FFY2015 Full Program Audit Tool (fPAT)

Service Provider Information<Service Provider Name>

1. Service Provider EAP ID Number: 2. Program Performance Auditor: 3. Executive Director: 4. EAP Coordinator: 5. Fiscal Director: 6. Other Relevant EAP Staff: 7. Dates of Initial Program Assessment Visit: 8. Date(s) and reason of any other on-site visit(s):

Intention: Evaluate Service Provider’s compliance with EAP policies, local plan, regulations, procedures and proper implementation of EAP activities

Instructions: Service Provider (SP) completes the fPAT and submits to the Department of ommerce (DOC) Program Performance Auditor (PPA) as instructed by the PPA.

On the day of the visit the SP must provide a copy (electronic preferred) of or access to the following, if requested:

FFY2015 Local Level Formal Appeals Tracking Sheet Allocated or approved indirect rate plan covering EAP costs, if applicable Inventory of equipment over $5,000 and all sensitive equipment purchased

with EAP funds Examples of Responsive and/or Proactive ESS materials/documentation Examples of Outreach materials (e.g., brochures, posters, etc.)

Control Environment 1. Describe what worked well with the SP’s staffing plan and why:2. Describe issues with the SP’s staffing plan and how the SP has addressed

them: 1. Any current or planned deviations in SP staffing from the

SP’s original Local Plan? If yes, please explain:

PPA NOTES:

Risk Assessment 1. Did the SP encounter instances of fraud, abuse and/or waste this

program year? If yes, describe how the SP responded to or managed them:

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Yes No

Yes No

2. Did the SP have any external or internal risk incidents (excluding fraud, abuse and/or waste) this year?If yes, identify the risks and describe how the SP responded to or managed

them:

PPA NOTES:

Appeals1. How many formal local level appeals has the SP received this year? 1. Does the SP have formal appeals not recorded on the

tracking sheet?If yes, explain why and the current status:

2. SP comments, observations or recommendations relating to appeals or complaints:

PPA NOTES:

Incidents1. What is the SP process for managing incidents that do not rise to the level of

reporting to the DOC (e.g., how does the SP determine which incidents get reported to the DOC)?

PPA NOTES:

Control ActivitiesApplication Processing

1. What challenges (besides timing of EAP federal funding) has the SP encountered throughout the year meeting the 30 day processing timeline?

2. SP comments, observations or recommendations relating to application processing activities:

PPA NOTES:

Eligibility1. Describe the SP’s issues or challenges with income verification or eligibility

determination: 2. Describe areas (old or new) needing further training and technical

assistance: 3. SP comments, observations or recommendations relating to eligibility

activities:

PPA NOTES:

Vendors 1. Describe the SP’s vendor issues or challenges that have not already been

reported to DOC: 2. What is the SP’s vendor monitoring schedule for FFY2015?

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Yes No

Yes No

3. SP comments, observations or recommendations relating to vendor management activities:

PPA NOTES:

Payments 1. Describe the SP’s issues or challenges with processing payments: 2. SP comments, observations or recommendations relating to payment

activities:

PPA NOTES:

Refunds 1. Describe the SP’s issues or challenges with processing refunds: 2. SP comments, observations or recommendations relating to refund activities:

PPA NOTES:

Crisis/Energy Related Repair (ERR)1. Are there any challenges for the SP meeting 18 or 48 hour

Crisis timelines in emergency or life-threatening situations? If yes, explain:

2. Are there any challenges for the SP meeting 18 or 48 hour timelines in emergency or life-threatening situations for ERR furnace emergencies? If yes, explain:

3. SP comments, observations or recommendations relating to Crisis or ERR activities:

PPA NOTES:

Assurance 16 (A16)1. Describe, in general, what worked well implementing Responsive ESS this

year:2. Describe general issues or challenges related to implementing Responsive

ESS this year:3. SP comments, observations or recommendations relating to Assurance 16

activities:

PPA NOTES:

Outreach1. Has the SP achieved all of the outreach activities outlined in the FFY15 Local

Plan?2. How effective were the activities performed? How does the SP know they

were effective?3. What strategies/approaches have been most effective for Outreach? Why?

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Yes No

Yes No

4. Describe issues or challenges related to implementing the Outreach activities:

5. Decribe the process you use to record or document Outreach:6. What additional outreach activities are you conducting that were not

documented in the FFY15 Local Plan?7. SP comments, observations or recommendations relating to outreach

activities:

PPA NOTES:

Funding and Cash1. Were there any findings in the most recent agency fiscal

audit? If yes, list all of the findings:

2. Describe how any findings in the agency fiscal audit may have affected EAP:3. Are there any non-EAP staff paid with administrative or A16

funds? If yes, please describe:

4. How does the SP track staff time for A16 activities?5. SP comments, observations or recommendations relating to funding and

cash activities:

PPA NOTES:

Equipment PurchasesDuring the program audit visit, the Program Performance Auditor will inspect equipment purchased with LIHEAP funds.

1. Did the SP spend EAP funds on any equipment purchases over $5,000 during the last two program years? If yes, describe:

2. How is the equipment being used by SP EAP staff for EAP purposes? 3. Is the equipment and its cost shared with other services

provided by the SP? If yes, explain:

4. SP comments, observations or recommendations relating to equipment purchases:

PPA NOTES:

Information & CommunicationReporting

1. Describe any issues or challenges related to communication within your agency:

2. Describe any issues or challenges related to communication within your community:

3. Describe any issues or challenges related to communication with other SPs.4. SP comments, observations or recommendations related to

communication/reporting activities:

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Yes No

Yes No

Yes No

Yes No

PPA NOTES:

Self-Monitoring1. Has the SP made any adjustments to self-monitoring activities described in

the Local Plan and Initial Program Assessment Visit?2. Describe the SP’s issues or challenges with self-monitoring activities: 3. SP comments, observations or recommendations relating to self-monitoring

activities:

PPA NOTES:

General EAP 1. SP suggestions for improving DOC communication, technical and

administrative support services: 2. SP topic suggestions for FFY2016 training in August: 3. SP questions comments, observations or recommendations relating to any

EAP activities:

PPA NOTES:

SP staff responsible for completing Full Program Audit Tool (fPAT) – add rows as neededName Title Date

Completed

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