Corrective Action Plans

Finding 383336 (2023-003)

Significant Deficiency 2023

ND

Allowable Costs / Cost Principles

Contact Person Kaye Seibel Corrective Action Plan Management agrees with the recommendation and will review their procedures to ensure all expenses are approved and this approval documentation is maintained. Completion Date Red River Valley Community Action will implement the plan in 2024.

View Audit 296532

Finding 383333 (2023-002)

Material Weakness 2023

Mfl Marmac Community School District

IA

We have reviewed procedures and plan to make the necessary changes to improve internal control.

View Audit 296527

Finding 383332 (2023-005)

Material Weakness 2023

Vermont Association for the Education of Young Children

VT

Reporting

Recommendation - We recommend that VTAEYC closely review the grant agreements for each grant listed on its Schedule of Expenditures of Federal Awards and verify that only federally funded expenditures are included on the Schedule of Expenditures of Federal Awards.Management’s response - VTAEYC was r...

Recommendation - We recommend that VTAEYC closely review the grant agreements for each grant listed on its Schedule of Expenditures of Federal Awards and verify that only federally funded expenditures are included on the Schedule of Expenditures of Federal Awards.Management’s response - VTAEYC was required to complete a Schedule of Expenditures of Federal Awards (SEFA) for the first time as part of a single audit. VTAEYC correctly identified all grants that were federally funded, however when reporting the expenses on the SEFA report, two of the grant awards were a mix of state and federal funds. VTAEYC reported all grant expenditures for FY23 and should have adjusted the total grant expenditures in FY23 to reflect only federally funded expenses. VTAEYC management is now aware of this issue and has noted this in their SEFA report template to ensure this is done correctly in the future.

View Audit 296524

Finding 383331 (2023-004)

Material Weakness 2023

Vermont Association for the Education of Young Children

VT

Reporting

Recommendation - We recommend that VTAEYC closely review the grant agreements for each grant listed on its Schedule of Expenditures of Federal Awards and verify that only federally funded expenditures are included on the Schedule of Expenditures of Federal Awards.Management’s response - VTAEYC was r...

Recommendation - We recommend that VTAEYC closely review the grant agreements for each grant listed on its Schedule of Expenditures of Federal Awards and verify that only federally funded expenditures are included on the Schedule of Expenditures of Federal Awards.Management’s response - VTAEYC was required to complete a Schedule of Expenditures of Federal Awards (SEFA) for the first time as part of a single audit. VTAEYC correctly identified all grants that were federally funded, however when reporting the expenses on the SEFA report, two of the grant awards were a mix of state and federal funds. VTAEYC reported all grant expenditures for FY23 and should have adjusted the total grant expenditures in FY23 to reflect only federally funded expenses. VTAEYC management is now aware of this issue and has noted this in their SEFA report template to ensure this is done correctly in the future.

View Audit 296524

Finding 383329 (2023-001)

Significant Deficiency 2023

Youth Services Network, Inc.

IL

Internal Control / Segregation of Duties

Youth Services Network, Inc. has implemented several compensating controls but simply cannot justify the expense of hiring additional staff to reach the standard of segregation of duties suggested.

View Audit 296522

Finding 383325 (2023-002)

Material Weakness 2023

Socioeconomic and Community Development Office

PR

Subrecipient Monitoring

During the fiscal year 2022-2023, the Office decided to hire an external company specialized in monitoring evaluation for the required Subrecipient Monitoring activities for the fiscal years 2020, 2021, and 2022. Monitoring Schedule: The contracted company has completed the monitoring activities as ...

During the fiscal year 2022-2023, the Office decided to hire an external company specialized in monitoring evaluation for the required Subrecipient Monitoring activities for the fiscal years 2020, 2021, and 2022. Monitoring Schedule: The contracted company has completed the monitoring activities as per the following schedule: (1) ASPRI Monitoring report delivered on November 13, 2023, with a response received by December 8, 2023. (2) INSEC: Monitoring report delivered on December 4, 2023, with a response received by January 4, 2024. A follow-up communication was sent on February 6, 2024, due to the lack of a Corrective Action Plan submission. (3) Municipality of San Juan: Monitoring report delivered on January 23, 2024, with a response received by February 23, 2024. They requested an extension on February 22, 2024, which was denied by Office. They did not deliver. (4) Municipality of Bayamon: Monitoring report delivered on December 29, 2023, with a response received by January 29, 2024. They sent a letter of objection, and it was responded. Evaluation and Follow-Up: The Office will review the effectiveness of the monitoring conducted by the external company and the corrective actions follow-up will be the responsibility of the Office. A follow-up audit will be scheduled to assess compliance with the Corrective Action Plans and ongoing monitoring requirements. Documentation: All monitoring reports, communications, and evidence of corrective actions will be properly documented and stored for reference and compliance verification purposes. For the fiscal year 2023-2024, the Office will compile a comprehensive report detailing the monitoring process, findings, corrective action and compliance status of sub-recipients. Implementation Date During the 2024-2025 fiscal year: Responsible Person Mrs. Nadia Torres Ortiz, Federal Program Director

View Audit 296516

Finding 383324 (2023-003)

Significant Deficiency 2023

San Juan Soil & Water Conservation District

NM

Procurement, Suspension & Debarment § 200.213 § 200.317 § 200.318 § 200.322 § 200.326

Auditor’s Recommendations: We recommend the District establish a policy and implement procedures regarding large purchases related to Federal grants to insure that no vendors who are suspended, debarred, or otherwise excluded from participating in transactions funded through Federal grants are used....

Auditor’s Recommendations: We recommend the District establish a policy and implement procedures regarding large purchases related to Federal grants to insure that no vendors who are suspended, debarred, or otherwise excluded from participating in transactions funded through Federal grants are used. As identified above, there are several methods in which the District can verify vendors who are not suspended or debarred. The District may have the vendor provide an annual certification that is s not currently suspended, debarred, or otherwise prevented from receiving Federal dollars. In other occasions in which a single purchase is going to be made, the purchasing procedures should include looking up the vendor on the GSA website, printing a copy of the verification, and placing it in the file with the purchase order. The District has options, and it should establish what method is the least intrusive, but also effective, in complying with the requirements of the Uniform Grant Guidance. Responsible Official’s Plan: • Specific corrective action plan for funding: The procurement Officer of SJSWCD has updated the procurement process on 12/7/23 that all contractors who will be receiving Federal monies must provide an annual certification that they are not suspended, debarred, inactive, or otherwise excluded from participating in transaction funded through Federal grants. The policy change will be approved at the next board meeting. • Timeline for completion of corrective action plan: December 7, 2023 • Employee position(s) responsible for meeting the timeline: Oralia Bridge, District Manager

View Audit 296514

Finding 383321 (2023-001)

None 2023

National Church Residences of Kearny, Nj, Inc. D/b/a Spruce Terrace

OH

HUD Housing Programs Reporting Internal Control / Segregation of Duties

Management acknowledges noncompliance in the current fiscal year and has taken measures to improve internal controls over compliance. Management deposited the underfunded amount of $12,275 to the replacement reserve account on August 4, 2023.

View Audit 296513

Finding 383316 (2023-002)

Material Weakness 2023

Michael Rueber

IA

We have reviewed procedures and plan to make the necessary changes to improve internal control.

View Audit 296511

Finding 383310 (2023-001)

None 2023

Council for Jewish Elderly and Subsidiaries

IL

Questioned Costs HUD Housing Programs

The Company paid the amount distributed in excess of surplus cash of $53,743 on December 7, 2023, and deposited into a residual receipt account subsequent fiscal year.

View Audit 296510 Questioned Costs: $1

Finding 383309 (2023-001)

Material Weakness 2023

Elk City Independent School District No. 06

OK

Subrecipient Monitoring Material Weakness Matching / Level of Effort / Earmarking

Elk City Public Schools will ensure that on all future construction contracts that deal with federal awards, will include requirements of the Davis-Bacon Act. Prevailing wages will be inserted into the language of the contract to be signed by contractors and subcontractors. All contracts will also...

Elk City Public Schools will ensure that on all future construction contracts that deal with federal awards, will include requirements of the Davis-Bacon Act. Prevailing wages will be inserted into the language of the contract to be signed by contractors and subcontractors. All contracts will also spell out weekly reporting requirements of certified wages paid by contractors and subcontractors. In addition, ECPS will ensure that Davis-Bacon information is posted at all job sites.

View Audit 296509

Finding 383307 (2023-004)

Material Weakness 2023

East Allen County Schools

IN

Procurement, Suspension & Debarment Subrecipient Monitoring § 200.303

FINDING 2023-004 Finding Subject: Special Education Cluster (IDEA) – Suspension and Debarment Summary of Finding: Prior to entering in subawards and covered transactions with federal award funds, receipts are required to verify that contractors are not suspended, debarred or otherwise excluded. Cont...

FINDING 2023-004 Finding Subject: Special Education Cluster (IDEA) – Suspension and Debarment Summary of Finding: Prior to entering in subawards and covered transactions with federal award funds, receipts are required to verify that contractors are not suspended, debarred or otherwise excluded. Contact Person Responsible for Corrective Action: Jeremiah Hruschak Contact Phone Number and Email Address: (260) 446-0100 ext.1006 / jhruschak@eacs.k12.in.us Views of Responsible Officials: East Allen County Schools concurs with finding. INDIANA STATE BOARD OF ACCOUNTS 29 Description of Corrective Action Plan: Covered transaction(s) that are equal or exceed $25,000.00, East Allen County Schools will collect a certification from the contractor and/ or review SAM exclusion and document the SAM review. Anticipated Completion Date: Implementation will take place immediately and will be corrected by the 2023-2024 / 2024-2025 audit cycle.

View Audit 296501

Finding 383306 (2023-003)

Material Weakness 2023

East Allen County Schools

IN

Procurement, Suspension & Debarment Subrecipient Monitoring § 200.303

FINDING 2023-003 Finding Subject: COVID-19 – Emergency Connectivity Fund Program – Suspension and Debarment Summary of Finding: Prior to entering in subawards and covered transactions with federal award funds, receipts are required to verify that contractors are not suspended, debarred or otherwise ...

FINDING 2023-003 Finding Subject: COVID-19 – Emergency Connectivity Fund Program – Suspension and Debarment Summary of Finding: Prior to entering in subawards and covered transactions with federal award funds, receipts are required to verify that contractors are not suspended, debarred or otherwise excluded. Contact Person Responsible for Corrective Action: Jeremiah Hruschak Contact Phone Number and Email Address: (260) 446-0100 ext.1006 / jhruschak@eacs.k12.in.us Views of Responsible Officials: East Allen County Schools concurs with finding. Description of Corrective Action Plan: Covered transaction(s) that are equal or exceed $25,000.00, East Allen County Schools will collect a certification from the contractor and/ or review SAM exclusion and document the SAM review. Anticipated Completion Date: Implementation will take place immediately and will be corrected by the 2023-2024 / 2024-2025 audit cycle.

View Audit 296501

Finding 383305 (2023-002)

Material Weakness 2023

East Allen County Schools

IN

Equipment & Real Property Management Internal Control / Segregation of Duties Matching / Level of Effort / Earmarking § 200.303

FINDING 2023-002 Finding Subject: COVID-19 – Emergency Connectivity Fund Program – Internal Controls Summary of Finding: An inventory sign-off was not present upon completion of entering an iPad purchase to ensure documentation was correct. Contact Person Responsible for Corrective Action: Jeremiah ...

FINDING 2023-002 Finding Subject: COVID-19 – Emergency Connectivity Fund Program – Internal Controls Summary of Finding: An inventory sign-off was not present upon completion of entering an iPad purchase to ensure documentation was correct. Contact Person Responsible for Corrective Action: Jeremiah Hruschak Contact Phone Number and Email Address: (260) 446-0100 ext.1006 / jhruschak@eacs.k12.in.us 1240 State Road 930 East New Haven, Indiana 46774-1732 Phone: (260) 446-0100 Fax: (260) 446-0107 INDIANA STATE BOARD OF ACCOUNTS 28 Views of Responsible Officials: East Allen County Schools concurs with finding. Description of Corrective Action Plan: Upon entry of all devices with the appropriate inventory detail, a sign off will take place by two officials to confirm all data are present and that only one device is assigned to each student. Anticipated Completion Date: Implementation will take place during next technology purchase and will be corrected by the 2023- 2024 / 2024-2025 audit cycle.

View Audit 296501

Finding 383304 (2023-009)

Significant Deficiency 2023

Eastern Regional Housing Authority

NM

HUD Housing Programs Reporting Significant Deficiency

2023-009: Application Access Control – Significant Deficiency in internal controls over compliance over Recommendation: We recommend that the Housing Authority should review each employee’s access permissions within the “Housi...

2023-009: Application Access Control – Significant Deficiency in internal controls over compliance over Recommendation: We recommend that the Housing Authority should review each employee’s access permissions within the “Housing Pro” software and modify their access according to their job responsibilities. Action Taken: All employee access was reviewed and corrected so that only the two Deputy Directors have administrative access. Due Date of Completion: November 30, 2023 Responsible Official: Irene Murillo, Deputy Director

View Audit 296494

Finding 383303 (2023-001)

Significant Deficiency 2023

Eastern Regional Housing Authority

NM

HUD Housing Programs Reporting Significant Deficiency

2023-001: Internal Controls over Federal Award – Reporting (VMS) - Significant Deficiency in Internal controls over compliance over reporting Recommendation: The Authority should establish a clearly documented review process wherein someone other than the preparer reviews the VMS report prior to sub...

2023-001: Internal Controls over Federal Award – Reporting (VMS) - Significant Deficiency in Internal controls over compliance over reporting Recommendation: The Authority should establish a clearly documented review process wherein someone other than the preparer reviews the VMS report prior to submission. Action Taken: The Authority will have a member of management review VMS submissions prior to submission. Due Date of Completion: February 2024 Responsible Official: Chris Herbert, Executive Director, Irene Murillo, Deputy Director, Carol Hensley, Assistant Deputy Director

View Audit 296494

Finding 383284 (2023-018)

Material Weakness 2023

State of Texas C/o Comptroller of Public Accounts

TX

Subrecipient Monitoring Eligibility Special Tests & Provisions § 200.303 § 200.334

Corrective action plan: In December 2021, HHSC implemented the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment Management System (PEMS), an automated system that is the single tool for provider enrollment, re-enrollment, revalidation, and maintenance requests (maintaining and upda...

Corrective action plan: In December 2021, HHSC implemented the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment Management System (PEMS), an automated system that is the single tool for provider enrollment, re-enrollment, revalidation, and maintenance requests (maintaining and updating provider enrollment record information). Medicaid provider enrollment, revalidation, and re-enrollment documentation, including risk-based screenings, are tracked in PEMS. Additionally, the relevant federal databases are checked at least monthly for all providers currently enrolled in Medicaid. Of the Medicaid providers requested during the fiscal year 2023 Statewide Single Audit, 47 of 60 samples had been enrolled or revalidated through PEMS and the auditor received all requested documentation. The listed exceptions only apply to Medicaid long-term care (LTC) providers whose enrollment and/or revalidation have not yet been processed through PEMS. The LTC enrollment and revalidation process mirrors the sampled acute care providers which were found to be 100 percent compliant during this review, further supporting that the process is working. HHSC operated under the public health emergency (PHE) between March 30, 2020, and May 11, 2023. In response to the PHE, the Centers for Medicare and Medicaid Services waived exclusion check requirements for provider reenrollments and revalidations. HHSC is in the process of revalidating providers through PEMS; however, as a result of the PHE end date and provider revalidation requirements, the projected completion date for the required revalidation of all LTC providers is January 2027. HHSC continues efforts to enroll LTC providers through PEMS and expects to eliminate errors related to these documents once all LTC providers have revalidated. Implementation dates: December 2021, PEMS implementation January 2027, LTC provider enrollment and revalidation completed Responsible persons: Jordan Nichols, Deputy Associate Commissioner, Medicaid and CHIP Services Operations Management

View Audit 296491

Finding 383283 (2023-017)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Internal Control / Segregation of Duties Special Tests & Provisions Subrecipient Monitoring § 200.303

Corrective action plan: To ensure compliance is being met with Risk Assessments, the Chief Information Security Officer (CISO) will implement regular compliance reviews, at the beginning of each quarter with Program Director level leadership. Any non-compliance will be addressed with the Program are...

Corrective action plan: To ensure compliance is being met with Risk Assessments, the Chief Information Security Officer (CISO) will implement regular compliance reviews, at the beginning of each quarter with Program Director level leadership. Any non-compliance will be addressed with the Program area by regularly sharing email reminders for reporting, training, and assistance from security. The reports will begin to be shared on July 31, 2024. Application Services, in collaboration with the CISO and the Information Technology (IT) Business Operations’ Policy, Planning, and Performance team, will establish and publish a process for the successful completion of Risk Assessments, including roles and responsibilities, processes, and procedures to ensure timely completion and ongoing compliance. The target implementation date for this document is January 15, 2025. Implementation date: January 15, 2025 Responsible persons: Leatha Marr, Director, IT Applications Services, and Vikram Muralidharan, Chief Information Security Officer

View Audit 296491

Finding 383255 (2023-130)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Questioned Costs Cash Management Matching / Level of Effort / Earmarking § 200.305

Corrective Action Plan: The University will remit annually any interest earned in excess of $500 to the Department of Health and Human Services. Implementation Date: 2/2024 Responsible Person: Andrea Wright, Executive Director of Accounting Services

View Audit 296491 Questioned Costs: $1

Finding 383223 (2023-110)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Student Financial Aid Special Tests & Provisions Matching / Level of Effort / Earmarking

Corrective Action Plan: The Office of Financial Aid has revised the award and disbursement notifications to TEACH Grant recipients to include all required elements. The award notification now describes how and when funds will be disbursed. The TEACH disbursement notification now includes the date of...

Corrective Action Plan: The Office of Financial Aid has revised the award and disbursement notifications to TEACH Grant recipients to include all required elements. The award notification now describes how and when funds will be disbursed. The TEACH disbursement notification now includes the date of disbursement, student's right to cancel all or part of the award, and guidance for procedures and time for canceling the award. The policy and procedure will be revised to include these updated procedures. Implementation Date: March 2024 Responsible Persons: Amanda Petrosian, Director of Financial Aid Josiah Mendoza, Assistant Director of Operations

View Audit 296491

Finding 383206 (2023-149)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Student Financial Aid Special Tests & Provisions Matching / Level of Effort / Earmarking

Corrective Action Plan: The University reviewed and corrected the queries used to ensure that students receive the appropriate notifications for disbursements made for TEACH grants and any Federal Direct Loans. Implementation Date: 05/2023 Responsible Person: Scott Lapinski, Assistant Vice President...

Corrective Action Plan: The University reviewed and corrected the queries used to ensure that students receive the appropriate notifications for disbursements made for TEACH grants and any Federal Direct Loans. Implementation Date: 05/2023 Responsible Person: Scott Lapinski, Assistant Vice President for Enrollment Management/Director of Financial Aid

View Audit 296491

Finding 383189 (2023-127)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Questioned Costs Special Tests & Provisions Student Financial Aid

Corrective Action Plan: • The University has already implemented significant process enhancements in this area. • The University immediately updated the ECAR to add the School of Veterinary Medicine at Amarillo. • The University has implemented updated procedures requiring both the Primary and Secon...

Corrective Action Plan: • The University has already implemented significant process enhancements in this area. • The University immediately updated the ECAR to add the School of Veterinary Medicine at Amarillo. • The University has implemented updated procedures requiring both the Primary and Secondary designee to review the ECAR quarterly for any required changes. Implementation Date: August 2023 Responsible Persons: Jamie Hansard and Kyle Phillips

View Audit 296491 Questioned Costs: $1

Finding 383165 (2023-161)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Student Financial Aid Special Tests & Provisions Reporting

Corrective Action Plan: The University has implemented a correction to the reporting logic that caused the inaccurate reporting of program begin date for some students. This implementation was effective for enrollment reporting beginning with the Fall 2023 semester. In addition, the University is ut...

Corrective Action Plan: The University has implemented a correction to the reporting logic that caused the inaccurate reporting of program begin date for some students. This implementation was effective for enrollment reporting beginning with the Fall 2023 semester. In addition, the University is utilizing available error reports via the National Student Clearinghouse to ensure program begin dates and other program-level data reported is accurate. Implementation Date: August 2023 Responsible Persons: Ashley Wheelis, Deputy Registrar Molly Collins, Associate Registrar Zach Yeager, Assistant Director

View Audit 296491

Finding 383163 (2023-159)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Student Financial Aid Subrecipient Monitoring Allowable Costs / Cost Principles

Corrective Action Plan: The University is updating procedures to ensure unallowable charges are not paid using Title IV funds without proper authorization from the student or parent. The University will review and improve, as necessary, existing controls to ensure that Title IV aid in excess of the ...

Corrective Action Plan: The University is updating procedures to ensure unallowable charges are not paid using Title IV funds without proper authorization from the student or parent. The University will review and improve, as necessary, existing controls to ensure that Title IV aid in excess of the student’s institutional charges will not be held without written authorization from the student or parent. Implementation Date: May 2024 Responsible Persons: Beth Tolan, Associate Vice President of Financial Aid & Scholarships Christopher Foster, Associate Vice President of Student Accounting

View Audit 296491

Finding 383162 (2023-158)

Significant Deficiency 2023

State of Texas C/o Comptroller of Public Accounts

TX

Student Financial Aid Matching / Level of Effort / Earmarking Reporting

Corrective Action Plan: The University will implement additional controls to check internal disbursement dates against disbursement dates reported in COD in instances where manual reporting is required. Implementation Date: May 2024 Responsible Persons: Kimberley Wells, Director of Financial Aid & S...

Corrective Action Plan: The University will implement additional controls to check internal disbursement dates against disbursement dates reported in COD in instances where manual reporting is required. Implementation Date: May 2024 Responsible Persons: Kimberley Wells, Director of Financial Aid & Scholarships John Robert, Associate Director of Financial Aid & Scholarships Beth Tolan, Associate Vice President of Financial Aid & Scholarships

View Audit 296491

Corrective Action Plans

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