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Risk Assesment Form

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U.S.A. forms for Commonwealth of Massachusetts

BROWSE COMMONWEALTH OF MASSACHUSETTS (MA) FORMS

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Exec
utive Office of Public Safety and Security
Homeland Security Division
RISK ASSESMENT
SECTION A: PURPOSE
The programmatic and fiscal responsibility of grantees must be such that the grantee can properly discharge the
public trust that accompanies the authority to expend public funds. Adequate accounting and program
management systems should meet the following criteria.
1. Accounting records should provide information needed to adequately identify the receipt of funds under each grant
awarded and the expenditure of funds for each grant.
2. Entries in accounting records should refer to subsidiary records and/or documentation that support the entry and can
be readily located.
3. The accounting system should provide accurate and current financial reporting information.
4. The accounting system should be integrated with an adequate system of internal programmatic controls to safeguard the
funds and assets covered, check the accuracy and reliability of accounting data, promote operational efficiency, and
encourage adherence to prescribed management policies.
SECTION B: ACCOUNTING SYSTEM
1.Which of the following best describes the accounting system: Manual Automated Combination
2. Does the accounting system identify the receipt and expenditure of program funds separately for each grant/contract? Yes No
3. Does the accounting system provide for the recording of expenditures for each grant/contract by the Yes No
budget cost categories shown in the approved budget?
4. Are time distribution records maintained for an employee when his/her effort can be Yes No
identified to a particular cost objective?
5. Does the accounting/financial system include budgetary controls to preclude
i
ncurring obligations in excess of:
a
. T
otal funds available for a grant? Yes No
b. Total funds available for a budget cost category (e.g. Personnel, Travel, etc.)? Yes No
6
. If Federal grant funds are commingled with organization funds, can the Federal funds and relate
d
Yes No
costs are readily identified?
SECTION C: PROGRAM MANAGEMENT
1.Is the organization new to managing federal grant funds or has the organization had recent staff turnover that
significantly reduces its institutional capacity to effectively manage federal funds? Yes No
If yes, please explain: (attach a separate sheet if necessary)
SECTION C: PROGRAM MANAGEMENT CONT.
2. If the organization has recently (past 5 years) or currently receives federal grant funding, has the organization
been out-of-compliance with reporting or other requirements?
If yes, please explain: Yes No
SECTION D: For Internal Use Only
1. Does the organization/entity receiving this award have an acceptable track record of managing funds provided by EOPSS?
Briefly explain. Yes No
2. Is the proposed program very complex, is the award above $1million, and/or is the proposed grant-funded activity such that additional risk can be
presumed? If yes, please explain. Yes No
3. The suspension and debarment list on the System for Award Management website (https://www.sam.gov/portal/SAM/##11) must be checked for
each subgrantees and vendor. Is the subgrantee/vendor eligible to receive federal funding? Yes No
SECTION E: APPLICANT CERTIFICATION
I certify that the above information is complete and correct to the best of my knowledge.
1. Signature
b. Organization Name:
Address:
Telephone Number:
a. Title
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Risk Assesment Form

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Completed 16 March 2020

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