Corrective Action Plans

Finding 1206102 (2023-004)

Material Weakness 2023

Future Ready Five

OH

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Reference Number: 2023-04 Finding Type: Significant Deficiency in Internal Control Over Compliance Description of Finding: During the audit, it was noted that the Organization was unable to provide formal support for the internal review of required reports under the major program before they were su...

Reference Number: 2023-04 Finding Type: Significant Deficiency in Internal Control Over Compliance Description of Finding: During the audit, it was noted that the Organization was unable to provide formal support for the internal review of required reports under the major program before they were submitted to the pass-through grantor. The Organization lacks established procedures which provide formal evidence that the accuracy and completeness of required reports was verified before submission. Without formal review controls in place, the Organization is more susceptible to reporting errors and/or noncompliance with federal requirements. Statement of Concurrence: Management agrees with the finding. Corrective Action: The Chief Financial Officer prepares the required reports, and the Chief Executive has informally approved the reports prior to submission. A formal review by the Chief Executive Officer has been implemented to document in writing the review by the Chief Executive Office prior to submission. Completion Date: January 31, 2026 Name of Contact Person: Maureen Thomas Chief Financial Officer 917-405-7185 maureen@frfive.org

View Audit 398055

Finding 1206100 (2023-002)

Material Weakness 2023

Future Ready Five

OH

Significant Deficiency Matching / Level of Effort / Earmarking Internal Control / Segregation of Duties § 200.303

Reference Number: 2023-02 Finding Type: Significant Deficiency in Internal Control Over Compliance Description of Finding: During the audit, it was noted that the Organization was unable to provide formal support for the internal review of costs submitted to the pass-through grantor under the major ...

Reference Number: 2023-02 Finding Type: Significant Deficiency in Internal Control Over Compliance Description of Finding: During the audit, it was noted that the Organization was unable to provide formal support for the internal review of costs submitted to the pass-through grantor under the major program. The Organization lacks established procedures which provide formal evidence that the allowability, accuracy and completeness of transactions were verified before submission. Without adequate internal controls in place to ensure that all charges to the federal program are properly reviewed for allowability, the Organization faces increased risk of noncompliance with the allowability requirement and could request funds for unallowed costs. Statement of Concurrence: Management agrees with the finding. Corrective Action: Beginning July 2025, management implemented a formal review process in Blackbaud Financial Edge NXT for the Director of RISE and the Chief Operating Officer to review and approve all invoices prior to submission to the Chief Financial Officer to ensure all charges are allowed. All invoices $25,000 and over are also reviewed and approved by the Chief Executive Officer prior to submission to the Chief Financial Officer for payment. Prior to July 2025, written approvals were obtained through either email or initial sign-off on invoices. Completion Date: July 2025 Name of Contact Person: Maureen Thomas Chief Financial Officer 917-405-7185 maureen@frfive.org

View Audit 398055

Finding 1206065 (2023-005)

Material Weakness 2023

Voices of Tomorrow

WA

Subrecipient Monitoring Allowable Costs / Cost Principles Reporting

Contact Person: Chief Financial Officer Contact Person: Iftin Hagimohamed; Chief Financial Officer Stephanie Sosa: Finance Manager Explanation and specific reasons for disagreement with the audit finding or that corrective action is not required (if applicable): Management concurs with the finding. ...

Contact Person: Chief Financial Officer Contact Person: Iftin Hagimohamed; Chief Financial Officer Stephanie Sosa: Finance Manager Explanation and specific reasons for disagreement with the audit finding or that corrective action is not required (if applicable): Management concurs with the finding. FFATA reporting was not completed for applicable subawards as required under 2 CFR Part 170. Status: Corrective Action Taken Corrective action planned: The revised policy includes tracking of allocation shared cost and perform FFATA review. • Develop and implement a formal FFATA reporting policy. • Confirm FSRS system access and assign reporting responsibility. • Establish a compliance calendar for timely submission. • Complete any outstanding required FFATA filings. • Conduct quarterly review of subawards for FFATA applicability. Anticipated completion date: February 2026

View Audit 397946

Finding 1206063 (2023-003)

Material Weakness 2023

Voices of Tomorrow

WA

Procurement, Suspension & Debarment Allowable Costs / Cost Principles Significant Deficiency § 200.318 § 200.326

Contact Person: Iftin Hagimohamed; Chief Financial Officer Stephanie Sosa: Finance Manager Explanation and specific reasons for disagreement with the audit finding or that corrective action is not required (if applicable): Management concurs with the finding. Procurement documentation did not consis...

Contact Person: Iftin Hagimohamed; Chief Financial Officer Stephanie Sosa: Finance Manager Explanation and specific reasons for disagreement with the audit finding or that corrective action is not required (if applicable): Management concurs with the finding. Procurement documentation did not consistently evidence compliance with internal policy and 2 CFR §§200.318–200.326. Status: Corrective Action Taken Corrective action planned: Voices of Tomorrow will implement procurement software to automate workflows and approval processes for procurement purchases. Voices of Tomorrow will • Revise and formalize procurement policy to align fully with Uniform Guidance requirements.Implement a standardized procurement documentation checklist requiring evidence of procurement method, cost/price analysis, and approvals. • Require CFO pre-approval for federally funded procurements above established thresholds. • Conduct staff training on federal procurement standards. • Implement quarterly internal procurement compliance reviews. Anticipated completion date: April 2026: Policy revision and training completed within 60 days; quarterly reviews beginning next fiscal quarter.

View Audit 397946

Finding 1182017 (2023-005)

Material Weakness 2023

Voices of Tomorrow

WA

Reporting Significant Deficiency Internal Control / Segregation of Duties

Corrective action planned: Management has organized their general ledger to allow for better matching and coding to better identify unallowable costs during the billing process. Additionally, necessary staff were trained on the tracking and approving expenditure on federal cost principles. Reviews w...

Corrective action planned: Management has organized their general ledger to allow for better matching and coding to better identify unallowable costs during the billing process. Additionally, necessary staff were trained on the tracking and approving expenditure on federal cost principles. Reviews will be made on quarterly baises, and all necessary documentation is collected and reviewed

View Audit 393387

Finding 1182016 (2023-004)

Material Weakness 2023

Voices of Tomorrow

WA

Allowable Costs / Cost Principles Significant Deficiency

Management partially disagrees with the characterization of the finding. The Organization had an established cost allocation methodology in place and provided documentation outlining the allocation basis and percentages applied to shared nonpayroll costs. The allocation methodology was reasonable, c...

Management partially disagrees with the characterization of the finding. The Organization had an established cost allocation methodology in place and provided documentation outlining the allocation basis and percentages applied to shared nonpayroll costs. The allocation methodology was reasonable, consistently applied, and based on operational usage. The matter identified during audit testing relates to a difference in interpretation regarding the allocation percentage applied to certain costs. The federal project expected 100% allocation of specific costs directly to the program, whereas the Organization allocated costs proportionally based on a documented cost allocation methodology. The variance was not due to a lack of methodology, but rather a disagreement regarding the appropriate allocation basis under the specific award expectations.

View Audit 393387

Finding 1182015 (2023-003)

Material Weakness 2023

Voices of Tomorrow

WA

Procurement, Suspension & Debarment Significant Deficiency Internal Control / Segregation of Duties

Implement a standardized procurement documentation checklist requiring evidence of procurement method, cost/price analysis, and approvals. Require CFO pre-approval for federally funded procurements above established thresholds. Conduct staff training on federal procurement standards. Implement quart...

Implement a standardized procurement documentation checklist requiring evidence of procurement method, cost/price analysis, and approvals. Require CFO pre-approval for federally funded procurements above established thresholds. Conduct staff training on federal procurement standards. Implement quarterly internal procurement compliance reviews.

View Audit 393387

Finding 1182014 (2023-002)

Material Weakness 2023

Voices of Tomorrow

WA

Subrecipient Monitoring Significant Deficiency

Corrective action planned: Management has revised its internal policies and procedures regarding subrecipient monitoring to follow 2 CFR 200.332. Ensure that subward are clearly identified and included in subrecipient agreement.

View Audit 393387

Finding 1179879 (2023-004)

Material Weakness 2023

North Homes, Inc.

MN

Cash Management Significant Deficiency Internal Control / Segregation of Duties § 200.303

Federal Agency Name: Department of Health and Human Services Assistance Listing Number: 93.829 Program Name: Section 223 Demonstration Programs to Improve Community Mental Health Services Finding Summary: There was no evidence retained that the Organization's cash management requests were reviewed a...

Federal Agency Name: Department of Health and Human Services Assistance Listing Number: 93.829 Program Name: Section 223 Demonstration Programs to Improve Community Mental Health Services Finding Summary: There was no evidence retained that the Organization's cash management requests were reviewed and approved prior to submission. Corrective Action Plan: The Organization has implemented a process to ensure that formal documentation of review and approval is obtained and retained (i.e. hard copies or email). Responsible Individual: Ashli Glorvigen, CFO Anticipated Completion Date: 12/31/2026

View Audit 392245

Finding 1179663 (2023-003)

Material Weakness 2023

Legacy Senior Services

MN

Reporting Significant Deficiency Internal Control / Segregation of Duties § 200.303

Federal Agency Name: Department of Health and Human Services Program Name: COVID-19 Provider Relief Fund and American Rescue Plan (ARP Rural Distribution) Assistance Listing Number: 93.498 Finding Summary: The Organization’s special reports submitted to the Department of Health and Human Services (H...

Federal Agency Name: Department of Health and Human Services Program Name: COVID-19 Provider Relief Fund and American Rescue Plan (ARP Rural Distribution) Assistance Listing Number: 93.498 Finding Summary: The Organization’s special reports submitted to the Department of Health and Human Services (HHS) for Period 5 were not reviewed and approved by a separate individual outside of the preparer. Responsible Individuals: Stephanie Schmidt Corrective Action Plan: Before future reports are submitted to the federal agency, documented approval of this submission will be acquired. Anticipated Completion Date: January 2025

View Audit 392080

Finding 1179344 (2023-003)

Material Weakness 2023

East Alabama Regional Planning and Development Commission

FL

Allowable Costs / Cost Principles Reporting Significant Deficiency

We plan to start the next fiscal year's audit right after issuance of September 30, 2023 financial statements to catch up on the filing of the reporting package.

View Audit 391711

Finding 1176970 (2023-004)

Material Weakness 2023

Papa Ola Lokahi

HI

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.512 § 200.514

Views of Responsible Officials and Planned Corrective Action The Organization concurred with the prior year (2022-004) and current year renumbered recommendation (2023-004), acknowledging that the unexpected resignation of the former independent auditor (January 2023), and the domino effect of a del...

Views of Responsible Officials and Planned Corrective Action The Organization concurred with the prior year (2022-004) and current year renumbered recommendation (2023-004), acknowledging that the unexpected resignation of the former independent auditor (January 2023), and the domino effect of a delay in securing a new independent auditor (April 2023) and related Organization and new auditor scheduling and staffing challenges, persists. The Organization notes the status and progress of the following single audits: • June 30, 2022, filed in the Federal Audit Clearinghouse in February 2025; • June 30, 2023, field work began March 2025, report draft issued February 2026 and scheduled for Board action; • June 30, 2024, field work began January 2026 and in progress; and • June 30, 2025, pending receipt of auditor engagement letter. The Organization notes the corrective actions that have been implemented, regarding internal controls to ensure compliance with the Uniform Guidance with respect to the submission deadline of single audit reports and the Data Collection Form: A. Internal Controls in Practice Since Inception of New Auditor Engagement – April 2023 As noted in the prior year corrective action response, the Organization established internal compliance controls related to the timely submission of single audit reports. Such process and review controls are implemented by the director of administrative operations, chief of staff (since December 2024), and chief executive officer; and subsequently communicated to the Board finance sub-committee and full Board, including the documented Board action(s) taken (e.g., Board agenda, minutes). B. Financial Policies and Procedures – May 2025. By May 2025, the Organization completed financial policies related to: implementation of significant accounting policies, internal control environment, cash and banking, cash disbursements and check issuance, payroll processes, procure to pay and revenue recognition policies, processes and procedures. Note the internal control policy of the Organization documents process and review controls, which were already in practice, applying to the timely filing of single audit reports. The current practices of the Organization, to the present period of the report dated March 2, 2026, is consistent with established process and review controls for timely submission of single audit reports.

View Audit 390799

Finding 1174703 (2023-014)

Material Weakness 2023

City of Woonsocket

RI

Special Tests & Provisions HUD Housing Programs Significant Deficiency

Reference Number: 2023-014 Finding: Housing Quality Standards Inspections for the HOME Program Name of Contact Person: Lara Auclair Corrective Active Plan: The division of housing and community development is now fully staffed, which will ensure that proper monitoring is completed annually. Current ...

Reference Number: 2023-014 Finding: Housing Quality Standards Inspections for the HOME Program Name of Contact Person: Lara Auclair Corrective Active Plan: The division of housing and community development is now fully staffed, which will ensure that proper monitoring is completed annually. Current staff has completed HUD training modules on monitoring to ensure that monitoring that takes place will follow all guidelines. With the updated catalogue of all HOME loans, the division of housing and community development can have an accurate list of properties that are in the period of affordability and subject to monitoring. Staff will refer to monitoring files from previous years to create documents and letters to be sent to homeowners. Proposed Completion Date: 6/30/26

View Audit 388245

Finding 1174686 (2023-005)

Material Weakness 2023

City of Woonsocket

RI

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

Reference Number: 2023-005 Finding: Update Documented Policies amt Procedures Over Federal Awards Name of Contact Person: Christine Chamberland Corrective Active Plan: The City will develop and implement comprehensive policies and procedures specifically addressing the management and oversight of fe...

Reference Number: 2023-005 Finding: Update Documented Policies amt Procedures Over Federal Awards Name of Contact Person: Christine Chamberland Corrective Active Plan: The City will develop and implement comprehensive policies and procedures specifically addressing the management and oversight of federal awards to ensure compliance with the Uniform Guidance. Designated staff will be tasked with drafting these documents, which will be reviewed and approved by senior management. Training sessions will be conducted for all relevant personnel to ensure consistent application of the new policies and procedures. Proposed Completion Date: 3/31/26

View Audit 388245

Finding 1174673 (2023-004)

Material Weakness 2023

City of Woonsocket

RI

Reporting Matching / Level of Effort / Earmarking Significant Deficiency

Reference Number: 2023-004 Finding: Improve Internal Controls over the Preparation of the Schedule of Expenditures of Federal Awards (SEFA) Name of Contact Person: James Lathrop, CPA Corrective Active Plan: The City will implement comprehensive procedures and internal controls to ensure the SEFA is ...

Reference Number: 2023-004 Finding: Improve Internal Controls over the Preparation of the Schedule of Expenditures of Federal Awards (SEFA) Name of Contact Person: James Lathrop, CPA Corrective Active Plan: The City will implement comprehensive procedures and internal controls to ensure the SEFA is both complete and accurate. This will include establishing a formal process for reconciling all reported federal expenditures with supporting documentation such as the general ledger and grant reports. Additionally, the SEFA will undergo a documented review by a qualified individual who was not involved in its preparation prior to finalization and submission. Proposed Completion Date: 3/31/26

View Audit 388245

Finding 1174135 (2023-001)

Material Weakness 2023

HOMES OF MONTCLAIR ECUMENICAL CORP

NJ

Subrecipient Monitoring Eligibility HUD Housing Programs

Management concurs with the finding. The Organization revised its tenant monitoring procedures to ensure timely annual recertification of income and compliance with HUD rent adjustment requirements. Training is being provided to all property management staff, and management has implemented procedure...

Management concurs with the finding. The Organization revised its tenant monitoring procedures to ensure timely annual recertification of income and compliance with HUD rent adjustment requirements. Training is being provided to all property management staff, and management has implemented procedures to ensure all required actions are taken when a tenant becomes over-income.

View Audit 387791

Finding 1174132 (2023-003)

Material Weakness 2023

Norman County

MN

Cash Management Reporting Significant Deficiency § 200.303

Finding Number: 2023-003 Finding Title: Reporting Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Taylor Spilde Corrective Action Planned: Taylor has been receiving supporting documents and reports since 1/1/2024. Taylor received notification sinc...

Finding Number: 2023-003 Finding Title: Reporting Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Taylor Spilde Corrective Action Planned: Taylor has been receiving supporting documents and reports since 1/1/2024. Taylor received notification since 2024 and has been reporting since receiving notification. Anticipated Completion Date: 1/1/2024

View Audit 387778

Finding 1174131 (2023-002)

Material Weakness 2023

Norman County

MN

Eligibility Significant Deficiency Internal Control / Segregation of Duties § 200.303

Finding Number: 2023-002 Finding Title: Eligibility - MAXIS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Teri Taylor Corrective Action Planned: Implementation of quarterly internal auditing of cases Annual Public Assistance Program review/train...

Finding Number: 2023-002 Finding Title: Eligibility - MAXIS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Teri Taylor Corrective Action Planned: Implementation of quarterly internal auditing of cases Annual Public Assistance Program review/trainings for staff Anticipated Completion Date: Quarterly internal audits anticipated start date: April 2026 Anticipated completion date of ongoing program training: July 2026

View Audit 387778

Finding 1173029 (2023-008)

Material Weakness 2023

Yankton Sioux Tribe

SD

Allowable Costs / Cost Principles Period of Performance Significant Deficiency § 200.313

2023 – 008: Activities Allowed and Unallowed, Allowable Costs, Period of Performance (Compliance; Internal Controls Over Compliance) (Repeat Finding: 2018-006, 2019-008, 2020-008, 2021-007 and 2022-009) Significant Deficiency ALN 93.441 Indian Self Determination ALN 20.205 Highway Planning & Constru...

2023 – 008: Activities Allowed and Unallowed, Allowable Costs, Period of Performance (Compliance; Internal Controls Over Compliance) (Repeat Finding: 2018-006, 2019-008, 2020-008, 2021-007 and 2022-009) Significant Deficiency ALN 93.441 Indian Self Determination ALN 20.205 Highway Planning & Construction ALN 93.575 Child Care and Development Block Grant Condition: During compliance requirement testing for Activities Allowed and Unallowed, Allowable Costs and Period of Performance for the above noted major programs, the auditors selected 120 transactions for testing from each major program. The following number of transactions were not provided for review during the audit: ALN 93.441 – Indian Self Determination – 18 transactions ALN 20.205 – Highway Planning and Construction – 16 transactions ALN 93.575 – Child Care and Development Block Grant – 7 transactions Corrective Action Plan: The Finance Department will become familiar with the requirements of 2 CFR, Part §200.313(a) and establish appropriate internal control policies and procedures to ensure compliance with the requirements of Uniform Guidance and each major program. In addition, all staff will be trained on those policies and procedures, so they are familiar with the requirements. The Finance Department will not process payment for disbursements that does not contain sufficient, appropriate supporting documentation and necessary approvals. The Finance Department will implement and execute an internal audit, by pulling random vouchers packets to test for compliance mid-year. An internal audit process is being developed and personnel assigned. Forms will be developed to assist with the internal audit process to ensure a timely and consistent process will be followed.

View Audit 386455

Finding 1173018 (2023-006)

Material Weakness 2023

Yankton Sioux Tribe

SD

Reporting Significant Deficiency Internal Control / Segregation of Duties

2023 - 006: Reporting (Compliance; Internal Controls Over Compliance) (Repeat 2014-004, 2015-008, 2016-005, 2017-006, 2018-005 2019-006,2020-006, 2021-005 and 2022-007) Significant Deficiency ALN 21.027 Coronavirus State and Local Fiscal Recovery Funds (ARPA) Condition: During the testing of the rep...

2023 - 006: Reporting (Compliance; Internal Controls Over Compliance) (Repeat 2014-004, 2015-008, 2016-005, 2017-006, 2018-005 2019-006,2020-006, 2021-005 and 2022-007) Significant Deficiency ALN 21.027 Coronavirus State and Local Fiscal Recovery Funds (ARPA) Condition: During the testing of the reporting compliance requirement for ALN 21.027 – Coronavirus State and Local Fiscal Recovery Funds, we noted that the necessary reports were filed timely; however, no general ledger backup was provided to verify the accuracy of the reported numbers. Corrective Action Plan: The Governmental Department will work to establish procedures to ensure that all reports submitted to funding agencies are accurate, complete, and supported by reconciled documentation. These procedures will include reconciling Federal Financial Reports (SF-425) to the general ledger on a quarterly basis, as required by ALN 21.027 – Coronavirus State and Local Fiscal Recovery Funds, and verifying the accuracy of the Project and Expenditure Report and the Recovery Plan Performance Report as required for ALN 21.027 – Coronavirus State and Local Fiscal Recovery Funds. Additionally, The Governmental Department will review and incorporate program-specific reporting requirements into a formal policy to maintain compliance with federal guidelines. An internal audit process is being developed and personnel assigned. Forms will be developed to assist with the internal audit process to ensure a timely and consistent process will be followed.

View Audit 386455

Finding 1172859 (2023-003)

Material Weakness 2023

Creating Housing Coalition

OR

Procurement, Suspension & Debarment Significant Deficiency Matching / Level of Effort / Earmarking § 200.318 § 200.320 § 200.326

Corrective Actions Planned To address the deﬁciency in internal controls over compliance with respect to procurement, CHC will implement the following corrective actions: CHC will develop and implement a written procurement policy that conforms to the Uniform Guidance.; CHC will ensure sta􀀁 receive ...

Corrective Actions Planned To address the deﬁciency in internal controls over compliance with respect to procurement, CHC will implement the following corrective actions: CHC will develop and implement a written procurement policy that conforms to the Uniform Guidance.; CHC will ensure sta􀀁 receive adequate training on the procurement policy and the required methods of procurement to be made when making procurements with federal awards. Responsible Person(s): CHC President, Rob Dibble as Primary; CHC Vice President Betsy Gordon as Backup Corrective Action Plan Dates: Schedule implementation starts: February 1, 2026; Staff training starts: March 1, 2026; Review process in effect starts: April 1, 2026

View Audit 386255

Finding 1172858 (2023-002)

Material Weakness 2023

Creating Housing Coalition

OR

Subrecipient Monitoring Reporting Significant Deficiency

Corrective Actions Planned To address the deﬁciency in internal controls over compliance with respect to reporting, CHC will implement the following corrective actions: CHC will implement a workﬂow process for federal grants that address speciﬁc steps and areas of responsibilities to meet grant repo...

Corrective Actions Planned To address the deﬁciency in internal controls over compliance with respect to reporting, CHC will implement the following corrective actions: CHC will implement a workﬂow process for federal grants that address speciﬁc steps and areas of responsibilities to meet grant reporting requirements; CHC will develop a grant procedure that outlines speciﬁc requirements of each grant that include supervisory review and reconciliation of data prior to submission.; Each Grant has a speciﬁc schedule for timely submission of reports. CHC plans to build a primary grant schedule that outlines each grant task, responsible member, milestones (if needed) and due date for each grant reporting cycle.; CHC will develop sta􀀁 training requirements that address federal and non-federal reporting responsibilities. Training will focus on the grant project manager, support sta􀀁, and other CHC board members to ensure comprehensive understanding of full disclosure. Responsible Person(s): CHC President, Rob Dibble as Primary; CHC Vice President Betsy Gordon as Backup Corrective Action Plan Dates: Schedule implementation starts: February 1, 2026; Staff training starts: March 1, 2026; Review process in effect starts: April 1, 2026

View Audit 386255

Finding 1171005 (2023-003)

Material Weakness 2023

Nation's Finest and Subsidiaries

CA

Subrecipient Monitoring Allowable Costs / Cost Principles Cash Management § 200.303

FINDING 2023-003 – Reporting: Significant Deficiency over Internal Controls over Compliance Condition/context – In a representative sample of monthly, quarterly, and annual reports due during the year ended December 31, 2023, auditors noted six of the six tested annual financial reports (SF-425) did...

FINDING 2023-003 – Reporting: Significant Deficiency over Internal Controls over Compliance Condition/context – In a representative sample of monthly, quarterly, and annual reports due during the year ended December 31, 2023, auditors noted six of the six tested annual financial reports (SF-425) did not agree to the underlying profit and loss detail from the Organization’s General Ledger(s) for the related grants. In addition, the certified authorized official was not an employee of the Organization and there was a lack of documentation for how the certifying official was deemed appropriate. In the sample quarterly reports, the Organization had contradicting responses related to whether reimbursement requests reflect actual spending of designated Supportive Services for Veteran Families (SSVF) funding. Corrective Action Plan: • Internal Controls are being evaluated and addressed with the Board of Directors on clarity of Financial Policy and Procedures • Implement a formal reconciliation process to ensure all grant financial reports agree to the underlying general ledger and profit and loss statements. • Establish a documented policy identifying employees authorized to certify grant reports, ensuring these individuals are employees of the Organization and appropriately trained. • Conduct regular training and internal reviews to confirm consistent understanding of grant-specific reporting requirements, particularly those related to reimbursement-based funding such as SSVF. • Develop a standard operating procedure (SOP) for reviewing and approving financial reports before submission to funders. Prior to sending to funder/portal. Must have reconciliation to numbers prior to next period reporting. • Site Review of reporting will have oversight of Financial Dept and reconciliation communication. Name of Contact Person: Chris Flaherty, Chief Executive Officer 707.890.6491 Laura Williams, Chief Financial Officer 707.335.0010 Projected Completion Date: We cannot alleviate within 12 months

View Audit 384402

Finding 1170987 (2023-001)

Material Weakness 2023

Fusion Parterships, Inc.

MD

Internal Control / Segregation of Duties Allowable Costs / Cost Principles Significant Deficiency

We concur with the finding, and a corrective action plan was created and implemented on January 1, 2024. We have modified our Accounting Policies and Procedures and trained all finance staff on reviewing the necessary backup for disbursements and have been loading this backup into our finance system...

We concur with the finding, and a corrective action plan was created and implemented on January 1, 2024. We have modified our Accounting Policies and Procedures and trained all finance staff on reviewing the necessary backup for disbursements and have been loading this backup into our finance system. The creation and implementation of a google submission for disbursements has added the necessary review and approval of all expenses. Additional Partner Engagement Coordinator review of requests and backup documentation has been implemented for weekly approval of disbursements.

View Audit 384386

Finding 1170910 (2023-001)

Material Weakness 2023

Grand Island Regional Medical Center

NE

HUD Housing Programs Reporting Significant Deficiency

Personnel Responsible for Corrective Action: Tracy Schmitt, Chief Financial Officer Anticipated Completion Date: November 30, 2024 Views of Responsible Officials and Planned Corrective Action: The missed reporting was completed in November 2024 and accepted by the granting organization on February 2...

Personnel Responsible for Corrective Action: Tracy Schmitt, Chief Financial Officer Anticipated Completion Date: November 30, 2024 Views of Responsible Officials and Planned Corrective Action: The missed reporting was completed in November 2024 and accepted by the granting organization on February 27, 2025. The Medical Center has implemented a tracking procedure for all grants that includes due dates for required reporting. The Controller maintains a list of compliance requirements for each grant which is reviewed by the Chief Financial Officer. Additionally, the primary contact information for grants is updated upon any changes in personnel to ensure communications are routed to the appropriate individual for follow-up.

View Audit 384219

Corrective Action Plans

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