350-11: External Audits and Agency Reviews

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Outlines the scope, responsibilities and procedures that will be employed in coordinating and managing external agency audit and investigation activities at UCSF.


External audits and agency reviews of University of California, San Francisco (UCSF) campus and medical center functions are performed by Federal, State, local government offices, private entities and The Regents' audit firm. This policy outlines the scope, responsibilities and procedures that will be employed in coordinating and managing external agency audit and investigation activities at UCSF, excluding the annual financial audit performed by the auditors for The Regents as outlined in Business and Finance Bulletin BUS-76.


A review conducted by any non-University federal, state, or private entity that may be conducted for purposes of monitoring contract and/or grant pre-award or post-award activities, billing, cost reports, or other University or hospital related financial information and reports, or administrative practices.

The State of California’s independent external audit entity responsible for assessment of government financial and operational activities.

One federal agency responsible for auditing the University on behalf of all other federal agencies. Because it is the largest provider of federal funds, the Department of Health and Human Services is the University's cognizant agency.

Independent appraisal, by a non-University audit entity, of the University's financial and administrative performance as a custodian of public funds. Such reviews typically include the annual A-133 and financial statement audits conducted by The Regents’ auditor.

An independent certified public accounting firm that annually audits University financial statements, and also performs regular audits required by the federal government to comply with federal regulations (See OMB Circular A-133, Audits of Institutions of Higher Education and Other Non-Profit Institutions). Separate annual reviews are conducted at the campus and medical center and coordinated by the campus Controller and Medical Center Chief Financial Officer (CFO).


It is the policy of UCSF to comply fully with all financial, administrative and audit requirements that arise from its role as a recipient of public and other extramural funds; and to cooperate fully with external auditors or other agency officials conducting external investigations. UCSF is committed to providing all available information pertinent to the scope of approved external audits in a reasonable period of time.


A. Departments, business units or individual principal investigators are responsible for notifying the Chief Audit Officer, Audit and Advisory Services (Chief Audit Officer) of all external audits and agency reviews when they become aware of or are informed that an agency representative wishes to commence a review or will be conducting fieldwork on campus.

B. The Chief Audit Officer will consult with the Chief Ethics and Compliance Officer, Assistant Vice Chancellor and Controller, and Chief Campus Counsel to determine the external audit coordinator to be assigned to coordinate and assist in getting the external audit completed. Normally, the external audit coordinator will be a representative from the department, school, or division associated with the audit or a representative from Audit and Advisory Services, Compliance, or another department.

C. In certain instances because of the size and complexity of an external audit, an ad-hoc committee will be formed by the Chief Audit Officer and Chief Ethics and Compliance Officer that will include the external audit coordinator and others to assist in managing and handling the external audit.

D. The Chief Audit Officer or designee should attend all entrance, interim, and exit audit conferences.

E. The Chief Audit Officer will inform appropriate campus management of the audit results and if any serious issues were identified which require immediate action.

F. When a written response is necessary to an external audit, the Chief Audit Officer and Chief Ethics and Compliance Officer will work with the respective school and/or department in preparing it and ensuring the response appropriately addresses issues raised and actions to be taken.

G. When external audits results in the campus committing to taking specific actions, Audit and Advisory Services will perform follow-up work to confirm that agreed upon actions have been taken.