Nevada Department of Public Safety Office of Traffic Safety                                                                            On-Site Monitoring Report

Date:

Grant Number

Sub Grantee

Grant Title:

Location of Site Visit:

Participant (s) name and title

Purpose of Monitoring:

____

Scheduled Monitoring

Preparation:

Review Project Agreement

____

Unscheduled Monitoring

Review Project Reports

____

Response to identified problem

Review Claim File

____

Other (Explain) _____________

Review Correspondence

Performance Information

Are all reports complete and submitted as required (  ) Yes  (  )  No - explain why

Provide information on each grant objective:

Objective 1:

(   )  Complete  (   ) In Progress    (   ) Scheduled    (   ) Will Not Complete Because

Objective 2:

(   )  Complete  (   ) In Progress    (   ) Scheduled    (   ) Will Not Complete Because

Objective 3:

(   )  Complete  (   ) In Progress    (   ) Scheduled    (   ) Will Not Complete Because

Were any special accomplishments, unique activities or actions identified?

(   )  Yes   (    )  No    (    )   Explain

Financial Reports and Records

Are claim vouchers submitted on time, correct, and accompanied by documentation for expendituress?

(    )  Yes   (    )  No - Explain

Are reported costs consistent with the amount approved in the grant?

(    )  Yes   (    )  No - Explain

Were costs reported in the budget period in which they were incurred?

(    )  Yes   (    )  No - Explain

Describe controls in place to prevent expenditures in excess of approved grant amounts

List financial records reviewed on site.

Describe the sampling method used to choose records for review.

Single Audit Compliance

Does the sub grantee agency receive $500,000 or more of federal financial assistance in the current year?

(    )  Yes   (    )  No

If Yes, has the subgrantee been audited or will they be audited when the grant period ends?

(    )  Yes   (    )  No - Explain

If Yes - Has the agency submitted a report of audit to DPS-OTS?

(    )  Yes   (    )  No - Explain

Contractual

Does the sub grantee utilize the services of a contractor?

(    )  Yes   (    )  No

If Yes, Describe the method the sub grantee used to select a contractor

Personnel

Does the award to the sub grantee include funding for personnel services?

(    )  Yes   (    )  No

If Yes, are methods in place to account for the time the Sub Grantee's employees works on this project?

(    )  Yes   (    )  No - Explain

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DPS Form 15 (Dec 06)

Program Income

Does the sub grantee receive program income from another source?

(    )  Yes   (    )  No

If Yes, what accounting process is used to account for the income

Public Information and Education (PI&E) items

Does the award to the sub grantee include funding for PI&E?

(    )  Yes   (    )  No

Did the sub grantee receive approval before purchasing PI&E items?

(    )  Yes   (    )  No - Explain

Property Management

Has property or equipment been purchased with grant funds?

(    )  Yes   (    )  No

If Yes, what was purchased:

If Yes was the property or equpment approved in the grant budget?

(    )  Yes   (    )  No - Explain

If Yes, does the sub grantee have a system in place to tag, control, protect, preserve, use and maintain?

(    )  Yes   (    )  No - Explain

Was a physical inventory of equipment or property done during the site visit?

(    )  Yes   (    )  No - Explain

Travel

Was travel included in the grant?

(    )  Yes   (    )  No

Is supporting documentation for travel expenses on file?

(    )  Yes   (    )  No - Explain

Evaluation

How is the sub grantee evaluating the effectivness of the grant activity?

Has the sub grantee experienced any obstacles in achieving the grant objectives?

(    )  Yes   (    )  No - Explain

Will the grant activities be completed by the end of the grant year?

(    )  Yes   (    )  No - Explain

Project Status

Was project started on schedule?

(    )  Yes   (    )  No - Explain

Is the project fully staffed with qualified, trained personnel?

(    )  Yes   (    )  No - Explain

Corrective Actions

Are corrective actions recommended?

(    )  No   (    )  Yes - Explain

Law Enforcement Grants

Is the sub grantee a law enforcement agency?

(    )  Yes   (    )  No

If Yes, did the sub grantee submit enforcement activity reports as required?

(    )  Yes   (    )  No

If Yes, did the sub grantee submit timesheets for officer overtime?

(    )  Yes   (    ) No - Describe

Comments and Recommendations:

Prepared by:

Reviewed by:

Name

Date

Name

Date

Distribution:

Origional - to Grant File

Copy 1 - Sub grantee

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DPS-OTS Form 15 (Dec 06)