Corrective Action Plans

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Finding Number: 2024-004 Finding Title: Reporting Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Erin Marks, Accounting & Support Services Supervisor - Main Contact Persons involved: Kim Giese, Fiscal Officer and Joan Stordalen, Social Services S...
Finding Number: 2024-004 Finding Title: Reporting Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Erin Marks, Accounting & Support Services Supervisor - Main Contact Persons involved: Kim Giese, Fiscal Officer and Joan Stordalen, Social Services Supervisor Corrective Action Planned: Regarding the DHS-3220.3 Local Collaborative Time Study (LCTS) Cost Schedule, it was discovered that the Sexual Reproductive Health Services Grant Award was not accurately reported on the LCTS Cost Schedule due to the misguidance from MN Department of Health (MDH) and the interpretation of Watonwan County. After clarification from MDH, all SRHS funds will be reported as state funds only and should not be reflected on the LCTS reporting. Fiscal Officer will amend the last 4 quarters of the LCTS reporting to reflect that change. Moving forward, we will retain documentation from MDH showing SRHS funds are state only funds, regardless of what our grant agreement shows, and ensure that this funding source is not reported on the LCTS reporting in the future. Fiscal Officer will continue to complete the quarterly LCTS reporting, while the Accounting & Support Services Supervisor will review and sign off on it. Regarding the late submission of the 2024 Annual Collaborative Report. This report is emailed and completed by the LCTS Coordinator. Watonwan County's LCTS Coordinator is our Social Services Supervisor. To ensure on time submission of the Annual Collaborative Report, that is due on April 30 each year, a reminder will be added to both the Social Services Supervisor and the Accounting & Support Services Supervisor's Outlook calendars for a reminder beginning April ist giving time to complete and submit the report prior to April 30th. Anticipated Completion Date: 9/12/2025 - Reporting 4/30/2026 - Late Submission
Finding Number: 2024-003 Finding Title: Eligibility - MAXIS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Jodi Halvorson Corrective Action Planned: Verification of Citizenship/assets: We will have discussions at our next unit meeting about makin...
Finding Number: 2024-003 Finding Title: Eligibility - MAXIS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Jodi Halvorson Corrective Action Planned: Verification of Citizenship/assets: We will have discussions at our next unit meeting about making sure all health care cases have their citizenship verified. We will also have training on the policy regarding verifying vehicles if there is more than one in the household. Anticipated Completion Date: 9/15/25 we will have the unit meeting
Finding Number: 2024-002 Finding Title: Eligibility - METS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Jodi Halvorson Corrective Action Planned: Timelines: This error occurred from a worker that is no longer in our agency. It was discovered af...
Finding Number: 2024-002 Finding Title: Eligibility - METS Program: 93.778 Medical Assistance Program Name of Contact Person Responsible for Corrective Action: Jodi Halvorson Corrective Action Planned: Timelines: This error occurred from a worker that is no longer in our agency. It was discovered after the worker left that the application was filed away without processing. This is not our policy, and we will be discussing the importance of program timelines in our unit meeting. Verification of Citizenship status (error with SSN entry): This case was received from a previous county. The SSN was entered incorrectly which did not produce citizenship verification in the system. It was noted that there was a birth certificate on file, but METS case files do not get transferred between counties, so we did not have the birth certificate. The SSN was corrected which was able to ping the verification of the citizenship. Going forward, for the next 3 months we will be looking at each case that is transferred into our county to make sure the citizenship has been verified and if not, request the birth certificate or other verification. After the initial 3 months, we plan to do random case checks. Anticipated Completion Date: 9/15/25 we will have the unit meeting and discuss timelines 12/31/25 will be our 3-month goal of checking transferred in cases for citizenship
CORRECTIVE ACTION PLAN August28, 2025 Cognizant oversight agency: U.S. Department of Housing and Urban Development The Housing Authority of the City of Decatur, Georgia respectfully submits the following corrective action plan for the year ended December 31 , 2024. Audit Firm: CohnReznick LLP 3560 L...
CORRECTIVE ACTION PLAN August28, 2025 Cognizant oversight agency: U.S. Department of Housing and Urban Development The Housing Authority of the City of Decatur, Georgia respectfully submits the following corrective action plan for the year ended December 31 , 2024. Audit Firm: CohnReznick LLP 3560 Lenox Road, Suite 2900 Atlanta, Georgia 30326 Audit period: for the year ended December 31, 2024 The finding from the December 31 , 2024 schedule of findings and questioned costs is discussed below. The finding is numbered consistently with the number assigned in the schedule. FINDING-FEDERAL AWARD PROGRAMS AUDIT DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT 2024-001 Housing Voucher Cluster -AL Nos. 14.871 , 14.879 Recommendation: the Authority reviews its internal controls to reduce the risk of unauthorized access to and/or misuse of PII contained within the EIV reports in the future to ensure compliance with eligibility requirements. Action Taken: As part of the Authority's standard internal controls, all HCV employees with access to EIV are required to sign the Rules of Behavior and complete HUD's annual cybersecurity training. In addition, the Authority maintains physical security measures and general IT controls onsite to reduce risks associated with unauthorized access. Since the incident occurred, the Authority has implemented several additional measures to strengthen data protection practices. Specifically: •Issued a new Information Protection Policy and Confidentiality Agreement, which all employees are required to review and sign. ·Conducted an all-staff training session to review the new policy in detail and reinforce best practices for safeguarding participant information. •The Chief Executive Officer reiterated the Authority's commitment to data security and emphasized that any violation of information protection policies will result in disciplinary action, up to and including termination of employment, as well as potential legal prosecution. If the U.S. Department of Housing and Urban Development has questions regarding this plan, please call Larry H. Padilla, CEO at 404-270-2101. Larry H. Padilla CEO/Executive Director
Management concurs. The Data Collection Form was submitted to the Federal Audit Clearinghouse on January 9, 2025, no further action is required.
Management concurs. The Data Collection Form was submitted to the Federal Audit Clearinghouse on January 9, 2025, no further action is required.
Finding Number: 2024-002 Anticipated Completion Date: 10-31-2025 Responsible Contact Person: Mark Bridenbaugh, CEO Planned Corrective Action: The organization does have an existing Procurement Policy that is compliant with 2 CFR Section 200.320 for federal grant expenditure related procurement metho...
Finding Number: 2024-002 Anticipated Completion Date: 10-31-2025 Responsible Contact Person: Mark Bridenbaugh, CEO Planned Corrective Action: The organization does have an existing Procurement Policy that is compliant with 2 CFR Section 200.320 for federal grant expenditure related procurement methods. This policy will be reviewed with all Officers, Directors and fiscal staff who are involved in managing any grant program or related purchases. Review and training will occur within the next month. Proper documentation, consistent with the policy, must be reviewed and approved by the CEO, CFO or designee prior to the purchase being made. Documentation will be kept by both the grant Project Director and the approving official.
Planned Corrective Action The University recognizes the deficiencies in maintaining proper documentation related to exit interviews for the Nursing Student Loan program. In response, the University is updating its policies and procedures to ensure full compliance with 42 CFR Part 57 § 57.310 (b), in...
Planned Corrective Action The University recognizes the deficiencies in maintaining proper documentation related to exit interviews for the Nursing Student Loan program. In response, the University is updating its policies and procedures to ensure full compliance with 42 CFR Part 57 § 57.310 (b), including: -Requiring signed Truth in Lending Statements for all borrowers -Maintaining evidence of mailings in cases where borrowers fail to attend in-person exit interviews or failed to return the mailing -Implementing a checklist and file audit process to ensure all required documentation is consistently retained Staff involved in loan processing and management will be retrained to ensure awareness of the regulatory documentation requirements. Implementation Date -Policy & Procedure Update: December 31, 2025 -Staff Training Completion: October 31, 2025 Responsible Personnel Tony Baraghimian Deputy CFO & Controller
Planned Corrective Action The University acknowledges the omission in reporting the third-party platform-related data breach to the Department of Education. Although the breach was internally addressed and affected individuals were notified, the external reporting protocol was not followed. In respo...
Planned Corrective Action The University acknowledges the omission in reporting the third-party platform-related data breach to the Department of Education. Although the breach was internally addressed and affected individuals were notified, the external reporting protocol was not followed. In response, the University is revising its cybersecurity incident response policy to incorporate specific guidance on reporting suspected or confirmed data breaches to the Department of Education in accordance with the Student Aid Internet Gateway Agreement. Staff responsible for incident response and information security will receive training on these updated procedures. The Deputy COO together with the Deputy CFO will be responsible for ensuring timely notifications are made. The University will enhance its vendor risk management procedures, ensuring that all third-party service providers handling sensitive data are conducting compliance training with their employees and reprimanding employees not following policy. The University will meet monthly with third-party service providers handling PII to discuss ongoing compliance trainings and document how the provide is staying current on managing threats. Implementation Date -Policy Update & Staff Training: October 31, 2025 Responsible Personnel Marcus D Walton Deputy Chief Operating Officer & CIO
Planned Corrective Action The University acknowledges the finding related to incomplete documentation of the formal risk assessment and the lack of monitoring over access levels to the financial aid system. We are currently developing a comprehensive, documented GLBA risk assessment that aligns with...
Planned Corrective Action The University acknowledges the finding related to incomplete documentation of the formal risk assessment and the lack of monitoring over access levels to the financial aid system. We are currently developing a comprehensive, documented GLBA risk assessment that aligns with federal requirements, including the identification of internal and external risks, evaluation of current safeguards, and implementation of appropriate remediation measures. Additionally, the University is implementing a formalized review process whereby system access roles are reviewed quarterly in collaboration with department managers to ensure user access is consistent with current job responsibilities. This will include a standardized user access review form and documented management sign-off. Implementation Date -Risk Assessment Documentation: December 31, 2025 -Access Review Procedure Implementation: December 31, 2025 Responsible Personnel Marcus D Walton Deputy Chief Operating Officer & CIO
View of Responsible Official The Executive Director will take action to make sure USDA reports are filed on time. The ED will work with the Finance Director and other accounting staff to ensure deadlines are met. Timeline Target implementation September 30, 2025. Staff Responsible Executive Director
View of Responsible Official The Executive Director will take action to make sure USDA reports are filed on time. The ED will work with the Finance Director and other accounting staff to ensure deadlines are met. Timeline Target implementation September 30, 2025. Staff Responsible Executive Director
Management agrees with the finding and will ensure all requested information is available for the auditor in order to facilitate timely completion of the audit by March 31.
Management agrees with the finding and will ensure all requested information is available for the auditor in order to facilitate timely completion of the audit by March 31.
2024-003: Water and Waste Disposal Systems for Rural Communities Reporting Corrective Action Plan: The Village is actively working with USDA personnel to submit the required reporting documents. Going forward, these will be submitted once available. Reponsible person: Sheila Schreiner Anticipated co...
2024-003: Water and Waste Disposal Systems for Rural Communities Reporting Corrective Action Plan: The Village is actively working with USDA personnel to submit the required reporting documents. Going forward, these will be submitted once available. Reponsible person: Sheila Schreiner Anticipated completetion date: Ongoing
Management strives to operate within a model of continuous improvement and will review and improve processes appropriately to provide for timely reporting on a go-forward basis.
Management strives to operate within a model of continuous improvement and will review and improve processes appropriately to provide for timely reporting on a go-forward basis.
Condition In two instances, the amounts recorded in the General Ledger (GL) did not match the corresponding amounts recorded in the payroll system. Corrective Action Plan Corrective Action Planned: Efforts were taken to verify Dayforce is configured to allocate salary expenses to an employee’s home ...
Condition In two instances, the amounts recorded in the General Ledger (GL) did not match the corresponding amounts recorded in the payroll system. Corrective Action Plan Corrective Action Planned: Efforts were taken to verify Dayforce is configured to allocate salary expenses to an employee’s home agency and department, regardless of where the employee assigns their hours in the timekeeping system. While the timesheet programmatic reflects the agency and department where hours and dollars are functionally charged, the payroll register aligns with the General Ledger based on home agency coding. As a result, the Payroll Register and General Ledger will reconcile with each other but may not align with programmatic reports, which are based on timesheet-level allocations. This system behavior is consistent with current configuration and financial reporting practices. The Payroll Department and the DHHS will meet in Q3 2025 to ensure grant/expense tracking activities are working as intended. Name(s) of Contact Person(s) Responsible for Corrective Action: Sue Drummond, Director Payroll & HRIS Interface Anticipated Completion Date: Completed January 2025.
Town’s Response: The Town concurs with the audit finding and has begun implementing the corrective actions outlined below. 1. Policy Alignment o Revise the Town’s Procurement Policy to explicitly state that federal Uniform Guidance procurement standards supersede state exemptions when federal funds ...
Town’s Response: The Town concurs with the audit finding and has begun implementing the corrective actions outlined below. 1. Policy Alignment o Revise the Town’s Procurement Policy to explicitly state that federal Uniform Guidance procurement standards supersede state exemptions when federal funds are used. 2. Procedural Controls o Require a funding source review step in the requisition process: if any portion of funding is federal, staff must apply federal standards. o Incorporate a mandatory compliance checklist for all federally funded procurements, including documentation of cost/price analysis, vendor selection, and conflict of interest certifications. 3. Training & Awareness o Conduct annual training for the Procurement Manager. o Provide written desk guides / “quick reference sheets” for federal vs. state thresholds and documentation requirements. 4. Oversight & Monitoring o Director of Finance/Assistant Finance Director to review and approve all federal-funded procurement files prior to award. o Establish quarterly compliance monitoring of federal procurements, with results reported to the Town Manager via Monthly reports submitted. 5. System Enhancements o Explore Munis configuration options to flag federally funded accounts during requisition entry, ensuring the correct rules are applied. 566 Washington Street, P.O. Box 40, Norwood, MA 02062-0040 Phone No. (781) 762-1240 Responsible Parties:  Procurement Manager – day-to-day compliance Completion Date:  Policy revision and training to be completed by December 31, 2025. Compliance checklist implementation and monitoring effective immediately for all new procurements using federal funds. Submitted By: Jeffrey O’Neill Director of Finance & Town Accountant
View Audit 367144 Questioned Costs: $1
CASEFILE REVIEW (2023-005) Recommendation: It is recommended the County review case files on a periodic basis throughout the year and document the reviews. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County...
CASEFILE REVIEW (2023-005) Recommendation: It is recommended the County review case files on a periodic basis throughout the year and document the reviews. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will continue to work at this area and internal controls to achieve the overall goal. Name of the contact person responsible for corrective action plan: Karen Anderson, Chief Financial Officer Planned completion date for corrective action plan: December 31, 2025
SSIS ACTIVITIES ALLOWED/ALLOWABLE COSTS (2023-009) Recommendation: It is recommended that the County implement procedures to document review of disbursements when not able to show an electronic approval in the SSIS system. Explanation of disagreement with audit finding: There is no disagreement with...
SSIS ACTIVITIES ALLOWED/ALLOWABLE COSTS (2023-009) Recommendation: It is recommended that the County implement procedures to document review of disbursements when not able to show an electronic approval in the SSIS system. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will implement procedures to document review for all SSIS disbursements. Name of the contact person responsible for corrective action plan: Karen Anderson, Chief Financial Officer Planned completion date for corrective action plan: December 31, 2025
FOSTER CARE REPORTING (2023-008) Recommendation: It is recommended that the County implement procedures to review the foster care report and retain evidence of the review on file. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in respons...
FOSTER CARE REPORTING (2023-008) Recommendation: It is recommended that the County implement procedures to review the foster care report and retain evidence of the review on file. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will start printing a coversheet for the Fiscal Supervisor to sign and retain physical evidence of the review being done. Name of the contact person responsible for corrective action plan: Karen Anderson, Chief Financial Officer Planned completion date for corrective action plan: December 31, 2025
SLFRF SUSPENSION AND DEBAREMENT (2023-011) Recommendation: It is recommended that the County ensure properly language related to suspension and debarment is included in the contract, or other records are kept on file to support a verification was done. Explanation of disagreement with audit finding:...
SLFRF SUSPENSION AND DEBAREMENT (2023-011) Recommendation: It is recommended that the County ensure properly language related to suspension and debarment is included in the contract, or other records are kept on file to support a verification was done. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: The County will continue to work at this area and internal controls to achieve the overall goal. Name of the contact person responsible for corrective action plan: Karen Anderson, Chief Financial Officer Planned completion date for corrective action plan: December 31, 2025
Oversight Agency for Audit, Rayne Elderly Housing Corporation respectfully submits the following corrective action plan for the year ended December 31, 2024. Name and address of independent public accounting firm: Bellows Associates, P.A., 5401 N University Drive, Suite 201 Coral Springs, Florida 33...
Oversight Agency for Audit, Rayne Elderly Housing Corporation respectfully submits the following corrective action plan for the year ended December 31, 2024. 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, 2024 through December 31, 2024 The finding from the December 31, 2024 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. 2024-001: Section 202 Supportive Housing for the Elderly, ALN 14.157 Recommendation: Management should implement procedures to ensure the replacement reserve is properly funded on a monthly basis. Action Taken: Staff training has been provided to ensure the correct RR amounts are deposited and a timely increase from HUD is received. This has been included in the monthly reporting procedures. If the Oversight Agency for Audit has questions regarding these plans, please call Irene Phillips at 954-835-9200. Sincerely yours, Irene Phillips, CFO
View Audit 367113 Questioned Costs: $1
Berkshire Training and Employment Inc. had to change auditors for FY24. The change in auditor was due to the previous auditor no longer providing auditing services, necessitating procurement of a new auditor for FY24. Difficulty in procuring a new auditor caused delays in the current audit. Manageme...
Berkshire Training and Employment Inc. had to change auditors for FY24. The change in auditor was due to the previous auditor no longer providing auditing services, necessitating procurement of a new auditor for FY24. Difficulty in procuring a new auditor caused delays in the current audit. Management has signed an engagement agreement with the current FY24 auditor for single audit FY25. Management does not anticipate any delays for Single Audit FY25.
Management of Presbyterian Urban Council brought up the overpayment to officials at the Arkansas Department of Education several times. Presbyterian Urban Council kept the overpayment in a noninterest-bearing account to avoid any profit from the federal award. Management is committed to take steps t...
Management of Presbyterian Urban Council brought up the overpayment to officials at the Arkansas Department of Education several times. Presbyterian Urban Council kept the overpayment in a noninterest-bearing account to avoid any profit from the federal award. Management is committed to take steps to reconciled any future descrepancies with Arkansas Department of Education. Management delivered a check in the amount of $509,000 to officials at the Arkansas Department of Education on August 7, 2025.
FINDING 2024-003 Finding Subject: COVID 19 Coronavirus State and Local Fiscal Recovery - Subrecipient Monitoring Contact Person Responsible for Corrective Action: Gretchen Parker Contact Phone Number and Email Address: 765-648-6113 gparker@cityofanderson.com Views of Responsible Officials: "We concu...
FINDING 2024-003 Finding Subject: COVID 19 Coronavirus State and Local Fiscal Recovery - Subrecipient Monitoring Contact Person Responsible for Corrective Action: Gretchen Parker Contact Phone Number and Email Address: 765-648-6113 gparker@cityofanderson.com Views of Responsible Officials: "We concur with the finding." Description of Corrective Action Plan: The city has several individuals involved in the monitoring of activities related to the COVID 19 Coronavirus State and Local Fiscal Recovery federal award. The city has implemented procedures to ensure oversight and review of subrecipient reports is properly documented. Anticipated Completion Date: September 1, 2025
FINDING 2024-002 Finding Subject: COVID 19 Coronavirus State and Local Fiscal Recovery - Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Neal McKee Contact Phone Number and Email Address: 765-648- 6429 nmckee@cityofanderson.com Views of Responsible Official...
FINDING 2024-002 Finding Subject: COVID 19 Coronavirus State and Local Fiscal Recovery - Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Neal McKee Contact Phone Number and Email Address: 765-648- 6429 nmckee@cityofanderson.com Views of Responsible Officials: “We concur with the finding.” Description of Corrective Action Plan: The City has a longstanding contractual relationship with an engineering firm with extensive knowledge of the City’s water department. The city has put controls and procedures in place to ensure services are bid where federal awards are involved and the dollar amount of such services is expected to exceed the simplified acquisition threshold. The City will review its procurement policy and amend where necessary to conform to the current requirements of CFR 200.318. The City has not contracted with suspended or debarred parties. The City has put controls and procedures in place to ensure timely documentation of suspension and debarment checks related to its federal awards. Anticipated Completion Date: January 1, 2026
FINDING 2024-001 Finding Subject: Department of Transportation Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Brad King Contact Phone Number and Email Address: 765-648-6171 bking@cityofanderson.com Views of Responsible Officials: “We concur with the findin...
FINDING 2024-001 Finding Subject: Department of Transportation Procurement and Suspension and Debarment Contact Person Responsible for Corrective Action: Brad King Contact Phone Number and Email Address: 765-648-6171 bking@cityofanderson.com Views of Responsible Officials: “We concur with the finding.” Description of Corrective Action Plan: The City has not contracted with suspended or debarred parties. The City has put controls and procedures in place to ensure timely documentation of suspension and debarment checks related to its federal awards. The City has implemented procedures to ensure the proper documentation of quotes taken where applicable. Anticipated Completion Date: September 1, 2025
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