination to ensure it is being calculated correctly. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action t...
Internal Control Over Compliance Recommendation: We recommend that the organization implement additional review process over the rate determination to ensure it is being calculated correctly. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Daycare Director will review all parent fee calculations with signed approval, beginning upon enrollment of the student and, annually, for as long as they remain enrolled at AELC. Name(s) of the contact person(s) responsible for corrective action: Michelle James Planned completion date for corrective action plan: May 23, 2025 f the State has questions regarding this plan, please call Michelle James at (203) 744-4700.
Ensure that the Organization's tenant compliance policies are strictly adhered to, complying with FHA Guidance and that proper procurement documentation maintained.
Ensure that the Organization's tenant compliance policies are strictly adhered to, complying with FHA Guidance and that proper procurement documentation maintained.
To address this issue identified with nonpayroll employee disbursements, we have implemented a new requirement that all such payments made through payroll must be preceded by a Personnel Action Form. This form must be submitted to HR in advance and signed by the applicable department director and wi...
To address this issue identified with nonpayroll employee disbursements, we have implemented a new requirement that all such payments made through payroll must be preceded by a Personnel Action Form. This form must be submitted to HR in advance and signed by the applicable department director and with the HR Director or CFO. This process ensures that all nonpayroll disbursements are properly reviewed and authorized prior to payment. The new procedure has been communicated to relevant staff and integrated into exisiting workflows to ensure compliance and strengthen internal controls moving forward.
Finding 563582 (2024-001)
Significant Deficiency 2024
We acknowledge the finding and have already addressed the issue. Additionally, we have incorporated this procedure into our compliance checklist. As a result, monthly reminders will be sent to a designated group within the Finance team to help prevent recurrence.
We acknowledge the finding and have already addressed the issue. Additionally, we have incorporated this procedure into our compliance checklist. As a result, monthly reminders will be sent to a designated group within the Finance team to help prevent recurrence.
2024-002 Corrective Action Plan: Expense Approval Documentation - Significant Deficiency Issue Summary A significant deficiency was identified during the audit process regarding inconsistent or missing documentation for expense approvals. Instance sincluded expenditures lacking evidence of required...
2024-002 Corrective Action Plan: Expense Approval Documentation - Significant Deficiency Issue Summary A significant deficiency was identified during the audit process regarding inconsistent or missing documentation for expense approvals. Instance sincluded expenditures lacking evidence of required approvals, incomplete support for business purposes, and deviations from documented approval thresholds. Root Cause Analysis - Inconsistent application of expense approval policies. Corrective Actions Expected Outcome - Consistent and complete documentation of all expense approvals. - Increased compliance with internal controls and audit standards. - Reduced risk of unauthorized or inappropriate expenditures. - Strengthened accountability among approvers and departments. Monitoring and Reporting The Finance Committee, the Director of Operations and Finance, and the Executive Director will monitor progress monthly and update executive leadership. Ongoing compliance will be tracked via audit findings and system-generated reports.
Finding 2024-017 U.S. Department of Health and Human Services AL No. 93.600 Head Start Significant Deficiency in Internal Controls and Noncompliance over Reporting Repeat Finding: No Auditee’s Corrective Action Plan: MOCFS has noted the requirement to complete the FFATA report on the annual Baltimor...
Finding 2024-017 U.S. Department of Health and Human Services AL No. 93.600 Head Start Significant Deficiency in Internal Controls and Noncompliance over Reporting Repeat Finding: No Auditee’s Corrective Action Plan: MOCFS has noted the requirement to complete the FFATA report on the annual Baltimore City Head Start Administrative Calendar and will put an alert in the Workday system. Filing the FFATA for each sub-recipient will be completed once the entire contract is approved by the BOE. Contact Person: Shannon Burroughs-Campbell, Executive Director of Baltimore City Head Start Lisa Dooley, Head Start Accountant Completion Date: June 30, 2025
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