Corrective Action Plans

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Finding Number: 2025-003 Planned Corrective Action: We concur with the finding. We will continue with retaining documentation of sliding scale determination electronically. The CFO will continue to monitor whether the record retention policy is being followed. Anticipated Completion Date: On-going R...
Finding Number: 2025-003 Planned Corrective Action: We concur with the finding. We will continue with retaining documentation of sliding scale determination electronically. The CFO will continue to monitor whether the record retention policy is being followed. Anticipated Completion Date: On-going Responsible Contact Person: Cynthia Diaz, Finance Administrator
Finding Number: 2025-002 Planned Corrective Action: We concur with the finding. We will continue to monitor our federal grant cash requirements and seek additional cash flow when governmental environment changes. The Finance Administrator will continue to monitor cash flow requirements to mitigate c...
Finding Number: 2025-002 Planned Corrective Action: We concur with the finding. We will continue to monitor our federal grant cash requirements and seek additional cash flow when governmental environment changes. The Finance Administrator will continue to monitor cash flow requirements to mitigate cash advances to ensure timely federal grant cash remittance policies are being followed. Anticipated Completion Date: On-going Responsible Contact Person: Cynthia Diaz, Finance Administrator
Finding Number: 2025-001 Planned Corrective Action: We concur with the finding. We will be meeting with the auditors and the Financial Eligibility staff to monitor the calculation of patient sliding scale levels and put in place additional monitoring checks to ensure correct application of discount ...
Finding Number: 2025-001 Planned Corrective Action: We concur with the finding. We will be meeting with the auditors and the Financial Eligibility staff to monitor the calculation of patient sliding scale levels and put in place additional monitoring checks to ensure correct application of discount to patients. The Finance Administrator will continue to monitor whether the monitoring policies are being followed. Anticipated Completion Date: On-going Responsible Contact Person: Cynthia Diaz, Finance Administrator
Finding 2025-001: Eligibility Recommendation: We recommend that management establish and implement formal policies and procedures for the administration of the FSEOG program, including clear guidance on the minimum and maximum award limits in accordance with federal regulations. Management should al...
Finding 2025-001: Eligibility Recommendation: We recommend that management establish and implement formal policies and procedures for the administration of the FSEOG program, including clear guidance on the minimum and maximum award limits in accordance with federal regulations. Management should also provide adequate training to Financial Aid Office personnel on applicable federal requirements, perform supervisory reviews of award calculations prior to disbursement, and conduct periodic monitoring to ensure ongoing compliance with established limits. Response: The College acknowledges the findings resulting from the initial year of the Federal Supplemental Educational Opportunity Grant (FSEOG) program's implementation. The College recognizes that the finding resulted from deficiencies in newly implemented award procedures during the first year of the FSEOG program. In light of this, we wish to provide context regarding the situation and the corrective actions undertaken to address the issue. The seven students identified in this finding were awarded FSEOG funds that reflected their significant financial need and the institution's commitment to enabling students to cover both direct and indirect enrollment costs. An internal review conducted by the Financial Aid Office revealed that these awards inadvertently exceeded the $4,000 annual maximum established by program regulations. Following this internal review, prompt corrective measures were enacted, culminating in the issuance of a formal memorandum to the Comptroller in October of FY26. This memorandum directed adjustments to the affected students’ FSEOG awards to ensure compliance with the prescribed annual maximum. This internal monitoring process underscores the College’s proactive commitment to program integrity and fiscal accountability. Furthermore, the unexpended funds were returned to the U.S. Department of Education during FY26. The College remains dedicated to the proper administration of the FSEOG program and has reinforced its internal review procedures. This includes conducting more frequent audits of award ceilings during active disbursement periods to prevent similar errors in future award years. To address the finding, the College will implement the following actions: 1. Establishment of Formal Policy and Standard Operating Procedures (SOPs): Within 30 days, the College will adopt and implement a dedicated section within the Financial Aid Policy and Procedures Manual specifically for the FSEOG program. This document will delineate federal award limitations, selection criteria based on exceptional financial need groupings, and compliance parameters in accordance with 34 CFR 676.20. 2. Staff Training and Competency Review: Prior to the next award cycle, the College will conduct a mandatory training workshop for all counselors and processing staff within the Financial Aid Office. This training will emphasize the identification of the FSEOG-eligible student population, the applicable selection criteria, and the importance of cross-referencing final award packages. 3. Monitoring and Long-Term Quality Control: The College will implement a mandatory two-tiered verification process. Prior to any FSEOG batch disbursement being sent to the Office of the Comptroller for final payment execution, a senior financial aid officer or director must review and authorize a compliance checklist. This checklist will confirm that there are no boundary violations, and any batch disbursement package containing an amount below $100 or exceeding $4,000 per academic year will be flagged for review. Quarterly compliance reviews will be documented and retained as part of the College's internal control records to verify continued compliance with FSEOG award requirements and to provide supporting documentation for future audits. Primary Responsible Office: Director, Financial Aid Office Oversight Office: Vice President for Enrollment Management and Student Services Overall CAP Completion Target: Addressed in Dec 2026
Finding Reference Number: SA2025-001 Late Submission of FDS (Significant Deficiency) Contact Person: Raul Marquez, Accounting Supervisor Corrective Action Plan: Management will establish timelines and interim milestones for completion of the City’s Annual Comprehensive Financial Report (ACFR) that s...
Finding Reference Number: SA2025-001 Late Submission of FDS (Significant Deficiency) Contact Person: Raul Marquez, Accounting Supervisor Corrective Action Plan: Management will establish timelines and interim milestones for completion of the City’s Annual Comprehensive Financial Report (ACFR) that support timely completion and submission of the City’s audited FDS by the 3/31 deadline. Anticipated Completion Date: June 30, 2026
Name of Auditee: Central Falls Housing Authority Name of Audit Firm: EFPR Group, CPAs, PLLC Period Covered by the Audit: September 30, 2025 CAP Prepared by: Bridgett Duquette, Executive Director Phone: (401) 727-9090 (A) Current Finding on the Schedule of Findings and Questioned Costs (1) Finding 20...
Name of Auditee: Central Falls Housing Authority Name of Audit Firm: EFPR Group, CPAs, PLLC Period Covered by the Audit: September 30, 2025 CAP Prepared by: Bridgett Duquette, Executive Director Phone: (401) 727-9090 (A) Current Finding on the Schedule of Findings and Questioned Costs (1) Finding 2025-001 (a) Comments on the finding and recommendation - The Authority agrees with the finding. The Authority also agrees with the recommendations, please see below for action taken. (b) Action taken - The Authority will submit all required documentation to HUD. (c) Planned implementation date of corrective action - Completed by September 30, 2026.
Finding 2025-002 Federal Agency Name: U.S. Department of the Treasury Program Name: COVID-19 Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) Assistance Listing Number: 21.027 Finding Summary: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal cont...
Finding 2025-002 Federal Agency Name: U.S. Department of the Treasury Program Name: COVID-19 Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) Assistance Listing Number: 21.027 Finding Summary: 2 CFR 200.303(a) establishes that the auditee must establish and maintain effective internal control over the federal award that provides assurance that the entity is managing the federal award in compliance with federal statutes, regulations, and conditions of the federal award. Per 31 CFR 19.300, prior to enter in subawards and contracts with award funds, recipients must verify that such contractors and subrecipients are not suspended, debarred, or otherwise excluded pursuant to 31 CFR § 19.300. The County did not retain documentation of the verification that vendors were not suspended, debarred, or otherwise excluded prior to entering into a transaction with them. Responsible Individuals: Elijah Anderson, County Auditor Corrective Action Plan: Going forward, Taylor County will continue retaining documentation of the verification of vendors paid with federal funds against the sam.gov suspension and debarment review tool. Anticipated Completion Date: Completed
Corrective Action Planned: Due to the Authority's size, it is cost-prohibitive and impractical to achieve the ideal level of segregation of duties. The Authority has implemented as many controls and segregation of duties as practically possible for an organization of this size. Completion Date: Ongo...
Corrective Action Planned: Due to the Authority's size, it is cost-prohibitive and impractical to achieve the ideal level of segregation of duties. The Authority has implemented as many controls and segregation of duties as practically possible for an organization of this size. Completion Date: Ongoing
The City will establish a process of documenting the approval of submitted reports along with the source of information input into said reports.
The City will establish a process of documenting the approval of submitted reports along with the source of information input into said reports.
The City will establish a process of documenting the approval of submitted reports along with the source of information input into said reports. Additionally, the City will establish a more formalized process for reporting to help ensure more uniform timing on reporting.
The City will establish a process of documenting the approval of submitted reports along with the source of information input into said reports. Additionally, the City will establish a more formalized process for reporting to help ensure more uniform timing on reporting.
The Cutter Morning Star is deeply disappointed by the findings identified through the audit and review involving the former superintendent. The State Board determined that violations occurred involving district, state, and/or federal policies and laws, including failure to honestly report enrollment...
The Cutter Morning Star is deeply disappointed by the findings identified through the audit and review involving the former superintendent. The State Board determined that violations occurred involving district, state, and/or federal policies and laws, including failure to honestly report enrollment, misuse of public funds, and misuse of school property. These actions do not reflect the values, expectations, or standards of the district. The findings exposed the district to unnecessary risk and damaged the trust that the community places in its school leadership. The district remains committed to operating with integrity, transparency, accountability, and full compliance with all applicable laws and policies moving forward.
The Band has developed and initiated a procedure to subject all employees with access to vulnerable populations to be subjected to background investigations. The Band has instituted these procedures; however, they were initiated post the September 30, 2025 financial statements. OMB will continue to ...
The Band has developed and initiated a procedure to subject all employees with access to vulnerable populations to be subjected to background investigations. The Band has instituted these procedures; however, they were initiated post the September 30, 2025 financial statements. OMB will continue to monitor this process in a quarterly review with Human Resources.
The Band has added additional staff within its OMB to increase their ability to perform more thorough seperation of duties and more accurately process these submissions. A complete internal review of the Band's OMB policies and procedures is scheduled and expected completion is December 31, 2026.
The Band has added additional staff within its OMB to increase their ability to perform more thorough seperation of duties and more accurately process these submissions. A complete internal review of the Band's OMB policies and procedures is scheduled and expected completion is December 31, 2026.
Finding – 2025-003 Allowable Costs and Cost Principles and Activities Allowed and Unallowed – Significant Deficiency in Internal Controls Over Compliance Federal Program: Provider Relief Funds Assistance Listing Number: 93.498 Year(s): 2025 Federal Agency: US Department of Health and Human Services ...
Finding – 2025-003 Allowable Costs and Cost Principles and Activities Allowed and Unallowed – Significant Deficiency in Internal Controls Over Compliance Federal Program: Provider Relief Funds Assistance Listing Number: 93.498 Year(s): 2025 Federal Agency: US Department of Health and Human Services Corrective Action: The Division will enhance controls to ensure that documentation of cost review is retained and stored for audit purposes. The Division will continue to train field staff on the importance of document retention. 1. Internal process to be continued throughout FY 2026. 2. The program managers and/or contract billing specialist will save all work pertaining to an invoice/bill (i.e. monthly, quarterly, addendums, etc.) and electronically via email submit to program directors for review and approval before submission can proceed to granting agency to ensure accuracy and for contract fulfillment and requirements. 3. The program managers and/or contract billing specialist will save all documentation of the reviewed and submitted process to the regional internal digital file storage system, as well as send a copy of the finance department for review/approval/storage for audit purposes and the finance department will lastly make sure it is filled out and fulfills the requirement of the contract, as a last line of grant requirement fulfillment. 4. Continued training of field staff and program directors to occur. Anticipated Completion Date: 10/01/2026 Responsible Contact Person: Kendall Phillips, Grants & Contracts Accountant
Corrective Action Plan Year Ended September 30, 2025 Finding 2024-002 AL Numbers: 93.837 Program: National Heart, Lung and Blood Institute Correction Action: Brown Health management concurs with this finding. We have already initiated re-training at the department level. For fiscal year 2026, we wil...
Corrective Action Plan Year Ended September 30, 2025 Finding 2024-002 AL Numbers: 93.837 Program: National Heart, Lung and Blood Institute Correction Action: Brown Health management concurs with this finding. We have already initiated re-training at the department level. For fiscal year 2026, we will perform a detailed review of all salaries charged to federal grants to ensure there is no salary over the cap. Additionally, we will review automated control enhancements within our ERP system where possible to assist in recognizing compliance rules and/or enhance monitoring controls where possible. Contacts: Stephen Almonte, Vice President and Corporate Controller Salmonte3@brownhealth.org Bharat Ramratnam, MD, Senior Vice President of Research BRamratnam@brownhealth.org Planned Completion Date: October 31, 2026
Effective immediately, the Executive Director will conduct a mid-year review each June to confirm that the first required subrecipient monitoring has been completed, and ensuring the second monitoring is scheduled and completed prior to fiscal year-end.
Effective immediately, the Executive Director will conduct a mid-year review each June to confirm that the first required subrecipient monitoring has been completed, and ensuring the second monitoring is scheduled and completed prior to fiscal year-end.
FINDING 2025-003 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Suspension and Debarment Contact Person Responsible for Corrective Action: Ryan Schwab Contact Phone Number and Email Address: 260-338-2700; ryan.schwab@huntertown.in.gov Views of Responsible Officials: ...
FINDING 2025-003 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Suspension and Debarment Contact Person Responsible for Corrective Action: Ryan Schwab Contact Phone Number and Email Address: 260-338-2700; ryan.schwab@huntertown.in.gov Views of Responsible Officials: We concur with this finding Description of Corrective Action Plan: We intend to include a section in all future agreements with the town to confirm that contractors/vendors acknowledge their suspension and debarment status. These agreements and contracts will be signed and approved by multiple Town officials. Anticipated Completion Date: This adjustment to agreements and contracts will go into effect April 24, 2026.
FINDING 2025-002 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Reporting Contact Person Responsible for Corrective Action: Ryan Schwab Contact Phone Number and Email Address: 260-338-2700; ryan.schwab@huntertown.in.gov Views of Responsible Officials: We concur with ...
FINDING 2025-002 Finding Subject: COVID-19 - Coronavirus State and Local Fiscal Recovery Funds - Reporting Contact Person Responsible for Corrective Action: Ryan Schwab Contact Phone Number and Email Address: 260-338-2700; ryan.schwab@huntertown.in.gov Views of Responsible Officials: We concur with this finding Description of Corrective Action Plan: Prior to the submission of the P&E report, a copy will be printed and reviewed by another individual from our office (Town Manager or Utility Office Manager), or a member of our Town Council and that individual will initial or sign off on the document after their review. Anticipated Completion Date: This procedure will go into effect on June 1, 2026.
CFDA 10.558 — Child and Adult Care Food Program Finding Type: Noncompliance / Significant Deficiency Corrective Action Plan The YMCA acknowledges the finding related to missing participant eligibility documentation maintained by operating sites. Management has implemented the following corrective ac...
CFDA 10.558 — Child and Adult Care Food Program Finding Type: Noncompliance / Significant Deficiency Corrective Action Plan The YMCA acknowledges the finding related to missing participant eligibility documentation maintained by operating sites. Management has implemented the following corrective actions: 1. Establish standardized procedures requiring all operating sites to submit enrollment forms and Income Eligibility Forms prior to reimbursement claims being submitted. 2. Develop a monitoring checklist to verify that all required participant documentation is collected, complete, and retained. 3. Require monthly compliance reviews of participant files for each operating site. 4. Provide additional training to site administrators regarding CACFP eligibility documentation and retention requirements. Responsible Party Jeff Reynolds and Sonja Williams Expected Completion Date September 30, 2026
The Department of Behavioral Health (DBH) Office of the Chief Financial Officer (OCFO) concurs with this finding. FFATA Reporting Compliance: In February 2026, the DBH Grants Management Office created an FFATA procedure to ensure compliance with timely FFATA reporting. As a result of this finding, t...
The Department of Behavioral Health (DBH) Office of the Chief Financial Officer (OCFO) concurs with this finding. FFATA Reporting Compliance: In February 2026, the DBH Grants Management Office created an FFATA procedure to ensure compliance with timely FFATA reporting. As a result of this finding, the procedure has been updated to report bi-weekly rather than monthly to ensure reporting under 30 days. The GMO Director will also provide continuous training to staff outside of the GMO to ensure staffing will not become a barrier, as experienced in early 2026. As of June 1, 2026, all FFATA entries as of the May 25th purchase order (R071) report have been reported. Additionally, as we plan for the forthcoming electronic grants management system (eGMS) we’re in discussion to add a report feature that will provide needed info for FFATA entry i.e., UEI, FAIN, award amount and purchase order # to automate the process. SEFA Reporting Compliance: Prior to the submission of the SEFA, the grant expenditures will be reviewed with the Accounting Officer, The AFO, and the Grants Program Manager for a detailed review of the SEFA to confirm expenditures are correctly categorized by fund and grants, reconciles to the DIFS R019 report and reflects the amount expended for sub-recipients. Effective FY26, subrecipient totals are uniquely identified with an account number that will reflect in the R019 report as a subset of total expenditures. This report will be used to complete the SEFA going forward.
The Department of Behavioral Health (DBH) agrees with the findings and will put controls in place to resolve the issue. On May 20, 2026, DBH trained all grants staff on how to use combo codes in the timekeeping system (Peoplesoft) so that individuals whose time is split across grants or split betwee...
The Department of Behavioral Health (DBH) agrees with the findings and will put controls in place to resolve the issue. On May 20, 2026, DBH trained all grants staff on how to use combo codes in the timekeeping system (Peoplesoft) so that individuals whose time is split across grants or split between grant and local projects can record their time to each funding source. This new process will be rolled out starting June 12, 2026.
The Department of Behavioral Health (DBH) Office of the Chief Financial Officer (OCFO) concurs with this finding. FFATA Reporting Compliance: In February 2026, the DBH Grants Management Office created an FFATA procedure to ensure compliance with timely FFATA reporting. As a result of this finding, t...
The Department of Behavioral Health (DBH) Office of the Chief Financial Officer (OCFO) concurs with this finding. FFATA Reporting Compliance: In February 2026, the DBH Grants Management Office created an FFATA procedure to ensure compliance with timely FFATA reporting. As a result of this finding, the procedure has been updated to report bi-weekly rather than monthly to ensure reporting under 30 days. The GMO Director will also provide continuous training to staff outside of the GMO to ensure staffing will not become a barrier, as experienced in early 2026. As of June 1, 2026, all FFATA entries as of the May 25th purchase order (R071) report have been reported. Additionally, as we plan for the forthcoming electronic grants management system (eGMS) we’re in discussion to add a report feature that will provide needed info for FFATA entry i.e., UEI, FAIN, award amount and purchase order # to automate the process. SEFA Reporting Compliance: Prior to the submission of the SEFA, the grant expenditures will be reviewed with the Accounting Officer, The AFO, and the Grants Program Manager for a detailed review of the SEFA to confirm expenditures are correctly categorized by fund and grants, reconciles to the DIFS R019 report and reflects the amount expended for sub-recipients. Effective FY26, subrecipient totals are uniquely identified with an account number that will reflect in the R019 report as a subset of total expenditures. This report will be used to complete the SEFA going forward.
The Department of Human Services (DHS) agrees with the findings, and we’ll work with the DCAS and DICM teams to mitigate the causes of the findings. These findings are mostly residual issues with the tables in DHS/ESA DCAS system. ESA needs to enhance DCAS to tie the income evidence in the income su...
The Department of Human Services (DHS) agrees with the findings, and we’ll work with the DCAS and DICM teams to mitigate the causes of the findings. These findings are mostly residual issues with the tables in DHS/ESA DCAS system. ESA needs to enhance DCAS to tie the income evidence in the income support case to the employment evidence in the person record to allow the employment hours to end date once the income evidence is end dated. This would be automating the process by connecting the 2-step process into one task. This automation process would be a permanent solution to curbing stale and unsubstantiated hours from migrating to Q5i. DCWET will work with DICM to request that a JIRA ticket be created to enhance DCAS to tie the income evidence in the income support case to the employment evidence in the person record to allow the employment hours to end date once the income evidence is end dated. The ESA DPO needs to conduct staff training (re-training) of all SSR on the DCAS screens which require action to confirm employment. This means that the DPO should dedicate resources to providing adequate training to SSRs involved in updating customers’ employment information in DCAS. The DCWET Deputy Administrator will take the lead with the DPO counterpart to implement the necessary training starting before September 30, 2027.
The University of the District of Columbia (UDC) agrees with the conditions and recommendations of this finding. The Office of Financial Aid experienced staff turnover, which impacted the timeliness of reporting submissions to the Common Origination and Disbursement (COD) system. This challenge was ...
The University of the District of Columbia (UDC) agrees with the conditions and recommendations of this finding. The Office of Financial Aid experienced staff turnover, which impacted the timeliness of reporting submissions to the Common Origination and Disbursement (COD) system. This challenge was further compounded by the need to train and cross-train staff to ensure continuity in reporting responsibilities. To address this issue, the office has identified and trained two staff members who are capable of originating and submitting enrollment reporting to COD. Additionally, we have implemented enhanced internal controls, including weekly reporting processes, to ensure compliance with all required deadlines. These measures are designed to ensure that records are submitted within the mandated 15-day timeframe.
The Office of the Deputy Mayor for Planning and Economic Development (DMPED) concurs with the auditor’s findings and recommendations. Create clear communications and instructions for DMPED grant administrators to include as a required reporting responsibility. Add internal controls and policies that...
The Office of the Deputy Mayor for Planning and Economic Development (DMPED) concurs with the auditor’s findings and recommendations. Create clear communications and instructions for DMPED grant administrators to include as a required reporting responsibility. Add internal controls and policies that include a supervisory review of the report information before it is submitted to the System for Award Management (sam.gov) website.
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