Corrective Action Plans

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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
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
Audit Finding Reference: 2023-001 Planned Corrective Action: This finding represents a typo and is attributable to a human error. The error was corrected immediately after the auditor brought it to our attention. The League has strengthened its internal controls over timely submission of subaward...
Audit Finding Reference: 2023-001 Planned Corrective Action: This finding represents a typo and is attributable to a human error. The error was corrected immediately after the auditor brought it to our attention. The League has strengthened its internal controls over timely submission of subaward data in FFATA (Federal Funding Accountability and Transparency Act) reports. NUL Legal Department used to be responsible for generating FFATA reports, as they are authorized with review of new grant agreements as well as related contracts/subrecipients agreements submitted for approval. In prior years some reports were not submitted in time because of continuous turnover in the department in 2021-22. The regular workflow was sometimes interrupted, and new appointees had to catch up following their priority lists. Eventually, at the end of February 2023, the function was moved to the Finance department and a specific position designated for completing FFATA reports. All pending FFATA reports have been completed immediately after that. We keep submitting FFATA reports for new grants as soon as subaward amounts are finalized. In view of the above error, we will establish an additional layer of control over FFATA report accuracy, so the reports are thoroughly reviewed, once entered into the system, and approved by either VP/Director, Budget & Grants or CFO. Overall, we believe the strength of our internal control ensures a timely and complete submission of FFATA reports. Name and Title of Contact Persons: Sidney Evans, Chief Financial Officer; Lisa Davis, Vice-President for Financial Operations; Triva John, Vice-President for Budget & Grants, Konstantin Yurashkevich, Director for Budget & Grants Name of Official: Sidney Evans Title: Chief Financial Officer Date: 05/30/2024
Moving to Work Demonstration Program – Assistance Listing No. 14.881 Recommendation: We recommend the Authority review their process and internal controls over HQS inspections to ensure compliance with HUD requirements and their administrative plan. Furthermore, management should ensure no HAP payme...
Moving to Work Demonstration Program – Assistance Listing No. 14.881 Recommendation: We recommend the Authority review their process and internal controls over HQS inspections to ensure compliance with HUD requirements and their administrative plan. Furthermore, management should ensure no HAP payments are issued for units that have not passed HQS housing inspections. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The Housing Choice Voucher department is addressing inspection controls in multiple ways. The Department has added additional staffing and also has created new tracking that makes it easier to review and identify units that have not passed inspection and not been abated. The Department has also instituted an ongoing process that has the inspections manager conducting a monthly review of units moving through the abatement process to ensure timely processing and cessation of HAP payments as needed. As part of this review the Department is also conducting a comprehensive review of units that have prior failed inspections to ensure abatement occurred. Name of the contact person responsible for corrective action: Mark La Brayere Planned completion date for corrective action plan: Three elements are continuous with no final completion date. The singular comprehensive review is scheduled to be completed within three months.
View Audit 315516 Questioned Costs: $1
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
Oversight Agency for Audit, Palermo Lakes, Inc. respectfully submits the following corrective action plan for the year ended December 31, 2023. Name and address of independent public accounting firm: Bellows Associates, P.A., 5401 N University Drive, Suite 201, Coral Springs, Florida 33067 Audit per...
Oversight Agency for Audit, Palermo Lakes, Inc. respectfully submits the following corrective action plan for the year ended December 31, 2023. Name and address of independent public accounting firm: Bellows Associates, P.A., 5401 N University Drive, Suite 201, Coral Springs, Florida 33067 Audit period: January 1, 2023 through December 31, 2023 The finding from the December 31, 2023 schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the numbers assigned in the schedule. SECTION III - FINDINGS AND QUESTIONED COSTS – MAJOR FEDERAL AWARD PROGRAMS AUDIT FINDING No. 2023-001: Section 202 Supportive Housing for the Elderly, ALN 14.157 Recommendation: The Project should make sufficient deposits to the escrow accounts in a timely manner. Action Taken: New procedures have been implemented to ensure appropriate amounts are reserved in escrow. If the audit Oversight Agency has questions regarding these plans, please call Irene Phillips at 954-835-9200. Sincerely yours, Irene Phillips CFO
Finding 478875 (2023-002)
Significant Deficiency 2023
Finding 2023-002 Significant Deficiency: Schedule of Expenditures of Federal Awards (SEFA) – Control Finding; Personnel Responsible for Corrective Action: Pete Vujcich, Public Works Division Manager; Anticipated Completion Date: June 30, 2024; Corrective Action Plan: In 2021, El Paso County recogniz...
Finding 2023-002 Significant Deficiency: Schedule of Expenditures of Federal Awards (SEFA) – Control Finding; Personnel Responsible for Corrective Action: Pete Vujcich, Public Works Division Manager; Anticipated Completion Date: June 30, 2024; Corrective Action Plan: In 2021, El Paso County recognized and appropriated $4 million from a CDOT grant (Fed) and $831,501 of local match that was provided by PPRTA (reimbursement) for construction on the South Academy widening project. The overall South Academy project is funded by PPRTA but managed by El Paso County. In May of 2023, PPRTA issued a Purchase Order for $59,965,997.99 to SEMA Construction and the construction contract with SEMA was executed. In December of 2023, SEMA performed work on the project resulting in billings of $4,456,362.07. A payment application was sent to the construction management firm (Wilson & Company) on January 17, 2024 from SEMA. This payment request was rejected due to insufficient certified payrolls. On February 27, 2024, Public Works received an invoice package with all required documentation. During February 2024, Public Works realized that PPRTA would not be able to submit for reimbursement because the IGA was directed to the County and not PPRTA. At that point, the project manager requested a 2024 Purchase Order to pay this invoice. On March 6, 2024, Public Works submitted the 2024 invoice along with a 2024 Purchase Order to Accounts Payable requesting payment was made to SEMA. At that point, the payment was issued and booked to 2024 without recognition of the actual work performance period. Since the invoice was booked in 2024, the expenditure was also not reflected on the 2023 SEFA. As soon as this expenditure was brought to our attention, we immediately requested Accounting record the $4.5 million on the 2023 SEFA. Standard operating procedures include a request of all project managers to identify any anticipated invoices that will be received in the following year to identify any potential reclassification situations. In this particular case, the project manager did identify this project, and anticipated payment request. At the time, this project was a PPRTA run project, and would not have had an impact on the county’s financial reports. Previously, Public Works had a very manual SEFA reporting process in place. Public Works just went live with a new Capital project tracking platform called eBuilder. eBuilder has a required field on the pay app approval screen that requires employees to enter the billing period start and end dates. When Managers go into eBuilder to approve payments, they are required to ensure the billing periods match the payment dates. In addition, as a double check, Public Works is working on customizing eBuilder to flag approvers if the invoice date has a different year listed than the billing period. Public Work has done training with employees to ensure employees understand the additional components of a progress billing pay application, to include timing issues with the review and approval process utilized. We have also reinforced the importance to communicate the correct year expenses were incurred when submitting to Accounts Payable and Accounting. eBuilder will allow Public Works to run reports showing expenses for the correct year. These reports will then be submitted to Accounting to assist with the SEFA preparation. Public Works is confident that all expenditures will be recorded correctly on the SEFA moving forward.
Federal Agency: U.S. Department of the Treasury Federal Program Name: Coronavirus State and Fiscal Recovery Funds Assistance Listing Number: 21.027 Federal Award Identification Number and Year: K3422 & K3724 - 2021 Pass-Through Agency: Washington State Department of Agriculture Pass-Through Number(s...
Federal Agency: U.S. Department of the Treasury Federal Program Name: Coronavirus State and Fiscal Recovery Funds Assistance Listing Number: 21.027 Federal Award Identification Number and Year: K3422 & K3724 - 2021 Pass-Through Agency: Washington State Department of Agriculture Pass-Through Number(s): E128H7X5KWX5 Award Period: 7/1/21-6/30/23; 11/19/21-6/30/23 Type of Finding: • Significant Deficiency in Internal Control over Compliance Section III – Findings and Questioned Costs – Major Federal Programs Condition: Harvest Against Hunger allocates costs to the program based on the available funding and number of employees working on the project. They do not use the timesheet to record the operating hours for the program, but rather management makes a judgmental decision based on their understanding of program operations during the payroll period. Questioned costs: None Cause: The Organization lacks documentation supporting the allocation determination used to determine payroll amounts charged to the major program. Views of responsible officials: There is no disagreement with the finding. Criteria or specific requirement: Per §200.303, non-Federal entities 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 statues, regulations, and the terms and conditions of the Federal awards." Additionally, non-Federal entities must charge salaries and wages "based on records that accurately reflect the work performed" (§200.430(i)). Effect: Without proper documentation of the payroll allocation used, the Organization could charge time to a federal program that does not reflect true expenditures incurred by that program. Repeat Finding: This is not a repeated finding. Recommendation: The Organization should implement policies for consistently determining time allocation to the federal program, and ensure internal controls help to ensure this allocation is correct and consistently documented
Internal Control over Financial Reporting
Internal Control over Financial Reporting
Recommendation: We recommend that the Board of Directors be aware of the internal control deficiencies over financial reporting. And, if possible, implement procedures to ensure that the Association has the expertise necessary to prevent, detect and correct misstatements and be capable of d...
Recommendation: We recommend that the Board of Directors be aware of the internal control deficiencies over financial reporting. And, if possible, implement procedures to ensure that the Association has the expertise necessary to prevent, detect and correct misstatements and be capable of drafting the financial statements, related footnote disclosures and SEFA in accordance with the cash basis method of accounting.
Response: The Board believes it has personnel who possess suitable skill, knowledge, or experience to oversee services the auditor provides in assisting with financial statement presentation which requires a lower level of technical knowledge than the competence required to prepare the financial st...
Response: The Board believes it has personnel who possess suitable skill, knowledge, or experience to oversee services the auditor provides in assisting with financial statement presentation which requires a lower level of technical knowledge than the competence required to prepare the financial statements, related footnote disclosures and SEFA in accordance with the cash basis of accounting.
Corrective Action Plan for Finding 2023-002 We are in receipt of the Finding Required to be Reported by Uniform Guidance, regarding an other instance of noncompliance with respect to Reporting. Management agrees with the finding. Policies and procedures over federal grant reporting will be modified...
Corrective Action Plan for Finding 2023-002 We are in receipt of the Finding Required to be Reported by Uniform Guidance, regarding an other instance of noncompliance with respect to Reporting. Management agrees with the finding. Policies and procedures over federal grant reporting will be modified to ensure reports are prepared using complete and accurate information. We will increase compensating controls by introducing additional oversight and review for future COVID-19 Provider Relief Fund reporting. Bridgette Reeves, CFO, will be responsible to ensure that the corrective action plan is followed. The Wilbarger County Hospital District had enough expenditures for Period 4 funding received so that no lost revenues were actually utilized as a basis for the funds received. The corrective action plan will be implemented by September 30, 2024.
Point of Contact (POC): the Deputy Director of Accounting (vacant) will oversee the corrective action plan with assistance from an Accountant III (Casey Waldron)  Resource Requirements: the main resources will be the Deputy Director of Accounting and an Accountant III. It is anticipated that the no...
Point of Contact (POC): the Deputy Director of Accounting (vacant) will oversee the corrective action plan with assistance from an Accountant III (Casey Waldron)  Resource Requirements: the main resources will be the Deputy Director of Accounting and an Accountant III. It is anticipated that the non-recurring milestones will take no more than 40 hours to complete.  Planned Milestones: o Create a tracker for balance sheet account reconciliations – completed 05/24 o Every June and July, send out reminders on transitioning to the new fiscal year while the prior fiscal year is being closed to ensure expenses/revenue are accounted for properly. o Staff complete monthly balance sheet account reconciliations by the 15th of the following month o As part of each balance sheet account reconciliation, staff will prepare a document for each account (by 08/24 and updated annually) that includes the following information:  Name/Title of account  General Ledger account number  Fund (if applicable)  Purpose  Types of transactions  Transaction flow o Tracker and reconciliations are discussed monthly at a meeting led by either POC or the Director of Finance (Bruce Miller), meetings will be held the week that includes the 15th, if possible o Create a checklist for a quarterly review of revenue and expenses by 10/24 o Using the above checklist, perform a quarterly review of the revenue and expense data for quarters 1 through 3 no later than 30 days after the end of the quarter.  Actual-to-budget comparison for expenses/revenue  Cost centers used with the wrong fund  Negative expense balances  Positive revenue balances  Adjustments for issues identified during the quarterly review will be posted prior to the next quarterly review Maryland Relay for Impaired Hearing or Speech: 1-800-735-2258 o Consolidate year-end checklists into a master checklist by 08/24. The checklist must include the following information:  Procedure to be performed  Where instructions for the procedure are located  Responsibility Party  Date Due  Date Completed  Reviewing Party  Date Due  Date Completed o Hold bi-weekly year-end status meetings starting the 2nd week in July through the issuance of the audited financial statements  Scheduled Completion Date: the target completion date for non-recurring milestones is 10/24. As part of the CAP, we will be implementing recurring milestones that will be completed within the timelines specified above.  Status Date: o The tracker for balance sheet account reconciliations was completed in 05/24. o Staff is working daily on account reconciliations for Fiscal Year (FY) 2024. o The June reminder regarding the end of FY 2024 and the start of FY 2025 was sent on 06/30/24.
2023-003 – Subrecipient Monitoring Compliance Person responsible for corrective action – Andrea Olson, Executive Director Responsible official’s response – Management is in agreement with this finding. Corrective action planned – CAPND has subsequently requested all audit reports from all subrecipie...
2023-003 – Subrecipient Monitoring Compliance Person responsible for corrective action – Andrea Olson, Executive Director Responsible official’s response – Management is in agreement with this finding. Corrective action planned – CAPND has subsequently requested all audit reports from all subrecipients. Additionally, CAPND has changed subaward formatting to ensure that all required information is included within the award. Planned implementation date of corrective action – July 10, 2024
2023-002 – Subrecipient Monitoring Controls Person responsible for corrective action – Andrea Olson, Executive Director Responsible official’s response – Management is in agreement with this finding. Corrective action planned – CAPND has a comprehensive monitoring plan to monitor all grantsupported ...
2023-002 – Subrecipient Monitoring Controls Person responsible for corrective action – Andrea Olson, Executive Director Responsible official’s response – Management is in agreement with this finding. Corrective action planned – CAPND has a comprehensive monitoring plan to monitor all grantsupported activities in accordance with program rules relative to CSBG program including rules established by the program, those established by CAPND, and by 2 CFR Part 200. The plan was not fully adhered to during 2023 but has been for 2024. Planned implementation date of corrective action – July 10, 2024
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.
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 funds are disbursed for expenditures incurred prior to requesting reimbursement and that expenditu...
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 funds are disbursed for expenditures incurred prior to requesting reimbursement and that expenditures are incurred within the contract’s performance period.
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.
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.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
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.
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.
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.
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.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
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 costs incurred are appropriately charged based on the contracts’ performance periods.
Condition: Obligations were overstated by approximately $650,000 on the March 31, 2023 Project and Expenditure report. Corrective Action Planned: The Town of Pepperell mis-stated $650,000 as obligated based on intended uses. $300,000 of those funds have been re-directed to real obligations and t...
Condition: Obligations were overstated by approximately $650,000 on the March 31, 2023 Project and Expenditure report. Corrective Action Planned: The Town of Pepperell mis-stated $650,000 as obligated based on intended uses. $300,000 of those funds have been re-directed to real obligations and the Select Board will be authorizing additional spending in the next 10 weeks. Anticipated Completion Date: October 31, 2024 Contact: Andrew MacLean, Town Administrator, Pepperell amaclean@town.pepperell.ma.us, 978-650-1621
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