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Corrective Action Plans

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Finding 1217212 (2025-002)
Material Weakness 2025
South Seven Senior Village
WA
Eligibility Significant Deficiency Questioned Costs
Management Response: Management concurs with the findings. OlyCAP recognizes the importance of maintaining complete and accurate tenant eligibility documentation to demonstrate compliance with HUD program requirements. The missing background verification documentation identified during the audit app...
Management Response: Management concurs with the findings. OlyCAP recognizes the importance of maintaining complete and accurate tenant eligibility documentation to demonstrate compliance with HUD program requirements. The missing background verification documentation identified during the audit appears to be the result of incomplete lease up processes at project inception in 2005. While management believes eligibility determinations were appropriately made, supporting documentation was not obtained in the early period of the project. Corrective Action Plan: 1. OlyCAP has implemented a standardized tenant file checklist identifying all required eligibility and compliance documentation, including background verification records, income documentation, lease agreements, and other required tenant file components. 2. Housing program staff has been trained on file documentation requirements, records retention standards, and file review procedures. 3. Management conducted a comprehensive review in 2024 of all current tenant files to identify missing documentation. 4. Supervisory file reviews are conducted on all tenant files at lease up using the standardized checklist to verify that required documentation is complete and maintained in accordance with program requirements. These corrective actions are intended to strengthen internal controls over tenant eligibility documentation and ensure ongoing compliance with HUD requirements. Anticipated Completion Date: July 1, 2026 Responsible officials: .Executive Director .Housing Director .Housing Program Managers .Compliance and Quality Assurance Staff
View Audit 403348
Finding 1217210 (2025-001)
Material Weakness 2025
South Seven Senior Village
WA
HUD Housing Programs
Management Response: Management concurs with the finding. The withdrawal of $14,853 from the Replacement Reserve account was made to address an emergent roof repair that required immediate action to protect the property and its residents. At the time, management did not obtain HUD approval prior to ...
Management Response: Management concurs with the finding. The withdrawal of $14,853 from the Replacement Reserve account was made to address an emergent roof repair that required immediate action to protect the property and its residents. At the time, management did not obtain HUD approval prior to the expenditure as required. Upon identification of the issue, management promptly consulted with HUD regarding the withdrawal and has worked with HUD to resolve the matter. HUD has accepted the explanation and the issue has been addressed. Management also identified that the required October 2025 Replacement Reserve deposit of $575 was inadvertently omitted. Upon discovery of the missed transfer, the deposit was made on March 27, 2026, restoring the reserve account to the required balance. To prevent future occurrences, management has implemented the following corrective actions: 1. A compliance checklist has been established for all HUD-regulated reserve accounts to ensure required approvals are obtained prior to any withdrawal. 2. Monthly reserve deposits have been incorporated into the organization's recurring accounting procedures and monitored through a monthly compliance review process. 3. Finance staff responsible for HUD properties have been provided additional training regarding reserve account requirements, including HUD approval requirements for withdrawals and required monthly reserve deposits. 4. Reserve account activity will be reviewed periodically by management to verify compliance with HUD regulations and applicable property agreements. Management believes these corrective actions adequately address the finding and strengthen internal controls over compliance with HUD reserve account requirements. Anticipated Completion Date: Completed with ongoing maintenance Responsible Officials: Holly Morgan, Executive Director
View Audit 403348
Finding 1217198 (2025-002)
Material Weakness 2025
Milton-Union Exempted Village School District
OH
School Nutrition Programs Eligibility
The staff member responsible for completing the verification process—Accounts Payable—will attend the required training/webinar to ensure full compliance with USDA regulations. Accounts Payable will complete training specifically covering the proper procedures and requirements for the verification p...
The staff member responsible for completing the verification process—Accounts Payable—will attend the required training/webinar to ensure full compliance with USDA regulations. Accounts Payable will complete training specifically covering the proper procedures and requirements for the verification process, as outlined by the State Agency and USDA guidelines. Documentation on the completed training will be retained on file and made available upon request. In addition to training, both Accounts Payable and Operations Manager are signed up to receive the Ohio Ed Updates SNP Items of Interest. This corrective action is being taken promptly to address the findings and to prevent future occurrences. The district is committed to ensuring all staff involved in child nutrition programs are appropriately trained and fully understand their responsibilities.
View Audit 403326
Finding 1217196 (2025-010)
Material Weakness 2025
Town of New Market
IA
The Council now approves all financial reports that are sent to USDA-RD. The Clerk will sign all reports before submitting.
The Council now approves all financial reports that are sent to USDA-RD. The Clerk will sign all reports before submitting.
View Audit 403320
Finding 1217195 (2025-001)
Material Weakness 2025
Dowagiac Housing Commission
MI
HUD Housing Programs Questioned Costs Eligibility
Housing Choice Vouchers – CFDA 14.871 Recommendation: The Commission should consider reviewing its current policy regarding rent certifications. The Commission should ensure all persons involved in the certification process are properly trained and understand regulations in order to accurately ident...
Housing Choice Vouchers – CFDA 14.871 Recommendation: The Commission should consider reviewing its current policy regarding rent certifications. The Commission should ensure all persons involved in the certification process are properly trained and understand regulations in order to accurately identify errors. Additionally, the Commission should implement a thorough second party review of annual certifications to verify accuracy. Action Taken: Management will implement stronger controls over tenant files including a more thorough second party review. Anticipated Completion Date of Action: August 31, 2025
View Audit 403316
Finding 1217194 (2025-001)
Material Weakness 2025
Jackson Local School District
OH
Eligibility School Nutrition Programs Matching / Level of Effort / Earmarking
The District will pull a sample of 5% of applicants entered into the Payschools system as of October 31 and perform an independent eligibility determination. Once the eligibility determination has been completed, we will compare it to the eligibility determination made by the Payschools system and n...
The District will pull a sample of 5% of applicants entered into the Payschools system as of October 31 and perform an independent eligibility determination. Once the eligibility determination has been completed, we will compare it to the eligibility determination made by the Payschools system and note any discrepancies.
View Audit 403312
Finding 1217192 (2025-004)
Material Weakness 2025
Johnston County
NC
Eligibility Internal Control / Segregation of Duties Questioned Costs
Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Q...
Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Question Costs Darren Phillips, Quality Assurance and Program Integrity Supervisor We are building a training slideshow presentation to provide tenured caseworkers refresher training for all of the Internal Error findings. This will cover Incorrect Resources, Incorrect Income, Incorrect HH and Residency issues. The SSI expartes that were in error have been completed as of 12/10/2025. We will cover the use of NCFAST reports to ensure that they are worked in a timely manner. A greater emphasis will be placed during training of new hires in the areas of the errors found. Supervisors will provide policy updates and review the income and recertification policies in the Monthly Unit Meetings. The Medicaid Division Director will meet with the Medicaid supervisors to address the untimely reviews and put a plan into place to work them in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. Training will be provided by 2/28/2026 for all Medicaid personnel. Darren Phillips, Quality Assurance and Program Integrity Supervisor We are currenty building a training slideshow presentation to provide tenured caseworkers refresher training on how to update income on cases. The training will cover Self-Employment, the use of pay stubs and pulling income from OVS and TWN. The training will cover both error findings, Incorrect Income and Inadequate Request for Income. A greater emphasis will be placed on the training of new hires for the areas of the errors found. A Desk Reference will be created to assist caseworkers with their duties. Supervisors will provide policy updates and review the income and recertification policies in their Monthly Unit Meetings. The Medicaid Director will meet with the Medicaid Supervisors to discuss the Untimely Reviews to ensure that cases are completed in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. 230
View Audit 403310
Finding 1217191 (2025-003)
Material Weakness 2025
Johnston County
NC
Eligibility Internal Control / Segregation of Duties Questioned Costs
Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Q...
Corrective Action Plan For the Year Ended June 30, 2025 Finding: 2025-003 Inaccurate Resources Entry Name of contact person: Corrective Action: Proposed Completion Date: Finding: 2025-004 Inaccurate Resources Entry Name of contact person: Corrective Action: Section III - Federal Award Findings and Question Costs Darren Phillips, Quality Assurance and Program Integrity Supervisor We are building a training slideshow presentation to provide tenured caseworkers refresher training for all of the Internal Error findings. This will cover Incorrect Resources, Incorrect Income, Incorrect HH and Residency issues. The SSI expartes that were in error have been completed as of 12/10/2025. We will cover the use of NCFAST reports to ensure that they are worked in a timely manner. A greater emphasis will be placed during training of new hires in the areas of the errors found. Supervisors will provide policy updates and review the income and recertification policies in the Monthly Unit Meetings. The Medicaid Division Director will meet with the Medicaid supervisors to address the untimely reviews and put a plan into place to work them in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. Training will be provided by 2/28/2026 for all Medicaid personnel. Darren Phillips, Quality Assurance and Program Integrity Supervisor We are currenty building a training slideshow presentation to provide tenured caseworkers refresher training on how to update income on cases. The training will cover Self-Employment, the use of pay stubs and pulling income from OVS and TWN. The training will cover both error findings, Incorrect Income and Inadequate Request for Income. A greater emphasis will be placed on the training of new hires for the areas of the errors found. A Desk Reference will be created to assist caseworkers with their duties. Supervisors will provide policy updates and review the income and recertification policies in their Monthly Unit Meetings. The Medicaid Director will meet with the Medicaid Supervisors to discuss the Untimely Reviews to ensure that cases are completed in a timely manner. A review of the Recertification process for Family and Children's Medicaid in terms of timeliness and pending notices will also be accomplished. 230
View Audit 403310
Finding 1216989 (2025-002)
Material Weakness 2025
Survivors of Torture, International
CA
Cash Management § 200.303 § 200.305
Finding 2025-002 Condition: During the auditors’ walkthroughs of the cash draw process, the Organization appeared to drawdown on federal funding before incurring related expenses. Corrective action plan: Management agrees with the recommendation and has established a written policy and implemented a...
Finding 2025-002 Condition: During the auditors’ walkthroughs of the cash draw process, the Organization appeared to drawdown on federal funding before incurring related expenses. Corrective action plan: Management agrees with the recommendation and has established a written policy and implemented a documented process for the preparation and review of federal drawdowns, including clear evidence of review such as signoffs or electronic approvals. Responsible Individual: Etleva Bejko, Executive Director Planned Completion date: 05/22/2026
View Audit 403295
Finding 1216988 (2025-001)
Material Weakness 2025
TOWN OF MENDON
MA
Procurement, Suspension & Debarment Internal Control / Segregation of Duties Subrecipient Monitoring § 200.214
Condition: Suspension and debarment compliance was not verified for nine covered transactions. Corrective Action Plan: The Town will verify that all vendors paid with ARPA (SLFRF) funds are not suspended or debarred by checking sam.gov prior to payment. Documentation of the verification will be reta...
Condition: Suspension and debarment compliance was not verified for nine covered transactions. Corrective Action Plan: The Town will verify that all vendors paid with ARPA (SLFRF) funds are not suspended or debarred by checking sam.gov prior to payment. Documentation of the verification will be retained with the supporting payment records. Anticipated Completion Date: June 30, 2026 Contact Information: Eric A. Kinsherf, CPA, Town Accountant
View Audit 403294
Finding 1216987 (2025-002)
Material Weakness 2025
Lakeland Union High School
WI
Internal Control / Segregation of Duties
Condition: One of the pupils tested who was claimed for Impact Aid had an address which was not within federal non-taxable property. Plan: The District will review its internal controls over compiling listings of pupils for Impact Aid, and ensure they are reviewing that the pupil's address agrees wi...
Condition: One of the pupils tested who was claimed for Impact Aid had an address which was not within federal non-taxable property. Plan: The District will review its internal controls over compiling listings of pupils for Impact Aid, and ensure they are reviewing that the pupil's address agrees with the category they are being reported under. Anticipated Date of Completion: The District will correct this for the 2025-2026 school year. Name of Contact Person: Erica Schley, Business Manager Management Response: The Lakeland Union High School District accepts the plan for the Corrective Action listed above and does not dispute anything.
View Audit 403293
Finding 1216986 (2025-001)
Material Weakness 2025
Lakeland Union High School
WI
Cash Management Reporting Internal Control / Segregation of Duties
Condition: During audit fieldwork, our testing resulted in a restatement of fund balance due to clarification by the actuaries of the trust documentation behind the OPEB Trust Fund. Plan: The District will implement internal controls to provide an accurate assessment of reporting requirements. This ...
Condition: During audit fieldwork, our testing resulted in a restatement of fund balance due to clarification by the actuaries of the trust documentation behind the OPEB Trust Fund. Plan: The District will implement internal controls to provide an accurate assessment of reporting requirements. This implementation of improved controls would result in the appropriate recognition for financial reporting requirements. Anticipated Date of Completion: The District will correct this for the 2025-2026 school year. Name of Contact Person: Erica Schley, Business Manager Management Response: The Lakeland Union High School District accepts the plan for the Corrective Action listed above and does not dispute anything.
View Audit 403293
Finding 1216985 (2025-004)
Material Weakness 2025
Montgomery County, North Carolina
NC
Reporting Cash Management Eligibility
Name of Contact Person: Kris Hernandez, Director of Social Services Corrective Action: The County has worked with NCDHHS to correct errors in the audit and they have issued a revised notice. The County has further achieved eligibility accuracy rates of 100% in both standards as a result of the immed...
Name of Contact Person: Kris Hernandez, Director of Social Services Corrective Action: The County has worked with NCDHHS to correct errors in the audit and they have issued a revised notice. The County has further achieved eligibility accuracy rates of 100% in both standards as a result of the immediate accuracy improvement approach taken with OCPI audit staff. “Kudos to your staff on the improvements” has been a forwarded comment. Date of completion: September 25, 2025
View Audit 403292
Finding 1216984 (2025-002)
Material Weakness 2025
The Village at Oasis Park - Phase Ii, Inc.
AZ
Questioned Costs HUD Housing Programs
Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner, therefore HUD is un...
Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner, therefore HUD is unable to track subsidies and ultimately pay for 2025 amounts timely. Context: The Organization hired an outside consultant and it was unclear who was responsible for filing the monthly vouchers. Vouchers were not filed timely but were filed and amounts were received subsequent to year end. Response: The Organization will ensure access to systems and reports are submitted timely. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.
View Audit 403291
Finding 1216982 (2025-001)
Material Weakness 2025
The Village at Oasis Park - Phase Ii, Inc.
AZ
Questioned Costs
Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Requi...
Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Required deposits were made but they were not made monthly due to cash flow restraint. Response: The Organization will make the required deposits monthly if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.
View Audit 403291
Finding 1216980 (2025-003)
Material Weakness 2025
The Village at Oasis Park - Phase I, Inc.
AZ
Questioned Costs HUD Housing Programs
Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner. Context: The Organi...
Required Monthly Vouchers Were Not Submitted Timely. Criteria: The program requires that organizations submit monthly vouchers to HUD so that rental subsidies can be calculated and paid to the Organization. Condition: Monthly vouchers were not submitted to HUD in a timely manner. Context: The Organization hired an outside consultant and it was unclear who was responsible for filing the monthly vouchers. Vouchers were not filed timely but were filed and amounts were received subsequent to year end. Response: The Organization will review policies and procedures to verify reports are submitted timely. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.
View Audit 403290
Finding 1216978 (2025-002)
Material Weakness 2025
The Village at Oasis Park - Phase I, Inc.
AZ
Questioned Costs HUD Housing Programs
Security Deposit Account Does Not Cover Liability Criteria: The amount of the segregated, interest-bearing account maintained by The Village at Oasis Park - Phase I, Inc. for security deposits must at all times equal the total amount collected from the families then in occupancy plus any accrued int...
Security Deposit Account Does Not Cover Liability Criteria: The amount of the segregated, interest-bearing account maintained by The Village at Oasis Park - Phase I, Inc. for security deposits must at all times equal the total amount collected from the families then in occupancy plus any accrued interest and less allowable administrative costs adjustments. Condition: The amount within the segregated, interest-bearing security deposits account was less than security deposits liability. Context: A separate, interest-bearing account is maintained, but did not total an amount equal or greater than the security deposit liability due to cash flow restraint. Response: The Organization will make a deposit to security deposit account if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.
View Audit 403290
Finding 1216976 (2025-001)
Material Weakness 2025
The Village at Oasis Park - Phase I, Inc.
AZ
Questioned Costs
Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Requi...
Required Monthly Deposits Not Made Timely. Criteria: Monthly deposits are required to be made to the replacement reserve account. Condition: Monthly deposits were not made. Deposits were made every few months and total amount deposited ties to the required total deposits for the year. Context: Required deposits were made but they were not made monthly due to cash flow restraint. Response: The Organization will make the required deposits monthly if cash flow allows. Management expects these corrective actions to ensure future compliance with applicable federal and HUD reporting requirements.
View Audit 403290
Finding 1216974 (2025-001)
Material Weakness 2025
The Housing Authority of the City of Mineral Wells, Texas
TX
The Housing Authority will conduct periodic internal file reviews to verify that EIV reports are consistently obtained and that utility allowances are correctly applied. Any errors identified during these reviews will be corrected promptly, and adjustments or repayments will be made as required. Man...
The Housing Authority will conduct periodic internal file reviews to verify that EIV reports are consistently obtained and that utility allowances are correctly applied. Any errors identified during these reviews will be corrected promptly, and adjustments or repayments will be made as required. Management expects full implementation of these corrective actions within ninety days.
View Audit 403283
Finding 1216973 (2025-014)
Material Weakness 2025
Comanche County
OK
Subrecipient Monitoring § 200.1 § 200.303 § 200.329 § 200.344
The Board of County Commissioners have hired a grant administrator to assist with the reporting process. We will ensure that the reports are accurate and reported in the proper period.
The Board of County Commissioners have hired a grant administrator to assist with the reporting process. We will ensure that the reports are accurate and reported in the proper period.
View Audit 403279
Finding 1216972 (2025-007)
Material Weakness 2025
Comanche County
OK
Procurement, Suspension & Debarment Subrecipient Monitoring Allowable Costs / Cost Principles § 200.303
The Board of County Commissioners will work with all County Officials to go over all grants and federal monies that Comanche County receives to ensure that proper internal controls are implemented.
The Board of County Commissioners will work with all County Officials to go over all grants and federal monies that Comanche County receives to ensure that proper internal controls are implemented.
View Audit 403279
Finding 1216971 (2025-006)
Material Weakness 2025
Comanche County
OK
Procurement, Suspension & Debarment Subrecipient Monitoring Internal Control / Segregation of Duties
The Board of County Commissioners will work toward assessing and identifying risks to design written county-wide controls.
The Board of County Commissioners will work toward assessing and identifying risks to design written county-wide controls.
View Audit 403279
Finding 1216969 (2025-004)
Material Weakness 2025
Clinica Sierra Vista
CA
Procurement, Suspension & Debarment § 200.214
2025-004 Suspension and Debarment Corrective action planned: Management shall ensure that the procurement staff perform vendor checks prior to entering into procurement arrangements with vendors. Staff will retain documentation that the checks were performed and when they were performed. In addition...
2025-004 Suspension and Debarment Corrective action planned: Management shall ensure that the procurement staff perform vendor checks prior to entering into procurement arrangements with vendors. Staff will retain documentation that the checks were performed and when they were performed. In addition, staff will update these checks on an annual basis. Management shall implement the following procedures to ensure compliance. • Standardize a vendor verification checklist for all procurements meeting the threshold. • Integrate checks into procurement workflows so they are not an afterthought. • Train procurement staff on SAM.gov use and due diligence criteria. • Maintain a centralized procurement log with dates, results, and responsible parties for audit readiness. Anticipated completion date: June 2026 Contact person responsible for corrective action: Harjeet Sidhu, Chief Financial Officer
View Audit 403260
Finding 1216965 (2025-003)
Material Weakness 2025
Clinica Sierra Vista
CA
Procurement, Suspension & Debarment § 200.320
2025-003 Procurement Corrective action planned: CSV will enforce its procedure policy that all competitive procurement transactions above the micro-purchase threshold, when expenditures are charged to a federal award, must have complete supporting documentation retained for at least four years after...
2025-003 Procurement Corrective action planned: CSV will enforce its procedure policy that all competitive procurement transactions above the micro-purchase threshold, when expenditures are charged to a federal award, must have complete supporting documentation retained for at least four years after final payment, in accordance with 2 CFR 200.320. This will be accomplished by providing training for procurement, finance, and administrative staff on: • Recognizing when a transaction exceeds the threshold. • Collecting and organizing supporting documentation. • Understanding retention periods and storage requirements. The Procurement Manager shall oversee compliance with the threshold and retention requirements. CSV shall conduct periodic audits to: • Review procurement files for completeness and compliance with retention requirements. • Identify gaps or missing documentation and correct them promptly. • Document audit findings and corrective actions. Anticipated completion date: June 2026 Contact person responsible for corrective action: Harjeet Sidhu, Chief Financial Officer
View Audit 403260
Finding 1216961 (2025-002)
Material Weakness 2025
Clinica Sierra Vista
CA
Cash Management Questioned Costs Subrecipient Monitoring § 200.305
2025-002 Cash Management Corrective action planned: Management will implement controls over all draws from the Payment Management System to minimize the time elapsed between the drawdown of funds from PMS and the payment for expenditures. The controls will incorporate the following: Prepare a detail...
2025-002 Cash Management Corrective action planned: Management will implement controls over all draws from the Payment Management System to minimize the time elapsed between the drawdown of funds from PMS and the payment for expenditures. The controls will incorporate the following: Prepare a detailed listing of expenditures claimed for reimbursement for each drawdown request. The expenditures listing will be reviewed by appropriate personnel to ensure cash payments for the expenditure are made before the date of the draw or within a reasonable time after the draw. Drawdowns are authorized and approved by the appropriate personnel before the drawdown is made and will be tracked and summarized in a ledger. Anticipated completion date: June 2026 Contact person responsible for corrective action: Harjeet Sidhu, Chief Financial Officer
View Audit 403260
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