B ~RD .. COUNTY

FLORIDA Community Partnerships Division

Desktop Monitoring Administrative Review Results for

PROVIDER NAME

Contract# DESKTOP MONITORING DATES SAMPLE

Bl\1QWARD COUNTY

FLORIDA Community Partnerships Division

PROVIDER NAME

Adm inistrative Review Report Sections and Assigned Reviewer

Tabs:

Section I: Non-Financial Administrative

Section II: Financial Administrative

Assigned to:

SAMPLE

PROVIDER NAME Administrative Summary of Results

Section I: Non-Financial Administrative A. Insurance/Risk Management and General B. HR Posting Compliance C. HR Policies, Reporting , Attendance

Section II : Financial Administrative A. General B. Banking C. Journals and Ledgers D. Budget E. Program Revenues F. Payroll Taxes

Section Ill: Personnel File Contents SEE Separate Programmatic Report(s)

Section IV: Invoice and Billing SEE Separate Programmatic Report(s)

Section IV B: Units of Service Review Summary SEE Separate Programmatic Report(s)

Section V: Client Service Reports SEE Separate Programmatic Report(s)

Section VI: Client File Contents SEE Separate Programmatic Report(s)

Section VII: Client File Contents SEE Separate Programmatic Report(s)

Section VIII: Procedures by Service Category (if Ryan White) SEE Separate Service Category Report(s)

Results

#DIV/0! #DIV/0! #DIV/0!

#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!

Items remaining to

monitor 6 2 13

14 14 2 3 3 5

SAMPLE

Section I: Non-Financial Administrative Provider Agency being monitored:

Area of Review

A. Insurance/Risk Management and General Are the fo llowing insurance policies in place?

General Liability Professional Liability Workers' Compensation Auto covera!=)e

Does the Agency's policy and procedures manual ensure that an independent person opens the mail? Is there a system for Continuous Quality Improvement (CQI)?

B. HR Posting Compliance Are the following postings conspicuously displayed in the office:

Florida State Required Posters: Anti-Fraud Notice, Florida Minimum Wage, Discrimination Notice, Unemployment Insurance/Compensation , Florida Equal Employment Opportunity, Workers ' Compensation, Child Labor Law Summary of Work Hours.

Federal Required Posters: Family and Medical Leave Act (FMLA), Equal Employment Opportunity (EEOC), Safety and Health in the Workplace (OSHA 3165)/Whistleblower, Fair Labor Standards Act (FLSA) Federal Minimum Wage, Uniform Services Employment and Re-Employment Rights Act (USERRA), Anti-Discrimination, Employee Polygraph Protection Act, includes Genetic Information Nondiscrimination Act !GINA), IRS Withholdinq Notice.

C. HR Pollcles, Reporting, Attendance Does the Agency's equal employment opportun ity policy comply with the contract? Does the Agency's client non-discrimination policy comply with the contract? Does the Agency's affirmative action plan comply with the contract? Does the Agency's Americans with Disabilities Act (ADA) policy comply with the contract? Does the Agency's community disadvantaged business enterprise !POiicy comply with the contract? Does the Agency have a drug-free workplace policy and program?

PROVIDER NAME

Compliance I = Interview O=Observation

D=Documentation Yes No NA /List Who or Whatl Comments

0 0 0

0 0 0

---

0 0 0 - - -SAMPLE

Section I: Non-Financial Administrative Provider Agency being monitored:

Area of Review Current organizational chart that reflects agency positions and lines of authority Does the Agency require training on chi ld abuse and/or elder abuse reporting for staff and volunteers who serve chi ldren, the elderlv , and other vulnerable populations? Does the Agency post hotline numbers for employees to report cases of child abuse and/or elder abuse? Are new policies or changes in existing policies communicated in a systematic manner to all employees? Does the Agency have a written policy that establishes a formal process to deal with employee complaints concern ing illegal activities in the organization, and that prevents retaliation? Does the Agency have a process for reviewing and responding to ideas, suggestions, comments , and perceptions from all staff members? Did the Provider ensure that staffing patterns and staff qualifications are sufficient to provide culturally competent services described within the contract?

PROVIDER NAME

Compliance I = Interview O=Observation

D=Documentation Yes No NA (List Who or What) Comments

2

SAMPLE

Section II: Financial Administrative Provider Agency being monitored:

Area of Review

A. General Are internal policies and procedures in the Agency's Accounting Policy and Procedures Manual fo llowed? Is the distribution of duties adeauate to safeauard assets? Does the FULL Board review and accept the Agency's audit and management letter (not just the Finance and/or Audit Committees)? Does the Board review the Agency's respon se to the Manaaement Letter? Are there written policies regarding reporting and responding to suspected fraud? Are current and complete disclosures of financial results of each funded program provided quarterly and annually to the Board of Directors? Is there an annual or multi-year financial plan addressing long term solvency and continuity of services? Are the Agency's Government contracts, purchase of service aareements, and grants aqreements in writinq? If the Agency's Government contracts , purchase of service agreements, and grants agreements are in writing , are they reviewed by a staff member of the organization to monitor compliance with all stated conditions?

Has the Agency established a plan identifying actions to take in the event of a reduct ion or loss in monetary resources?

Has the Agency developed a plan to establish a reserve of funds to cover at least three months of operating expenses?

Are records maintained of client fees collected? Do records identify County in-kind match solely for County contract?

Does the program's inventory match the documented purchases using grant/contract dollars?

B. Banking Are bank statements reconciled monthly? Are bank statement reconciliations performed by a different employee than the one preparinq checks? Do the preparer of the reconcili ation report and the immediate supervisor sign the reconciliation?

PROVIDER NAME

Compliance I = Interview O=Observat ion

Comments Yes No NA D=Documentation

(List Who or What)

0 0 0

0 0 0

SAMPLE

Section II: Financial Administrative Provider Agency being monitored:

Area of Review

Are adjustments properly documented and explained?

Select a random month (indicate month in column G); Were the items listed above performed correctly for this month? Select another random month (ind icate month in column G); Were the items listed above performed correctly for this month? Select a third random month (indicate month in column G); Were the items listed above performed correctly for this month? Based on bank statements, is it true that no checks have been returned due to insufficient funds? Do bank statements reflect a positive balance at the end of the month? Are checks pre-numbered? Does Agency have a policy for signing checks (i.e. checks in excess of X amount require two siqnatures)? Are blank checks stored securely (under lock and key)? Is it true that checks have an expiration date? Are voided checks mutilated in some manner (i.e. signature section removed and "VOID" indicated)? C. Journals and Ledgers Does the yearly audited financial statement fairly reflect the financial standinq of the company? Are there findings/notes in the yearly audited financial statement? --Q.:.._B_y_dget

Indicate fiscal year start and end dates in column H

Does the agency maintain a program budget that captures all IProaram expenses? Is the agency adhering to the approved budget submitted within the proposal? Does agency prepare a Budget Variance Report or otherwise track expenditures versus budgeted amounts on a regular basis? (reqular = not less than quarterly) E. Program Revenues Does the agency have procedures for collection of program revenues (i.e. fees , interests)?

PROVIDER NAME

Compliance I = Interview O=Observation

Comments Yes No NA D=Documentation

(List Who or What)

D- [MONTH]

D- [MONTH]

D- [MONTH]

0 0 0

-1··- - . 0 0 0

FY Start Date: FY End Date

0 0 _Q_

2

SAMPLE

Section II: Financial Administrative Provider Agency being monitored:

Area of Review

Are revenues deposited in the bank account of the program within 48 hours? Are revenues re-invested in program activities or otherwise expended as allowed by the program funder? F. Payroll Taxes Are withholding and FICA taxes deposited on a timely basis and in accordance with payroll reqister data? Does Form 941 (Federal Quarterly Payroll Tax Return) indicate that the provider is remitting payroll taxes, including federal withholding tax, employee share of FICA and employer share of FICA? Does Form UCT-6 (Florida Unemployment Compensation Tax) and supporting documentation verify that the provider is filing state unemplovment compensation returns? Is the Annual IRS Form #990 completed? Is the Annual IRS Form #990 submitted on time?

PROVIDER NAME

Compliance I = Interview O=Observation

Comments Yes No NA D=Documentation

(List Who or What)

- ~ · 0 0 0

3

SAMPLE