Corrective Action Plans

Finding 563891 (2023-001)

Material Weakness 2023

NJ

Reporting

Criteria Management is responsible for timely and accurate financial reporting. Condition Identified: Various reconciliations, adjustments, and year-end close procedures were not completed in a timely and accurate manner, resulting in a delay in the completion of the annual audit and untimely filin...

Criteria Management is responsible for timely and accurate financial reporting. Condition Identified: Various reconciliations, adjustments, and year-end close procedures were not completed in a timely and accurate manner, resulting in a delay in the completion of the annual audit and untimely filing of the required Single Audit Data Collection Form. Corrective Action Plan • Implementation of a Year-End Close Calendar: Develop and adopt a comprehensive year-end close calendar with specific deadlines and responsibilities for each required task, including reconciliations, adjustments, and audit preparation. This calendar will be communicated to all relevant personnel at least 60 days before fiscal year-end. • Monthly Reconciliation Schedule: Enforce a standardized monthly reconciliation process for all key accounts (e.g., cash, receivables, payables, grants), to ensure that year-end tasks do not accumulate and can be completed efficiently and accurately. • Staff Training and Cross-Training: Provide targeted training for accounting and finance staff on proper reconciliation techniques, closing procedures, and audit requirements. Cross-training will also be provided to ensure continuity and reduce reliance on single individuals. • Audit Preparation Checklist: Create and utilize an internal audit prep checklist that is reviewed quarterly and finalized before year-end. This will ensure all necessary reports, schedules, and documentation are prepared well in advance of the auditor’s arrival. • Automation and Software Improvements: Evaluate and implement improvements in accounting software or systems to automate reconciliation reports and reduce the risk of manual errors. • Ongoing Monitoring: The Finance Director will perform monthly reviews of account reconciliations and quarterly mock close-outs to assess timeliness and accuracy. Issues will be flagged early for resolution. Responsible Person(s): Chief Executive Officer, Finance Director, & Senior Accountant Anticipated Completion Date: All corrective measures will be implemented (insert date) in preparation for the FY 2024 year-end.

View Audit 358094

Finding 563845 (2023-003)

Significant Deficiency 2023

Global Fund to End Modern Slavery

DC

Reporting Subrecipient Monitoring

2023-003 – Reporting Management’s Corrective Action Plan: The federal subaward in question had been mistakenly recorded as a non-USG government grant in the Fund's accounting records by previous Fund financial teams in 2022. As a result, it was omitted from the SEFA. This will not happen in 2024.

View Audit 358064

Finding 563841 (2023-004)

Significant Deficiency 2023

Global Fund to End Modern Slavery

DC

Allowable Costs / Cost Principles Matching / Level of Effort / Earmarking § 200.430

2023-004 – Allowable Costs relating to Time and Effort and Internal Controls Management’s Corrective Action Plan: Management agrees with the Federal award finding identified in the audit. We acknowledge that a few timesheets and spreadsheets were missing from appropriate files during a two-month p...

2023-004 – Allowable Costs relating to Time and Effort and Internal Controls Management’s Corrective Action Plan: Management agrees with the Federal award finding identified in the audit. We acknowledge that a few timesheets and spreadsheets were missing from appropriate files during a two-month period of transition at the Fund, while maintaining that proper allocation process was followed up to the point of record keeping. The Fund understands the reasons for the missing timesheets and that these cases were unique and not indicative of the normal and prevalent internal control over the completion and approval of timesheets. The allocation of payroll for the months tested were based on the consistent and correct application of the payroll costs allocation methodology however in a limited number of cases the allocation spreadsheets weren’t properly saved. After announcement of dissolution, there was considerable staff turnover and rapid transition which created challenges and delays. We did maintain an effective control environment. This has been resolved. Management is saving allocation spreadsheets, and other required documentation as per policy on an ongoing basis.

View Audit 358064

Finding 563840 (2023-002)

Significant Deficiency 2023

Global Fund to End Modern Slavery

DC

Subrecipient Monitoring Reporting § 200.512

2023-002 – Submission of Data Collection Form Management’s Corrective Action Plan: Management agrees with the finding identified in the audit. The constraint of finance staffing limitations pushed the issuance of the audited financial statements past the September 30, 2024 deadline. We anticipate ...

2023-002 – Submission of Data Collection Form Management’s Corrective Action Plan: Management agrees with the finding identified in the audit. The constraint of finance staffing limitations pushed the issuance of the audited financial statements past the September 30, 2024 deadline. We anticipate meeting any filing deadlines in the future.

View Audit 358064

Finding 563813 (2023-002)

Significant Deficiency 2023

Trinity Housing CORP of Greeley

CO

Subrecipient Monitoring

Name of auditee: Trinity Housing Corporation of Greeley HUD auditee identification number: 101-98145 Name of audit firm: Dauby O'Connor & Zaleski, LLC Period covered by the audit: Year ended October 31, 2023 CAP prepared by Name: Tashawndra Welch Position: Chief Financial Officer Tel...

Name of auditee: Trinity Housing Corporation of Greeley HUD auditee identification number: 101-98145 Name of audit firm: Dauby O'Connor & Zaleski, LLC Period covered by the audit: Year ended October 31, 2023 CAP prepared by Name: Tashawndra Welch Position: Chief Financial Officer Telephone number: 901-435-7764 Current Findings on the Schedule of Findings, Questioned Costs, and Recommendations Finding #2023-002 Comments on the Finding and Each Recommendation: The Corporation did not furnish Form SF-SAC Single Audit Data Collection Form for the years ended October 31, 2023 was not submitted to the federal audit clearinghouse in the required timeframe. Action(s) taken or planned on the finding: Management concurs with the finding and recommendation. The audited financial statements will be submitted to the federal audit clearinghouse.

View Audit 358034

Finding 563812 (2023-001)

Significant Deficiency 2023

Trinity Housing CORP of Greeley

CO

Questioned Costs Subrecipient Monitoring HUD Housing Programs

Name of auditee: Trinity Housing Corporation of Greeley HUD auditee identification number: 101-98145 Name of audit firm: Dauby O'Connor & Zaleski, LLC Period covered by the audit: Year ended October 31, 2023 CAP prepared by Name: Tashawndra Welch Position: Chief Financial Officer Tel...

Name of auditee: Trinity Housing Corporation of Greeley HUD auditee identification number: 101-98145 Name of audit firm: Dauby O'Connor & Zaleski, LLC Period covered by the audit: Year ended October 31, 2023 CAP prepared by Name: Tashawndra Welch Position: Chief Financial Officer Telephone number: 901-435-7764 Current Findings on the Schedule of Findings, Questioned Costs, and Recommendations Finding #2023-001 Comments on the Finding and Each Recommendation: For the year ended October 31, 2023, the Corporation paid management fees to the Agent in excess of the fees earned resulting in prepaid management fees of $8,370 at October 31, 2023. Action(s) taken or planned on the finding: The Corporation concurs with the finding and agrees with the auditor’s recommendation.

View Audit 358034 Questioned Costs: $1

Finding 563805 (2023-004)

Significant Deficiency 2023

Taylor Regional Hospital, Inc.

GA

Significant Deficiency Matching / Level of Effort / Earmarking

Taylor Regional Hospital (Hospital) respectfully submits the following corrective action plan for the year ended March 31, 2023. The findings from the March 31, 2023 Schedule of Findings and Questioned Costs is discussed below. The findings are numbered consistently with the numbers assigned in the ...

Taylor Regional Hospital (Hospital) respectfully submits the following corrective action plan for the year ended March 31, 2023. The findings from the March 31, 2023 Schedule of Findings and Questioned Costs is discussed below. The findings are numbered consistently with the numbers assigned in the schedule. FEDERAL AWARD PROGRAMS AUDIT FINDINGS Significant Deficiency (2023-004) Recommendation: The Hospital should immediately fund the Reserve Account to the proper funding level required by the USDA loan. Planned Corrective Action: The hospital agrees with this finding. See 2023-002.

View Audit 358013

Finding 563782 (2023-009)

Significant Deficiency 2023

County of Montgomery

PA

Questioned Costs Reporting § 200.303 § 200.502 § 200.510

2023-009- Reporting Federal Agency: U.S. Department of the Treasury Federal Program Name: American Rescue Plan Act / Coronavirus State Fiscal Recovery Fund (ARPA) Assistance Listing Number: 23.027 Federal Award Identification Number and Year: Various Pass-Through Agency: Pennsylvania Department of H...

2023-009- Reporting Federal Agency: U.S. Department of the Treasury Federal Program Name: American Rescue Plan Act / Coronavirus State Fiscal Recovery Fund (ARPA) Assistance Listing Number: 23.027 Federal Award Identification Number and Year: Various Pass-Through Agency: Pennsylvania Department of Health and Human Services Pass-Through Number(s): Not Available Award Period: 1/1/2023 – 12/31/23 Type of Finding: Significant Deficiency in Internal Control Over Compliance Condition: Policies and controls in place regarding the completeness of the SEFA were not properly functioning. Within the supporting listing of expenses relating to ARPA expenditures, multiple transactions were identified as 2022 fiscal year expenditures that were included in the 2023 expenditure total. The County revised the 2023 SEFA to exclude the 2022 expenditures. Recommendation: We recommend management should review the process of recording federal expenditures to determine expenditures are being included in the appropriate fiscal year. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned and taken in response to finding: The reason for the finding’s recurrence is in part a result of the timing of when the finding was issued. For example, the 2022 Single Audit was issued in August 2024. At this point, the 2023 fiscal year was already complete. Additionally, the implementation of corrective actions are in progress, including providing training, oversight and guidance to departments administering the grants, but these efforts take time to complete and/or are ongoing. A Deputy Controller of Grant Accounting was hired in February 2023, and a Manager-Grant Accounting was hired in July 2024, after working in this capacity as a temporary staff member since mid-2023. The County approved an additional full-time grant accounting position in May 2025 and will begin recruiting for this position in June 2025. These positions are responsible for establishing accounting policies based on best practices for grant-related activities, developing and providing training and resources to grant- funded departments, reviewing grant-related accounting in the Infor system, preparation of the annual SEFA, and assisting in the facilitation and preparation of documents needed for the Single Audit. The work performed by these positions had been vacant since the departure of Internal Audit Staff who helped General Accounting prior to the 2021 audit as well as the SEFA. Several changes have been made since the grant accounting team was created including the following: The grant accounting team is developing streamlined and standardized SEFA templates for each department for SEFA preparation. The expenditures reported on each SEFA are being compared to the financial information in the GL where possible to ensure all appropriate expenditures are included. Additionally, we are incorporating tracking of lifetime grant expenditures into the SEFA process to ensure no expenditures are missed due to cut off or timing issues. In 2023, the grant accounting team created a Montgomery County Grant Repository. This repository is used to store all grant agreements awarded to the County. Departments submit grant information to the repository upon notification of grant award. The grant accounting team reviews the Grant Repository when preparing the SEFA to ensure no grant programs are inadvertently left off of the SEFA. Additionally, the availability of the Grant Repository enables members of the accounting, finance and grant departments to quickly access grant award information when needed for audits, reporting, or other requirements. The grant accounting team is continuing to review and update the County’s Grant Accounting policies and is working closely with departments to understand their utilization of Infor to account for grant- related activities. As these policies are formalized, we will continue to provide training and resources; in late 2023, the County hired an outside trainer to provide an in-depth training on the accrual method of accounting, grant accruals, and the treatment of grant revenue. The Grant Accountant provided training in April 2024 to explain and outline the SEFA and Single Audit processes. Grant-funded departments received a two-day training on utilization of the Grant Management components of Infor in February 2024. We are also providing guidance and education to departments on the differences in timing of various grant fiscal years and how these impact the financial audit, SEFA and Single Audit. For example, departments must understand how to report expenditures and receipts in the correct period regardless of the fiscal year associated to the contract (State: July-June; Federal: October-September; County: January-December) and understand how these amounts reconcile to the amounts reported to the funding agencies. The accounting department continues to work with departments to emphasize the importance of submitting financial documentation timely and reviewing what is in the General Ledger promptly at the end of each month. The Finance department is performing quarterly reviews with departments to go over financial status, including grant financials. Departments are continuing to utilize Project Codes and other components of Infor’s Grant Management System to ensure the proper accounting of grant-related expenses, receipts, and revenues in the GL. Name(s) of the contact person(s) responsible for corrective action: Thomas Landauer and Fonta Reilly Planned completion date for corrective action plan: September 2025

View Audit 357994 Questioned Costs: $1

Finding 563779 (2023-008)

Significant Deficiency 2023

County of Montgomery

PA

Questioned Costs Reporting § 200.303 § 200.502 § 200.510

2023-008 – Reporting Federal Agency: U.S. Department of the Treasury Federal Program Name: Emergency Rental Assistance Program (ERAP) Assistance Listing Number: 23.023 Federal Award Identification Number and Year: Various Pass-Through Agency: Pennsylvania Department of Health and Human Services Pass...

2023-008 – Reporting Federal Agency: U.S. Department of the Treasury Federal Program Name: Emergency Rental Assistance Program (ERAP) Assistance Listing Number: 23.023 Federal Award Identification Number and Year: Various Pass-Through Agency: Pennsylvania Department of Health and Human Services Pass-Through Number(s): Not Available Award Period: 1/1/2023 – 12/31/23 Type of Finding: Significant Deficiency in Internal Control Over Compliance Condition: Policies and controls in place regarding the completeness of the SEFA were not properly functioning. Within the supporting listing of expenses relating to ERAP expenditures, six transactions were identified as prior fiscal-year expenditures that were included in the unadjusted 2023 expenditure total. The County revised the 2023 SEFA to exclude the 2022 expenditures. Recommendation: We recommend management should review the process of recording federal expenditures to determine expenditures are being included in the appropriate fiscal year. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned and taken in response to finding: The reason for the finding’s recurrence is in part a result of the timing of when the finding was issued. For example, the 2022 Single Audit was issued in August 2024. At this point, the 2023 fiscal year was already complete. Additionally, the implementation of corrective actions are in progress, including providing training, oversight and guidance to departments administering the grants, but these efforts take time to complete and/or are ongoing. A Deputy Controller of Grant Accounting was hired in February 2023, and a Manager-Grant Accounting was hired in July 2024, after working in this capacity as a temporary staff member since mid-2023. The County approved an additional full-time grant accounting position in May 2025 and will begin recruiting for this position in June 2025. These positions are responsible for establishing accounting policies based on best practices for grant-related activities, developing and providing training and resources to grant- funded departments, reviewing grant-related accounting in the Infor system, preparation of the annual SEFA, and assisting in the facilitation and preparation of documents needed for the Single Audit. The work performed by these positions had been vacant since the departure of Internal Audit Staff who helped General Accounting prior to the 2021 audit as well as the SEFA. Several changes have been made since the grant accounting team was created including the following: The grant accounting team is developing streamlined and standardized SEFA templates for each department for SEFA preparation. The expenditures reported on each SEFA are being compared to the financial information in the GL where possible to ensure all appropriate expenditures are included. Additionally, we are incorporating tracking of lifetime grant expenditures into the SEFA process to ensure no expenditures are missed due to cut off or timing issues. In 2023, the grant accounting team created a Montgomery County Grant Repository. This repository is used to store all grant agreements awarded to the County. Departments submit grant information to the repository upon notification of grant award. The grant accounting team reviews the Grant Repository when preparing the SEFA to ensure no grant programs are inadvertently left off of the SEFA. Additionally, the availability of the Grant Repository enables members of the accounting, finance and grant departments to quickly access grant award information when needed for audits, reporting, or other requirements. The grant accounting team is continuing to review and update the County’s Grant Accounting policies and is working closely with departments to understand their utilization of Infor to account for grant- related activities. As these policies are formalized, we will continue to provide training and resources; in late 2023, the County hired an outside trainer to provide an in-depth training on the accrual method of accounting, grant accruals, and the treatment of grant revenue. The Grant Accountant provided training in April 2024 to explain and outline the SEFA and Single Audit processes. Grant-funded departments received a two-day training on utilization of the Grant Management components of Infor in February 2024. We are also providing guidance and education to departments on the differences in timing of various grant fiscal years and how these impact the financial audit, SEFA and Single Audit. For example, departments must understand how to report expenditures and receipts in the correct period regardless of the fiscal year associated to the contract (State: July-June; Federal: October-September; County: January-December) and understand how these amounts reconcile to the amounts reported to the funding agencies. The accounting department continues to work with departments to emphasize the importance of submitting financial documentation timely and reviewing what is in the General Ledger promptly at the end of each month. The Finance department is performing quarterly reviews with departments to go over financial status, including grant financials. Departments are continuing to utilize Project Codes and other components of Infor’s Grant Management System to ensure the proper accounting of grant-related expenses, receipts, and revenues in the GL. Name(s) of the contact person(s) responsible for corrective action: Thomas Landauer and Fonta Reilly Planned completion date for corrective action plan: September 2025

View Audit 357994 Questioned Costs: $1

Finding 563695 (2023-007)

Significant Deficiency 2023

County of Montgomery

PA

Reporting Significant Deficiency Internal Control / Segregation of Duties

2023-007 – Completion and Submission of the Annual Single Audit Federal Agency: U.S. Department of Labor, U.S. Department of Transportation, U.S. Department of Health and Human Services and U.S. Department of Homeland Security Federal Program Name: Various Assistance Listing Numbers: 17.258, 17.259...

2023-007 – Completion and Submission of the Annual Single Audit Federal Agency: U.S. Department of Labor, U.S. Department of Transportation, U.S. Department of Health and Human Services and U.S. Department of Homeland Security Federal Program Name: Various Assistance Listing Numbers: 17.258, 17.259, 17.277, 17.278, 17.283, 20.205, 21.023, 21.027, 93.558, 93.959, 93.778, 97.036 Federal Award Identification Number and Year: Various Pass-Through Agency: Various Pass-Through Number(s): Various Award Period: 1/1/2023 – 12/31/23 Type of Finding: Other Matters and Significant Deficiency in Internal Control Over Compliance Condition: The County’s single audit and reporting package was delayed for the year ended December 31, 2023, beyond the due date. Recommendation: The County should evaluate its procedures around timely submission of the single audit. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action planned and taken in response to finding: The reason for the recurrence of the finding is in part a result of the timing of when the finding was issued. The 2023 ACFR was issued on February 14, 2025. The Single Audit began after that in late February 2025. At that point the 2023 Single Audit was already past the submission deadline. The County prioritized completion of the 2023 Single Audit and has allocated staff time from the Controller’s department and hired outside temporary professional staffing to complete the audit. Throughout the process, the Grant Accountant and Controller staff have facilitated communication and information between grant-funded departments and CLA resulting in a quick turnaround and completion of the Single Audit. Continued use of Infor’s grant management system and Project codes are increasing efficiency in accurately completing the SEFA and providing documentation as requested for programs being audited. The County began implementing a grant accounting system as part of our implementation of Infor in mid-2021 and are continuing to work with departments to refine their use of the systems. The County is working to compile information required for the 2024 ACFR, and the 2024 SEFA preparation is underway. To expedite this process, the County has engaged additional contract professional staff and is also in the process of hiring an additional full-time employee in the Grant Accounting area. Depending on external auditor availability and other Financial Audits being conducted, the 2024 SEFA will be complete and ready for review by August 2025, with a goal of timely completion of the 2024 Single Audit by the due date of September 30, 2025. Name(s) of the contact person(s) responsible for corrective action: Thomas Landauer and Fonta Reilly Planned completion date for corrective action plan: September 2025

View Audit 357994

Finding 563692 (2023-002)

None 2023

Safe Harbor, Inc.

CT

2023-002 RESERVE ACCOUNT FUNDING Criteria: The Project’s reserve account must be fully funded in accordance with the budget as approved by USDA-RD and maintained in a separate bank account. Condition: During our audit testing, we noted that while the Project maintained a separate bank account for re...

2023-002 RESERVE ACCOUNT FUNDING Criteria: The Project’s reserve account must be fully funded in accordance with the budget as approved by USDA-RD and maintained in a separate bank account. Condition: During our audit testing, we noted that while the Project maintained a separate bank account for reserve funds, it was not funded in accordance with the budget. Cause: Budgeted transfers were not made before yearend to ensure the account is fully funded. Effect: Reserve bank account is underfunded. Questioned Costs: None noted. Recommendation: The Project should implement controls to ensure that the reserve bank account is fully funded. Management’s Views and Corrective Action Plan: Management will correct this when sufficient funds are available and able to be transferred into the reserve account.

View Audit 357984

Finding 563668 (2023-002)

Material Weakness 2023

City of Puyallup

WA

Procurement, Suspension & Debarment Subrecipient Monitoring

Finding ref number: 2023-002 Finding caption: The City did not have adequate internal controls and did not comply with federal suspension and debarment requirements. Name, address, and telephone of City contact person: Barbara Lopez, Finance Director 333 S Meridian Puyallup, WA 98371 (25...

Finding ref number: 2023-002 Finding caption: The City did not have adequate internal controls and did not comply with federal suspension and debarment requirements. Name, address, and telephone of City contact person: Barbara Lopez, Finance Director 333 S Meridian Puyallup, WA 98371 (253) 841-5478 Corrective action the auditee plans to take in response to the finding: In this situation, the contractor was intended to be a subcontractor performing work included in the scope of work outlined in a contract with another primary contractor. The contract with the primary contractor included a suspension and debarment clause. However, staff processed payment to the subcontractor directly, which required separate suspension and debarment verification. The City has taken steps to clarify its contracting practices with staff and ensure verification of suspension and debarment for purchases using federal funds. In addition, the City will be providing mandatory procurement training this year for all staff responsible for purchasing and contracting. Anticipated date to complete the corrective action: 12/31/2025

View Audit 357972

Finding 563643 (2023-007)

Material Weakness 2023

Faribault County

MN

Procurement, Suspension & Debarment § 200.303

Finding Number: 2023-007 Finding Title: Suspension and Debarment Program: 21.027 COVID-19 – Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Charles Schrader, Auditor / Treasurer Corrective Action Planned: Faribault County will implement pro...

Finding Number: 2023-007 Finding Title: Suspension and Debarment Program: 21.027 COVID-19 – Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Charles Schrader, Auditor / Treasurer Corrective Action Planned: Faribault County will implement procedures to ensure documentation is maintained verifying that vendors are not debarred, suspended, or otherwise excluded from conducting business with the County. This verification will be completed and documented prior to entering into any covered transaction. Anticipated Completion Date: December 31, 2025

View Audit 357953

Finding 563642 (2023-006)

Significant Deficiency 2023

Faribault County

MN

Reporting Significant Deficiency Internal Control / Segregation of Duties § 200.303

Finding Number: 2023-006 Finding Title: Reporting Program: 21.027 COVID-19 – Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Charles Schrader, Auditor / Treasurer Corrective Action Planned: Faribault County will implement procedures to ensu...

Finding Number: 2023-006 Finding Title: Reporting Program: 21.027 COVID-19 – Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Charles Schrader, Auditor / Treasurer Corrective Action Planned: Faribault County will implement procedures to ensure federal program reports are completed accurately. This includes consulting reporting instructions provided by grantor agencies and seeking clarification from grantors when needed. Anticipated Completion Date: December 31, 2025

View Audit 357953

Finding 563619 (2023-003)

Material Weakness 2023

Dallam Hartley Counties Hospital District

TX

Questioned Costs Allowable Costs / Cost Principles Cash Management

Contact Information: Sharon Hunt, Interim Chief Financial Officer, Dallam Hartley Counties Hospital District Audit Finding Reference Number: 2023-003 Planned Corrective Action: DHCHD has contracted with another payroll provider. Human Resources staff will work with the payroll provider to ensure th...

Contact Information: Sharon Hunt, Interim Chief Financial Officer, Dallam Hartley Counties Hospital District Audit Finding Reference Number: 2023-003 Planned Corrective Action: DHCHD has contracted with another payroll provider. Human Resources staff will work with the payroll provider to ensure that appropriate documentation regarding pay amounts and other essential payroll and personnel data is maintained on each employee. Anticipated Completion Date: Completed as of October 1, 2024

View Audit 357940 Questioned Costs: $1

Finding 563611 (2023-001)

Material Weakness 2023

Mental Health Resource of Texas, Inc.

TX

Questioned Costs Internal Control / Segregation of Duties Allowable Costs / Cost Principles

I. VIA HOPE 2023 MANAGEMENT CORRECTIVE ACTION PLAN: ► BACKGROUND: CONTINUATION, ADDRESS MULTI-YEAR FRAUD: STRENGTHEN INTERNAL CONTROLS: Management and staff continue to work with the insurance carrier and local law enforcement agencies to restore funds and strengthen its internal controls. ► Update:...

I. VIA HOPE 2023 MANAGEMENT CORRECTIVE ACTION PLAN: ► BACKGROUND: CONTINUATION, ADDRESS MULTI-YEAR FRAUD: STRENGTHEN INTERNAL CONTROLS: Management and staff continue to work with the insurance carrier and local law enforcement agencies to restore funds and strengthen its internal controls. ► Update: History and Board Actions: In FY 2021, Via Hope experienced a significant loss of revenue due to the ending of contracts from its two primary funding streams – the Health and Human Services Commission and the Hogg Foundation for Mental Health. This loss of revenue resulted in the Board recommending and approving the reduction of staff and the departure of the CEO. In FY 2022, the Board recommended and approved the termination of its Accounts Manager and the former Board Chairman stepped in to voluntarily manage the finances until the organization could make other arrangements. The former chairman stepped down from his role and an election of officers was held to install a new Chair. By January 2022, with new revenue coming into the organization, the Board selected a new CEO and in December 2022, a new accounts manager was hired. Once the new accounts manager began reconciling the accounts, a pattern of questionable expenditures became evident with PayPal and other accounts. The CEO and staff informed the Board of what appeared to have happened and recognizing its fiduciary responsibility, the Board approved the engagement of a forensic audit by an external audit firm, The Wesley Peachtree Group (WPG) of Atlanta, Georgia. The forensic audit resulted in findings that fraudulent activity in the amount of $233,000 was likely to have occurred. As a result, the CEO was instructed to file an insurance claim with Frost Insurance. To process the claim, Frost required the involvement of law enforcement which was approved by the Board. Formal investigations were launched and remain ongoing with the Austin Police Department and the Travis County District Attorney's office. Recently, law enforcement met with the Board and provided an update on the investigation. Subsequently, the CEO was requested to follow up with the insurance carrier and state regulatory agencies to ensure the prompt receipt of its insurance claim from PayPal and other potential sources. II. FINDINGS AND RECOMMENDATIONS: Finding 2023-001 - Internal Control Deficiencies (Material Weakness) a) Time and Effort, Payroll and Human Resource Forms and Contracts - In response to the finding, Management will require monthly Time and Effort reports for each employee, develop new human resource forms, and update staff contracts at the beginning of the fiscal year. b) Drawdowns and Written Approvals - With the addition of the new Finance staff member in January 2025, management will initiate a written approval process. All payroll adjustments, drawdowns, credit card purchases, and payments will require invoices, receipts, and written approvals before payment is made. The Accounting Manager will also work with the CEO to ensure that staff provide receipts promptly and that journal entries are recorded on a monthly basis. c) Receipts, Written Approvals, PP&E Schedule - Receipts and written approvals were addressed in Response (C). While the organization maintains an equipment log, we will establish a formal Property, Plant, and Equipment Schedule (PP&E), particularly noting equipment purchased with federal funds. d) Segregation of Duties - Management has begun the process of interviewing qualified staff to segregate duties in the Finance office. This will ensure that one individual will no longer be responsible for handling funds, payments, reconciliations, and General Ledger (GL) postings. The individual will be in place by January 2025.

View Audit 357888 Questioned Costs: $1

Finding 563598 (2023-001)

None 2023

Malama Kauai

HI

Management will continue to complete annual audits within the prescribed due dates. Management will monitor accounting function needs as to provide more timely updated information.

View Audit 357862

Finding 562202 (2023-004)

Material Weakness 2023

Mississippi County Public Facilities Board

AR

HUD Housing Programs

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September...

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September 1st 2024 for a management contract. These findings will be corrected by the executive team that is managing the housing authority. We plan to have everything corrected and in place by July 1st 2026. This staff will follow all rules and regulations in the future and will bring everything up to date. Wixson Huffstetler, Executive Director 5/6/2025

View Audit 357803

Finding 562201 (2023-003)

Material Weakness 2023

Mississippi County Public Facilities Board

AR

Internal Control / Segregation of Duties Procurement, Suspension & Debarment Reporting

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September...

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September 1st 2024 for a management contract. These findings will be corrected by the executive team that is managing the housing authority. We plan to have everything corrected and in place by July 1st 2026. This staff will follow all rules and regulations in the future and will bring everything up to date. Wixson Huffstetler, Executive Director 5/6/2025

View Audit 357803

Finding 562200 (2023-002)

Significant Deficiency 2023

Mississippi County Public Facilities Board

AR

HUD Housing Programs Reporting

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September...

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September 1st 2024 for a management contract. These findings will be corrected by the executive team that is managing the housing authority. We plan to have everything corrected and in place by July 1st 2026. This staff will follow all rules and regulations in the future and will bring everything up to date. Wixson Huffstetler, Executive Director 5/6/2025

View Audit 357803

Finding 562199 (2023-001)

Significant Deficiency 2023

Mississippi County Public Facilities Board

AR

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September...

Views of Responsible Officials and Planned Corrective Actions: The Mississippi County Public Facilities Board has several findings in their past years audit. These findings were under the past administration that was let go on June 30th 2024. We were contacted by the board and took over on September 1st 2024 for a management contract. These findings will be corrected by the executive team that is managing the housing authority. We plan to have everything corrected and in place by July 1st 2026. This staff will follow all rules and regulations in the future and will bring everything up to date. Wixson Huffstetler, Executive Director 5/6/2025

View Audit 357803

Finding 562180 (2023-002)

Significant Deficiency 2023

Wilkin County

MN

Procurement, Suspension & Debarment § 200.303

Finding Number: 2023-002 Finding Title: Suspension and Debarment Program: 21.027 COVID-19 - Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Matthew Walberg and Tarah Yaggie Corrective Action Planned: We now have access to sam.gov and we wil...

Finding Number: 2023-002 Finding Title: Suspension and Debarment Program: 21.027 COVID-19 - Coronavirus State and Local Fiscal Recovery Funds Name of Contact Person Responsible for Corrective Action: Matthew Walberg and Tarah Yaggie Corrective Action Planned: We now have access to sam.gov and we will access the website and search for the vendor to ensure that they are not listed on the suspension list. We will then store the printout in the F-DRIVE and will also keep a paper copy. Anticipated Completion Date: 1/1/2026

View Audit 357786

Finding 562173 (2023-012)

Material Weakness 2023

Libson Regional School District

NH

Questioned Costs Matching / Level of Effort / Earmarking

2023-012 Maintenance of Effort (Material Weakness) Management’s Response: Training has been more of a self-learned activity but we are trying to get these done. Working with the auditors helped the most to understand what these reports should look like. The hope is to have 25-26 MOE’s completed in ...

2023-012 Maintenance of Effort (Material Weakness) Management’s Response: Training has been more of a self-learned activity but we are trying to get these done. Working with the auditors helped the most to understand what these reports should look like. The hope is to have 25-26 MOE’s completed in the Fall of 2025. Name of Contact Person and Completion Date: Toni Butterfield Anticipated Completion Date – 10/1/2025

View Audit 357779 Questioned Costs: $1

Finding 562170 (2023-011)

Material Weakness 2023

Libson Regional School District

NH

Questioned Costs School Nutrition Programs Internal Control / Segregation of Duties § 200.303

2023-011 Excess Food Service Fund Balance (Material Weakness) Management’s Response: We completed and Excess Balance Use of Funds report and worked with the State to understand exactly the parameters of this/ The funds were spent down and we are working hard to make sure to stay under the three mon...

2023-011 Excess Food Service Fund Balance (Material Weakness) Management’s Response: We completed and Excess Balance Use of Funds report and worked with the State to understand exactly the parameters of this/ The funds were spent down and we are working hard to make sure to stay under the three months of expenses as worded in CFR Title 7, 210.14(b). Again management is trying to take on a bigger role as this monitoring was not considered prior to COVID. Fund Balances at year end averaged no more than $10,000. Name of Contact Person and Completion Date: Toni Butterfield Anticipated Completion Date - Immediately

View Audit 357779 Questioned Costs: $1

Finding 562147 (2023-013)

Significant Deficiency 2023

Libson Regional School District

NH

Procurement, Suspension & Debarment Subrecipient Monitoring Allowable Costs / Cost Principles

2023-013 Document Policies and Procedures over Federal Awards (Significant Deficiency) Management’s Response: We do have policies and procedures for Federal Awards that need to be tweaked to assure the work is done as required. We will have this in place in the first part of 25-26. Name of Contact...

2023-013 Document Policies and Procedures over Federal Awards (Significant Deficiency) Management’s Response: We do have policies and procedures for Federal Awards that need to be tweaked to assure the work is done as required. We will have this in place in the first part of 25-26. Name of Contact Person and Completion Date: Toni Butterfield Anticipated Completion Date – 12/31/2025

View Audit 357779

Corrective Action Plans

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