Corrective Action Plans

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The sliding fee schedule has been updated several times in the last 24 months with subsequent staff training. Beginning in December 2024 our organization will begin charging a nominal fee then accurately utilizing sliding discounts based on income levels/family size. The organization has also increa...
The sliding fee schedule has been updated several times in the last 24 months with subsequent staff training. Beginning in December 2024 our organization will begin charging a nominal fee then accurately utilizing sliding discounts based on income levels/family size. The organization has also increased training in processing and entering the collected patient income forms and sliding fee schedule packet of forms needed to accurately account for providing the patient with the sliding fee schedule adjustment.
Analysis is provided on a monthly basis by the Chief Financial Officer and the Accounting department. Balance Sheet, Profit & Loss, Cash Flow and A/P Agings are reviewed and provided to the CEO, the BOD Finance Committee and then to all BOD Members. Also provided is an organization dashboard present...
Analysis is provided on a monthly basis by the Chief Financial Officer and the Accounting department. Balance Sheet, Profit & Loss, Cash Flow and A/P Agings are reviewed and provided to the CEO, the BOD Finance Committee and then to all BOD Members. Also provided is an organization dashboard presentation with 12-14 Key Performance Indicators monthly.
Management agrees with the finding. The excess funds were accrued to offset future Section 8 HAP requests.
Management agrees with the finding. The excess funds were accrued to offset future Section 8 HAP requests.
Condition: Of the 40 students selected for enrollment reporting testing, 1 student did not have their program-level status change updated appropriately and another student was not updated from less than half time to withdrawn by the University's third party administrator. Planned Corrective Action: ...
Condition: Of the 40 students selected for enrollment reporting testing, 1 student did not have their program-level status change updated appropriately and another student was not updated from less than half time to withdrawn by the University's third party administrator. Planned Corrective Action: Clearinghouse reporting process has been reassessed, and error reporting will be completed weekly. Training will be done for registrar staff on process, and how to verify information has successfully been accepted by NSLDS. The Registrar's office will work closely with Financial Aid to verify enrollment updates and complete error resolution. Contact person responsible for corrective action: Callie Zake, Senior Director Student Financial Services Anticipated Completion Date: June 30, 2025
Condition: There was a lack of internal controls in place related to the return of Title IV funds. Planned Corrective Action: Director will update academic calendar on COD R2TIV calculator yearly and verify dates and length of breaks are correct. The University will continue to have the Senior Fina...
Condition: There was a lack of internal controls in place related to the return of Title IV funds. Planned Corrective Action: Director will update academic calendar on COD R2TIV calculator yearly and verify dates and length of breaks are correct. The University will continue to have the Senior Financial Aid Advisor complete R2TIV and the Director will sign off on calculations. Contact person responsible for corrective action: Callie Zake, Senior Director Student Financial Services Anticipated Completion Date: June 30, 2025
View Audit 349964 Questioned Costs: $1
Finding 539409 (2024-004)
Significant Deficiency 2024
Finding 2024‐004: Significant Deficiency and Non‐Material Noncompliance – Housing Voucher Cluster REAC Report Name of Contact Person: Joan Duckett, Director of Housing & Community Development Corrective Action: The Office of Housing and Community Development (OHCD) has taken corrective measures to e...
Finding 2024‐004: Significant Deficiency and Non‐Material Noncompliance – Housing Voucher Cluster REAC Report Name of Contact Person: Joan Duckett, Director of Housing & Community Development Corrective Action: The Office of Housing and Community Development (OHCD) has taken corrective measures to ensure that the REAC reports are supported with accurate data and submitted in a timely manner. There are monthly reconciliation procedures in place which include management oversight and review of all reports. OHCD has and will continue to enter into a contractual agreement with a knowledgeable and reputable accounting firm that the County is under contract for services applicable to the need. REAC reports will be extensively reviewed by management prior to submission to HUD. Proposed Completion Date: Immediately
Finding 539408 (2024-003)
Significant Deficiency 2024
Finding 2024‐003: Significant Deficiency and Non‐Material Noncompliance – Housing Voucher Cluster Special Test 8 – Bank Accounts Name of Contact Person: Joan Duckett, Director of Housing & Community Development Corrective Action: The Office of Housing and Community Development began working with the...
Finding 2024‐003: Significant Deficiency and Non‐Material Noncompliance – Housing Voucher Cluster Special Test 8 – Bank Accounts Name of Contact Person: Joan Duckett, Director of Housing & Community Development Corrective Action: The Office of Housing and Community Development began working with the County’s Finance Department and the current Banking Financial Institution (Wells Fargo) and opened two separate accounts, one for the Housing Choice Voucher (HCV) program and one for the FSS Escrow Accounts in April 2024. The task included revised mapping of deposits and expenditures, including the establishment of related workflows within the County’s financial management system and therefore these changes were adequately tested. The migration to the two new bank accounts went live on July 1, 2024, and per HUD regulations a General Depository Agreement (HUD‐51999 GDA) was entered. Proposed Completion Date: Immediately
Recommendation: CLA recommends the University review its existing policies to ensure it is up to date with federal regulations. They also recommend documenting the subrecipient was checked on the SAM.gov website prior to executing the subaward agreement. CLA suggests a secondary review should be per...
Recommendation: CLA recommends the University review its existing policies to ensure it is up to date with federal regulations. They also recommend documenting the subrecipient was checked on the SAM.gov website prior to executing the subaward agreement. CLA suggests a secondary review should be performed prior to payment and that the second review should be documented and retained to support the suspension and debarment requirements were followed and completed before entering into a covered transaction. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: St. Thomas updated processes and procedures to verify subrecipient status’ on a twofold bases. First, at initiation via the Office of Sponsored programs. A secondary review is performed by the Purchasing and Payables team. Name(s) of the contact person(s) responsible for corrective action: Michael Warnock, mjwarnock@stthomas.edu and Karen Harthorn, kmharthorn@stthomas.edu Planned completion date for corrective action plan: This change has been implemented in the spring of 2025.
Recommendation: CLA recommends the University implements a process place to ensure the required reporting is completed in the timeline allowed by the granting agency and to complete any missed or late reporting as required. Explanation of disagreement with audit finding: There is no disagreement wit...
Recommendation: CLA recommends the University implements a process place to ensure the required reporting is completed in the timeline allowed by the granting agency and to complete any missed or late reporting as required. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: St. Thomas identified the applicable FFATA reporting requirements and assigned responsibility to the appropriate party. Name(s) of the contact person(s) responsible for corrective action: Sarah Ervin, sarah.ervin@stthomas.edu Planned completion date for corrective action plan: The additional reporting requirement has been added to the accounting department’s list of responsibilities beginning in January 2025.
Recommendation: CLA recommends the University review its reporting procedures to ensure the students' statuses are accurately reported to NSLDS as required by regulations. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to fin...
Recommendation: CLA recommends the University review its reporting procedures to ensure the students' statuses are accurately reported to NSLDS as required by regulations. Explanation of disagreement with audit finding: There is no disagreement with the audit finding. Action taken in response to finding: By reviewing the ordering of internal processes and procedures St. Thomas determined two internal processes ran out of order causing incorrect reporting. Procedural documentation has been updated and training provided to ensure this error is not repeated. Name(s) of the contact person(s) responsible for corrective action: Yuko Kachinsky: yuko.kachinsky@stthomas.edu Planned completion date for corrective action plan: A process error was identified and corrected in August 2024.
Finding 539399 (2024-001)
Significant Deficiency 2024
The City took corrective action to address this area of deficiency in March 2024. The original audit finding, 2023-001, was communicated in March 2024. Immediately following this notification, the City implemented corrective actions by retroactively verifying the suspension and debarment list for al...
The City took corrective action to address this area of deficiency in March 2024. The original audit finding, 2023-001, was communicated in March 2024. Immediately following this notification, the City implemented corrective actions by retroactively verifying the suspension and debarment list for all open purchase orders and ensuring prospective compliance. The audit sampling for the fiscal year ending June 30, 2024, included transactions that occurred prior to the March 2024 communication of the finding. For all sampled transactions dated after the finding was communicated to the City, verification against the suspension and debarment list occurred prior to transaction completion. However, finding 2024-001 for the current audit year includes transactions occurring during the fiscal year ended June 30, 2024, for which the City performed the suspension and debarment verification retroactively, as they predated the implementation of the corrective measures.
Edit Check Worksheets will be matched to requests for State of NJ Division of Agriculture reimbursement on a monthly basis for accuracy.
Edit Check Worksheets will be matched to requests for State of NJ Division of Agriculture reimbursement on a monthly basis for accuracy.
The County's procurement policies covering all of the Uniform Guidance requirements must be in writing. a) We concur with finding 2024-002 that the procurement policies covering all of the Uniform Guidance requirements must be in writing. Management is preparing written procurement policies for revi...
The County's procurement policies covering all of the Uniform Guidance requirements must be in writing. a) We concur with finding 2024-002 that the procurement policies covering all of the Uniform Guidance requirements must be in writing. Management is preparing written procurement policies for review and approval of the county commissioners. b) Nina Lott is responsible for the corrective action process and will work with the county commissioners to accomplish the corrective action.
VIEWS OF RESPONSIBLE OFFICIALS The youth committee attached to the Norwest Local Board will compromise a representative from finance, budget and planning staff (youth program and executive) who will measure the achievement of the 20% benchmark on a quarterly basis. This committee will take appropr...
VIEWS OF RESPONSIBLE OFFICIALS The youth committee attached to the Norwest Local Board will compromise a representative from finance, budget and planning staff (youth program and executive) who will measure the achievement of the 20% benchmark on a quarterly basis. This committee will take appropriate actions in order to verify the correctness of the expenditures according to the 20% expense requirement mentioned above. This committee will provide to the Executive Director, recommendations to the operational areas in order to comply to the goal of expenditures required under sections 20 CFR 681.590, 681.00(a)(3) and 681.600 of WIOA. A report will be issue to the operational levels in accordance to the recommendations adopted by the Executive Director. The public policy for the implementation of the work experience element of the youth program gave the opportunity to increase youth service. The Northwest Local Area has established strategies for the dissemination of services for the youth program. This is done through the integration of social networks (fakebook, TikTok, Instagram) radio, signs press, television and official internet page. Employment and Educational Fairs for the Youth Program are being developed to recruit out of school Youth and promote work experience activity. We will continue to join efforts through mass campaigns with an effective strategic plan to outreach the youth program. IMPLEMENTATION DATE Immediately RESPONSIBLE PERSONS Executive Director, Area Executive, Finance Director
Finding 539389 (2024-007)
Significant Deficiency 2024
The Department of Transportation will develop an electronic document storage policy and procedure for the on-site retention of project documentation, to include QAP testing, required by state and federal grant awards. The policy will include forms and reports completed by staff, contractors, and con...
The Department of Transportation will develop an electronic document storage policy and procedure for the on-site retention of project documentation, to include QAP testing, required by state and federal grant awards. The policy will include forms and reports completed by staff, contractors, and consultants, and will be reviewed for compliance prior to the distribution of vendor payments.
Finding 539387 (2024-006)
Significant Deficiency 2024
Internal controls will be established over reporting to the Virginia Department of Education to ensure accuracy of data, to include: · Student enrollment and membership data will be verified by the Department of Assessment, Research and Accountability. · Cost data and other financial information wil...
Internal controls will be established over reporting to the Virginia Department of Education to ensure accuracy of data, to include: · Student enrollment and membership data will be verified by the Department of Assessment, Research and Accountability. · Cost data and other financial information will be verified by the Accounting Department. · Information regarding children with disabilities will be verified by the Department of Learning Support.
Finding 539386 (2024-005)
Significant Deficiency 2024
The Department of Public Works, will incorporate the Federal Statement of Compliance form (C-56) within the Technical Specifications section of all federally-funded VDOT project contracts.
The Department of Public Works, will incorporate the Federal Statement of Compliance form (C-56) within the Technical Specifications section of all federally-funded VDOT project contracts.
View Audit 349937 Questioned Costs: $1
Finding 539385 (2024-004)
Significant Deficiency 2024
The Ryan White Office will complete a thorough review of contract templates to identify deviations from required subaward information. Appropriate language to address gaps will be drafted and incorporated into future agreements. Additional training on these requirements will be provided to relevant ...
The Ryan White Office will complete a thorough review of contract templates to identify deviations from required subaward information. Appropriate language to address gaps will be drafted and incorporated into future agreements. Additional training on these requirements will be provided to relevant staff. Future agreements will be monitored to ensure compliance.
BREF will ensure that the data collection form and the Single Audit package are filed the earlier of nine (9) months after year end or thirty (30) days after delivery of the financial statements.
BREF will ensure that the data collection form and the Single Audit package are filed the earlier of nine (9) months after year end or thirty (30) days after delivery of the financial statements.
Finding 539383 (2024-001)
Significant Deficiency 2024
Management agrees with the finding and recommendations, but also has determined that this finding will not be repeated in future years, as the arrearages program has come to a close.
Management agrees with the finding and recommendations, but also has determined that this finding will not be repeated in future years, as the arrearages program has come to a close.
Contact Person: Travis Mickey, Registrar Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The College will collaborate with NSC to evaluate the errors in the file transmissions and to develop procedures to minimize further errors in ...
Contact Person: Travis Mickey, Registrar Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The College will collaborate with NSC to evaluate the errors in the file transmissions and to develop procedures to minimize further errors in the future. More specifically, the College will review the reporting procedures for withdrawn and graduating students to ensure the correct information is transmitted to NSLDS. Anticipated Completion Date: 6/30/2025
Contact Person: Regina Elliott, Chief Information Officer Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The College updated and implemented a comprehensive information security program on 1/19/25 that meets all requirements. And w...
Contact Person: Regina Elliott, Chief Information Officer Views of Responsible Officials and Planned Corrective Action: There is no disagreement with the audit finding. The College updated and implemented a comprehensive information security program on 1/19/25 that meets all requirements. And we will continue to review and update our IT policies and procedures on a regular basis. Furthermore, the College has strengthened our internal controls in order to ensure we are aware of new regulatory requirements and enhance our process for addressing them in a timely manner. Anticipated Completion Date: 1/19/2025
Description of Corrective Action Plan: Argos Community Schools will ensure that going forward any construction we have done, funded with federal dollars will be compliant with Davis-Bacon Act Reporting laws and ensure we receive required documentation, as required by Federal Law.
Description of Corrective Action Plan: Argos Community Schools will ensure that going forward any construction we have done, funded with federal dollars will be compliant with Davis-Bacon Act Reporting laws and ensure we receive required documentation, as required by Federal Law.
Verification Planned Corrective Action: We will periodically review students selected for verification with a status of verification not completed to ensure they did not receive need based federal aid. Person Responsible for Corrective Action Plan: Andrea Ruth, Director of Financial Aid Anticipated...
Verification Planned Corrective Action: We will periodically review students selected for verification with a status of verification not completed to ensure they did not receive need based federal aid. Person Responsible for Corrective Action Plan: Andrea Ruth, Director of Financial Aid Anticipated Date of Completion: 3/22/2025
View Audit 349900 Questioned Costs: $1
Finding 539367 (2024-001)
Significant Deficiency 2024
Incorrect Return of Title IV (R2T4) Funds Calculations and Untimely Returns Planned Corrective Action: When this was identified last year, the Director of Financial Aid Office spent the next year working with the Department of Education as they conducted two separate reviews. The first review was c...
Incorrect Return of Title IV (R2T4) Funds Calculations and Untimely Returns Planned Corrective Action: When this was identified last year, the Director of Financial Aid Office spent the next year working with the Department of Education as they conducted two separate reviews. The first review was completed and we were notified that everything was good. The second review recently concluded via an exit interview where we were notified that a final report would be sent to us within the next two months. Additionally, the Director of Financial Aid has been working with the IT department, the Registrar’s Office, and our Academic Technology department to streamline the identification of students who need a R2T4 completed. This has been an ongoing process in the midst of the program reviews and getting clarification and guidance from the Department of Education, coupled with the FAFSA issues, continued to cause further delays with R2T4 calculations. Person Responsible for Corrective Action Plan: Andrea Ruth, Director of Financial Aid Anticipated Date of Completion: 3/22/2025
View Audit 349900 Questioned Costs: $1
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