Corrective Action Plans

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Management will implement enhanced year-end closing and audit coordination procedures, including earlier preparation timelines, improved tracking of audit deliverables and reporting deadlines, and increased coordination with outsourced accounting and audit partners to help ensure timely completion a...
Management will implement enhanced year-end closing and audit coordination procedures, including earlier preparation timelines, improved tracking of audit deliverables and reporting deadlines, and increased coordination with outsourced accounting and audit partners to help ensure timely completion and submission of future Single Audit reporting packages.
Controls Over Reporting for SMT Program Management acknowledges that encounter notes were not entered on a timely basis and that an inactive participant remained on the program listing during the audit period. The Organization will implement a supervisory review process requiring that encounter note...
Controls Over Reporting for SMT Program Management acknowledges that encounter notes were not entered on a timely basis and that an inactive participant remained on the program listing during the audit period. The Organization will implement a supervisory review process requiring that encounter notes are entered within a defined timeframe following each program interaction and reviewed by a supervisor for completeness and accuracy. The participant listing will be reconciled monthly to ensure that inactive individuals are promptly flagged and removed. Monthly reports will be documented as reviewed and dated at the time of submission to maintain an auditable record of timely reporting. This process has already taken place in late 2025 and the CFO and Controller will oversee the process.
Controls Over Federal Programs Management acknowledges that documented control procedures were absent across all selections tested for federal expenditures, and that payroll allocations were not consistently reviewed or supported throughout the year. The Organization will require that all invoices c...
Controls Over Federal Programs Management acknowledges that documented control procedures were absent across all selections tested for federal expenditures, and that payroll allocations were not consistently reviewed or supported throughout the year. The Organization will require that all invoices coded to federal award programs include documentation of review, proper allocation rationale, and management approval before payment is processed. Payroll allocations will be updated in both the payroll and accounting systems on a regular basis, supported by actual time records or documented time studies rather than year-end estimates. This process has already taken place in late 2025 and the CFO and Controller will oversee the process.
Vaccine Education Grant Reporting Management acknowledges the repeat finding that quarterly reports required under the NYS OMH Vaccine Education Block Grant were not submitted as required by the contract. The Organization will designate a staff member responsible for tracking all grant reporting dea...
Vaccine Education Grant Reporting Management acknowledges the repeat finding that quarterly reports required under the NYS OMH Vaccine Education Block Grant were not submitted as required by the contract. The Organization will designate a staff member responsible for tracking all grant reporting deadlines and will implement a reporting calendar that captures submission requirements for each active grant contract. Grant contracts will be reviewed in full prior to execution so that all reporting obligations are understood and built into operational workflows. Management will also establish an internal review and approval process for all grant reports prior to submission to ensure completeness and timeliness. This will be overseen by the Controller in FY26.
2024-002 SCDA Special Tests Significant Deficiency and Non-Material Noncompliance Corrective Action: We've hired competent staff that understand how to reconcile inventory to the general ledger. Person Responsible: Stephano Blake Email: SBlake@harvesthope.org Phone: 803-636-6635
2024-002 SCDA Special Tests Significant Deficiency and Non-Material Noncompliance Corrective Action: We've hired competent staff that understand how to reconcile inventory to the general ledger. Person Responsible: Stephano Blake Email: SBlake@harvesthope.org Phone: 803-636-6635
U.S. Department of Health and Human Services - Community Service Block Grant Significant Deficiency in Internal Control over Compliance - Other Matters Recommendation: We recommend the Neighborhood Service Center, Inc. reevaluate its current process, implement proper controls and perform additional ...
U.S. Department of Health and Human Services - Community Service Block Grant Significant Deficiency in Internal Control over Compliance - Other Matters Recommendation: We recommend the Neighborhood Service Center, Inc. reevaluate its current process, implement proper controls and perform additional training over fiduciary responsibilities under the CSBG Act. The Neighborhood Service Center, Inc. should adhere to the board composition and vacancy reporting requirements. Documentation should be readily available for audit. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned/taken in response to finding: The Executive Director and Deputy Director of the Neighborhood Service Center are actively recruiting individuals to join the Board. The Deputy Director, or their designee, will provide information to the Maryland Department of Housing and Community Development on the Board composition and vacancies on a monthly basis. Name of the contact persons responsible for corrective action: E. Yvette Robinson, Deputy Director Planned completion date for corrective action plan: For immediate implementation and ongoing.
Period of Performance Child Care and Development Block Grant – Assistance Listing No. 93.575 Recommendation: We recommend that the Organization design, implement, monitor and maintain evidence over internal controls. Explanation of disagreement with audit finding: There is no disagreement with the a...
Period of Performance Child Care and Development Block Grant – Assistance Listing No. 93.575 Recommendation: We recommend that the Organization design, implement, monitor and maintain evidence over internal controls. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Management will assign responsibility for maintaining source documentation to a specific individual or team and develop a system for organizing and storing source documentation, such as a centralized electronic database. Monitoring and testing procedures will be implemented to ensure that source documentation is being maintained and is readily accessible. Lastly, there will be regular reviews and updates to the system for organizing and storing source documentation as needed to ensure ongoing effectiveness. Name of the contact person responsible for corrective action: Lyn Elliot, CEO Planned completion date for corrective action plan: 7/1/2026
Management concurs with the finding and will ensure that records are maintained to indicate timely submission of reports.
Management concurs with the finding and will ensure that records are maintained to indicate timely submission of reports.
We agree with the finding. The Hospital's annual financial statements were not issued until February 2026 and we were not able to complete the single audit filing until that time. The Hospital doesn't anticipate delays in the future.
We agree with the finding. The Hospital's annual financial statements were not issued until February 2026 and we were not able to complete the single audit filing until that time. The Hospital doesn't anticipate delays in the future.
CORRECTIVE ACTION PLAN The Town of Uxbridge, Massachusetts respectfully submits the following corrective action plan for the year ended June 30. 2024. Audit period: July 1, 2023 through June 30, 2024 The finding from the June 30, 2024, schedule of findings and questioned costs is discussed below. Th...
CORRECTIVE ACTION PLAN The Town of Uxbridge, Massachusetts respectfully submits the following corrective action plan for the year ended June 30. 2024. Audit period: July 1, 2023 through June 30, 2024 The finding from the June 30, 2024, schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. Audit Finding Reference: 2024-003 Document Policies and Procedures Over Federal Awards Views of responsible officials: The Town agrees with the recommendation to implement written policies and procedures to be in accordance with the Uniform Guidance. Planned Implementation Date of Corrective Action: The Town plans to implement recommendations for the next fiscal year. Official Responsible for Implementing Corrective Action: Kurt Ginthwain Finance Director/Town Accountant
Views of Responsible Officials and Planned Corrective Actions The Organization’s management is aware of this significant deficiency and addresses it by obtaining the auditor's assistance in the preparation of the Organization’s annual financial statements. Management reviews and approves the complet...
Views of Responsible Officials and Planned Corrective Actions The Organization’s management is aware of this significant deficiency and addresses it by obtaining the auditor's assistance in the preparation of the Organization’s annual financial statements. Management reviews and approves the completed statements and distributes them to the users.
Corrective Action Plan: Management acknowledges the delay in submission of the audited financial statements, which was partly due to this being the organization’s first Single Audit and delays in completing the year-end close process. To address this, the organization will implement a structured yea...
Corrective Action Plan: Management acknowledges the delay in submission of the audited financial statements, which was partly due to this being the organization’s first Single Audit and delays in completing the year-end close process. To address this, the organization will implement a structured year-end closing timeline, including a detailed checklist, assigned responsibilities, and internal deadlines to ensure all reconciliations and journal entries are completed prior to the audit. Management will also establish a pre-audit review process and coordinate closely with auditors to ensure timely completion and submission to the Federal Audit Clearinghouse within required deadlines. Responsible Official: Abel Olivo, Executive Director, with support from the outsourced accounting firm Anticipated Completion Date: December 31, 2025
CSLFRF Reporting (ALN 21.027) Condition The required Treasury report was not submitted due to insufficient tracking mechanisms and lack of internal controls. Corrective Action Plan To ensure timely and accurate CSLFRF reporting, the City will: • Establish a Treasury reporting calendar with all requi...
CSLFRF Reporting (ALN 21.027) Condition The required Treasury report was not submitted due to insufficient tracking mechanisms and lack of internal controls. Corrective Action Plan To ensure timely and accurate CSLFRF reporting, the City will: • Establish a Treasury reporting calendar with all required deadlines. • Assign a designated preparer and reviewer for each reporting cycle. • Provide training on the Treasury reporting portal. • Implement a pre-submission checklist to ensure completeness and accuracy. • Conduct semiannual internal reviews of reporting processes and documentation. Responsible Staff Chief Financial Officer (CFO) Target Completion Date July 31, 2026
Views of Responsible Officials Management agrees with the federal award finding identified in the audit. The System Fund will file the audit reporting package shortly after issuance and ensure that any future audits are completed and filed timely, by working closely with audit partner and frequently...
Views of Responsible Officials Management agrees with the federal award finding identified in the audit. The System Fund will file the audit reporting package shortly after issuance and ensure that any future audits are completed and filed timely, by working closely with audit partner and frequently accessing the substantive status, stage of completion or any other pertinent aspect of the audit necessary to meet the filing deadline.
Concerning Finding 2024-002 Reporting Contact Person Responsible for Corrective Action: William Dobbins, Superintendent Corrective Action: The Limestone Public Schools will take the following actions to address finding 2024-002: Limestone Community School will strengthen internal controls over feder...
Concerning Finding 2024-002 Reporting Contact Person Responsible for Corrective Action: William Dobbins, Superintendent Corrective Action: The Limestone Public Schools will take the following actions to address finding 2024-002: Limestone Community School will strengthen internal controls over federal reporting to ensure all required reports are completed, submitted timely, and properly retained. The school will develop written procedures outlining reporting requirements for all federal programs, including ESSER (ALN 84.425). These procedures will identify responsible personnel, submission deadlines, and documentation retention requirements. Copies of all submitted federal reports, including Annual Performance Reports and Annual Performance and Expenditure Reports will be saved electronically and maintained in a centralized grant compliance file. The School will also maintain documentation confirming submission, such as submission receipts or screenshots from the online reporting system."Please note, all Invoices, and back up materials were available along with the draft of the final report. The final report was not obtainable due to the web page being closed. Also, the audit was competed half way through FY-26." Anticipated Completion Date: February 2, 2026
Description of Finding: The Organization submitted its Audited Financial Statements and Single Audit report to the federal clearing house in May 2026, eight months after it was due. Statement of Concurrence or Nonconcurrence: The Organization concurs with this finding. In 2025, the Organization hired...
Description of Finding: The Organization submitted its Audited Financial Statements and Single Audit report to the federal clearing house in May 2026, eight months after it was due. Statement of Concurrence or Nonconcurrence: The Organization concurs with this finding. In 2025, the Organization hired a new accounting firm with a firm commitment to system integration to improve efficiency in month-end and year-end close, as well as upgrades to its time keeping and payroll system that allows for real time posting of allocated time directly to the accounting software. In prior years, this was a manual process. This automation will eliminate the lag time in posting payroll allocations to the general ledger and greatly reduce the end of year closing process timeline. David Heitstuman, Chief Executive Officer, Phone 916 442-0185, email David.heitsuman@sacccenter.org
2024-005 REPORTING - SIGNIFICANT DEFICIENCY Federal Program Education Stabilization Fund - U.S. Department of Education passed through the Pennsylvania Department of Education COVID-19 - Elementary and Secondary School Emergency Relief Fund (ARP ESSER) ALN 84.425U; Contract #223-21-0141; Grant Perio...
2024-005 REPORTING - SIGNIFICANT DEFICIENCY Federal Program Education Stabilization Fund - U.S. Department of Education passed through the Pennsylvania Department of Education COVID-19 - Elementary and Secondary School Emergency Relief Fund (ARP ESSER) ALN 84.425U; Contract #223-21-0141; Grant Period 03/13/20 - 09/30/24 COVID-19 - ARP ESSER Learning Loss Set Aside ALN 84.425U; Contract #225-21-0141; Grant Period 03/13/20 - 09/30/24 Criteria The District is required to submit an annual performance report to the Commonwealth of Pennsylvania (the “State”) with data on expenditures, planned expenditures, subrecipients, and uses of funds, including for mandatory reservations. Condition During the year ended June 30, 2024, the District submitted a report for the funds used during the year ended June 30, 2023. The report submitted by the District contained expenditure amounts that did not agree to the amounts reported on the schedule of expenditures of federal awards for the year ended June 30, 2023 as well as other key reporting line items. Recommendation We recommend the District keep a reconciliation of grant awards available to expenditure incurred. The accurate use of funding source codes will assist in that process. We also recommend the District continue working toward more timely financial and compliance audits. Management Response When the district received the audit, the 2023 federal reports were already submitted. The District made the adjustments for non-allowable expenses in the 2023 SEFA and took out the non-allowable in the 2024 State reports. The District has begun using and reconciling funding source codes related to grants more timely.
The Authority has revised its policy for Section 3 and will include the policy and requirements in all applicable agreements, pre-bid documents, and resulting contracts. Section 3 requirements will also be reviewed during pre-construction meetings for any applicable projects.
The Authority has revised its policy for Section 3 and will include the policy and requirements in all applicable agreements, pre-bid documents, and resulting contracts. Section 3 requirements will also be reviewed during pre-construction meetings for any applicable projects.
While the Authority continues to be delinquent on the current year audit completion, a consulting firm was hired to assist with bringing records up to date. The Authority also had hired an assistant fiscal officer in the fall of 2021 and another assistant fiscal officer in the fall of 2022. As a res...
While the Authority continues to be delinquent on the current year audit completion, a consulting firm was hired to assist with bringing records up to date. The Authority also had hired an assistant fiscal officer in the fall of 2021 and another assistant fiscal officer in the fall of 2022. As a result of the hiring, job responsibilities have been re-assigned and data gathering for future audits will occur in a timely manner. Accounts have been reconciled through December 31, 2025 prior to the 2024 audit commencing. The Authority will continue to execute their plan to have the audits completed on a timely basis and expects to submit the audited financial statements and single audit reporting package for the year ended December 31, 2025 to the Federal Audit Clearinghouse timely.
The Authority implemented a new policy to track and document program income: a. Upon receipt of program income, it shall be entered individually into IDIS and assigned to an activity or activities within fifteen (15) calendar days of receipt. b. At the next request for funds for an activity which in...
The Authority implemented a new policy to track and document program income: a. Upon receipt of program income, it shall be entered individually into IDIS and assigned to an activity or activities within fifteen (15) calendar days of receipt. b. At the next request for funds for an activity which includes funding from program income, program income shall be used prior to requesting federal funds for the activity. c. The request for federal funds shall be prepared by the Fiscal Officer and reviewed by one of the Assistant Fiscal Officers to determine if program income is being used prior to the request of federal funds. d. If it has been determined and documented that program income is being used prior to the request for federal funds, the request shall be forwarded to the Executive Director for approval. This finding has since been resolved in 2025, with a new policy developed and implemented on April 1, 2025.
In general, management agrees with the finding. It should be noted that internal controls for supervisory review of reporting requirements were in place but were not written controls or processes. Reporting for the CDBG Program is accomplished through the preparation of the annual Comprehensive Annu...
In general, management agrees with the finding. It should be noted that internal controls for supervisory review of reporting requirements were in place but were not written controls or processes. Reporting for the CDBG Program is accomplished through the preparation of the annual Comprehensive Annual Performance and Evaluation Report (CAPER). Written policies and procedures for the CAPER have been developed. Reporting for the Emergency Rental Assistance Program is accomplished through an online reporting system of the U.S. Treasury and by email to the Pennsylvania Human Services Department. This finding has since been resolved in 2025, with a new policy developed and implemented on December 12, 2025.
Planned Corrective Action: The Division will implement their control of ensuring that they only charge allowable costs incurred during the approved budget period of a federal award’s period of performance or will obtain authorization from the grantor for any costs incurred before the grant's approve...
Planned Corrective Action: The Division will implement their control of ensuring that they only charge allowable costs incurred during the approved budget period of a federal award’s period of performance or will obtain authorization from the grantor for any costs incurred before the grant's approved budget period. Anticipated Completion Date: 9/30/2026 Responsible Contact Person: Al Agpoon, Golden State Division Controller
Rndlng 2024-017: Spedal Tests and Provisions Significant Defldency In Internal Control over Compliance Crit eria: Per 45 CFR 1356.2l (ml(l ), in meeting the requirements of section 47l(a)(ll) of the Act, the tilie IV·E agency must review at reasonable, specifi c, tim e-limi tedperiods, to be establi...
Rndlng 2024-017: Spedal Tests and Provisions Significant Defldency In Internal Control over Compliance Crit eria: Per 45 CFR 1356.2l (ml(l ), in meeting the requirements of section 47l(a)(ll) of the Act, the tilie IV·E agency must review at reasonable, specifi c, tim e-limi tedperiods, to be established by the agency, the amount of the payments made for foster care maint enance to assure their continued appropriateness , and that the amount made to a licensed or approved relative or kinship foster famil y home is the same as th e amount that would have been made if the child was placed in a licensed or appr oved non-relative foster family home. Based on the Olicia Y. Lawsuit' s Mi ssissippi Sett.lem ent Agreement and Reform Plan, MOCPS is requ ired to review and publi sh u pdated! foster boardpayment rates every two years. Per 45 CFR 75.303(a), non-Federal entities expending HHS awards must establish and maintain effective internal contro ls over comp liance with Federal states, regulations, and the terms and conditions of the Federal award. Condit ion: Our audit procedures over foster care board payments disclosed that the approved payment board rates were unattai nable . The rates had not been updated from the rate approved in 2019 and no documentation could be provided for the required biannual review. Furt her, therate applied for children aged 0- 8 were not the most recent approved rates resulting in underpayments to foster families. Perspective: Below are the exceptions noted in our testing of foster care board payments for proper allocation of the rates and their approval. The samples were not statistically valid. • One of tenrate categories did not have the proper rateappliedbased on provided board rates resulting in twenty-six of forty sample payment Items being underpaid. • MDCPS did not maintain adequate documentation for the required rate review. Personnel Responsible for Corrective Action: Name: A/asha King Title: Grants Accounting Team Lead Email: Aiasha.King@mdcps.ms.gov Phone Number: 601-359-4016 Co rr ective Acti on Plan: Prior to lhe Single Audit, MDCPS im plemented the Foster Board Payment Review Standard Operating Proce dure (2.15.9.1) to ensure payment rates are verified and approved prior to issuan ce. Annual reviews of board payment rates will be conducted to ensure alignment with approved rates. Antldpatecl Completion Date: Completed as of March 19, 2026.
Finding 2024 - 016: Ellglblllty Significant Defldency In Internal Control Over Compliance Criteria: Per 45 CFR 75.1356.21, .22 and .30, a title IV-E agency must determine eligibility of foster homes and foster children prior to providing foster care maintenance payments. Per 45 CFR 7S. 303(a), non-F...
Finding 2024 - 016: Ellglblllty Significant Defldency In Internal Control Over Compliance Criteria: Per 45 CFR 75.1356.21, .22 and .30, a title IV-E agency must determine eligibility of foster homes and foster children prior to providing foster care maintenance payments. Per 45 CFR 7S. 303(a), non-Federal entities expending HHS awards must establish and maintai n effective inte rnal contro ls over compliance with Federal states, regulat ions, and the terms and conditions of the Federal award. MDCPS policies and procedures require a two-level approval for child eligibility determinations . A Social Worker comp letes an eligibility packet for each child and signs of f before submitting the eligibility packet to the Eligibility department. An Eli gibility Worker reviews and approves the eligibility packets prior to submitt ingthe packet for the El i gibility Supervisor's review. The Eli gibility Supervisor makes the necessary adjustments prior to final approval. Condition: Our audit procedures over eligibility packets disclosed a lack of approval from the Social Worker and second-level approval from the Eligibility Supervisor. Perspective: Below are the exceptions noted in our testing of eligibility for proper approval of eligibility packets. The sample was not statistically valid. • Eleven of forty sample items did not have proper Social Worker sign off. • Twenty-eight of forty sample had only one level of approval documented. All eligibility determinations included at least one level of approval, but MCOPS's policies were not implemented consistently. Personnel Responsib le for Corrective Action: Name: Kristi Plotner Title: Deputy Commissioner of Care Management Email : Kristi .Pl otner@md cps.ms.gov Phone Number: 769-352-5532 Corrective Action Plan: MDCPS will enforce our policy requiring approval of eligibility packets to ensure all eligibility packets are complete and accurate. The Agency is also evaluating its existing policy to strengthen internal controls while improving operational efficiency. As part of this effort, we are reviewing eligibility determination procedures to determine whether to move to a single level of approval model. The objective is to ensure that eligibility determinations remain accurate, well-documented, and compliant with federal requirements, while aligning internal processes with best practices in risk­ based control design. Antidpated Completion Date: Policy enforcement completed as of March 31, 2026 Agency review of eligibility determination procedures to be completed as of Juty 1, 2027. Agency will continue to follow current policy in effect.
Finding 2024- 015: Allowable Costs/ Cost Principle Signifi cant Deficiency In Internal Contro l Over Compliance Criteria: Per 45 CFR 1355.57(d), a title N·E agency must allocate project costs in accordance with applicab le HHS regulations and other guidance. Per 45 CFR 75.303(a), non-Federal entitie...
Finding 2024- 015: Allowable Costs/ Cost Principle Signifi cant Deficiency In Internal Contro l Over Compliance Criteria: Per 45 CFR 1355.57(d), a title N·E agency must allocate project costs in accordance with applicab le HHS regulations and other guidance. Per 45 CFR 75.303(a), non-Federal entities expending HHS awards must establish and maintain effective internal con trols over compliance with Federal sta tes, regu lations, and the terms and conditionsof the Federal award. Condition: Our audit procedures over administrative services disclosed that MDCPS lacked proper policies and procedures over data editing or modification of the cost allocation system. Perspe ctive: Per discussion with management, it was determined that no formal policies and procedures were established for data editing or modifications. Personnel Responsible for Corrective Action : Name: Christopher Roy Title : Deputy Director to the CFO Email: Christopher.Roy@mdcps.ms.gov Phone Number: 601-359-4043 Corrective Action Plan: MDCPS Is strengthening segregation of duties within the Cap Plus system by limiting administrative privileges and ensuring supervisory approval is documented for all cost allocation changes. AntJdpated Completion Date: Permissions were corrected and completed as of March 31, 2026. Documented process and policy anticipated completed May 30, 2026.
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