Corrective Action Plans

Finding 478931 (2023-017)

Significant Deficiency 2023

MA

Questioned Costs Subrecipient Monitoring Reporting § 200.303

DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION 2023-017 Title I Grants to Local Educational Agencies – Assistance Listing No. 84.010 Action taken in response to the finding: In FY24, internal controls and procedures were implemented to ensure that all required subawards are reported timely to FSR...

DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION 2023-017 Title I Grants to Local Educational Agencies – Assistance Listing No. 84.010 Action taken in response to the finding: In FY24, internal controls and procedures were implemented to ensure that all required subawards are reported timely to FSRS no later than the end of the month following the month of issuance. Name of the contact person responsible for corrective action: Robert Curtain, Chief Officer for Data and Accountability Planned completion date for corrective action plan: July 1, 2023

View Audit 315520

Finding 478930 (2023-016)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Eligibility Questioned Costs Significant Deficiency § 200.303

EXECUTIVE OFFICE OF HOUSING AND LIVABLE COMMUNITIES 2023-016 COVID-19 – Emergency Rental Assistance Program – Assistance Listing No. 21.023 Action taken in response to the finding: EOHLC has notified Nan McKay of the income ineligibility. Nan McKay and EOHLC agreed with the finding. In February 202...

EXECUTIVE OFFICE OF HOUSING AND LIVABLE COMMUNITIES 2023-016 COVID-19 – Emergency Rental Assistance Program – Assistance Listing No. 21.023 Action taken in response to the finding: EOHLC has notified Nan McKay of the income ineligibility. Nan McKay and EOHLC agreed with the finding. In February 2024 Nan McKay sent payment recoupment letters to the landlord and the utility company to attempt to recoup the funds paid on behalf of an ineligible household. EOHLC met with Nan McKay leadership staff on 04/18/2024 to review income eligibility steps for emergency rental assistance programs. Name of the contact person responsible for corrective action: Amy Mullen Planned completion date for corrective action plan: April 18, 2024

View Audit 315520 Questioned Costs: $1

Finding 478929 (2023-015)

Material Weakness 2023

Commonwealth of Massachusetts

MA

Subrecipient Monitoring § 200.303 § 200.332

EXECUTIVE OFFICE OF HOUSING AND LIVABLE COMMUNITIES 2023-015 COVID-19 – Emergency Rental Assistance Program – Assistance Listing No. 21.023 Action taken in response to the finding: The Emergency Rental Assistance Program (ERA or ERAP) was a temporary program relating to the COVID-19 emergency which...

EXECUTIVE OFFICE OF HOUSING AND LIVABLE COMMUNITIES 2023-015 COVID-19 – Emergency Rental Assistance Program – Assistance Listing No. 21.023 Action taken in response to the finding: The Emergency Rental Assistance Program (ERA or ERAP) was a temporary program relating to the COVID-19 emergency which was administered by the Executive Office of Housing and Livable Communities (EOHLC), formerly the Department of Housing and Community Development (DHCD or Department). Most of the ERA contracts that are still in place will be ending as of 6/30/2024. In the event that EOHLC’s ERA contracts are extended or renewed before the performance period ends, EOHLC will amend the contracts to include a reference to the required information. EOHLC is committed to reviewing internal controls and procedures and making the enhancements that are necessary to ensure that required information is included in its subawards going forward. Name of the contact person responsible for corrective action: Henok Teffera Planned completion date for corrective action plan: July 1, 2024

View Audit 315520

Finding 478926 (2023-014)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Matching / Level of Effort / Earmarking Questioned Costs § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-014 WIOA Cluster– Assistance Listing No. 17.258, 17.259, 17.278 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior audit findings related to Federal Financial Repor...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-014 WIOA Cluster– Assistance Listing No. 17.258, 17.259, 17.278 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior audit findings related to Federal Financial Reports (FFR). Prior audit findings were a result of extraordinary turnover within EOLWD’s Finance Office, which resulted in having no staff who were fully dedicated to filing Federal Financial Reports (FFR). The CAP included: (1) filling vacant positions; (2) training new staff in the federal reporting process and requirements; (3) automating business practices; and (4) drafting and implementing an FFR Standard Operating Procedure (SOP). The first three corrective actions identified in the CAP were implemented in FY 2023. The SOP for Federal Financial Reporting was developed in FY 2023 and implemented in FY 2024. The necessary controls for ensuring ETA 9130 reports reflect earmarking requirements and are accurately supported by documentation that support reported balances were implemented with the implementation of the FFR SOP in FY 2024. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: October 1, 2023

View Audit 315520

Finding 478923 (2023-013)

Material Weakness 2023

Commonwealth of Massachusetts

MA

Questioned Costs Subrecipient Monitoring Material Weakness § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-013 WIOA Cluster– Assistance Listing No. 17.258, 17.259, 17.278 Action taken in response to the finding: EOLWD Finance is drafting a Standard Operating Procedure (SOP) that includes the necessary controls to ensure subawards subject to Federa...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-013 WIOA Cluster– Assistance Listing No. 17.258, 17.259, 17.278 Action taken in response to the finding: EOLWD Finance is drafting a Standard Operating Procedure (SOP) that includes the necessary controls to ensure subawards subject to Federal Funding Accountability and Transparency Act (FFATA) reporting are reviewed, approved, and submitted timely to FSRS. EOLWD Finance will also conduct training for staff. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: July 1, 2024

View Audit 315520

Finding 478918 (2023-012)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Subrecipient Monitoring Reporting § 200.303 § 200.331 § 200.332 § 200.513 § 200.521

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-012 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: The corrective action plan (CAP) for this finding was implemented and completed in Fiscal Y...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-012 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: The corrective action plan (CAP) for this finding was implemented and completed in Fiscal Year 2023 with the addition of the FAIN numbers to the subawards and the completion of FY23 CommCorp monitoring. MDCS continues to include FAIN as part of the revised documented process and monitoring is current and timely performed. MDCS therefore considers this item to be completed and closed. Name of the contact person responsible for corrective action: Michael Williams, Director of Field management and Oversight Planned completion date for corrective action plan: December 31, 2022

View Audit 315520

Finding 478913 (2023-011)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Questioned Costs Reporting Significant Deficiency § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-011 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior aud...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-011 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior audit findings related to Federal Financial Reports (FFR). Prior audit findings were a result of extraordinary turnover within EOLWD’s Finance Office, which resulted in having no staff who were fully dedicated to filing Federal Financial Reports (FFR). The CAP included: (1) filling vacant positions; (2) training new staff in the federal reporting process and requirements; (3) automating business practices; and (4) drafting and implementing an FFR Standard Operating Procedure (SOP). The first three corrective actions identified in the CAP were implemented throughout FY 2023. The SOP for Federal Financial Reporting was developed throughout FY 2023 and implemented in FY 2024. The necessary controls for ensuring that ETA 9130 reports reflect earmarking requirements and are accurately supported by documentation that support reported balances were implemented with the implementation of the FFR SOP in FY 2024. In addition, the automated business practices cited in the CAP were refined throughout FY 2023 to ensure data in supporting documentation correlates to what is reported on an ETA 9130 report. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: October 1, 2023

View Audit 315520

Finding 478908 (2023-010)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Allowable Costs / Cost Principles Questioned Costs § 200.303 § 200.430

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-010 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: EOLWD Budget and Human Resources (HR) will update procedures and controls to ensure all new...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-010 WIOA Cluster, Employment Service Cluster – Assistance Listing No. 17.258, 17.259, 17.278, 17.207, 17.801 Action taken in response to the finding: EOLWD Budget and Human Resources (HR) will update procedures and controls to ensure all new staff are notified and trained to comply with entering Self-Service Time and Attendance (SSTA) combination codes on their timesheets. As programs are assigned unique combination codes, EOLWD Budget and HR will annually remind staff that SSTA combination codes are required when entering timesheets and, if none are entered, timesheet approvers are required to reject timesheets and notify staff to comply with the requirement. Additionally, a weekly Data Mart report will be created to identify timesheets entered without SSTA combination codes so HR can send notifications to staff to update timesheets for compliance. Name of the contact person responsible for corrective action: Steve J. Wong, Budget Director, and Cheryl Stanton, Secretariat Human Resources Officer Planned completion date for corrective action plan: December 31, 2024

View Audit 315520 Questioned Costs: $1

Finding 478906 (2023-009)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Reporting § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-009 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior audit findings related to Federal Financia...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-009 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented to address prior audit findings related to Federal Financial Reports (FFR). Prior audit findings were a result of extraordinary turnover within EOLWD’s Finance Office, which resulted in having no staff who were fully dedicated to filing Federal Financial Reports (FFR). The CAP included: (1) filling vacant positions; (2) training new staff in the federal reporting process and requirements; (3) automating business practices; and (4) drafting and implementing an FFR Standard Operating Procedure (SOP). The first three corrective actions identified in the CAP were implemented during FY 2023. The SOP for Federal Financial Reporting was developed in FY 2023 and implemented in FY 2024. The necessary controls for ensuring VETS-402(A/B) reports are accurately supported by documentation that support reported balances were implemented with the implementation of the FFR SOP in FY 2024. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: October 1, 2023

View Audit 315520

Finding 478904 (2023-008)

Material Weakness 2023

Commonwealth of Massachusetts

MA

Matching / Level of Effort / Earmarking § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-008 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: The MassHire Department of Career Services (MDCS) budgets WIOA Adult, Youth, and Dislocated Worker funds in accordance with the De...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-008 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: The MassHire Department of Career Services (MDCS) budgets WIOA Adult, Youth, and Dislocated Worker funds in accordance with the Department of Labor’s (DOL) earmarking requirements. This finding is a result of reporting deficiencies cited in the FY 2022 audit. The FY 2022 audit findings were a result of extraordinary turnover within EOLWD’s Finance Office, which resulted in having no staff fully dedicated to filing Federal Financial Reports (FFR). In FY 2023, a Corrective Action Plan (CAP) was drafted and implemented by new staff to address the FY 2022 findings related to reporting. The CAP included developing a Standard Operating Procedure (SOP) for Federal Financial Reports, which was done throughout FY 2023. The SOP was implemented in September of 2023, and should resolve the underlying reporting issues that resulted in this finding. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: October 1, 2023

View Audit 315520

Finding 478902 (2023-007)

Material Weakness 2023

Commonwealth of Massachusetts

MA

Questioned Costs Subrecipient Monitoring Material Weakness § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-007 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: EOLWD Finance is drafting a Standard Operating Procedure (SOP) that includes the necessary controls to ensure subawards subject to...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-007 Employment Service Cluster – Assistance Listing No. 17.207, 17.801 Action taken in response to the finding: EOLWD Finance is drafting a Standard Operating Procedure (SOP) that includes the necessary controls to ensure subawards subject to Federal Funding Accountability and Transparency Act (FFATA) reporting are reviewed, approved, and submitted timely to FSRS. EOLWD Finance will also conduct training for staff. Name of the contact person responsible for corrective action: Malachy Rice, Director of Federal Grants Management Planned completion date for corrective action plan: July 1, 2024

View Audit 315520

Finding 478900 (2023-006)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Questioned Costs Special Tests & Provisions Significant Deficiency § 200.303

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-006 Unemployment Insurance, COVID-19 – Unemployment Insurance – Assistance Listing No. 17.225 Action taken in response to the finding: While Massachusetts BAM unit (MBAM) had been making progress in meeting timeliness deadlines, it began suff...

EXECUTIVE OFFICE OF LABOR AND WORKFORCE DEVELOPMENT 2023-006 Unemployment Insurance, COVID-19 – Unemployment Insurance – Assistance Listing No. 17.225 Action taken in response to the finding: While Massachusetts BAM unit (MBAM) had been making progress in meeting timeliness deadlines, it began suffering setbacks in or around July 2022. MBAM was experiencing difficulties with the SUN server not accepting data and the system adding additional edits that should not have existed. Consistent work with the USDOL Hotline resolved the issues and/or created workarounds. Ultimately the SUN server failed after degrading for a year. The server was unavailable for use sporadically through the year and for four full separate weeks in May, June, and July 2023. Not only were staff unable to submit DCI data but it took additional organizational work of handling unentered cases, additional time to work with the Hotline and test fixes, while needing additional steps to implement work arounds for items that could not be fixed. MBAM continues to utilize work arounds for BAM data entry. Since SWA’s SUN server has become functional again, MBAM has been improving timeliness. MBAM also continues to work with ETA Hotline to report and resolve defects within the SUN system. MBAM management also developed an organizational strategy for the unit to provide its investigators with weekly updates on what cases should be worked on based on batch due dates. A case status report has been developed to provide unit supervisors with the status of each case assigned, expected date of completion, work completed to date on case, and cause for delay. Additionally, MBAM management has developed in-house reporting to track individual investigators. The reports track each investigator, telling management the number of cases closed each week and tracking the aging of Investigations. The manager uses these reports to identify cases to be prioritized based on aging and to quickly identify if a specific investigator is lagging in their case closure. Based on performance, the Manager has coaching sessions with individual investigators a minimum of every two weeks where work prioritization, organization, and any other additional necessary issues are reviewed and discussed. A meeting with all investigators is held weekly to provide education, discuss change to policy/procedure, and provide an open forum for BAM program implementation questions. Monitoring also occurs at the end of each quarter. Based on outcome, discussion of weaknesses and development of new levels of support are discussed and implemented. Name of the contact person responsible for corrective action: Susan Saulnier, Director of UI Performs Planned completion date for corrective action plan: September 30, 2024

View Audit 315520

Finding 478898 (2023-005)

Material Weakness 2023

Commonwealth of Massachusetts

MA

Subrecipient Monitoring Period of Performance § 200.1 § 200.303 § 200.332 § 200.414

DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION 2023-005 Child and Adult Care Food Program – Assistance Listing No. 10.558 Action taken in response to the finding: The Office for Food and Nutrition Programs (FNP) has moved from a paper based permanent agreement to a web form that exists on the DES...

DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION 2023-005 Child and Adult Care Food Program – Assistance Listing No. 10.558 Action taken in response to the finding: The Office for Food and Nutrition Programs (FNP) has moved from a paper based permanent agreement to a web form that exists on the DESE Security Portal. All existing and new Child Nutrition Sponsors will continue to sign off on the document via the web-based portal allowing for a more efficient collection and document retention process. A change will be made in the portal to automatically apply a DESE signature upon submission of the permanent agreement to avoid a late DESE signature. Name of the contact person responsible for corrective action: Rob Leshin, Director of FNP Planned completion date for corrective action plan: July 1, 2024

View Audit 315520

Finding 478897 (2023-004)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Subrecipient Monitoring § 200.303 § 200.332

DEPARTMENT OF ELEMENTARY PUBLIC HEALTH 2023-004 WIC Special Supplemental Nutrition Program for Women, Infants, and Children – Assistance Listing No. 10.557 Action taken in response to the finding: DPH will continue to automatically generate a subrecipient notification whenever federal funding amoun...

DEPARTMENT OF ELEMENTARY PUBLIC HEALTH 2023-004 WIC Special Supplemental Nutrition Program for Women, Infants, and Children – Assistance Listing No. 10.557 Action taken in response to the finding: DPH will continue to automatically generate a subrecipient notification whenever federal funding amounts change. However, because FAIN# and grant award date information is not currently available through our automated systems, we will require bureaus to include a contract attachment that includes this information. The state’s current accounting system is being replaced by a new system, with improved grant functionalities. If the FAIN# and grant award information is available through this system, DPH will be able to add these data to our automatically generated subrecipient notification in the future. Name of the contact person responsible for corrective action: Sharon Dyer, Director Purchase of Service Office Planned completion date for corrective action plan: September 30, 2024

View Audit 315520

Finding 478896 (2023-003)

Significant Deficiency 2023

Commonwealth of Massachusetts

MA

Allowable Costs / Cost Principles Subrecipient Monitoring Period of Performance § 200.303 § 200.308 § 200.309 § 200.403

DEPARTMENT OF ELEMENTARY PUBLIC HEALTH 2023-003 WIC Special Supplemental Nutrition Program for Women, Infants, and Children – Assistance Listing No. 10.557 Action taken in response to the finding: The Department and the WIC Nutrition Program will have all fiscal staff review the Operating Procedur...

DEPARTMENT OF ELEMENTARY PUBLIC HEALTH 2023-003 WIC Special Supplemental Nutrition Program for Women, Infants, and Children – Assistance Listing No. 10.557 Action taken in response to the finding: The Department and the WIC Nutrition Program will have all fiscal staff review the Operating Procedures to refresh themselves of the procedures surrounding Purchase Orders and Expenditures. (Excerpt from Operating Procedures) All Staff should complete a “Request for Purchase” form with all pertinent information such as quotes, renewal notices, conference registration, etc. and submit it to supervisor or Director for initial approval. Once the request is approved, the form is given to a fiscal staff to start the process of encumbering funds through MMARS and preparing a PURCHASE ORDER. At the very least, staff will identify that the service performed is correct and that funds are available and already encumbered to process the payment. All federal payments require a Program Code, and so the fiscal staff need to be sure the appropriate one is entered based on the dates of service or the date of the Purchase Order. Once all documents have been uploaded and submitted, then either the WIC State Director or the Fiscal Director will need to electronically approve the transaction in the Tracking System. The Fiscal Director and the State Director will more thoroughly review the assignment of Program Codes as they pertain to the Federal grant award dates before approving payment documents. This review will involve verifying: • The type of service • Date of service or receipt of item • Date of Purchase Order • Program Codes Name of the contact person responsible for corrective action: Beverly Andrew and Rachel Colchamiro Planned completion date for corrective action plan: April 30, 2024

View Audit 315520

Finding 478877 (2023-001)

Significant Deficiency 2023

Housing Authority of the City of Seattle

WA

Allowable Costs / Cost Principles Questioned Costs Reporting § 200.303 § 200.430

Moving to Work Demonstration Program – Assistance Listing No. 14.881 Recommendation: We recommend the Authority implements an adequate review process to ensure costs charged to the grant are reasonable, accurate, and properly allocated. We recommend the Authority perform and document this review qua...

Moving to Work Demonstration Program – Assistance Listing No. 14.881 Recommendation: We recommend the Authority implements an adequate review process to ensure costs charged to the grant are reasonable, accurate, and properly allocated. We recommend the Authority perform and document this review quarterly at minimum. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: Budget division will continue to send an annual summary at the beginning of the fiscal year for all employees who have split funding for federal and non-federal funds. During the MSS process there will be a coding added if the payroll certification is required by a comment in the system. Monthly the Budget and Payroll Division will have a monthly review of all MSS employee changes during the month to evaluate the payroll certifications for the changes are accurate. Name(s) of the contact person(s) responsible for corrective action: Jared Cummer, CFO and Olivia Hunsinger, Controller Planned completion date for corrective action plan: Progress has been made and full completion is expected 06/30/2024.

View Audit 315516 Questioned Costs: $1

Finding 478779 (2023-010)

Significant Deficiency 2023

Alameda Health System, A Public Hospital Authority

CA

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that required reports are prepared and reviewed by separate individuals. Documentation will be mai...

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that required reports are prepared and reviewed by separate individuals. Documentation will be maintained by the program to evidence preparation and review processes and timely filing of required reports.

View Audit 315421

Finding 478777 (2023-008)

Significant Deficiency 2023

Alameda Health System, A Public Hospital Authority

CA

Allowable Costs / Cost Principles § 200.303

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to prevent duplicate transactions from being charged to the program.

View Audit 315421

Finding 478774 (2023-005)

Significant Deficiency 2023

Alameda Health System, A Public Hospital Authority

CA

Reporting Significant Deficiency Matching / Level of Effort / Earmarking § 200.303

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that required reports are prepared and reviewed by separate individuals. Documentation will be mai...

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that required reports are prepared and reviewed by separate individuals. Documentation will be maintained by the program to evidence preparation and review processes and timely filing of required reports.

View Audit 315421

Finding 478773 (2023-004)

Significant Deficiency 2023

Alameda Health System, A Public Hospital Authority

CA

Matching / Level of Effort / Earmarking § 200.303

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will implement policies and procedures to ensure earmarking requirements are completed and evidence of review documented.

View Audit 315421

Finding 478772 (2023-003)

Significant Deficiency 2023

Alameda Health System, A Public Hospital Authority

CA

HUD Housing Programs Reporting Significant Deficiency § 200.303

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that performance reports are prepared and reviewed by separate individuals. Documentation will be ...

Views of Responsible Officials and Planned Corrective Action: Management agrees with the finding. The Health System will review, modify, and implement policies and procedures over the program to ensure that performance reports are prepared and reviewed by separate individuals. Documentation will be maintained by the program to evidence preparation and review processes and timely filing of annual report.

View Audit 315421

Finding 478710 (2023-002)

Significant Deficiency 2023

Douglas County Government

CO

Reporting Allowable Costs / Cost Principles Period of Performance § 200.303

2023-002 Finding: Allowable Costs and Allowable Activities Status: Corrective action in progress Criteria: According to 2 CFR Part 200.303 - The non-Federal entity must (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Feder...

2023-002 Finding: Allowable Costs and Allowable Activities Status: Corrective action in progress Criteria: According to 2 CFR Part 200.303 - The non-Federal entity must (a) Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). (b) Comply with the U.S. Constitution, Federal statutes, regulations, and the terms and conditions of the Federal awards. (c) Evaluate and monitor the non-Federal entity's compliance with statutes, regulations and the terms and conditions of Federal awards Condition: During testing, we noted that one transaction totaling $1,501,269 related to 2022 activities and was included as an expenditure on the fiscal year 2023 Schedule of Expenditures of Federal Awards. The period of performance for the project began in 2022 and extended through 2023. Corrective Action: To facilitate more accurate and timelier grant reporting the following improvements are proposed: 1. Increased grant training for all departments. The Engineering Department is bringing in CDOT to do this, last year Forvis Mazars provided countywide training and the Finance Department will provide additional training on an ad hoc basis. A full understanding of the requirements of the grants that are being applied for is crucial. 2. Departments receiving grants will provide monthly reconciliations of all grants and provide grant agreements to the Finance Department to ensure accurate reporting on the SEFA (Schedule of Expenditures of Federal Awards). 3. Effective communication is essential to successful reporting and the Finance Department will formalize meetings with departments to address issues that surface and reporting expectations. Person(s) Responsible for Implementation: Jill Janz – Accounting Manager, Christie Guthrie – Assistant Finance Director Implementation Date: 6/1/24 and ongoing

View Audit 315378

Finding 478672 (2023-001)

Material Weakness 2023

Centro Legal De La Raza

CA

Questioned Costs Cash Management Reporting § 200.303

CORRECTIVE ACTION PLAN Summary Schedule of Current Year Audit Findings In accordance with Title 2 CFR 200 Uniform Administrative Requirements, Cost Principles and Audit Requirements under Section 200.511, Audit Findings follow-up, the following detail the summary of current year audit findings (and ...

CORRECTIVE ACTION PLAN Summary Schedule of Current Year Audit Findings In accordance with Title 2 CFR 200 Uniform Administrative Requirements, Cost Principles and Audit Requirements under Section 200.511, Audit Findings follow-up, the following detail the summary of current year audit findings (and the related corrective action plan) is presented below: Finding 2023-001: Inadequate Financial Reporting Condition: The tracking of eligible (billable) costs within the accounting system was inadequate and required a significant amount of work to generate reconciliations of billable costs to contract billings. In additional certain grants were inconsistently reflected as restricted or conditional compared to similar grants. As part of the process to review year end, management identified errors which required adjustments, the most common of which was adjusting revenue between restricted and conditional revenue. Criteria: CFR 200.303, Internal Controls, states that the non-Federal entity must: Establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States or the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). Additionally, management is responsible for the preparation and fair presentation of the financial statements in accordance with accounting principles generally accepted in the United States of America; this includes the design, implementation and maintenance of internal control relevant to the preparation and fair presentation of financial statements that are free from material misstatement, whether due to fraud or error. Cause: The Organization did not have in place a formal, clear system which reconciled the billings to the funders and related eligible costs or releases related to certain restricted grants. Effect: Significant adjustments were proposed by management during the audit, principally between conditional and restricted revenue. Recommendation: We strongly recommend that all costs are coded directly to a contract within the accounting system and on a monthly or quarterly (at a minimum) basis there is a reconciliation of the billings between the funders and the revenue/costs related to the contracts to assure that all costs have been capture for billings and releases from restrictions. We also recommend detailed reviews/approvals of such reconciliations be performed. Questioned Costs: None identified. Context: While performing initial audit procedures, we requested management to perform a reconciliation of billings and related costs and review its recording of restricted and conditional grants. During management review, errors were identified by management and requested to be corrected. The condition noted is deemed to be systemic in nature. We did not identify any misstatements during our audit once the review was completed by management. Identification as a Repeat Finding: This is not a repeat finding. Management Views and Corrective Action Plan: Management agrees with the finding and recommendation. The Organization implemented a new accounting system effective July 1, 2023, in which substantially all costs are now coded to respective contracts which will provide much easily generatable support for billings. Management is working with the accounting team to implement a new process as part of the monthly closing procedures in which for cost reimbursement contacts there will be a review of revenue compared to costs to ascertain that the billing is accurate and complete. Name and Title of Responsible Official: Eos de Feminis, Interim CFO Planned Completion Date: Completed

View Audit 315304

Finding 478631 (2023-002)

Material Weakness 2023

Nexus Family Healing

MN

School Nutrition Programs Allowable Costs / Cost Principles Reporting § 200.303

Corrective Action Plan: Review and approval of invoices, meal count sheets, and reimbursement requests will be more closely monitored, and leadership will continue to engage and teach agency staff to follow existing policies to assure compliance. No further policy revisions are necessary. Staff trai...

Corrective Action Plan: Review and approval of invoices, meal count sheets, and reimbursement requests will be more closely monitored, and leadership will continue to engage and teach agency staff to follow existing policies to assure compliance. No further policy revisions are necessary. Staff training will be strengthened. Responsible Individuals: Dr. Kenneth D. Varble – Vice President of Accounting Anticipated Completion Date: December 2024

View Audit 315245

Finding 478425 (2023-005)

Material Weakness 2023

Cottrellville Township

MI

Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking Procurement, Suspension & Debarment § 200.302 § 200.303 § 200.305 § 200.318 § 200.319

Management agrees with the finding. Our current federal project is substantially completed, however, should the Township receive additional federal grants, the Township will adopt the required written procedures. The anticipated completion date is prior to receiving another federal award.

View Audit 315126

Corrective Action Plans

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