Corrective Action Plans

Finding 502738 (2023-007)

Significant Deficiency 2023

Martin University

IN

Questioned Costs Eligibility Significant Deficiency § 200.303

United States Department of Education 2023-007 Student Financial Aid Cluster – Assistance Listing No. 84.063 Condition: Students were disbursed Pell funds inaccurately. Auditors’ Recommendation: We recommend the University implement policies to review all student award packages at the start of the ...

United States Department of Education 2023-007 Student Financial Aid Cluster – Assistance Listing No. 84.063 Condition: Students were disbursed Pell funds inaccurately. Auditors’ Recommendation: We recommend the University implement policies to review all student award packages at the start of the academic year to ensure no over and under awards exist. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Summer 2023 Martin University’s main power source was struck by lightning. This caused all Summer processing, that had not yet been backed up on our servers, to be deleted from the system. All transactions that took place at that time had to be manually re-entered. During that manual process, there appears to be a human error in inputting the dates. SIS dates will be corrected to original and actual COD disbursement dates. Name(s) of the contact person(s) responsible for corrective action: Qiana Hall, Associate VP of Enrollment Services Planned completion date for corrective action plan: November 30, 2024

View Audit 324814 Questioned Costs: $1

Finding 502724 (2023-008)

Significant Deficiency 2023

Martin University

IN

Special Tests & Provisions Questioned Costs Student Financial Aid § 200.303

United States Department of Education 2023-008 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Under an institution’s Program Participation Agreement with the Department of Education and the Gramm-Leach-Bliley Act, schools must protect student financ...

United States Department of Education 2023-008 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Under an institution’s Program Participation Agreement with the Department of Education and the Gramm-Leach-Bliley Act, schools must protect student financial aid information, with particular attention to information provided to institutions by the Department or otherwise obtained in support of the administration of the federal student financial aid programs. Auditors’ Recommendation: We recommend the University engage a third party or perform the risk assessment for the two areas required by the Gramm-Leach-Bliley Act that have not been completed and documented and ensure that there are documented safeguards for identified risks. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The University has implemented a new SIS and Financial Aid processing system. The new systems are Jenzebar products and are fully compliant. Name(s) of the contact person(s) responsible for corrective action: Qiana Hall, Associate VP of Enrollment Services Planned completion date for corrective action plan: June 30, 2024

View Audit 324814

Finding 502723 (2023-006)

Significant Deficiency 2023

Martin University

IN

Student Financial Aid Reporting Significant Deficiency § 200.303

United States Department of Education 2023-006 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Students tested in the Common Origination and Disbursement (COD) reporting were not properly reported based upon University documents, including disburseme...

United States Department of Education 2023-006 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Students tested in the Common Origination and Disbursement (COD) reporting were not properly reported based upon University documents, including disbursement dates and applied dates. Auditors’ Recommendation: We recommend that the entity strengthen its internal controls to ensure that all disbursement dates are reported to COD accurately and timely. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The previous SIS was subject to frequent interruptions which prevent timely data exchange with COD. Beginning with the 2024-2025 award year a new financial aid processing system was implemented. The new processing system is a more secure environment and hosted by Jenzabar for added compliance assurance. Name(s) of the contact person(s) responsible for corrective action: Qiana Hall, Associate VP of Enrollment Services Planned completion date for corrective action plan: June 30, 2024

View Audit 324814

Finding 502722 (2023-005)

Significant Deficiency 2023

Martin University

IN

Matching / Level of Effort / Earmarking Special Tests & Provisions Questioned Costs § 200.303

United States Department of Education 2023-005 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: The University is not reporting student information to the Clearinghouse. Students tested did not have their enrollment status properly reported to the Cle...

United States Department of Education 2023-005 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: The University is not reporting student information to the Clearinghouse. Students tested did not have their enrollment status properly reported to the Clearinghouse. Auditors’ Recommendation: We recommend that the entity strengthen its internal controls to ensure that all enrollment records are reported correctly and within the required time frame. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The university uses HEAG Consultant Group for enrollment reporting to NSLDS. HEAG has been made aware of these findings and corrective actions have been requested. Name(s) of the contact person(s) responsible for corrective action: Qiana Hall, Associate VP of Enrollment Services Planned completion date for corrective action plan: November 30, 2024

View Audit 324814

Finding 502721 (2023-004)

Significant Deficiency 2023

Martin University

IN

Questioned Costs Student Financial Aid Significant Deficiency § 200.303

United States Department of Education 2023-004 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Student checks related to student refunds of Title IV federal financial aid was outstanding more than 240 days as of June 30, 2023. Auditors’ Recommendatio...

United States Department of Education 2023-004 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: Student checks related to student refunds of Title IV federal financial aid was outstanding more than 240 days as of June 30, 2023. Auditors’ Recommendation: We recommend that the University review its procedures related to outstanding student refund checks to ensure they are being returned to the Department of Education after 240 days. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The University engaged an external consultant in June 2023, hired a new staff accountant in September 2023 and a CFO in November 2023. The University is implementing financial internal controls policies and processes to improve the financial statements preparation and preparation of the schedule of expenditures and federal awards and ensure compliance with the DOE. This includes procedures related to outstanding student refund checks over 240 days. Name(s) of the contact person(s) responsible for corrective action: E. ZeNai Savage, CPA, CFO and Executive VP of Finance and Administration

View Audit 324814

Finding 502720 (2023-003)

Significant Deficiency 2023

Martin University

IN

Internal Control / Segregation of Duties Questioned Costs Student Financial Aid § 200.303

United States Department of Education 2023-003 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: The University submitted inaccurate data in its annual FISAP report. Auditors’ Recommendation: We recommend the applicable campus revise procedures to ens...

United States Department of Education 2023-003 Student Financial Aid Cluster – Assistance Listing No. 84.007, 84.033, 84.063, 84.268 Condition: The University submitted inaccurate data in its annual FISAP report. Auditors’ Recommendation: We recommend the applicable campus revise procedures to ensure that the record retention requirements are met and supporting documentation agrees to the FISAP, including a supervisory review by someone other than the preparer. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Unduplicated Recipients for Ungrad/Dependent with salary range of $1000,000 and over was reported as one but should have been two. Completed FISAP reports are sent to the CFO for additional review prior to submission. Name(s) of the contact person(s) responsible for corrective action: Qiana Hall, Associate VP of Enrollment Services Planned completion date for corrective action plan: June 30, 2024

View Audit 324814

Finding 502700 (2023-002)

Significant Deficiency 2023

Housing Authority of the City of Annapolis

MD

HUD Housing Programs Reporting Significant Deficiency § 200.512

Finding 2023-002 Late Submission of Financial Statements to FAC and REAC (Significant Deficiency) Recommendation: The Authority should review and enhance its policies, procedures, and internal controls to ensure the financial reporting package and audited financial statements are submitted by the re...

Finding 2023-002 Late Submission of Financial Statements to FAC and REAC (Significant Deficiency) Recommendation: The Authority should review and enhance its policies, procedures, and internal controls to ensure the financial reporting package and audited financial statements are submitted by the required due date. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Authority will evaluate its’ financial reporting and close processes and controls to determine whether additional controls over the preparation of the final trial balances and related schedules should be implemented. As part of this process, we will create a yearend checklist with deadlines established, and set up status meetings to monitor the progress. Name(s) of the contact person(s) responsible for corrective action: Cia Cook, Deputy Executive Director & CFO Planned completion date for corrective action plan: August 31, 2024

View Audit 324736

Finding 502646 (2023-002)

Significant Deficiency 2023

J.h. Floyd Sunshine Village, Inc.

FL

Allowable Costs / Cost Principles HUD Housing Programs Questioned Costs

B. Finding 2023-002 Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects (Section 207/223(f)) (CFDA# 14.155) Allowable costs/cost principles The Project disbursed $47,837 of legal costs that were not operating expenses for the pro...

B. Finding 2023-002 Mortgage Insurance for the Purchase or Refinancing of Existing Multifamily Housing Projects (Section 207/223(f)) (CFDA# 14.155) Allowable costs/cost principles The Project disbursed $47,837 of legal costs that were not operating expenses for the project. (1) Comments on the Finding and Each Recommendation Management concurs with this finding and the current management agent has ensured that $47,837 was reimbursed from entity non-project funds. (2) Actions Taken on the Finding The funds were reimbursed from entity non-project funds.

View Audit 324633 Questioned Costs: $1

Finding 502634 (2023-008)

Significant Deficiency 2023

Promise Healthcare Nfp

IL

Questioned Costs Allowable Costs / Cost Principles Cash Management § 200.403

Action taken in response to finding: 1. Create a standard procedure for tracking grant expenses: Completed 2. Train staff on procedures: Completed 3. Create an independent review process for all grant tracking: In progress Name of the contact person responsible for corrective action: Keith Flores, C...

Action taken in response to finding: 1. Create a standard procedure for tracking grant expenses: Completed 2. Train staff on procedures: Completed 3. Create an independent review process for all grant tracking: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609 Questioned Costs: $1

Finding 502631 (2023-007)

Significant Deficiency 2023

Promise Healthcare Nfp

IL

Reporting Internal Control / Segregation of Duties Significant Deficiency § 200.329

Action taken in response to finding: 1. Develop documentation procedures: In Progress a. Establish a standardized procedure for documenting the preparation and review of Federal Financial Reports. 2. Select appropriate party for independent review: Complete ...

Action taken in response to finding: 1. Develop documentation procedures: In Progress a. Establish a standardized procedure for documenting the preparation and review of Federal Financial Reports. 2. Select appropriate party for independent review: Complete 3. Store and maintain documentation in a shared location for future audit and review: Complete Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609

Finding 502630 (2023-006)

Significant Deficiency 2023

Promise Healthcare Nfp

IL

Allowable Costs / Cost Principles Questioned Costs Significant Deficiency § 200.303

Action taken in response to finding: 1. Move all purchase and invoice approvals to Intacct: Complete 2. Establish approval matrix in accordance with delegation of authority: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for correc...

Action taken in response to finding: 1. Move all purchase and invoice approvals to Intacct: Complete 2. Establish approval matrix in accordance with delegation of authority: In progress Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: End of 2024

View Audit 324609

Finding 502577 (2023-007)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Cash Management Allowable Costs / Cost Principles Significant Deficiency

Action taken in response to finding: The grant biller performs additional review of grant billings for accuracy. In addition, the new CFO reviews and approves at a detailed level the grant billing. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion ...

Action taken in response to finding: The grant biller performs additional review of grant billings for accuracy. In addition, the new CFO reviews and approves at a detailed level the grant billing. Name(s) of the contact person(s) responsible for corrective action: Patty Brandt Planned completion date for corrective action plan: August 31, 2024

View Audit 324580

Finding 502575 (2023-005)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Cash Management Allowable Costs / Cost Principles Period of Performance

Action taken in response to finding: The new CFO reviews and approves federal grant draw requests prior to the submission to the granting agency. Name(s) of the contact person(s) responsible for corrective action: Carrie Anthony Planned completion date for corrective action plan: August 31, 2024

View Audit 324580

Finding 502574 (2023-004)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

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

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are charged appropriately, approved by a knowledgeable supervisor, and supporting documentation is main...

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are charged appropriately, approved by a knowledgeable supervisor, and supporting documentation is maintained on file. Additionally, AP and Finance team review supporting documentation and ensure completeness. Name(s) of the contact person(s) responsible for corrective action: Floral Reed Planned completion date for corrective action plan: June 30, 2024

View Audit 324580

Finding 502573 (2023-003)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Questioned Costs Allowable Costs / Cost Principles Cash Management

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are incurred, charged appropriately and supporting documentation is maintained on file. Additionally, ...

Action taken in response to finding: The program experienced transition in management and staff during FY23. The new Recovery Support Services staff are now fully trained and ensures expenditures are incurred, charged appropriately and supporting documentation is maintained on file. Additionally, AP and Finance team review supporting documentation and ensure completeness. Name(s) of the contact person(s) responsible for corrective action: Floral Reed Planned completion date for corrective action plan: June 30, 2024

View Audit 324580

Finding 502572 (2023-002)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Cash Management Significant Deficiency

Action taken in response to finding: The new CFO reviews and approves federal grant draw requests prior to the submission to the granting agency. Name(s) of the contact person(s) responsible for corrective action: Carrie Anthony Planned completion date for corrective action plan: August 31, 2024

View Audit 324580

Finding 502571 (2023-001)

Significant Deficiency 2023

Okanogan Behavioral Healthcare

WA

Questioned Costs Allowable Costs / Cost Principles Period of Performance

Action taken in response to finding: The Finance team corrected their processes to ensure proper recording of payroll costs during the time of the FY22 Audit procedures; however, the changes were made to subsequent months and previously submitted months were not retroactively corrected. Additionall...

Action taken in response to finding: The Finance team corrected their processes to ensure proper recording of payroll costs during the time of the FY22 Audit procedures; however, the changes were made to subsequent months and previously submitted months were not retroactively corrected. Additionally, the OBHC team is currently working with the HCA in restructuring the rate schedule to incorporate the payroll costs into the direct service rates for the SOR/SABG grants. This effectively removes this issue going forward in FY25 once approved by the HCA. Name(s) of the contact person(s) responsible for corrective action: Carrie Anthony Planned completion date for corrective action plan: Sep 2023 & New rates: Sep 30, 2024

View Audit 324580

Finding 502544 (2023-003)

Significant Deficiency 2023

Brooklyn Bureau of Community Service Dba Brooklyn Community Services

NY

Questioned Costs Reporting Significant Deficiency § 200.512

Finding 2023-03 Reporting – Data Collection Form and Reporting Package (Significant Deficiency) U.S. Department of Health and Human Services Community Services Block Grant (Federal Assistance Listing #93.569) Federal Award Numbers: 60204, 60215, 60225, and 60235 Federal Award Year: 2020-2023 R...

Finding 2023-03 Reporting – Data Collection Form and Reporting Package (Significant Deficiency) U.S. Department of Health and Human Services Community Services Block Grant (Federal Assistance Listing #93.569) Federal Award Numbers: 60204, 60215, 60225, and 60235 Federal Award Year: 2020-2023 Responsible Officials Contact Information: 1) Monae Priolenau-Jones Telephone 718-310-5610, mpriolenau@wearebcs.org 2) Jodi Querbach Telephone 718-310-5600, X 1015 jquerbach@wearebcs.org View of Responsible Officials and Corrective Action Plan: Management agrees that the single audit reporting package was not submitted within the required timeframe due to key employee turnover coupled with staffing challenges subsequent to year end. In addition, BCS began a transition from one third-party external firm to another third-party firm in September of 2022. The former firm held the general ledger data for BCS and has been slow to turn it over in a manageable manner causing the delay in filing of the single audit report package. Dmitriy Goyzman (current Chief Financial Officer) was hired in December of 2022 and is actively in the process of hiring a new internal finance team. Back office finance department operations are currently filled by the second third-party external firm. In addition to the CFO, BCS has payroll, purchasing and 2 staff accountants and will have a Controller on staff by mid-June of 2023. Hiring of five additional positions for grants management will be completed in the Fall of 2023 replacing BDO personnel with in-house staff. In our new configuration, BCS will: 1) own its financial software and data, 2) be sufficiently staffed to run its day-to-day financial operations, 3) be able to support program operations in an efficient manner and 4) be able to respond and complete audits on time. The management will ensure that the single audit report package is submitted before the March 31, 2025 deadline. Pursuant to the action plan outlined in the response to Finding 2023 001, the audited financial statements will be issued by November 30th, 2024. Immediately following, the finance team will turn their attention to the reports required by the Uniform Guidance and the Federal Form 990 with a goal of completing fiscal 2024 reporting requirement by January 2025. Recommendation: We recommend that BCS enhance its closing and reporting process to ensure the reports required by the Uniform Guidance is submitted by the aforementioned deadline.

View Audit 324549

Finding 502505 (2023-004)

Significant Deficiency 2023

Catholic Charities West Michigan

MI

Reporting Significant Deficiency

Action Taken: Timely reporting as well as documented approvals are very important to Catholic Charities West Michigan and we agree that we must demonstrate that proper reviews or reports have occurred. We have implemented a process including monthly meetings with the Program Manager and the Finance...

Action Taken: Timely reporting as well as documented approvals are very important to Catholic Charities West Michigan and we agree that we must demonstrate that proper reviews or reports have occurred. We have implemented a process including monthly meetings with the Program Manager and the Finance Accountant to review activity and close the month. All reporting is now filed timely with proper documented review.

View Audit 324497

Finding 502499 (2023-002)

Significant Deficiency 2023

Catholic Charities West Michigan

MI

Reporting Cash Management Significant Deficiency

Action Taken: Modifications of the Administrative Financial Management and Cash Management policies will be made to further address concerns identified in the Single Audit. In addition, the reconciliation process will be reviewed and improved to assure timely preparation of the SEFA. CCWM will rec...

Action Taken: Modifications of the Administrative Financial Management and Cash Management policies will be made to further address concerns identified in the Single Audit. In addition, the reconciliation process will be reviewed and improved to assure timely preparation of the SEFA. CCWM will reconcile federal programs to the passthrough agencies 9 months into the fiscal year at a minimum as part of the preparation of the SEFA report.

View Audit 324497

Finding 502132 (2023-002)

Significant Deficiency 2023

Henry C. Nevins Home, Inc.

MA

HUD Housing Programs Significant Deficiency Internal Control / Segregation of Duties

Recommendation: The organization should obtain the requisite fidelity bond coverage and monitor the coverage to ensure it is in compliance with HUD requirements. Action Taken: Fidelity bond coverage was increased accordingly.

View Audit 324360

Finding 502117 (2023-002)

Material Weakness 2023

Organic Crop Improvement Association International, Inc.

NE

Internal Control / Segregation of Duties Material Weakness Significant Deficiency

Segregation of Duties Corrective Action Planned: The Association will continue to rely on its system of oversight provided by the board of directors in reviewing the financial statements of the Association. The Association will also be mindful of identifying a qualified volunteer or potential boa...

Segregation of Duties Corrective Action Planned: The Association will continue to rely on its system of oversight provided by the board of directors in reviewing the financial statements of the Association. The Association will also be mindful of identifying a qualified volunteer or potential board member who could review the financial statements. Anticipated Completion Date: December 31, 2024 Responsible Parties: Management and Board of Directors

View Audit 324340

Finding 502031 (2023-005)

Significant Deficiency 2023

El Hogar Del Nino

IL

Questioned Costs Significant Deficiency Internal Control / Segregation of Duties

SIGNIFICANT DEFICIENCY IN INTERNAL CONTROL OVER COMPLIANCE 2023 – 005 Payroll Disbursements Recommendation: Management should continue to follow established controls to ensure the appropriate compensation of its employees at approved rates. Explanation of disagreement with audit finding: There is...

SIGNIFICANT DEFICIENCY IN INTERNAL CONTROL OVER COMPLIANCE 2023 – 005 Payroll Disbursements Recommendation: Management should continue to follow established controls to ensure the appropriate compensation of its employees at approved rates. Explanation of disagreement with audit finding: There is no disagreement with this finding. Action taken in response to finding: As of July 1, 2023, the Organization was acquired by Brightpoint, a social service organization with complimentary operations. The finance leadership of the acquiring organization has robust internal controls is experienced to resolve this finding in the subsequent year. Name of the contact person responsible for corrective action: Ed Balogh, Controller Planned completion date for corrective action plan: June 30, 2024. If the U.S. Department of Health and Human Services has questions regarding this plan, please call Ed Balogh, Controller, at 312-424-0200.

View Audit 324229 Questioned Costs: $1

Finding 501984 (2023-005)

Significant Deficiency 2023

Danville Redevelopment & Housing Authority

VA

Special Tests & Provisions HUD Housing Programs Significant Deficiency

Authority Response and Planned Corrective Action: The Authority accepts the recommendation of the auditor. The Authority will increase oversight in the Public Housing Capital Fund program to ensure that established internal control policies related to wage rate requirements are being followed. Dona...

Authority Response and Planned Corrective Action: The Authority accepts the recommendation of the auditor. The Authority will increase oversight in the Public Housing Capital Fund program to ensure that established internal control policies related to wage rate requirements are being followed. Donald Paredez, Executive Director, is responsible for implementing this corrective action by December 31, 2024.

View Audit 324142

Finding 501944 (2023-005)

Significant Deficiency 2023

Delaware County Community College

PA

Reporting Questioned Costs Allowable Costs / Cost Principles

PREPARATION OF THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) - SIGNIFICANT DEFICIENCY Federal Program COVID-19 Education Stabilization Fund (ALN 84.425 C, F, & M) and Student Financial Assistance Cluster (ALN 84.007, 84.033, 84.063, and 84.268) Condition/Cause The College did not prepare a...

PREPARATION OF THE SCHEDULE OF EXPENDITURES OF FEDERAL AWARDS (SEFA) - SIGNIFICANT DEFICIENCY Federal Program COVID-19 Education Stabilization Fund (ALN 84.425 C, F, & M) and Student Financial Assistance Cluster (ALN 84.007, 84.033, 84.063, and 84.268) Condition/Cause The College did not prepare an accurate SEFA. The College provided information relating to the federal programs including agreements and other supporting documentation. However, a complete and accurate SEFA was not prepared. Recommendation We recommend the College designate an individual to be responsible for assembling the SEFA after reviewing grant activity to determine that a SEFA is required for the year. The SEFA should be reviewed by management for accuracy and completeness after preparation before being sent to the auditors. Management Response We agree with the auditor's comments. The College is actively recruiting to fill critical accounting vacancies. The College is reviewing standard operating procedures for all federal activity to include grants and student aid. Procedures, training, and processes to review the SEFA will be implemented by the end of FY 2025.

View Audit 324121

Corrective Action Plans

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