"Site Monitoring Form" - Arizona

Site Monitoring Form is a legal document that was released by the Arizona Department of Homeland Security - a government authority operating within Arizona.

Form Details:

  • The latest edition currently provided by the Arizona Department of Homeland Security;
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  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Arizona Department of Homeland Security.

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Download "Site Monitoring Form" - Arizona

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Final Review
Staff Initials
Date
ARIZONA DEPARTMENT OF HOMELAND SECURITY
☐Planner
☐Finance Staff
☐Equipment
☐Supervisor
Section A: Administrative and Background Information
Date of Visit:
Subrecipient:
Enter Date
Click here to enter text.
Location of Site Visit:
Date of Notification Letter
Click here to enter text.
:
Enter Date
AZDOHS Staff Conducting the Site Visit:
Name
Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Subrecipient Staff Present (Including name, department, and title/position):
Name
Department
Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Grants Reviewed:
Grant
Grant
Ext.
PCF
Performance Period
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Qtr 5
Qtr 6
Qtr 7
Qtr 8
Number
Source
(Y/N)
(Y/N)
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Enter Subrecipent Agency Name
1
Final Review
Staff Initials
Date
ARIZONA DEPARTMENT OF HOMELAND SECURITY
☐Planner
☐Finance Staff
☐Equipment
☐Supervisor
Section A: Administrative and Background Information
Date of Visit:
Subrecipient:
Enter Date
Click here to enter text.
Location of Site Visit:
Date of Notification Letter
Click here to enter text.
:
Enter Date
AZDOHS Staff Conducting the Site Visit:
Name
Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Select Name
Enter Title/Position
Subrecipient Staff Present (Including name, department, and title/position):
Name
Department
Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Enter Name
Enter Department
Enter Title/Position
Grants Reviewed:
Grant
Grant
Ext.
PCF
Performance Period
Qtr 1
Qtr 2
Qtr 3
Qtr 4
Qtr 5
Qtr 6
Qtr 7
Qtr 8
Number
Source
(Y/N)
(Y/N)
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Source
Enter Subrecipent Agency Name
1
Pre-Monitoring Checklist:
☐Finance
If applicable, is stakeholder current on audits (Within 9 months of end of fiscal year)? Review and discuss any
findings that should be addressed during the site visit.
Review Reimbursement requests, master reports and any pending items.
o Summary of items to address during visit:
Are reimbursements submitted regularly? Yes _____ No _____
Do reimbursement request forms include all information such as dates, signatures and support
documentation?
Yes _____ No _____
Are there recurring errors? Yes _____ No _____
Final Reimbursements: Review invoices; if invoice date is within 10 days of the POP end date,
are packing slips included? If no, obtain from subrecipient. Yes _____ No _____
What is the date of the most recent procurement policy on file at AZDOHS? __________
If applicable, what is the date of the most recent payroll/overtime policy on file at AZDOHS?
__________
Make note of any special conditions related to the grant.
☐Programmatic
Subrecipient Agreement
o Signatures on last page?
o Performance period
Reallocations / Extensions / Modifications
o Was an extension/modification granted?
o Is amendment documentation in file, and does it include appropriate signatures?
Do the reimbursements correspond with the percentage of completion indicated in the quarterly report?
☐Quarterly Reports
Are all quarterly reports current?
What is the percentage of completion?
Is there any concern about completion of the project within the remaining of the performance period?
If the project is primarily equipment purchases, are there delays in getting the equipment purchases made?
☐Responds in a timely manner to inquiries from the AZDOHS?
☐EHP (Environmental and Historic Prevention)
Did the award require an EHP "B" approval and is notification in the grant file?
Is the EHP approval in the grant file (spreadsheet)?
Summary of items to address during visit:
Enter Subrecipient Agency Name
2
Section B: Financial and Administrative Review:
Were items
invoiced and
Does Invoice
Check
Authorized
received
Invoice
Amount
Grant
agree w/ Check
Vendor
Invoice Number
Number/
Check Date
for
prior to the
Date
Reimbursed
Number
or itemized in
EFT #
Payment?
end of the
remittance?
subrecipient
agreement?
Total number
Does
Authorizing
Hours
of OT hours in
Payroll
reimbursement
Reimbursement
signature on
reported on
OPSG
AZDOHS
their packet
payment to
packet mirror
Packet - Total
Amount
Grant
DARs in
Validation
Review of
Received
agrees with
officers
the one
Amount
Reimbursed
Number
subrecipient
form and
Subrecipient’s
Date
number
verified
received at
Submitted
records
DARs match
grant file
submitted to
(Y/N)
AZDOHS?
(Y/N)
(Y/N)
AZDOHS (Y/N)
(Y/N)
Comments:
Enter Subrecipient Agency Name
3
Finance
I.
Does the subrecipient(s) master grant file include the following: grant award letter,
subrecipient agreement, amendments, copies of reimbursement requests, and
☐ Yes ☐ No
quarterly programmatic reports?
a. Who maintains the file?
Click here to enter text.
Are there special conditions related to the grant? If so, what are they? (i.e. EHP review,
II.
☐ Yes ☐ No
match requirements, stakeholder restrictions)
Please ensure that the subrecipient is not spending the grant award until the EHP has been
approved (purchase orders and expenses are not acceptable).
Approval Date:
Enter Date
Click here to enter text.
III.
Are separate ledger accounts kept so that revenues and expenses for each project and/or
☐ Yes ☐ No
grant are tracked? (Required: 2 CFR 200.302 for state, local governments, and non-
profits. Request to see sample ledger.)
a. If yes, what is the contract's account code/number?
Click here to enter text.
b. Does the system identify the CFDA number, Federal Award ID number and
year, name of Federal Agency, and name of pass-through agency
(AZDOHS)?
Click here to enter text.
(Note: Compare against invoices when expenditures are reviewed. If not the
same, you may need to discuss with the appropriate individuals.)
IV.
Explain the system(s) in place that are used by the project manager to monitor budgets
and actual costs on an ongoing basis. Who monitors, and who's informed of budget
status?
Click here to enter text.
V.
Are internal financial reports on the grants maintained and kept current? Who
☐ Yes ☐ No
reconciles, and how often are they reconciled? (names/titles)
Click here to enter text.
VI.
Does the relevant staff have knowledge of the Super Circular OMB 2 CFR 200?
☐ Yes ☐ No
www.ecfr.gov
If not, remind them that this is a requirement of the grant and identified in the
subrecipient agreement.
Personnel
☐ N/A
VII.
Are grant funds being used to supplement existing budgets, and not to supplant
☐ Yes ☐ No
budgets? Supplanting budgets with grant funds is unallowable.
VIII.
Are time and effort reports in the grant file?
☐ Yes ☐ No
IX.
Are time and effort reports reviewed before payroll is processed? If so, by whom?
☐ Yes ☐ No
Click here to enter text.
X.
Is the agency participating in the E-Verify program?
☐ Yes ☐ No
If not or if uncertain, have the stakeholder contact their HR department to verify.
(Note: Tribal entities are not required to participate in E-Verify)
Operation Stonegarden
☐ N/A
Enter Subrecipient Agency Name
4
XI.
Date of the most recent overtime policy on file with AZDOHS (refer to pg. 2)
☐ Yes ☐ No
Enter Date
Is there an updated version available? If yes, obtain a copy during the site visit.
Enter Date
XII.
Describe how subrecipient employee-related expenses (ERE) are calculated. Request examples.
(Note: Only EREs which increase incrementally based upon pay [required retirement, Social Security and Medicare
(FICA), Worker's Compensation] are allowable.
Click here to enter text.
Procurement
☐ N/A
Professional and Contractual Services:
XIII.
Are trainer/instructor/consultant services included in the grant award? If not, skip to
☐ Yes ☐ No
Question XIV.
☐ Yes ☐ No
a. If yes, was the $450 per day fee limitation observed or was a waiver approved?
XIV.
Were State and local procurement procedures and laws followed?
☐ Yes ☐ No
a. Was a competitive bid process, when applicable, adhered to when contract was
☐ Yes ☐ No
awarded? Request to see evidence of the bidding process (i.e., copy of other bids or
other paperwork).
XV.
Are written policies and procedures related to grants management, accounting and
☐ Yes ☐ No
procurement available to relevant staff? If not, explain why.
Click here to enter text.
a. Date of the most current procurement policy on file with AZDOHS (refer to page 2):
Enter Date
Is there an updated version of the policy available?
☐ Yes ☐ No
If yes, obtain a copy during the site visit.
Insurance Coverage
I.
Subrecipient representative affirms the organization maintains insurance coverage as
☐ Yes ☐ No
described in 2 CFR §200.310.
(§ 200.310 Insurance coverage -- The non-Federal entity must, at a minimum, provide the
equivalent insurance coverage for real property and equipment acquired or improved with Federal
funds as provided to property owned by the non-Federal entity. Federally-owned property need
not be insured unless required by the terms and conditions of the Federal award.)
Print/Type Name:
Click here to enter text.
Recordkeeping
II.
Are all records (programmatic and fiscal) maintained for three (3) years after the close of
☐ Yes ☐ No
the grant at the federal level as required by AZDOHS and the Arizona Department of
Library, Archives, and Public Records?
Who is responsible?
Click here to enter text.
III.
Are fiscal records for the grant kept in a secure location?
☐ Yes ☐ No
IV.
Are invoices and/or receipts kept on file to support reported expenditures?
☐ Yes ☐ No
Match Requirements
☐ N/A
V.
If applicable, how was the match requirement met?
☐ Cash ☐ In-kind
Enter Subrecipient Agency Name
5
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