Corrective Action Plans

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Corrective action steps taken and/or planned: The Administrator and Compliance Manager will update the risk assessment and monitor to ensure providers are monitored at least on a three-year cycle. The department is in the process of reviewing and updating audit program and steps to ensure efficiency...
Corrective action steps taken and/or planned: The Administrator and Compliance Manager will update the risk assessment and monitor to ensure providers are monitored at least on a three-year cycle. The department is in the process of reviewing and updating audit program and steps to ensure efficiency which will provide additional provider coverage. D. Timetable of dates for performance of planned corrective action steps including completion date: The Compliance Manager will update the audit program by May 31, 2026. The Administrator and Compliance Manager will meet quarterly beginning June 30, 2026 to review risk assessment and providers to be listed on audit schedule. E. Description of monitoring to be performed to ensure corrective action steps are taken: The Administrator will review and ensure audit program is updated and incorporated by May 31, 2026. Quarterly meetings between Administrator and Compliance Manager will be scheduled to ensure review is completed
Corrective action steps taken and/or planned: Programs were instructed to update all current client files to include the rent reasonableness studies, and this should happen annually when the lease is renewed o r any time a client needs to m o v e t o a n o t h e r unit. Providers a r e also n o w ma...
Corrective action steps taken and/or planned: Programs were instructed to update all current client files to include the rent reasonableness studies, and this should happen annually when the lease is renewed o r any time a client needs to m o v e t o a n o t h e r unit. Providers a r e also n o w maintaining a r e n t reasonableness tracking sheet with all rent related information f o r units considered f o r t h e rent reasonableness analysis. Also, during each m o n t h l y invoice review, program staff look a t each rent payment within each grant and flag any rents that seem excessive and reach out to the provider with any questions. If the rent is deemed too high o r ineligible, we will ask the provider to remove the amount from the invoice. We also have an updated, HUD approved, Rent Reasonableness policy, which has been provided to all housing providers. Timetable of dates for performance of planned corrective action steps including completion date: Active. The communication of the process changes to housing providers had occurred and monitoring is taking place. Since 2024, our office has made a full push regarding monitoring of the providers, especially related to rent calculations and rent reasonableness policies and procedures. Our Fiscal Specialist has accompanied our monitoring team throughout their technical assistance season (Nov2025 — Feb2026) and the actual monitoring season (Feb2026 — still ongoing but wrapping up in July). Fiscal Specialist has worked with the provider’s fiscal staff to create, revise and maintain new policies and procedures to ensure rent reasonableness processes are completed. We will continue to monitor these items specifically throughout 2026 and beyond. E. Description of monitoring to be performed to ensure corrective action steps are taken: Program monitors have added the Rent Reasonableness test to their annual monitoring. This has also been added to our Fiscal Monitoring, which is done annually as well, but with more focus on invoicing a n d contracting. During Fiscal Monitoring, some leases a r e reviewed to e n s u r e all items are covered along with the rent reasonableness. We will continue to work with providers to ensure they are adhering to HUD’s requirements. We will continue to monitor their policies and train them to enhance their compliance in order to continue to utilize these much needed federal funds.
Housing Division staff at Economic Development will complete monitoring of owner records related to tenant income eligibility and on-site monitoring for the 24 developments that are behind schedule. These 24 will be in addition to those that are scheduled to be monitored in the 2026 fiscal year (7/0...
Housing Division staff at Economic Development will complete monitoring of owner records related to tenant income eligibility and on-site monitoring for the 24 developments that are behind schedule. These 24 will be in addition to those that are scheduled to be monitored in the 2026 fiscal year (7/01/2026-6/30/2027), for a total of 40 properties in all. One property in question is in litigation at this moment so that visit may depend on advice of counsel on how to proceed. Timetable of dates for performance of planned corrective action steps including completion date: All of the above-noted properties will be monitored between this date and the end of the fiscal year – June 30, 2027. Staff will prioritize those properties that are behind schedule for completion by September 30, 2026. Description of monitoring to be performed to ensure corrective action steps are taken: Staff will prioritize those properties that are behind schedule with the goal of completion by the end of the 3rd calendar quarter (September 30, 2026). The Housing Division Manager will require staff to provide on a bi-weekly basis a list of properties that have been scheduled for visits as well as results of those recently completed (both for the 24 properties and regularly scheduled visits). Unlike in past years, the monitoring visits will be spread throughout the year so that they can be completed in an orderly fashion and staff will have more flexibility to adjust to the property managers’ schedules for the visits. Once this fiscal year is complete, all of the properties should be back on a triennial basis for monitoring.
ACED accounting staff will make the journal entry to reclassify the expenditure. The accounting staff will document more closely all program income and consistently record all expenditures in the appropriate expenditure accounts. D. Timetable of dates for performance of planned corrective action ste...
ACED accounting staff will make the journal entry to reclassify the expenditure. The accounting staff will document more closely all program income and consistently record all expenditures in the appropriate expenditure accounts. D. Timetable of dates for performance of planned corrective action steps including completion date: This will be an immediate action as of July 8, 2026. Description of monitoring to be performed to ensure corrective action steps are taken: The accounting staff will maintain a tracking sheet of the dates of the expenditures and notate the accounts the items were recorded to and this will be reviewed by the Assistant Director of Finance.
Corrective action steps taken and/or planned: The delay in reporting the initial project (50-7.4A) is the result of the Federal government transitioning the FSRS system to SAM.GOV. The staff member responsible for entering the data experienced a delay in getting his permission and access to enter da...
Corrective action steps taken and/or planned: The delay in reporting the initial project (50-7.4A) is the result of the Federal government transitioning the FSRS system to SAM.GOV. The staff member responsible for entering the data experienced a delay in getting his permission and access to enter data into the system. Once administrative permissions were granted the project was entered. The second project contained an erroneous subaward date. Once the error was discovered the error was corrected. There are two staff with sufficient access to report in SAM.gov, therefore we anticipate no further delays going forward. Timetable of dates for performance of planned corrective action steps including completion date: This has been completed E. Description of monitoring to be performed to ensure corrective action steps are taken: Staff will provide the SAM.GOV tracking spreadsheet to the Operations Manager, Kaseem Bey monthly.
The Administrator and Compliance Manager will update the risk assessment to redefine High Risk Providers based on Concerns and not on date of prior visit to ensure appropriate visits are conducted timely. Timetable of dates for performance of planned corrective action steps including completion date...
The Administrator and Compliance Manager will update the risk assessment to redefine High Risk Providers based on Concerns and not on date of prior visit to ensure appropriate visits are conducted timely. Timetable of dates for performance of planned corrective action steps including completion date: The Administrator and Compliance Manager will update risk assessment by September 30, 2026 and meet quarterly beginning October 31, 2026 to review risk assessment and providers to be listed on audit schedule. E. Description of monitoring to be performed to ensure corrective action steps are taken: The Administrator will review and ensure risk assessment is updated and incorporated by October 31, 2026. Quarterly meetings between Administrator and Compliance Manager will be scheduled to ensure appropriate providers are included in the audit schedule.
DHS will reiterate to providers the importance of timely submission of their expenses. If issues arise or system issues occur, as was the case here, DHS will be proactive in requesting an extension from SAMHSA. DHS will follow the Federal Funding Accountability and Transparency Act requirements and ...
DHS will reiterate to providers the importance of timely submission of their expenses. If issues arise or system issues occur, as was the case here, DHS will be proactive in requesting an extension from SAMHSA. DHS will follow the Federal Funding Accountability and Transparency Act requirements and will report first-tier subawards of $30,000 or more to the Federal Funding Accountability and Transparency Act Subaward Reporting System (FSRS). DHS will identify all first-tier direct recipients who meet the eligibility criteria and the required data elements will be entered into FSRS. Timetable of dates for erforman‘ f corrective a n he ' In ‘ completion date: All first-tier direct recipients who meet the eligibility criteria will be identified, and the required data elements for those first-tier direct recipients will be entered into FSRS by 12/31/26. Annually, a review of financial transactions and payments to first-tier direct recipients associated with Federal awards will be performed to determine the direct recipients that received $3 0,000 or more. The list of direct recipients will be reconciled to the submissions that have been made into F SRS during the year to ensure completeness of reporting.
Finding 2025-001 – Subaward Documentation and Subrecipient Monitoring-Corrective Action Completed or In Progress: • In September 2026, SI2 completed documented risk assessments for five subrecipients using a form addressing the factors in 2 CFR 200.332(c), and documented its cost-share review proces...
Finding 2025-001 – Subaward Documentation and Subrecipient Monitoring-Corrective Action Completed or In Progress: • In September 2026, SI2 completed documented risk assessments for five subrecipients using a form addressing the factors in 2 CFR 200.332(c), and documented its cost-share review process in a written narrative. SI2 will complete the assessments for the remaining subrecipients, prepare an assessment at the time of each new subaward, and update assessments as circumstances change. • SI2 will execute a formal subaward agreement with Kearns & West for the SUDS engagement, in the form used for the SEEDS subawards, and will adopt a standard subaward template and execution checklist for all future subawards. • SI2 will perform and retain evidence of the monitoring activities (invoice review and approval, determination of applicable subrecipient audit requirements and verification of compliance with those requirements, including review of Single Audit reports when applicable) beginning with fiscal year 2026. • SI2 will expand its Accounting Policies and Procedures Manual to specify how subrecipient monitoring activities are performed, documented, and retained.
Corrective action planned: Community-Minded Enterprises (CME) agrees with the finding and has implemented a formal Subrecipient Risk Assessment and Monitoring Policy and related procedures to strengthen its subrecipient oversight process and ensure compliance with 2 CFR §200.332. Under the new polic...
Corrective action planned: Community-Minded Enterprises (CME) agrees with the finding and has implemented a formal Subrecipient Risk Assessment and Monitoring Policy and related procedures to strengthen its subrecipient oversight process and ensure compliance with 2 CFR §200.332. Under the new policy, CME will conduct and document a risk assessment prior to executing a subaward. The assessment evaluates factors including prior experience with similar awards, financial stability, audit and monitoring history, internal controls, management or staffing changes, prior corrective actions, fraud risk indicators, and SAM/debarment status. Each subrecipient will be assigned a documented risk rating of Low, Moderate, or High, and the results of the assessment will determine the appropriate level and frequency of monitoring throughout the subaward period. CME has also established defined responsibilities for risk assessment, financial review, program monitoring, compliance oversight, and documentation. Risk assessments and related monitoring documentation will be maintained as part of the subrecipient file to demonstrate compliance with federal requirements. Anticipated completion date: October 1, 2026 Contact person responsible for corrective action: Director of Risk & Compliance, Finance, and applicable Program Director
Greenwich Communities accepts the audit finding that electronic income verification was not performed timely in twenty-nine instances, and we have already implemented corrective actions to resolve the issue. Corrective Actions Completed: • Targeted Training was provided to the manager responsible fo...
Greenwich Communities accepts the audit finding that electronic income verification was not performed timely in twenty-nine instances, and we have already implemented corrective actions to resolve the issue. Corrective Actions Completed: • Targeted Training was provided to the manager responsible for income verifications. • Process Review sessions ensured that the manager fully understands the correct verification workflow and strict compliance deadlines. • Updated Tracking mechanisms were put in place to flag pending verifications before they become overdue. Preventive Measures: • Regular Monitoring by supervisors will catch any delayed verifications immediately. • Monthly Checks will ensure staff continue to follow the correct timeline for electronic income verification.
Audit Finding: During the 2025 audit, PDAI was notified that it is a requirement to document and maintain SAM.gov vendor eligibility verifications for procurement transactions that exceed $25,000.00 per contracted year and are charged to federal programs or any sub awardees regardless of amount. Vie...
Audit Finding: During the 2025 audit, PDAI was notified that it is a requirement to document and maintain SAM.gov vendor eligibility verifications for procurement transactions that exceed $25,000.00 per contracted year and are charged to federal programs or any sub awardees regardless of amount. Views of officials responsible: We acknowledge that internal control should be strengthened by reviewing the current Uniform Guidance Requirements - all vendors at or above the designated threshold (2025 was $25,000.00/contracted year) and all sub awardees must be verified thorugh the System for Award Management website (SAM.gov) and a screenshot/printed screen must be kept for documentation. Corrective Action: Beginning in Quarter 4 of 2026, routine checks will be completed for any PDAI vendors that are contracted to be paid over the threshold designated in the Uniform Guidance Requirements and all sub awardees before any initial payments are made and then concurrently on a quarterly basis. This threshold will be reviewed on a yearly basis to stay up to date with the Uniform Guidance Requirements. Management has designated a specific preparer and reviewer while requiring sign offs as a secondary check and balance. Responsible Parties: Jennell Miller, Accounting Manager Tina Fornstrom, Business Manager Implementation Date: October 1, 2026 (start of Q4 2026) Ongoing Monitoring: The Accounting Manager and Business Manager will work together ensuring guidelines are up to date, regular checks are completed and the opposite party will sign off after reviewing the documentation.
Corrective Action Planned: The Authority will closely monitor all deposits to make sure that the amount of funds on deposit are protected by federal deposit insurance, corporate surety bond, or collateral.
Corrective Action Planned: The Authority will closely monitor all deposits to make sure that the amount of funds on deposit are protected by federal deposit insurance, corporate surety bond, or collateral.
Finding 1237984 (2025-002)
Material Weakness 2025
FINDING 2025-002 Finding Subject: COVID-19 – Coronavirus State and Local Fiscal Recovery Fund – Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Annette Phillippo Contact Phone Number and Email Address: 765-472-3901, ext. 1240 and aphillippo@miamicountyin.go...
FINDING 2025-002 Finding Subject: COVID-19 – Coronavirus State and Local Fiscal Recovery Fund – Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Annette Phillippo Contact Phone Number and Email Address: 765-472-3901, ext. 1240 and aphillippo@miamicountyin.gov Views of Responsible Officials: We concur with the finding. Description of Corrective Action Plan: Policies and procedures will be put in place to search on sam.gov to determine if a vendor has been suspended or disbarred. Anticipated Completion Date: September 2026 INDIANA STATE
Finding Number: 2025-002 Planned Corrective Action: Board of Elections has been provided with additional training by the Commissioners Finance staff on grant management and reporting. Necessary reports were filed with Secretary of State as required for the current fiscal year. Anticipated Completion...
Finding Number: 2025-002 Planned Corrective Action: Board of Elections has been provided with additional training by the Commissioners Finance staff on grant management and reporting. Necessary reports were filed with Secretary of State as required for the current fiscal year. Anticipated Completion Date: 08/31/2026 Responsible Contact Person: Dante Lewis, Board of Elections Director
Finding 1237948 (2025-003)
Material Weakness 2025
FINDING 2025-003 Finding Subject: 21.027 State and Local Fiscal Recovery Fund - Suspension and Debarment Contact Person Responsible for Corrective Action: Angela Jarvis, County Auditor Contact Phone Number and Email Address: 765-668-6552 ajarvis@grantcounty.in.gov Views of Responsible Officials: We ...
FINDING 2025-003 Finding Subject: 21.027 State and Local Fiscal Recovery Fund - Suspension and Debarment Contact Person Responsible for Corrective Action: Angela Jarvis, County Auditor Contact Phone Number and Email Address: 765-668-6552 ajarvis@grantcounty.in.gov Views of Responsible Officials: We Concur with the finding. Description of Corrective Action Plan: We recognize the importance of ensuring that federal funds are not provided to individuals or entities that are suspended or debarred. To correct this issue on future agreements, the appropriate suspension and debarment provisions will be incorporated into the agreement at the time of drafting and prior to execution. Anticipated Completion Date: September 8, 2026
FINDING 2025-005 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Suspension and Debarment Contact Person Responsible for Corrective Action: Catherine MM Lane Contact Phone Number and Email Address: 812-677-3959 clane@vincennes.in.gov Views of Responsible Officials: We...
FINDING 2025-005 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Suspension and Debarment Contact Person Responsible for Corrective Action: Catherine MM Lane Contact Phone Number and Email Address: 812-677-3959 clane@vincennes.in.gov Views of Responsible Officials: We concur with the findings. Description of Corrective Action Plan: The clerk’s office will verify that vendors are not excluded or disqualified by checking the SAM’s website, addressing the vendor or adding a clause or condition to the contract to be signed by the vendor. Any documentation will be retained in the city’s grant files. Anticipated Completion Date: The corrective action plan will be implemented by December 31, 2026.
There is no disagreement with the audit finding. Action planned/taken in response to finding: Management concurs with the finding. The Organization acknowledges that controls intended to ensure annual renewal of sliding fee discount applications were not consistently operating as intended. Managemen...
There is no disagreement with the audit finding. Action planned/taken in response to finding: Management concurs with the finding. The Organization acknowledges that controls intended to ensure annual renewal of sliding fee discount applications were not consistently operating as intended. Management is strengthening monitoring procedures by implementing tracking mechanisms to identify expiring applications and requiring verification of eligibility documentation prior to continued application of discounts, consistent with the requirement under Section 330(k)(3)(G) of the Public Health Service Act (42 U.S.C. 254b(k)(3)(G)) that health centers establish systems for sliding fee eligibility determination. In addition, management will provide additional training to all billing and front-desk staff on the sliding fee discount program, including eligibility determination, income and household-size documentation requirements, application renewal procedures, and the proper application of discounts in the practice management system. Periodic supervisory reviews will be performed to ensure compliance with the Board-approved sliding fee discount policy, consistent with the internal control requirements of the Uniform Guidance (2 CFR 200.303). Management will also review the sliding fee discount schedule on a regular basis, no less than annually, and will update it in a timely manner whenever necessary, including upon publication of the annual Federal Poverty Guidelines, so that discounts continue to be adjusted on the basis of each patient’s ability to pay as required by 42 CFR 51c.303(f), with all updates presented to the Board of Directors for approval and communicated promptly to billing staff. Documentation of staff training, schedule reviews, and Board approvals will be retained to demonstrate compliance with HRSA Health Center Program requirements, including Chapter 9 (Sliding Fee Discount Program) of the HRSA Health Center Program Compliance Manual. Name(s) of the contact person(s) responsible for corrective action: Edward Murphy, Asante Muyungga, Charity Gutierrez, Anthony Parker, Bennett Baber, Jannell Robinson. Planned completion date for corrective action plan: December 31st, 2026
Views of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and has taken the steps to implement controls surrounding federal reporting for future grants to ensure accuracy in reporting. Responsible party and timeline for completion: Clerk Treasurer Vicki Kitche...
Views of Responsible Officials and Planned Corrective Actions: Management agrees with the finding and has taken the steps to implement controls surrounding federal reporting for future grants to ensure accuracy in reporting. Responsible party and timeline for completion: Clerk Treasurer Vicki Kitchen will get the sub-recipient removed for submittal for the final 2026 report that is filed in 2027. A work ticket was filed to correct the subrecipient but the Town of North Liberty was never contacted by the SLFRF. This is the only way I could get the annual report completed. I will work on the final SLFRF report submitted. The work can't be completed until the next required report is due in 2027.
In 2026, procedures to ensure that future procurements associated with Federal awards comply with applicable Federal procurement requirements were developed, documented, and implemented. These procedures include requirements for public solicitation and full and open competition when applicable, as w...
In 2026, procedures to ensure that future procurements associated with Federal awards comply with applicable Federal procurement requirements were developed, documented, and implemented. These procedures include requirements for public solicitation and full and open competition when applicable, as well as review of existing contracts before they are used for Federal award activities. The Organization will maintain appropriate documentation demonstrating compliance with applicable Federal procurement requirements.
In 2026, procedures were implemented to strengthen oversight of Single Audit reporting requirements and ensure timely submission of future reporting packages. Responsibility for monitoring applicable filing deadlines has been assigned to designated finance personnel, with deadlines incorporated into...
In 2026, procedures were implemented to strengthen oversight of Single Audit reporting requirements and ensure timely submission of future reporting packages. Responsibility for monitoring applicable filing deadlines has been assigned to designated finance personnel, with deadlines incorporated into the Organization’s annual audit calendar. Finance personnel will also coordinate with the independent auditors throughout the audit process to monitor completion and submission requirements and will address any potential delays or required extensions prior to the applicable deadline.
If we receive federal funds in the future, we will stay abreast of current and changing policies and procedures.
If we receive federal funds in the future, we will stay abreast of current and changing policies and procedures.
The Village will implement procedures to ensure that qualified vendors who receive over $25,000 of federal funds have not been suspended or debarred.
The Village will implement procedures to ensure that qualified vendors who receive over $25,000 of federal funds have not been suspended or debarred.
Condition: During testing of subrecipient payments, we identified 15 instances in which payments to subrecipients were made more than 30 calendar days after receipt of a complete and approved invoice. Planned Corrective Action: During the audit period, the organization experienced delays in processi...
Condition: During testing of subrecipient payments, we identified 15 instances in which payments to subrecipients were made more than 30 calendar days after receipt of a complete and approved invoice. Planned Corrective Action: During the audit period, the organization experienced delays in processing certain subrecipient invoices. As a result, some subrecipients were not paid in accordance with the requirements of 2 CFR 200.305(b)(3). To address this finding, management has implemented the following corrective actions: Revised internal procedures to ensure payments are made within 30 calendar days of the approval of subrecipient invoices, regardless of when reimbursement is received from the federal awarding agency. Implemented a weekly aging report to identify subrecipient invoices approaching payment due dates and to ensure timely resolution. Provided additional training to the program, finance and the management teams on federal payment requirements and internal procedures. Established periodic management reviews to monitor compliance with payment timeliness requirements and identify process improvements as needed. Management fully implemented all corrective actions as of June 30, 2026. Contact person responsible for corrective action: Nancy Cummins, Controller Anticipated Completion Date: June 30, 2026
Finding Number 2025-003: Matching – Significant Deficiency in Internal Control over Compliance and Noncompliance Corrective Action: Management will update its matching procedures to require staff to verify that each cost is allowable under the applicable grant before including it in the matching poo...
Finding Number 2025-003: Matching – Significant Deficiency in Internal Control over Compliance and Noncompliance Corrective Action: Management will update its matching procedures to require staff to verify that each cost is allowable under the applicable grant before including it in the matching pool. The procedures will specifically exclude unrecovered indirect costs from CoC Program match unless HUD provides prior written approval. Grant accounting staff will retain support for each matching cost, and a supervisor will review and approve the matching schedule before submission. Any ineligible costs identified will be removed and corrected. Name of Responsible Individual(s): Jason Brenier and Judy Bokhari Anticipated Completion Date: December 2026
Finding Number 2025-002: Period of Performance – Significant Deficiency in Internal Control Over Compliance and Noncompliance Corrective Action: Management will update its grant allocation procedures to require staff to verify and document that costs were incurred within the applicable grant period ...
Finding Number 2025-002: Period of Performance – Significant Deficiency in Internal Control Over Compliance and Noncompliance Corrective Action: Management will update its grant allocation procedures to require staff to verify and document that costs were incurred within the applicable grant period before charging them to an award. The accounting system will be used to track grant periods, retain allocation support, and flag costs charged outside the applicable period. A supervisor will review allocations and resolve exceptions before claims are submitted. Any costs charged to the wrong period will be corrected. Name of Responsible Individual(s): Jason Brenier, Judy Bokhari, Luz Gonzales-Toscano Anticipated Completion Date: December 2026
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