Corrective Action Plans

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Finding 2025-005: Significant Deficiency - Cash Management Condition: The Club drew down federal funds in advance of actual cash needs. For two cash draws tested for each program, the federal funds were not disbursed to vendors within 5 business days of the funds being drawn down. Corrective Action:...
Finding 2025-005: Significant Deficiency - Cash Management Condition: The Club drew down federal funds in advance of actual cash needs. For two cash draws tested for each program, the federal funds were not disbursed to vendors within 5 business days of the funds being drawn down. Corrective Action: The Club is working with the EBCI Grant's office to increase communication and coordinate the drawdowns so funds are received and processed for payment within the given grant timelines. Person Responsible For Corrective Action: Rhonica Via, Finance Director Anticipated Completion Date: June 30, 2026
Finding 2025-004: Significant Deficiency - Special Tests and Provisions Repeat of Prior Year Finding 2024-005 Condition: While documentation exists that a background investigation was completed, no documentation was maintained that the results of the background investigation were compared to the emp...
Finding 2025-004: Significant Deficiency - Special Tests and Provisions Repeat of Prior Year Finding 2024-005 Condition: While documentation exists that a background investigation was completed, no documentation was maintained that the results of the background investigation were compared to the employment application or that a suitability determination was conducted by an appropriate adjudicating official who herself/himself was the subject of a favorable background investigation. Corrective Action: The Club and Cherokee Central Schools (CCS) agree with this finding and CCS notes that its Employment Suitability Investigations policy was updated and formally adopted on July 22, 2019. The audit included a sample of employee files from prior years, before the policy was implemented and before consistent personnel changes were made. Since the policy's adoption, appropriate procedures have been put in place to ensure background investigations and employment suitability assessments are conducted and properly documented. CCS will continue to monitor compliance with the policy and ensure that documentation is consistently maintained in employee personnel files moving forward. Current updates to be enacted immediately include documentation that the Superintendent has reviewed the files. Person Responsible For Corrective Action: Heather Driver, Interim CCS HR Director Anticipated Completion Date: June 30, 2026
FINDING 2025-002: Audit report deadline Response: Management accepts this finding. Beginning with the fiscal year ending June 30, 2026, the City will begin its year-end closing and reconciliation processes as soon as possible to help ensure that the financial statements and other information require...
FINDING 2025-002: Audit report deadline Response: Management accepts this finding. Beginning with the fiscal year ending June 30, 2026, the City will begin its year-end closing and reconciliation processes as soon as possible to help ensure that the financial statements and other information required for the annual audit will be reviewed for accuracy and completeness in a timely manner, and it will coordinate with its auditor to establish an appropriate schedule for completing these activities.
Management Response: Management acknowledges the audit finding related to Special Tests and Provisions requirements for Federal programs. We recognize the importance of adhering to all applicable federal regulations, grant requirements, and program-specific compliance standards. We have new HR Perso...
Management Response: Management acknowledges the audit finding related to Special Tests and Provisions requirements for Federal programs. We recognize the importance of adhering to all applicable federal regulations, grant requirements, and program-specific compliance standards. We have new HR Personnel who are committed to ensuring all files are up to date and all background checks have been completed for all personnel. As previously stated Personnel files were disassembled by previous Management and not replaced. Our HR Staff have worked diligently on an HR File Audit to ensure all documents are in place and that we are in compliance with the Indian Child Protection and Family Violence Prevention Act. Anticipated Completion Date: In process already for the current fiscal year (2026), Management anticipates full implementation by August 31, 2026. Management is monitoring progress and ensuring timely completion, we have four (4) Certified background screeners and adjudicators on staff aside from using an outside adjudicator to complete background checks and adjudication. Responsible Party: Business Manager, HR Director and staff.
Management Response: Management agrees with the audit finding regarding internal controls over payroll. To strengthen payroll controls and ensure the accuracy and integrity of payroll processing, the organization has implemented and will continue to enhance the following procedures: Payroll is proce...
Management Response: Management agrees with the audit finding regarding internal controls over payroll. To strengthen payroll controls and ensure the accuracy and integrity of payroll processing, the organization has implemented and will continue to enhance the following procedures: Payroll is processed based on approved employee contracts, work agreements and authorized timesheets. Supervisors are responsible for reviewing and approving employee timesheets before payroll is processed. We have a new payroll manager who is ensuring that all required documentation is on file and works closely with the HR Department. We acknowledge that HR Files were incomplete due to previous staff disassembling files for HR Audits and not replacing documents to original folders. Anticipated Completion Date: In process for FY2026, we have a new payroll manager and HR Director that started in May of 2025 and both are ensuring all proper documentation is in place. Management anticipates full implementation by June 30, 2026. Responsible Party: Business Manager, Payroll Manager, Accounting Tech & HR Director.
Management Response: Management acknowledges the audit finding related to the late submission of the Single Audit, which was identified as a significant deficiency. We recognize the importance of timely submission in accordance with federal audit requirements and applicable regulatory deadlines. Man...
Management Response: Management acknowledges the audit finding related to the late submission of the Single Audit, which was identified as a significant deficiency. We recognize the importance of timely submission in accordance with federal audit requirements and applicable regulatory deadlines. Management has evaluated the audit timeline process and identified delays in the coordination of year-end financial reporting, supporting documentation, and audit fieldwork completion. We have reviewed our processes for fiscal year end closing and are committed to ensuring timely completion and submission of future Single Audits. Anticipated Completion Date: Immediately upon the start of the new Fiscal Year on July 1.Management anticipates full implementation by July 30, 2027. Responsible Party: All Business Office Staff. 39
Management Response: Management agrees with the finding and is committed to strengthening internal controls over financial reporting. We have discussed updating what we can complete in house to improve documentation, reconciliations and staff training. We use an outside accounting firm to provide ac...
Management Response: Management agrees with the finding and is committed to strengthening internal controls over financial reporting. We have discussed updating what we can complete in house to improve documentation, reconciliations and staff training. We use an outside accounting firm to provide accounting oversight and financial reporting, the firm provides technical expertise, reviews financial records for accuracy and completeness, assists with financial preparation and offers guidance on compliance with applicable accounting standards and regulatory requirements. Anticipated Completion Date: Immediately upon the start of the new Fiscal Year on July 1. Management anticipates full implementation by June 30, 2027. Responsible Party: Business Manager, Accounting Tech and the outside Accounting Firm.
Management has established a documentation tracking system to ensure that all stages of the monthly reporting process including preparation, review, approval, and submission are properly documented and retained.
Management has established a documentation tracking system to ensure that all stages of the monthly reporting process including preparation, review, approval, and submission are properly documented and retained.
Management has implemented a comprehensive continuing education program for employees who work on the SSVF program. Monthly internal audits are conducted by the Program leadership team to monitor compliance with funder guidelines.
Management has implemented a comprehensive continuing education program for employees who work on the SSVF program. Monthly internal audits are conducted by the Program leadership team to monitor compliance with funder guidelines.
Management will standardize the budget allocation forms to reflect approved wage rates across all employees and ensure all employees have up-to-date forms on file.
Management will standardize the budget allocation forms to reflect approved wage rates across all employees and ensure all employees have up-to-date forms on file.
Recommendation: We recommend that the Town continue to strengthen its formal procurement policies with the criteria in 2 CFR sections 200.318 and 200.326. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: While to fi...
Recommendation: We recommend that the Town continue to strengthen its formal procurement policies with the criteria in 2 CFR sections 200.318 and 200.326. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: While to finance department has a procedure in place to review the Excluded Parties List system to ensure that the vendor is not debarred or suspended and to document such confirmation, we will further strengthen our procurement policies as follows: As part of the bid and vendor review, the Town Engineer will print off the Excluded Parties List at that time, initial and date it, and keep it with all bid documents. This will ensure that the list has been checked prior to any contract being executed. The finance office will continue their review when the vendor is set up in the financial management system. Name(s) of the contact person(s) responsible for corrective action: Cherie Trahan Planned completion date for corrective action plan: 06/30/2026
Management will implement corrective actions to ensure compliance going forward, including revising written procedures to identify reportable subawards, assigning responsibility for preparation and review of FFATA submissions, maintaining a tracking log of subawards and reporting deadlines, and perf...
Management will implement corrective actions to ensure compliance going forward, including revising written procedures to identify reportable subawards, assigning responsibility for preparation and review of FFATA submissions, maintaining a tracking log of subawards and reporting deadlines, and performing supervisory reviews to ensure reports are submitted completely and timely. Management will also provide training for relevant personnel and evaluate prior subawards to determine whether any required reports were omitted and will complete any necessary submissions to the extent permitted.
Management will review its cash management procedures to ensure that federal drawdowns are supported by actual or immediate cash needs based on expenditures incurred. Management will also closely monitor subrecipient expenditure activity and reimbursement timing to ensure compliance with 2 CFR 200.3...
Management will review its cash management procedures to ensure that federal drawdowns are supported by actual or immediate cash needs based on expenditures incurred. Management will also closely monitor subrecipient expenditure activity and reimbursement timing to ensure compliance with 2 CFR 200.305(b) and minimize the time between receipt and disbursement of federal funds.
Management will coordinate with external auditors to ensure timely completion of the audit and to ensure compliance with 2 CFR 200.512 requirements.
Management will coordinate with external auditors to ensure timely completion of the audit and to ensure compliance with 2 CFR 200.512 requirements.
The City will implement additional control procedures to ensure all reports are filed in a timely manner.
The City will implement additional control procedures to ensure all reports are filed in a timely manner.
The Lorman Waterworks Association, Inc. acknowledges the late submission of the audit report and will make it a priority. The water association will implement accurate timelines for 2026 fiscal year audit.
The Lorman Waterworks Association, Inc. acknowledges the late submission of the audit report and will make it a priority. The water association will implement accurate timelines for 2026 fiscal year audit.
Procurement – Assistance Listing No. 93.224/93.527 Recommendation: We recommend the Organization consistently follow its established policies and procedures related to the maintaining of necessary documentation to support the method of procurement utilized. The Organization may also consider qualify...
Procurement – Assistance Listing No. 93.224/93.527 Recommendation: We recommend the Organization consistently follow its established policies and procedures related to the maintaining of necessary documentation to support the method of procurement utilized. The Organization may also consider qualifying multiple vendors for particular goods/service and then utilizing an approved vendors list. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: • Review Contract and procurement policies and procedures. • Compare current procurement process and training to the policies and identify areas for correction and improvement. • Update Policies and procedures as needed. • Implement procedures to review vendors on a periodic basis. • Implement procedures and assign responsibility for checking off that procurement documentation exists and is in the vendor folder or designated area. • Retrain staff involved in procurement on updated procedures. • Monitor process and adjust as needed. Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: January 2027
Reporting – Assistance Listing No. 93.224/93.527 Recommendation: We recommend the Organization perform a final review of amounts entered within the UDS report, as compared to the supporting schedules, prior to submission. Explanation of disagreement with audit finding: There is no disagreement with ...
Reporting – Assistance Listing No. 93.224/93.527 Recommendation: We recommend the Organization perform a final review of amounts entered within the UDS report, as compared to the supporting schedules, prior to submission. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: • Update UDS procedure to pull detail reports on all numbers reported in the UDS. • Add to the UDS procedure a review of detail reports to tie them to UDS report • Add a sign off to UDS report as part of final review that detail reports were pulled and verified. Name of the contact person responsible for corrective action: Keith Flores, CFO Planned completion date for corrective action plan: July 2026
View of Responsible Officials and Corrective Action Plan WESST acknowledges this finding, remains committed to continuous improvement, and has already taken proactive, substantive corrective action. During the fiscal year under review, the organization experienced a leadership transition when a new ...
View of Responsible Officials and Corrective Action Plan WESST acknowledges this finding, remains committed to continuous improvement, and has already taken proactive, substantive corrective action. During the fiscal year under review, the organization experienced a leadership transition when a new Chief Executive Officer assumed responsibility following the departure of a CEO who had served for 33 years. At the same time, WESST faced significant and sudden changes in long-term funding sources, requiring prompt financial and operational adjustments. A significant finance department change occurred in October 2025. As noted in the Statement of Condition above, no exceptions were identified after that point. In connection with this change, WESST implemented key control processes, including: o All expenses will be reviewed for allowability, allocability, and reasonableness before being charged to the grant. o Payroll charges recorded in the general ledger will be reconciled to employee time records or approved allocation schedules each month. Variances will be investigated and corrected in a timely manner. o All changes to payroll allocations require documented justification and formal review and approval. o Monthly expense reviews will be performed by the: • Staff Accountant • Program Director • Accounting Controller o These reviews will support proper classification of direct and indirect costs and help prevent inconsistent treatment Corrective Action Plan Timeline Completed implementation in March of 2026. Designation of Employee Position Responsible for Meeting Deadline Chief Executive Officer
We will improve our internal control procedures related to record keeping and adjustments in order to ensure compliance with the March 31 federal requirement. Implementation Date: During the 2026-2027 fiscal year. Responsible Person: Mrs. Yadira Pereira Nieves Finance Director
We will improve our internal control procedures related to record keeping and adjustments in order to ensure compliance with the March 31 federal requirement. Implementation Date: During the 2026-2027 fiscal year. Responsible Person: Mrs. Yadira Pereira Nieves Finance Director
Finding 2025-002 Federal Agency Name: U.S. Department of Treasury Program Name: Coronavirus State and Local Fiscal Recovery Funds FFALN # 21.027 Finding Summary: Eide Bailly LLP prepared our single audit for Federal Coronavirus State and Local Fiscal Recovery Funds where the Town is a subrecipient t...
Finding 2025-002 Federal Agency Name: U.S. Department of Treasury Program Name: Coronavirus State and Local Fiscal Recovery Funds FFALN # 21.027 Finding Summary: Eide Bailly LLP prepared our single audit for Federal Coronavirus State and Local Fiscal Recovery Funds where the Town is a subrecipient to Douglas County who is the recipient of the funds. Eide Bailly LLP identified that the Town did not have documented or consistently applied internal controls to ensure compliance with the County’s subrecipient guidance requiring the submission of formal special reports for ALN 21.027. Responsible Individuals: Mark Henderson, Assistant Director of Castle Rock Water Corrective Action Plan: Staff will complete quarterly reports including project progress and estimated project infrastructure costs. The reports will be reviewed by management prior to submission to the recipient of the Federal Funds (Douglas County). Anticipated Completion Date: Ongoing during the period that the Town is a subrecipient of these funds for the project.
Finding 2025-002 Procurement and Suspension and Debarment (Compliance) – 2020 Criteria The City must comply with procurement standards set out at 2 CFR sections 200.318 through 200.326 within the Uniform Guidance. Condition The City’s procurement standards do not include all the essential elements a...
Finding 2025-002 Procurement and Suspension and Debarment (Compliance) – 2020 Criteria The City must comply with procurement standards set out at 2 CFR sections 200.318 through 200.326 within the Uniform Guidance. Condition The City’s procurement standards do not include all the essential elements as outlined in 2 CFR sections 200.318 through 200.326. In addition, the City did not retain adequate documentation for verification that vendors were not suspended or debarred parties. Corrective Action Plan Although the City was performing the review, the report from the SAM.gov website being maintained by the City to document said review did not provide evidence that there were no active exclusion records. Under the direction of the Finance Director working with the Senior Buyer / Analyst, this Procurement procedure and policy have been updated and distributed to the appropriate individuals. Adherence to this policy and procedure will be monitored by the Finance Director and the Internal Auditor.
Subject: 2025 Single Audit Finding 2025-004 2025-004 Management Response: Management acknowledges the finding. DEMRS did not submit the required quarterly financial and performance reports to the Illinois Emergency Management Agency (IEMA) for the Homeland Security Grant Program during the fiscal ye...
Subject: 2025 Single Audit Finding 2025-004 2025-004 Management Response: Management acknowledges the finding. DEMRS did not submit the required quarterly financial and performance reports to the Illinois Emergency Management Agency (IEMA) for the Homeland Security Grant Program during the fiscal year. Root Cause Analysis: Over multiple years, DEMRS experienced significant turnover in key finance and grant management positions, which created gaps in continuity and delayed the department's transition to IEMA's Amplifund reporting system. As prior management departed and new staff were onboarded, the department faced operational challenges that affected the consistency of its grant reporting processes. Due to Amplifund's requirement that reimbursement requests be submitted sequentially before performance reports can be filed, the delays in prior period submissions prevented DEMRS from accessing and submitting the quarterly reports. Statewide pauses in FEMA and IEMA grant processing further contributed to the backlog. Corrective Action: DEMRS will complete and submit all outstanding reimbursement requests and performance reports for UASI 2022, UASI 2023, and UASI 2024 to bring the County into full compliance with grantor requirements. Preventive Action: DEMRS will implement a grants compliance calendar that tracks all reporting deadlines. Future reports will be prepared by the Manager of Grants & Contracts and reviewed and approved by the Associate Director of Finance, with documented evidence of review. Responsible Party: Damian Albert, Associate Director of Finance, damian.albert@cookcountyil.gov. 312.603.8177 Tina Bhaga, Manager, Grants & Contracts, tina.bhaga@cookcountyil.gov, 312.603.8543 Planned Completion Date: January 1, 2027
Memo: Cause and Corrective Action Plan for Finding 2025-003 This correspondence serves as Cook County Health (CCH) and Cook County Department of Public Health (CCDPH) response to Finding 2025-003. During the FY2025 Single Audit, one audit finding was identified by Washington, Pittman & McKeever, LLC...
Memo: Cause and Corrective Action Plan for Finding 2025-003 This correspondence serves as Cook County Health (CCH) and Cook County Department of Public Health (CCDPH) response to Finding 2025-003. During the FY2025 Single Audit, one audit finding was identified by Washington, Pittman & McKeever, LLC. The root cause and corrective action plan is identified below. Condition During the current audit period, the Cook County Department of Public Health (DPH) did not comply with federal regulations regarding the use and reporting of program income as it relates to funds awarded through the RWHAP Root Cause Analysis The HIV grants transitioned to CCH from an external organization in July 2025. Award amounts were granted in multiple phases, requiring four budget revisions, with the final revision approved in December 2025. The contractual period covered March 2025 through December 2025. During the transition period, CCH lacked formal operational procedures to identify, record, and track program income. Several operational and administrative challenges contributed to this issue, including: • No written internal procedures were in place to define or track program income requirements. • No formal transition teams were established to identify core grant obligations, resulting in unclear interpretation of sponsor requirements. • CCH had not yet identified the appropriate internal systems or interdepartmental collaborations necessary to retrieve and reconcile program income data. • Organizational priorities during the transition focused on maintaining existing deliverables, including vouchering, budget compliance, hiring, and onboarding of direct and administrative staff. • Staffing Shortages, CCH onboarded personnel quickly as contractual employees, direct staff transitioned onboard as CCH employees in phases upon execution of grant contracts. Corrective Action Plan CCH Director of Grants Accounting is implementing formal written processes and procedures to ensure compliance with Federal Uniform Guidance requirements related to program income. The corrective action plan includes: • Developing standardized written procedures that clearly define program income requirements and tracking responsibilities. • Establishing shared roles and responsibilities across departments to support consistent data collection, reconciliation, and reporting. • Identifying the specific data elements required to accurately record and monitor program income. • Formalizing interdepartmental collaboration processes necessary to retrieve and validate program income information. • Defining the systems and reporting tools that will be used to track and maintain program income records. • Providing staff training on program income requirements, documentation standards, and compliance expectations. These actions will strengthen internal controls and ensure timely, accurate identification and tracking of program income moving forward, official approval/implementation is expected December 2026
Re: FY2025 Single Audit Finding 2025-002 In respect to 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Section 200.332, it was brought to my attention that the County performed inadequate monitoring of its subrecipients funded through ...
Re: FY2025 Single Audit Finding 2025-002 In respect to 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Section 200.332, it was brought to my attention that the County performed inadequate monitoring of its subrecipients funded through Coronavirus State and Local Fiscal Recovery Funds (SLFRF), as required by its internal policies. Below is the corrective action plan to address the finding. Each County department that issues sub-recipient agreements is responsible for the day-to-day monitoring of their respective SLFRF subrecipients, including reviewing financial and programmatic reports and ensuring compliance with the federal and County requirements. The Bureau of Finance (BOF) also been overseeing the monitoring of subrecipients in order to help identify potential compliance issues. Compliance Oversight and Technical Support (COTS) under the Bureau of Finance coordinates and conducts an annual review of each SLFRF programs and assesses all subrecipients or vendor relationships to ensure compliance across the County. The COTS process has helped the County address inadequate monitoring and compliance concerns. Most of the County s subrecipient activities are scheduled to conclude in September 2026 and the end of the SLFRF programmatic performance period is nearing. As such, the County has started the closeout preparation for both County departments and their subrecipients. The process includes: Communication of the closeout procedures including required documentation of monitoring activities Confirmation of receipts of financial reports and the supporting documents such as proof of payments Expenditure reconciliations between the County s financial system and ARPA grants management system Confirmation of all monitoring logs and programmatic reports submission It is expected the final COTS review to be completed by the end of the fiscal year and we believe these measures will mitigate and address any future instances of inadequate monitoring identified in the current finding 2025-002.
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