Internal Control Questionnaire (2) page 1 of 5 7/17/2012 General Information Control Questionnaire Objective: To gather departmental information and documentation as a part of the preliminary survey phase of an audit or Internal Control Review. Completed By: Date: Name and Title: (please print) Cash Handling & Management Policies & Procedures 1. Is there a departmental cash collection and receipting policy? [If so, how is the cash receipting policy communicated to individuals responsible for payment processing?] 2. Please provide the names of all employees responsible for the cashiering process (cashiering, depositing and reconciliation) 3. On average, what is the amount of receipts (cash, checks and credit card) collected daily? 4. How the cash receipts are recorded (cash register, pre-numbered manual receipts, computer system)? 5. Have all employees involved in the cashiering process been fingerprinted and received a background check? 6. Have all employees involved in the cashiering process attended the required training? Cash Transactions 1. Does the Point of Sale (POS) system interface with the Medical Center s financial accounting system? 2. Are prices per menu matched with prices in the POS system? 3. Are any periodic audits done of the cashiering process? 4. How are voided receipts/transactions handled? What supporting documentation is required for register voids? Who reviews and approves the voided 1
Internal Control Questionnaire (2) page 2 of 5 7/17/2012 transactions? 5. What is the policy regarding refunds? How are refunds processed? Who reviews and approves refunds? Physical Security 1. Where are the cash/checks receipts kept during the day? Who has access to these storage areas (please provide names)? 2. If more than one individual is responsible for monies, how is accountability maintained? 3. Where is cash receipts stored overnight? Who has access to these areas? 4. Where are keys/combinations to storage areas maintained? 5. What records are used to document issuance of keys/combinations? Where are back-up keys stored and who has access? Deposits 1. Who is responsible for preparing the deposit(s)? 2. How often are deposits made? 3. Has the depositor received refresher training in the past year? 4. Is a review performed to match the deposit report to payments collected and to the receipts for the day? If so, who performs the review and how is this documented? 5. Where is the deposits stored pending transport to the bank? Who has access? 6. How often are deposits made? How is the money transported for deposit? 2
Internal Control Questionnaire (2) page 3 of 5 7/17/2012 7. Where are copies of deposit record, validated receipt and individual patient receipts retained? Who is responsible for retaining them? Please provide names. How long are they retained? Reports & Reconciliation 1. What type of reports are available and how frequently are they run? 2. Who is responsible for reviewing the sales report and reconciling it with the cash receipts/deposit information? 3. If a discrepancy is detected between the information on the report and the amount collected or deposited, what is the process to resolve it? 4. Who is responsible for reconciling to the financial ledgers? How often is the reconciliation done? Food Purchasing & Inventory Management Policies & Procedures 1. Does the department have policies and procedures regarding the ordering and purchasing of food supplies? 2. Are nominated officers responsible for procurement? Is an authorized signatory list in place? Contracts 1. Are contract suppliers used wherever possible? 2. Do these relate to an approved suppliers catalogue? 3. If an alternative supplier is used, is a written reason submitted? Ordering 1. Is the purchase process manual or automated? 2. Are orders supported by requisitions? 3. Are requisitions secured and is their use controlled? (please explain how these are 3
Internal Control Questionnaire (2) page 4 of 5 7/17/2012 controlled) 4. How are cancelled orders handled? 5. Are goods accompanied by delivery notes? Who signs the delivery notes and checks the goods when they arrive? Segregation of Duties 1. Is access to ordering and receiving functions restricted? 2. Are ordering and receiving functions separated from invoice processing and General Ledger review functions? Inventory Management 1. Is a perpetual inventory maintained? 2. Are inventory logs documenting receipt, withdrawals and balance in hand maintained? 3. Is expiration date or received date recorded on the inventory to ensure that ageing inventory is used first and that obsolescence is kept to a minimum? 4. Are periodic inventory counts conducted? Who is responsible for performing the counts? 5. How are write-offs as a result of wastage or spoilage documented and monitored? Who is authorized to perform write-offs? 6. Is use per daily production reports agreed with inventory withdrawn? Food Safety 1. Is there a committee that oversees the safety, quality and standards of food services? 2. How do you ensure compliance with the agreed standards? 3. Is food safety an agenda item at all management / supervisory meetings? 4. Is training is provided to employees on food preparation, safety and material and equipment 4
Internal Control Questionnaire (2) page 5 of 5 7/17/2012 handling? 5. Are safety procedures developed for each piece of equipment / task for training and daily operational use? 6. Are First Aid kits, supplies available in all areas? 7. How often is safety inspections performed? 8. Are cited deficiencies followed up timely? 9. What systems are in place for monitoring refrigerator temperatures? 10. Has an injury reporting system been established? 5