Corrective Action Plans

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2023-001 Material Weakness Name of contact person: Michael Crooker, County Administrator Corrective Action: The County will develop and implement a subrecipient monitoring program. Proposed implementation date: The corrective action plan will be implemented as soon as possible.
2023-001 Material Weakness Name of contact person: Michael Crooker, County Administrator Corrective Action: The County will develop and implement a subrecipient monitoring program. Proposed implementation date: The corrective action plan will be implemented as soon as possible.
Finding 2023-003 Compliance Requirement: Special Tests and Provisions-Sliding Fee Discounts Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 US Department of Health and Human Services Condition and Context: Documents to verify income could not ...
Finding 2023-003 Compliance Requirement: Special Tests and Provisions-Sliding Fee Discounts Material Weakness Assistance Living Number 93.224 Health Center Programs Grant Award Number H80CS00112 US Department of Health and Human Services Condition and Context: Documents to verify income could not be located for six of the twenty-five patients selected for testing. Also, there was no documentation of family size for five of the patients in this sample. The result is that we were unable to determine eligibility for a total of seven of the fourteen tested. Action Planned in Response to the Finding: Procedures will be implemented and actively monitored to ensure that all supporting documentation used to determine patient eligibility is properly collected, maintained, and retained. These procedures will help ensure compliance with applicable guidelines and support the accuracy and integrity of eligibility determinations. Official Responsible for Ensuring the CAP: Sabrina SalazarPlanned Completion Date: December 2024
Finding 555797 (2023-003)
Significant Deficiency 2023
Description of Finding: IYT did not submit its FY22-23 Single Audit and Audited Financial tatements to the federal audit clearinghouse by the required deadline of March 31, 2024. The delay was attributed to internal capacity constraints and staff turnover, which resulted in late preparation of the S...
Description of Finding: IYT did not submit its FY22-23 Single Audit and Audited Financial tatements to the federal audit clearinghouse by the required deadline of March 31, 2024. The delay was attributed to internal capacity constraints and staff turnover, which resulted in late preparation of the Schedule of Expenditures of Federal Awards and other key audit deliverables. Statement of Concurrence or Nonconcurrence: We concur with the audit finding. Corrective Action: IYT acknowledges the late submission of the FY22-23 Single Audit and recognizes delays in the FY23-24 audit timeline as well. This reflects a breakdown in internal ownership and process awareness related to the Single Audit. The CFAO is taking full responsibility for implementing new internal systems, including a detailed audit readiness timeline, early preparation of the SEFA, and clear role assignments.. IYT is also evaluating whether additional staff capacity or process changes are needed to ensure future compliance with federal reporting deadlines. Name of Contact Person: Macarena O’Brien, Chief Financial & Administrative Officer (480)993-4764 | macarena@improveyourtomorrow.org Projected Completion Date: March 31, 2026
The County did experience issues with the reporting portal for these funds.  When we requested assistance, we received generic responses and little assistance from the Treasury.  It wasn’t until November 2024 that we were finally able to gain the assistance we needed to gain full access to the Treas...
The County did experience issues with the reporting portal for these funds.  When we requested assistance, we received generic responses and little assistance from the Treasury.  It wasn’t until November 2024 that we were finally able to gain the assistance we needed to gain full access to the Treasury portal as well as some guidance on the reports.  On January 1, 2025, the Treasury provided guidance that is helpful to us in understanding the reporting requirements.  Now that we have the access and guidance we need, all reports will be submitted accurately and on time.
Recommendation: We recommend that the Agency reviews the controls in place to ensure that wage rate requirements are met. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we b...
Recommendation: We recommend that the Agency reviews the controls in place to ensure that wage rate requirements are met. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we began implementing a corrective action plan. Specifically, we are enhancing our internal controls and began developing a comprehensive technical procedure manual that will serve as a detailed guide that provides a clear reference for Procurement and Program Administration to ensure consistency, compliance. Name(s) of the contact person(s) responsible for corrective action: Christine Weichert, Director of Development Planned completion date for corrective action plan: December 31, 2025
Community Development Block Grants/Entitlements – Assistance Listing No. 14.218 Recommendation: We recommend that the Agency provide additional training to program managers regarding the reporting requirements of the grant to ensure compliance requirements are met. Explanation of disagreement wit...
Community Development Block Grants/Entitlements – Assistance Listing No. 14.218 Recommendation: We recommend that the Agency provide additional training to program managers regarding the reporting requirements of the grant to ensure compliance requirements are met. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we have implemented a comprehensive corrective action plan. Specifically, our federal program manager has completed appropriate HUD training and updated Federal Programs Desk Guide to ensure the inclusion of language regarding requirements of the Federal Funding Accountably and Transparency Act. Detailed supporting documentation can be found at the following link: https://sachousing.box.com/s/bakb9wcaxqo33cpsoq348es91nwqncaq Name(s) of the contact person(s) responsible for corrective action: Irene De Jong, DIRECTOR OF FINANCE Planned completion date for corrective action plan: December 31, 2025
Emergency Solutions Grants Program – Assistance Listing No. 14.231 Recommendation: We recommend that the Agency reviews the controls in place to ensure that subrecipient payments are paid timely and within program requirements. Explanation of disagreement with audit finding: There is no disagreeme...
Emergency Solutions Grants Program – Assistance Listing No. 14.231 Recommendation: We recommend that the Agency reviews the controls in place to ensure that subrecipient payments are paid timely and within program requirements. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we began implementing a corrective action plan. Specifically, we are enhancing our internal controls and began developing a comprehensive technical procedure manual that will serve as a detailed guide that provides a clear reference for finance and accounting staff to ensure consistency, compliance and efficiency in financial operations. Additionally, as SHRA is filling vacancies due to significant turnover across the entire Finance Department, specific training is provided to new employees in the following areas: • Building HOME • Capital Fund • CDBG • Continuum of Care • Developing a Cost Allocation Plan • Financial Management Part I and Part II (for CPD programs) • HCV Two Year Tool • IDIS • Mainstream Vouchers • Overview of Asset Management • PHA Financial Management Name(s) of the contact person(s) responsible for corrective action: Irene De Jong, DIRECTOR OF FINANCE Planned completion date for corrective action plan: December 31, 2025
Recommendation: We recommend that management ensure that internal controls are in place and operating effectively for period of performance requirements. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent...
Recommendation: We recommend that management ensure that internal controls are in place and operating effectively for period of performance requirements. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we began implementing a corrective action plan. Specifically, we are enhancing our internal controls and began developing a comprehensive technical procedure manual that will serve as a detailed guide that provides a clear reference for finance and accounting staff to ensure consistency, compliance and efficiency in financial operations. Additionally, as SHRA is filling vacancies due to significant turnover across the entire Finance Department, specific training is provided to new employees in the following areas: • Building HOME • Capital Fund • CDBG • Continuum of Care • Developing a Cost Allocation Plan • Financial Management Part I and Part II (for CPD programs) • HCV Two Year Tool • IDIS • Mainstream Vouchers • Overview of Asset Management • PHA Financial Management Name(s) of the contact person(s) responsible for corrective action: Irene De Jong, DIRECTOR OF FINANCE Planned completion date for corrective action plan: December 31, 2025
View Audit 354004 Questioned Costs: $1
Recommendation: We recommend management should designate one person to review a sample of the files that have been recertified each month. The purpose of the review is to determine if the tenant files were prepared in accordance with internal policies and verify the compliance deficiencies have been...
Recommendation: We recommend management should designate one person to review a sample of the files that have been recertified each month. The purpose of the review is to determine if the tenant files were prepared in accordance with internal policies and verify the compliance deficiencies have been corrected. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we have implemented a comprehensive corrective action plan. Staff developed a Public Housing File Order Checklist, written Standard operating Procedures (SOP’s) for interviewing tenants; conducting income examinations and re-examinations; verifying income eligibility using third-party verification; and determining income eligibility and calculating the tenant’s rent payment. Additionally, SHRA developed an Intake Caseworker Training Schedule to assist staff with accurately determining program eligibility. Detailed supporting documentation can be found at the following link: https://sachousing.box.com/s/or3rc8z1hml3hhxmp9f0e2t31yv6odyo Name(s) of the contact person(s) responsible for corrective action: Irene De Jong, DIRECTOR OF FINANCE Planned completion date for corrective action plan: December 31, 2025
Recommendation: We recommend that management should designate one person to review a sample of the files that have been recertified each month. The purpose of the review is to determine if the tenant files were prepared in accordance with internal policies and verify the compliance deficiencies have...
Recommendation: We recommend that management should designate one person to review a sample of the files that have been recertified each month. The purpose of the review is to determine if the tenant files were prepared in accordance with internal policies and verify the compliance deficiencies have been corrected. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: To prevent a recurrence of the issue, we have implemented a comprehensive corrective action plan. Specifically, we developed a comprehensive Standard Operating Procedure (SOP) for file reviews related to recertification. Additionally, the HCV Operations Unit is reviewing a sample of completed recertifications monthly to ensure compliance. Detailed supporting documentation can be found at the following link: https://sachousing.box.com/s/fiqoaoddr7ae6nydf63f1mhwfnrpzfr6 Name(s) of the contact person(s) responsible for corrective action: MaryLiz Paulson, Director, Housing Choice Vouchers Planned completion date for corrective action plan:: December 31, 2025
View Audit 354004 Questioned Costs: $1
2023-004 Program: WIOA Cluster Federal Financial Assistance Listing Number: 17.258, 17.259, 17.277, 17.278 Federal Grantor: U.S. Department of Labor Pass-Through: California Department of Employment Development Award No. and Year: AA211008/AA111008 - FY22-23 Compliance Requirements: Subrecipient Mo...
2023-004 Program: WIOA Cluster Federal Financial Assistance Listing Number: 17.258, 17.259, 17.277, 17.278 Federal Grantor: U.S. Department of Labor Pass-Through: California Department of Employment Development Award No. and Year: AA211008/AA111008 - FY22-23 Compliance Requirements: Subrecipient Monitoring Type of Finding: Material Weakness Management’s or Department’s Response: Imperial County Workforce Development Office (ICWDO) agrees with the finding. Views of Responsible Officials and Corrective Action Plan: The questions from finding 2023-004 relate to a formalization of the fiscal processes and protocols. ICWDO operates under WIOA guidelines and follows Imperial County’s fiscal policies. Internal policy will be formally updated to reflect compliance with WIOA regulations, as well as Imperial County policies. These policies will include formal controls and procedures to evaluate each subrecipient’s risk of noncompliance. Once the formal procedure is drafted, it will go through the ICWDO Policy Committee for comment and direction, and then finally reviewed and approved for implementation by the full Workforce Development Board. Additionally, for any future Memorandums of Understanding (MOUs) between this Imperial County department and any outside agency, there will be an additional step to include review by Imperial County Counsel to reflect that recital around the funding source will specify the following required information: • Federal Award Identification Number • Federal award date of award to recipient by the Federal agency • Name of Federal awarding agency • CFDA Number • Specific identification of whether the award is research and development ICWDO will develop internal policies for formalizing all subrecipient monitoring process. ICWDO operates under WIOA guidelines for monitoring; therefore a formal internal policy for future contracts will be developed and implemented using the usual review and approval procedures followed by the department. ICWDO will develop a formal internal documentation system, with appropriate checks and signatures, for the evaluation and assessment of each subrecipient’s risk of noncompliance. ICWDO will utilize this formal process to properly document the risk assessment of all subrecipients. ICWDO anticipates to implement the corrective action by December 31, 2023. Name of Responsible Person: Priscilla A Lopez, ICWDB Director Implementation Date: December 31, 2023
Management recognizes its compliance requirements for maintaining and implementing sound controls over financial reporting and the potential non-compliance impacts of a lack of such control environment. Leadership is currently considering options for adequate oversight and review. Until such time th...
Management recognizes its compliance requirements for maintaining and implementing sound controls over financial reporting and the potential non-compliance impacts of a lack of such control environment. Leadership is currently considering options for adequate oversight and review. Until such time that adequate staffing for review is in place, a member of management or their designee will develop and maintain a tickler list of all reporting requirements and due dates to ensure all reports are submitted timely.
Condition: During the audit it was noted that, in most of the instances, employee timecards were missing. Plan: The Club will review their monitoring procedures to ensure consistent retention of employee timecards. Anticipated Date of Completion: As soon as possible – before FY25 year end Name of Co...
Condition: During the audit it was noted that, in most of the instances, employee timecards were missing. Plan: The Club will review their monitoring procedures to ensure consistent retention of employee timecards. Anticipated Date of Completion: As soon as possible – before FY25 year end Name of Contact Person: Germain Castellanos, CEO Management Response: Since the audit, we have reviewed our monitoring procedures to ensure consistent approval of employees timecards.
Finding 555111 (2023-002)
Significant Deficiency 2023
Management recruited a procurement officer in December 2024 to design and implement best practice procurement processes effective the first quarter 2025. Procurement policies will ensure full compliance with Federal and State requirements. Procurement policies will incorporate clearly defined proc...
Management recruited a procurement officer in December 2024 to design and implement best practice procurement processes effective the first quarter 2025. Procurement policies will ensure full compliance with Federal and State requirements. Procurement policies will incorporate clearly defined procedures around all contractors ensuring appropriate selection processes and contractual terms.
Finding 555110 (2023-001)
Material Weakness 2023
Effective October 1, 2023, management implemented extensive accounting and documentation controls to ensure full accounting and reporting compliance on direct costs incurred for all federal grants and expenditures. These controls are reviewed and monitored for compliance by management on a periodic ...
Effective October 1, 2023, management implemented extensive accounting and documentation controls to ensure full accounting and reporting compliance on direct costs incurred for all federal grants and expenditures. These controls are reviewed and monitored for compliance by management on a periodic basis during the year.
View Audit 353705 Questioned Costs: $1
Two full days of on-site training on federal grants management were provided for all DCH staff in May of 2023. In June of 2023, WWCDCH contracted with ENJ Consulting to create a federally compliant policy and procedures manual for the management of federal grants, and to train staff on the content a...
Two full days of on-site training on federal grants management were provided for all DCH staff in May of 2023. In June of 2023, WWCDCH contracted with ENJ Consulting to create a federally compliant policy and procedures manual for the management of federal grants, and to train staff on the content and use of the manual. The final product has been delayed due to OMB’s proposed changes to the Uniform Guidance; however, OMB has announced that they will release the final update on April 4, 2024, and we expect to receive our finalized policy and procedures manual shortly thereafter. DCH Grants and Contractions Coordinator will attend a webinar on April 4, 2024 covering the launch of the revised Uniform Guidance. DCH’s source grant and subaward under 21.019 were successfully closed 2021, so no action was taken to perform a retroactive risk assessment or monitoring activities. In response to the finding and consistent with WWDCH's commitment to compliance with applicable laws, rules, regulations, and award terms and conditions, WWDCH obtained training regarding subrecipient monitoring requirements and best practices regarding implementation of the same. In addition, WWDCH established a monitoring program for ERAP 2.0, which included testing of a sample of 25 applications for compliance with programmatic and financial requirements. Testing of the 25 sampled applications is complete; however, final reporting and resolution of monitoring observations are still in-process. WWDCH anticipates completion of this corrective action to occur during FY25.
Recommendation: We recommend the Center establish a formal tracking process to record in real time the value of all of its in-kind goods and services received to help determine whether or not it is meeting its match requirements. Action Taken: Tri-County O1C has initiated the development of a form...
Recommendation: We recommend the Center establish a formal tracking process to record in real time the value of all of its in-kind goods and services received to help determine whether or not it is meeting its match requirements. Action Taken: Tri-County O1C has initiated the development of a formal, standardized tracking system for recording all in—kind contributions (goods and services) as they are received. This system includes: A centralized In-Kind Contribution Log maintained in a shared digital format (e.g. Google Sheets). Use Pennsylvania Department of Education’s form for staff and partners to document the nature, source, estimated fair value, and date of each in~kind donation. Internal procedures that require all in~kind contributions to be logged within 48 hours of receipt. Training for key staff on recognizing and properly valuing in»kind contributions in accordance with federal grant guidelines (e.g., Uniform Guidance 2 CFR Part 200). Monthly review by the Finance Department to reconcile iii-kind entries with match requirement reports. Anticipated Completion Date: April 30, 2025 Contact Person Responsible: Christina Johnson, Executive Director
Recommendation: We recommend the Center establish a formal monitoring process to review the activities on each of its recipients. This should include site visits, review of annual external audits when applicable and training when deemed necessary. Action Taken: Tri-County OIC has developed and ...
Recommendation: We recommend the Center establish a formal monitoring process to review the activities on each of its recipients. This should include site visits, review of annual external audits when applicable and training when deemed necessary. Action Taken: Tri-County OIC has developed and begun implementing a comprehensive Sub recipient Monitoring Plan to ensure compliance and accountability. Actions taken include: Development of Sub recipient Monitoring Policies and Procedures, which outline expectations, responsibilities, and steps for oversight. Creation of a Sub recipient Risk Assessment Tool to categorize sub recipients based on risk level and determines appropriate monitoring frequency. Scheduling of Annual On-Site or Virtual Monitoring Visits, including programmatic and fiscal reviews. Formal Collection and Review of Annual External Audits or Financial Statements from sub recipients, as applicabie. Documentation Protocols to maintain records of all monitoring activities, communications, findings, and corrective actions. Anticipated Completion Date: May 31, 2025 Contact Person Responsible: Christina Johnson, Executive Director
Recommendation: We recommend the Center review its contracts against the criteria set forth in the Uniform Guidance to ensure that all sub-awards in the future contain the required information for subrecipients. Action Taken: Tri-County 010 has taken the following corrective steps: Re...
Recommendation: We recommend the Center review its contracts against the criteria set forth in the Uniform Guidance to ensure that all sub-awards in the future contain the required information for subrecipients. Action Taken: Tri-County 010 has taken the following corrective steps: Reviewed and Updated the Subrecipient Contract Template to include all required elements as outlined in Pennsylvania Department of Education. Implemented a Pro-Award Contract Review Checklist to ensure each contract is verified for compliance prior to execution. Established a Documentation Process for storing all subrecipient agreements and related compliance materials in a centralized location. Anticipated Completion Date: March 31, 2025 Contact Person Responsible: Christina Johnson, Executive Director
Recommendation: We recommend that the Center implement procedures to ensure that the audit reports are filed within the regulatory deadlines. Action Taken: Tri-County OIC has taken the following steps to ensure timely submission of audit reports: Created a Compliance Calendar that...
Recommendation: We recommend that the Center implement procedures to ensure that the audit reports are filed within the regulatory deadlines. Action Taken: Tri-County OIC has taken the following steps to ensure timely submission of audit reports: Created a Compliance Calendar that includes all major reporting deadlines, including audit report submission due dates. Assigned Responsibility to the Finance Administrator and Executive Director to monitor deadlines and coordinate with the external auditors in a timely manner. Established a 90-Day Pre-Deadline Notification System to ensure ail audit preparation materials are compiled and submitted to auditors well in advance. Incorporated Audit Timeline Planning into the organization's annual financial closeout procedures. Scheduled Regular Check-ins between the Finance Team and auditors to track progress and address delays proactively. These steps are desitzned to improve internal coordination and accountabiiity, ensuring that all future audits are submitted within the reguired timeframe. Anticipated Completion Date: April 15, 2025 Contact Person Responsible: Christina Johnson, Executive Director
Finding ref number: 2023-002 Finding caption: The County did not have adequate internal controls for ensuring compliance with federal suspension and debarment requirements. Name, address, and telephone of County contact person: Natasha Warmenhoven, County Auditor PO Box 638 Friday Harbor, WA 9825 (3...
Finding ref number: 2023-002 Finding caption: The County did not have adequate internal controls for ensuring compliance with federal suspension and debarment requirements. Name, address, and telephone of County contact person: Natasha Warmenhoven, County Auditor PO Box 638 Friday Harbor, WA 9825 (360) 378-2161 Corrective action the auditee plans to take in response to the finding: • With the assistance of the County Manager’s Office, the Auditor’s Office will review and update the Grant Policy to include an effective internal control for federal suspension and debarment requirements. • SJC Grants Administrator will offer a training that all grant/project managers must complete. Anticipated date to complete the corrective action: Both action items will be completed by December 31, 2025
2023-06 Federal Audit Issuance i. Condition: The audit report was not submitted in a timely manner. ii. Corrective Action Plan: The District provided all documentation to auditors by requested deadlines.
2023-06 Federal Audit Issuance i. Condition: The audit report was not submitted in a timely manner. ii. Corrective Action Plan: The District provided all documentation to auditors by requested deadlines.
Finding 554521 (2023-005)
Significant Deficiency 2023
The County will ensure future reports are completed on time.
The County will ensure future reports are completed on time.
2023-002 - Reporting Auditee’s Response and Planned Corrective Action The Authority is now under the management of the Quincy Housing Authority and all controls and processes have been updated to account for the needs of the Holbrook Housing Authority, including internal controls over financial re...
2023-002 - Reporting Auditee’s Response and Planned Corrective Action The Authority is now under the management of the Quincy Housing Authority and all controls and processes have been updated to account for the needs of the Holbrook Housing Authority, including internal controls over financial reporting, documentation retention, and timeliness of reporting. Planned Implementation Date of Corrective Action: June 30, 2024 Person Responsible for Corrective Action: James Marathas, Executive Director
The College will retain all procurement documentation going forward.
The College will retain all procurement documentation going forward.
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