Common use of Work Verification Clause in Contracts

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:or

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (610) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (610) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • elements: Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below::  

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • explain how staff will:  Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; •  Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; •  Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; •  Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and •  Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (615) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (615) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district will maintain supporting documentation for the cases that are reviewed and make them readily available for review by A&QI auditors upon request. The results of Outside Providers/Vendors‌ Does these audits will enable the district utilize outside providers/vendors to collect identify policies, processes or cases that may need corrective action. We will ensure that a summary report will be prepared following each review period and forwarded to Xxxxx Xxxx, Xxxxxxxx.Xxxx@xxxx.xx.xxx, and Xxxx Xxxxxx, Xxxx.Xxxxxx@xxxx.xx.xxx. Please describe the process the district will use to review provider collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): NCDSS doesn't have providers that enter data directly into WTWCMS? Yes No If Yes, does . All data is submitted to NCDSS and reviewed prior to entry into the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:WTWCMS.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (620) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (620) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (675) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (650) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (325) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (325) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: HRA does not use WTWCMS but rather NYCWAY and other local systems. HRA workers and the providers follow the same process for maintaining the supporting documentation for participation in paid employment and make it readily available for review by XXXX A&QC upon request. For unpaid work activities, HRA’s providers will maintain the supporting documentation for unpaid work activities and make it readily available for HRA to submit to OTDA A&QC for review upon request. This process includes entering a participant’s time into the district’s attendance systems. This process is the same process that HRA workers would follow to enter attendance and document unpaid work activities. In addition, HRA workers will also retain documentation related to the caretaker of a child under 12 months of age or caretaker of a disabled household member and made available upon request. HRA will validate attendance reporting by monitoring visits to providers and viewing attendance records for program participation. HRA will visit Career Services program providers and other providers on a semi-annual basis to assess the accuracy of attendance reporting.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (650) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (640) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (320) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district will maintain supporting documentation for the cases that are reviewed and make them readily available for review by A&QI auditors upon request. The results of Outside Providers/Vendors‌ Does these audits will enable the district utilize outside providers/vendors to collect documentation identify policies, processes or cases that may need corrective action. We will ensure that a summary report will be prepared following each review period and enter data directly into WTWCMS? Yes No If Yesforwarded to Xxxxx Xxxx, does the district’s provider/vendor collected documentationXxxxxxxx.Xxxx@xxxx.xx.xxx, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If NoXxxx Xxxxxx, please Xxxx.Xxxxxx@xxxx.xx.xxx. Please describe the process used below:the district will use to review provider collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): HRA will maintain the supporting documentation for participation in paid and unpaid work activities and make it readily available for review by XXXX A&QC upon request. In addition, documentation related to the caretaker of a child under 12 months of age or caretaker of a disabled household member will also be retained and made available upon request. HRA will validate attendance reporting by monitoring visits to providers and viewing attendance records for program participation. Over 2016 and 2017, HRA will visit employment vendors and other providers on a semi-annual basis to assess the accuracy of attendance reporting.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6four) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6four) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3two) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3two) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district will maintain supporting documentation for the cases that are reviewed and make them readily available for review by A&QI auditors upon request. The results of Outside Providers/Vendors‌ Does these audits will enable the district utilize outside providers/vendors to collect documentation identify policies, processes or cases that may need corrective action. We will ensure that a summary report will be prepared following each review period and enter data directly into WTWCMS? Yes No If Yesforwarded to Xxxxx Xxxx, does the district’s provider/vendor collected documentationXxxxxxxx.Xxxx@xxxx.xx.xxx, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If NoXxxx Xxxxxx, please Xxxx.Xxxxxx@xxxx.xx.xxx. Please describe the process used below:the district will use to review provider collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): N/A - Providers do not collect documentation or conduct data entry.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (615) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (615) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (610) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (610) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (35) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: Wayne County does not currently have program providers who are responsible for collection of documentation or entry of data into WTWCMS.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance accordanc e with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation docume ntation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • elements: Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below::  

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • explain how staff will:  Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; •  Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; •  Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; •  Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and •  Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (620) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (620) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • explain how staff will:  Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; •  Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; •  Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; •  Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and •  Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6( ) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6( ) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6( ) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6( ) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district will maintain supporting documentation for the cases that are reviewed and make them readily available for review by A&QI auditors upon request. The results of Outside Providers/Vendors‌ Does these audits will enable the district utilize outside providers/vendors to collect documentation identify policies, processes or cases that may need corrective action. We will ensure that a summary report will be prepared following each review period and enter data directly into WTWCMS? Yes No If Yesforwarded to Xxxxx Xxxx, does the district’s provider/vendor collected documentationXxxxxxxx.Xxxx@xxxx.xx.xxx, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If NoXxxx Xxxxxx, please Xxxx.Xxxxxx@xxxx.xx.xxx. Please describe the process used below:the district will use to review provider collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews):

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (675) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (650) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (325) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (325) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: HRA does not use WTWCMS but rather NYCWAY and other local systems. HRA workers and the providers follow the same process for maintaining the supporting documentation for participation in paid employment and make it readily available for review by XXXX A&QC upon request. For unpaid work activities, HRA’s providers will maintain the supporting documentation for unpaid work activities and make it readily available for HRA to submit to OTDA A&QC for review upon request. This process includes entering a participant’s time into the district’s attendance systems. This process is the same process that HRA workers would follow to enter attendance and document unpaid work activities. In addition, HRA workers will also retain documentation related to the caretaker of a child under 12 months of age or caretaker of a disabled household member and made available upon request. HRA will validate attendance reporting by monitoring visits to providers and viewing attendance records for program participation. HRA will visit Career Services program providers and other providers on a semi-annual basis to assess the accuracy of attendance reporting.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 38or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (624) cases semicasessemi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is attendanceis accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit 48-timelimit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district will maintain supporting documentation for the cases that are reviewed and make them readily available for review by A&QI auditors upon request. The results of Outside Providers/Vendors‌ Does these audits will enable the district utilize outside providers/vendors to collect documentation identify policies, processes or cases that may need corrective action. We will ensure that a summary report will be prepared following each review period and enter data directly into WTWCMS? Yes No If Yesforwarded to Xxxxx Xxxx,Xxxxxxxx.Xxxx@xxxx.xx.xxx, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please Xxxx Xxxxxx,Xxxx.Xxxxxx@xxxx.xx.xxx. Please describe the process used below:the district will use to review provider collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): Onondaga will perform a random sample of 24 cases semi-annually for participation in paid work activities. Both the temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms, and direct phone contact with the employer documented in case notes. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS are consistent with the documentation. Onondaga will perform a random sample of 24 cases semi-annually for participation in unpaid work activities. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets have been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and that documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. Onondaga County will assess and verify that participation in the work activities reported for work eligible individuals meets the Federal definition for the activity. Xxxxxxxx will perform a random sample of 12 cases semi-annually in which a case member is reported as an employability code 38 (needed in the home fulltime to care for an incapacitated household member). The temporary assistance and employment case files will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. Xxxxxxxx will perform a random sample of 12 cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months. The temporary assistance and employment case files will be reviewed to ensure there is a birth certificate, footprint documentation, or documentation from the hospital present to verify the child is under the age of one. A summary report will be prepared following each review period and forwarded to Xxxxx Xxxx at Xxxxxxxx.Xxxx@xxxx.xxxxx.xx.xx and Xxx Xxxxxx at Xxxxxxxxx.Xxxxxx@xxxx.xxxxx.xx.xx. Onondaga County will maintain the supporting documentation for participation in paid and unpaid work activities and make it readily available for review by A&QI auditors upon request. In addition, documentation related to the caretaker of a child under the age of 12 months or caretaker of incapacitated household member exemptions/exclusions will also be retained and made available upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (620) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (620) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: Each individual Coach and Technical Assistant has been trained in proper data entry procedures for WTWCMS and local databases. The job coach will create enrollments, enter case narratives and calculate attendance. Once the attendance entry is calculated by the coach, Technical Assistants will enter the data on WTW CMS. All staff are required to adhere to established data entry, system use and confidentiality policies. Team Leaders review and audit entries for accuracy.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual actu al and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (624) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (624) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (312) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ elements: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ follows: The district will perform a random sample of (6( ) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6( ) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3( ) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Vendors Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: The provider/vendor complete attendance sheets and fax them weekly.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:: Xxxxxx County randomly selects the cases for review. We do not have any providers doing data entry. Our employment unit/social welfare examiners do the collecting and data entry.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (614) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (614) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ The district will perform a random sample of (6six) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6six) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3three) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3three) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry of the above listed elements. The district will assess and verify that participation in the reported work activities listed above meet the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does the district utilize outside providers/vendors to collect documentation and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used by the district worker? Yes No If No, please describe the process used below:

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (6( 75 ) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (6( 50 ) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (3( 25 ) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (3( 25 ) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate accurat e and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases cas es will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State St ate review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the district will use to review district worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (620) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (620) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (310) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social soc ial security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.

Work Verification. ‌ Consistent with New York State’s approved Work Verification Plan (WVP), and in accordance with the requirements established by the United States Department of Health and Human Services, districts must develop a quality assurance plan to ensure that the data reported, from which their work participation rates are derived, are accurate. The plan must include the district’s procedure for monitoring reported scheduled and actual attendance in paid employment and unpaid work activities and the controls in place to ensure that reported exemption statuses resulting in federal exclusions from the work participation rate calculation are accurately made, work eligible individuals are correctly identified, hours of attendance reported are accurate and documented, data entry is accurate and that the district and its providers adhere to the approved work activity definitions and the determination of countable excused absences and holiday reporting within federal limits. Each district must maintain the documentation to verify what is being reported to NYS OTDA. Each district must describe how it will conduct periodic self audits to determine that system entries are consistent with documentation in case files. The district must also explain how it will choose the sample size, select sample cases and establish the review period (no less frequently than semi-semi- annually). The plan must indicate the district will maintain documentation on all pertinent findings produced through its self audit process and that case records for all reviewed cases will be available for State and other auditors in their review of the local work verification system for the standard 6 year period associated with such reviews. The district will sample cases from each month within the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The results of these audits will enable the district to identify policies, processes or cases that may need corrective action. After each self audit is completed, the district must submit a summary of findings to OTDA A&QI at XXX.XX.XxxxXxxxxx@xxxx.xx.xxx for State review including specific information on each of the errors identified. In addition, when monitoring reveals substantial problems, the district must describe the corrective action it will take. The Quality Assurance (QA) plan must include the following elements:‌ explain how staff will: • Ensure that documentation of wages and actual hours of employment is verified and accurately projected/reported and present in the case file, is actual and is projected correctly; • Ensure that the documentation for actual hours, supervision/attendance, excused absences, and holidays in other activities is present in the case file; • Assess whether participation in the work activities reported for work eligible individuals meets the approved federal definition for the activity; • Assess that the data entered into either WTWCMS, NYCWAY or other automated systems used for reporting work activities is accurate, including actual hours, excused absences and holidays; and is based on documentation in the case record; and • Ensure that documentation necessary to determine an individual to be exempt due to being the parent caretaker of a disabled household member (Employability Code 38 or 48), and/or parent or caretaker relative of a child in the household under 12 months of age, (Employability code 31), is present in the case file and that individuals meet the exempt status based on the required documentation. The District’s Quality Assurance Process is as follows:‌ Please describe the process the District will use to review District worker collected documentation and data entry of the above listed elements (include a description of how a case sample for review will be selected, sample size and frequency of reviews): The district will perform a random sample of (612) cases semi-annually for paid work activities to review district worker collected documentation and data entry. Both the TA temporary assistance and employment case files will be reviewed. Hours of employment will be verified through receipt of pay stubs, employer verification forms or collateral contact with the employer. The review will ensure the hours of employment on the XXXX budget are consistent with the hours reported on WTWCMS and documentation is in the file to support hours reported on WTWCMS and that the scheduled hours on WTWCMS is consistent with the documentation. The district will perform a random sample of (612) cases semi-annually for participation in unpaid work activities to review district worker collected documentation and data entry. The employment case files will be reviewed. Actual hours of attendance will be documented by attendance sheets showing actual hours of attendance, any excused absences during the month, any unexcused absences during the month, and holiday time. The review will ensure the actual hours of attendance reported on the monthly attendance sheets has been correctly reported on WTWCMS, excused absences and holiday time are documented in the case file and correctly reported on WTWCMS in accordance with federal limitations, and documentation of actual hours of attendance is accurate and matches the hours of participation reported on WTWCMS by district or provider staff. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 38-needed in the home fulltime or employability code 48- 48-time limit exemption to care for a disabled household member to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is presence of medical documentation to support the exemption and that the documentation has a timeframe for the exemption and that the individual is the appropriate caretaker. The district will perform a random sample of (36) cases semi-annually in which a case member is reported as an employability code 31-caretaker of a child under the age of 12 months to review district worker collected documentation and data entry. The TA temporary assistance case file will be reviewed to ensure there is documentation from hospital, birth certificate or social security card present to verify the child under the age of one. TA Temporary assistance records will also be reviewed to ensure that the household composition is in fact a one parent case and that the individual has not exceeded the 12-12 month lifetime limit. The district will review district worker or approved provider/vendor collected documentation and data entry In each of the above listed elements. The samples, the district will assess and verify that participation in the reported work activities listed above meet meets the State approved definition for the activity. Use of Outside Providers/Vendors‌ Does The district will sample cases from each month within in the (6 month) semi-annual period. The October to March review will be due by May 20th. The April to September review will be due by November 20th. The district utilize outside providers/vendors to collect will maintain supporting documentation for the cases that are reviewed and enter data directly into WTWCMS? Yes No If Yes, does the district’s provider/vendor collected documentation, data entry and management of WTWCMS follow the same process that would be used make them readily available for review by the district worker? Yes No If No, please describe the process used below:A&QI auditors upon request.