CLINICA SIERRA VISTA

2025-002 Cash Management Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-23, H8GCS48292, H8LCS51370 Criteria Title 2 CFR 200.305 requires that organizations “must minimize the time elapsing between the transfer of funds from the United States Treasury or the pass-through entity and the disbursement by the non-federal entity whether the payment is made by electronic funds transfer, or issuance or redemption of checks, warrants, or payment by other means.” [X] Compliance Finding [ ] Significant Deficiency [X] Material Weakness Condition The Organization was not able to provide documentation for certain cash draws made from the Payment Management System (PMS) to show that expenditures were incurred or expected to be incurred within a minimal amount of time. …

Corrective action: 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 summarize…

2025-003 Procurement Program Information Federal Organizations U.S Department of Health and Human Services U.S Department of Agriculture (passed through California Department of Public Health) Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster 10.557 WIC Special Supplemental Nutrition Program for Women, Infants, and Children Award Numbers H80CS00540-23, H8GCS48292, H8LCS51370, 22-10237 A05 Criteria Entities receiving federal awards must have and use their documented procurement policies. Title 2 CFR 200.320 outlines the acceptable methods of procurement and establishes the maximum thresholds allowed. Purchases below the simplified acquisition threshold, but above the micro-purchase threshold, require price or rate quotations to be obtained from an adequate number of qualified sources. [X] Compliance Finding [ ] Significant Deficiency [X] Material Weakness Condition …

Corrective action: 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 reten…

2025-004 Suspension and Debarment Program Information Federal Organizations U.S Department of Health and Human Services U.S Department of Agriculture (passed through California Department of Public Health) Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster 10.557 WIC Special Supplemental Nutrition Program for Women, Infants, and Children Award Numbers H80CS00540-23, H8GCS48292, H8LCS51370, 22-10237 A05 Criteria Title 2 CFR 200.214 and Title 2 CFR 180.300 require that organizations “verify that the person with whom you intend to do business is not excluded or disqualified” before entering into covered transactions (procurement contracts, purchase orders, or agreements greater than or equal to $25,000) with persons or vendors. [ ] Compliance Finding [ ] Significant Deficiency [X] Material Weakness Condition The Organization entered into covered transactions without ve…

Corrective action: 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 procuremen…

2023-002 Application of Sliding Fee Discount Program Information Federal Organization U.S Department of Health and Human Services Assistance Listing Numbers 93.224 & 93.527 Health Center Program Cluster Award Numbers H80CS00540-21, H8FCS41201, H8GCS48292 Criteria [X] Compliance Finding [ ] Significant Deficiency [ ] Material Weakness Title 2 U.S. Code of Federal Regulations (CFR) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards, Subpart F, Compliance Supplement, Part 4, Compliance Requirement N, Special Tests and Provisions states, “Health Centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patients ability to pay.” Condition During our testing of sliding fee discounts for health center patients qualifying for …

Corrective action: 2023-002 Application of Sliding Fee Discount Corrective action planned: Management has implemented an improved education and training procedures for the registration staff to ensure all required patient information is recorded properly. Management will perform random audits throughout the year to ensure 100 percent compliance. Anticipated completion date: January 31, 2024 Contact person responsible for corrective action: John Church, Chief Financial Officer

U.S. Department of Health and Human Services Health Center Program Cluster CFDA Numbers 93.224 and 93.527 Program Year 2018 ? 2019 Criteria or specific requirement ? Reporting in accordance with 45 CFR Sections 75.341 and 75.342. Condition ? The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year, an annual Federal Financial Report (FFR) for each grant year and quarterly Federal Cash Transactions Reports (FCTR) for each grant budget period. These reports are to be prepared using accurate financial information. Questioned costs ? None Context ? One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Out of a population of 19 inputs tested on the UDS, FFR and FCTR, 2 …

Corrective action: Audit Finding Reference Number 2019-003 U.S. Department of Health and Human Services Health Center Program Cluster CFDA Numbers 93.224 and 93.527 Program Year 2018-2019 Criteria or specific requirement - Reporting in accordance with 45 C.F.R. Sections 75.341 and 75.342. Condition - The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year, an annual Federal Financial Report (FFR) for each grant year and quarterly Federal Cash Transactions Reports (FCTR) for each grant budget period. These reports are to be prepared using accurate financial information. Questioned costs - None Effect - Errors were made in the annual UDS and FFR r…