CUSTOMER SERVICE * INTEGRITY ~ ACCOUNTABILITY

U.S. Chemical Safety Board

Contractor-Produced
Report: CSB Is at Increased
Risk of Losing Significant
Data and Is Vulnerable
to Exploitation

Report No. 22-E-0025

March 29, 2022

Needs Improvement

&

Configuration
Management

Needs Improvement •

Level 3: Consistently Implemented
Level 4: Managed and Measurable

Level 5: Optimized


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Abbreviations:

CSB

EPA

FISMA

FY

IG

OIG

U.S. Chemical Safety and Hazard Investigation Board

U.S. Environmental Protection Agency

Federal Information Security Modernization Act

Fiscal Year

Inspector General

Office of Inspector General

Cover Image:

The CSB's information security program is not consistently implemented.
Improvements are needed in configuration management and contingency
planning. (EPA OIG image)

Are you aware of fraud, waste, or abuse in a CSB
program?

EPA Inspector General Hotline

1200 Pennsylvania Avenue, NW (2431T)
Washington, D.C. 20460
(888) 546-8740
(202) 566-2599 (fax)

OIG Hotline@epa.gov

Learn more about our OIG Hotline.

EPA Office of Inspector General

1200 Pennsylvania Avenue, NW (2410T)
Washington, D.C. 20460
(202) 566-2391
www.epa.gov/oiq

Subscribe to our Email Updates.
Follow us on Twitter @EPAoig.
Send us your Project Suggestions.


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Office of Inspector General

U.S. Environmental Protection Agency

At a Glance

22-E-0025
March 29, 2022

Why This Evaluation Was
Done

This evaluation was performed to
assess the U.S. Chemical Safety
and Hazard Investigation Board's
compliance with performance
measures outlined in the fiscal
year 2021 inspector general
reporting instructions for the
Federal Information Security
Modernization Act of 2014.

SB & Company was contracted
to perform this evaluation under
the direction and oversight of the
U.S. Environmental Protection
Agency's Office of Inspector
General.

The performance measures
outline and provide potential
ratings for security function areas
to help federal agencies manage
cybersecurity risks.

This evaluation supports the CSB
mission-related effort:

• Preventing recurrence of
significant chemical incidents
through independent
investigations.

Address inquiries to our public
affairs office at (202) 566-2391 or
OIG WEBCOMMENTS@epa.gov.

List of OIG reports.

Contractor-Produced Report: CSB Is at
Increased Risk of Losing Significant Data and
Is Vulnerable to Exploitation

What SB & Company Found

SB & Company assessed the effectiveness of the
CSB's information security program at "Level 2,
Defined," which means that the CSB's policies,
procedures, and strategies for its information
security program are formalized and that its
strategies are documented but not consistently
implemented.

SB & Company found
that the lack of off-site
data backups
increases the CSB's
risk of losing
significant data.

While the CSB has policies, procedures, and strategies in place for the
information security program, SB & Company identified that the CSB lacks a
Vulnerability Disclosure Policy to protect its public website. This increases the
risk that vulnerabilities identified by external stakeholders are not being
reported in a timely manner to CSB management. A delay in reporting identified
vulnerabilities may increase the risk of exploitation of those vulnerabilities and
lead to the disruption of operations.

SB & Company also identified that the CSB discontinued the off-site storage of
tape backups, which increases the risk of losing data and disrupting operations.
This issue was previously identified in OIG Report No. 21-E-0071, CSB's
Information Security Program Is Not Consistently Implemented; Improvements Are
Needed to Address Four Weaknesses, issued February 9, 2021. The CSB
concurred with the recommendation in that report, implemented a corrective
action, and restarted off-site backups. The CSB provided supporting documents
for the corrective action taken, and we considered the corrective action for that
recommendation completed. However, with the lack of on-site staff during the
coronavirus pandemic, the CSB once again did not store backup tapes off-site.
As a result, if the CSB headquarters loses data during an incident, those data
could be permanently lost and impact the CSB's ability to fulfill its mission.

Recommendations and Planned Agency Corrective Actions

SB & Company made two recommendations to the CSB, and the OIG agrees
with and adopts these recommendations. The CSB agreed with the
recommendations and provided acceptable corrective actions. The OIG
considers Recommendation 1 to be resolved with corrective action completed,
and Recommendation 2 to be resolved with corrective action pending.


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UNITED STATES ENVIRONMENTAL PROTECTION AGENCY

WASHINGTON, D.C. 20460

THE INSPECTOR GENERAL

March 29, 2022

Katherine A. Lemos, Ph.D.

Chairperson and Chief Executive Officer
U.S. Chemical Safety and Hazard Investigation Board
1750 Pennsylvania Avenue NW, Suite 910
Washington, D.C. 20006

Dear Dr. Lemos:

This is a report on the U.S. Chemical Safety and Hazard Investigation Board's information security
program. The report synopsizes the results of information technology security work performed by SB &
Company under the direction of the U.S. Environmental Protection Agency's Office of Inspector General.
This report also includes SB & Company's completed fiscal year 2021 Federal Information Security
Management Act reporting template, as prescribed by the Office of Management and Budget. The project
number for this evaluation is OA-FY21-0205. This evaluation was conducted in accordance with Quality
Standards for Inspection and Evaluation, published in January 2012 by the Council of the Inspectors
General on Integrity and Efficiency.

This report contains SB & Company's findings and recommendations. We agree with SB & Company's
recommendations and adopt them as our own.

Your staff provided acceptable corrective actions in response to the recommendations. All
recommendations are resolved, and no final response to this report is required. If you submit a response,
however, it will be posted on the OIG's website, along with our memorandum commenting on your
response. Your response should be provided as an Adobe PDF file that complies with the accessibility
requirements of Section 508 of the Rehabilitation Act of 1973, as amended. The final response should not
contain data that you do not want to be released to the public; if your response contains such data, you
should identify the data for redaction or removal along with corresponding justification.

We will post this report to our website at www.epa.gov/oig.

Sincerely,

Sean W. O'Donnell


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Contractor-Produced Report: CSB Is
at Increased Risk of Losing Significant
Data and Is Vulnerable to Exploitation

22-E-0025

	Table of Contents	

SB & Company Report	1

CSB Response and OIG Assessment	7

Status of Recommendations	8

Appendixes

B Status of CSB Corrective Actions for FY 2018, FY 2019, and FY 2020 FISMA

Report Recommendations	38

C CSB Response to Report	40

D Distribution	41


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Report of Independent Public Accountants

To the Management of U.S. Chemical Safety and Hazard Investigation Board-.

This report presents the results of our independent evaluation of the U.S. Chemical Safety and
Hazard Investigation Board (CSB)'s information security program and practices. The Federal
Information Security Modernization Act of 2014 (FISMA) requires federal agencies, including
CSB, to have an annual independent evaluation performed of their information security program
and practices and to report the results of the evaluations to the Office of Management and Budget
(OMB). OMB has delegated its responsibility for the collection of annual FISMA responses to the
Department of Homeland Security (DHS). DHS, in conjunction with OMB and the Council of the
Inspectors General on Integrity and Efficiency (CIGIE), developed the Fiscal Year (FY) 2021
FISMA Reporting Metrics to collect these responses. FISMA requires the agency Inspector
General (IG) or an independent external auditor to perform the independent evaluation as
determined by the IG. The Environmental Protection Agency Office of Inspector General (OIG)
contracted SB & Company, LLC (SBC) to conduct this independent evaluation and monitored our
work to ensure we met professional standards and contractual requirements.

We conducted our independent evaluation in accordance with CIGIE Quality Standards for
Inspection and Evaluation and applicable American Institute of Certified Public Accountants
(AICPA) standards.

The objective for this independent evaluation was to assess the effectiveness of CSB's information
security program and practices, including CSB's compliance with FISMA and related information
security policies, procedures, standards, and guidelines for the period October 1, 2020, to
September 30, 2021. We based our work on a selection of CSB-wide security controls and a
selection of system specific security controls across CSB information systems. Additional details
regarding the scope of our independent evaluation are included in the report, Background, Scope,
and Methodology. Appendix A contains the FISMA Matrix and Appendix B the status of prior
year recommendations.

Consistent with applicable FISMA requirements, OMB policy and guidance, and National Institute
of Standards and Technology (NIST) standards and guidelines, CSB established and maintained
its information security program and practices for its information systems for the five cybersecurity
functions and eight FISMA metric domains. Based on the results entered into CyberScope, we
determined that CSB's overall information security program was "Defined" because a majority of
the FY 2021 FISMA metrics were rated Defined (Level 2). We reported deficiencies impacting
specific CyberScope questions in Identify (supply chain risk management) and Protect
(configuration management).

In our report, we have provided the Chief Information Officer (CIO) two findings and two
recommendations that when addressed should strengthen CSB's information security program.
The CSB CIO agreed with our conclusions and recommendations (see Management Response,
page 44).


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This independent evaluation did not constitute an engagement in accordance with Generally
Accepted Government Auditing Standards. SB & Company, LLC did not render an opinion on
CSB's internal controls over financial reporting or over financial management systems as part of
this evaluation. We caution that projecting the results of our evaluation to future periods or other
CSB information systems not included in our selection is subject to the risk that controls may
become inadequate because of changes in technology or because compliance with controls may
deteriorate.

Washington, D.C.
January 14, 2022


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	Table of Contents	

Background	1

Scope and Methodology	2

Prior Audit	4

Results	5

Conclusion	6

Recommendations	6

Appendix

A SB & Company-Completed Department of Homeland Security

CyberScope Template	9


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Background

Under the Federal Information Security Modernization Act of 2014 (FISMA),
agency heads are responsible for providing information security protections
commensurate with the risk and magnitude of harm resulting from the unauthorized
access, use, disclosure, disruption, modification or destruction of information and
information systems.

Each fiscal year, the U.S. Department of Homeland Security and the Office of
Management and Budget issue an IG FISMA Reporting Metrics template for the
Inspector General of each federal agency to use to assess the agency's information
security program. The FY 2021 IG FISMA Reporting Metrics,1 which can be found
in Appendix A, identifies nine domains within the five security functions defined
in the National Institute of Standards and Technology (NIST) Framework for
Improving Critical Infrastructure Cybersecurity (Figure l).2 This cybersecurity
framework provides agencies with a common structure for identifying and
managing cybersecurity risks to critical infrastructure across the enterprise.

Figure 1: FY 2021 cybersecurity framework security function areas and domains

Function
Areas:

Identify

Risk
Management

Supply
Chain Risk
Management

Protect

Configuration
Management

Identity & Access
Management

Data Protection &
Privacy

Security Training

Detect

Information

Security
Continuous
Monitoring

Recovery

Contingency
Planning

Source: OIG-created graphic based on FY 2021 IG FISMA Reporting Metrics information.

The effectiveness of an agency's information security program is based on a
five-tiered maturity model spectrum (Table 1). An agency's IG is responsible for
annually assessing the agency's rating along this spectrum by determining whether
the agency possesses the required policies, procedures and strategies for each of the
nine domains. The IG makes this determination by answering a series of questions

1	FY 2021 Inspector General Federal Information Security Modernization Act of 2014 (FISMA) Reporting Metrics,
Version 1.1, dated May 12, 2021. These metrics were developed as a collaborative effort between the Office of
Management and Budget, the Department of Homeland Security, and the Council of the Inspectors General on
Integrity Management and Efficiency, in consultation with the Federal Chief Information Officer Council

2	Executive Order 13636, Improving Critical Infrastructure Cybersecurity, was issued February 19, 2013, and
directed NIST to develop a voluntary framework based on existing standards, guidelines, and practices to reduce
cyber risks to critical infrastructure.

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about the domain-specific criteria that are presented in the annual IG FISMA
Reporting Metrics template.

An agency must fully satisfy each maturity level before it can be evaluated at the
next maturity level. This approach requires the agency to develop the necessary
policies, procedures and strategies during the foundational levels (1 and 2). The
advanced levels (3, 4 and 5) describe the extent to which the agencies have
institutionalized those policies and procedures.

Table 1: Maturity model spectrum

Maturity level

Description

1

Ad Hoc

Policies, procedures and strategies are not formalized; activities are
performed in an ad hoc, reactive manner.

2

Defined

Policies, procedures and strategies are formalized and documented
but not consistently implemented.

3

Consistently
Implemented

Policies, procedures and strategies are consistently implemented, but
quantitative and qualitative effectiveness measures are lacking.

4

Managed and
Measurable

Quantitative and qualitative measures on the effectiveness of policies,
procedures and strategies are collected across the organization and
used to assess them and make necessary changes.

5

Optimized

Policies, procedures and strategies are fully institutionalized,
repeatable, self-generating, consistently implemented and regularly
updated based on a changing threat and technology landscape and
business/mission needs.

Source: FY 2021 IG FISMA Reporting Metrics.

Scope and Methodology

SB & Company, LLC (SBC or We) conducted this evaluation from June to October
2021 in accordance with accordance with CIGIE Quality Standards for Inspection
and Evaluation and applicable American Institute of Certified Public Accountants
(AICPA) standards.

During our evaluation, we assessed whether the CSB exceeded Maturity Level 1,
Ad-Hoc, for each of the 66 questions for the nine domains in the FY 2021 IG FISMA
Reporting Metrics. We conducted a risk assessment of the FY 2021 IG FISMA
metrics to determine whether changes made to the underlying criteria of the FISMA
metric questions significantly changed since the FY 2020 evaluation.

We also evaluated the new FY 2021 criteria to assess whether they significantly
changed the CSB's responses to the overall metric questions since the FY 2020
evaluation. We assessed each new criterion as either:

¦ High Risk—The Office of Management and Budget introduced new
reporting metrics, or the CSB made significant changes to its information
security program since the FY 2020 evaluation for the identified metric
question.

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¦ Low Risk—The CSB made no significant changes to its information
security program since the FY 2020 evaluation for the identified metric
question.

We relied on the responses to the FY 2020 CSB FISMA metric questions to answer
the FY 2021 metric questions rated as low risk, and we conducted additional
evaluation work to answer the questions rated as high risk.

We limited our assessment to determine whether the agency possessed the noted
policies, procedures and strategies required for each metric under the function area.
If the policies, procedures and strategies were formalized and documented, we rated
the agency at Level 2, Defined. If not, we rated the agency at Level 1, Ad Hoc.

We worked with the CSB and briefed the agency on the evaluation results for each
function area of the FY 2021IG FISMA Reporting Metrics.

Appendix A provides the OIG response to each FISMA metric, as submitted to the
Office of Management and Budget on October 31, 2021.

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Prior Audit

During our testing of the CSB's FY 2021 FISMA compliance, SBC followed up
on deficiencies identified in the FY 2020 FISMA evaluation, as documented in
Report No. 21-E-0071 CSB's Information Security Program Is Not Consistently
Implemented; Improvements Are Needed to Address Four Weaknesses, dated
February 9, 2021. We reported that the CSB lacked documented procedures and
needed improvement in one domain: (1) Identity and Access Management.
Specifically, SBC found that the CSB did not:

1.	Complete the Risk Assessment process as required by NIST 800-37 re-
evaluate the Risk Management Framework to make in more fluent to
leverage day-to-day processes in place for completing the risk assessment
and determine how to best implement an organization-wide governance
process for monitoring and reporting on risks.

2.	Document the process in place to monitor required flaw remediation to
resolution and enhance the flaw remediation process to require approvals if
risks cannot be mitigated to an acceptable level in a timely manner. In
addition, develop timeframes and monitoring on the timeliness of applying
patch updates.

3.	Implement a process to ensure that privacy awareness training is provided
to all individuals, including role-based training where needed.

4.	Implement Information Security awareness and specialized security
training policies and procedures to provide exposure to areas specific to
individuals that have a role supporting Information Security or technology
related areas. In addition, document an Information Security awareness and
training strategy that leverages its organizational skills assessment and
factors the training program priorities, funding, the goals of the program,
and targeted audiences.

5.	Perform disaster recovery testing on an annual basis. In addition, evaluate
alternate methods to store backup media offsite.

The CSB completed corrective actions for recommendation 3 listed above. See
Appendix B for more details on the status of these corrective actions.

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Results

The CSB's information security program is assessed overall at Maturity Level 2,
Defined. Table 2 specifies the maturity level for each function area and the
associated domains.

Table 2: Maturity level of reviewed CSB function areas and domains

Function
area

Domain

Overall OIG-
assessed maturity
level

Identify

Risk Management

Level 2, Defined

Identify

Supply Chain Risk Management

Level 1, Ad-Hoc

Protect

Configuration Management

Level 2, Defined

Protect

Identity and Access Management

Level 2, Defined

Protect

Data Protection and Privacy

Level 2, Defined

Protect

Security Training

Level 2, Defined

Detect

Information Security Continuous Monitoring

Level 2, Defined

Respond

Incident Response

Level 2, Defined

Recover

Contingency Planning

Level 2, Defined

Source: FY 2021 IG FISMA Reporting Metrics.

However, in FY 2021, the CSB continued to need improvements for a specific
question in the "Configuration Management" and "Contingency Planning"
domains, as shown in Table 3.

Table 3: CSB domains that require further improvement

Function
area

Domain

FISMA questions that need improvement

Protect

Configuration
Management

The CSB has not published a Vulnerability
Disclosure Police to their public facing website. See

Appendix A, FISMA Question 24.

Recover

Contingency
Planning

The CSB does not consistently store system backups
offsite at a sufficient distance from its headquarters.
Lack of consistent, off-site backups increases the risk
of loss of data and a disruption to operations. See

Appendix A, FISMA Question 64.

Source: SBC analysis

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Conclusion

The CSB would improve and strengthen its cybersecurity program by publishing a
Vulnerability Disclosure Policy (VDP) on its public facing websites. A VDP will
provide ethical hackers instruction on how to report vulnerabilities that they have
identified and promote cooperation between internal and external stakeholders
pertaining to vulnerabilities.

The CSB would also improve its cybersecurity program by consistently storing
system backups at an off site location a sufficient distance from its headquarters.
Due to lack of on-site staffing during the COVID-19 pandemic, the offsite storage
of tape backups was discontinued. Lack of consistent, off-site backups increases
the risk of loss of data and a disruption to operations. In the case of an incident that
causes the loss of the CSB's headquarters, this lack of off-site backups could lead
to significant loss of data and impact the agency's ability to fulfill its mission.

Recommendations

We recommend that the Chairperson for the U.S. Chemical Safety and Hazard
Investigation Board:

1.	Develop and deploy a Vulnerability Disclosure Policy to formalize security
feedback and to comply with Office and Management and Budget M-20-32
and U.S. Department of Homeland Security Binding Operational Directive
20-01.

2.	Immediately restore off-site storage of backup tapes and implement a
strategy that will ensure that the Agency consistently stores backups of its
systems at an off-site location. Additionally, explore alternative methods of
off-site backup that can be performed automatically and do not require
physical intervention by CSB personnel, such as storing backups in the
cloud.

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CSB Response and OIG Assessment

The CSB agreed with the recommendations and provided acceptable corrective actions. With
respect to Recommendation 1, the CSB stated it approved and published a Vulnerability
Disclosure Policy to the CSB website in accordance with the recommendation. The OIG
reviewed the CSB website and verified that the Vulnerability Disclosure Policy was posted. The
OIG considers this recommendation resolved with corrective action completed.

With respect to Recommendation 2, the CSB stated that it has resumed off-site manual backup
procedures, hired a new agency purchasing officer, and conducted preliminary market research
to understand its need for cloud services. The OIG considers this recommendation resolved with
corrective action pending.

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Status of Recommendations

RECOMMENDATIONS











Planned

Rec.

Page







Completion

No.

No.

Subject

Status1

Action Official

Date

Develop and deploy a Vulnerability Disclosure Policy to formalize
security feedback and to comply with Office and Management
and Budget M-20-32 and U.S. Department of Homeland Security
Binding Operational Directive 20-01.

Chairperson

3/15/22

Immediately restore off-site storage of backup tapes and
implement a strategy that will ensure that the Agency
consistently stores backups of its systems at an off-site location.
Additionally, explore alternative methods of off-site backup that
can be performed automatically and do not require physical
intervention by CSB personnel, such as storing backups in the
cloud.

Chairperson

7/15/22

1 C = Corrective action completed.

R = Recommendation resolved with corrective action pending.
U = Recommendation unresolved with resolution efforts in progress.

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Appendix A

SB & Company-Completed Department of Homeland
Security CyberScope Template

This section shows the information uploaded to the Department of Homeland Security's CyberScope program by
the EPA OIG, based on the template completed by the SB & Company.

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Inspector General

2021

Section Report



Chemical Safety Board

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Function 0: Overall

0.1. Please provide an overall IG self-assessment rating (Effective/Not Effective)

Effective

Comments: The U.S. Chemical Safety and Hazard Investigation Board's Information Security Program has demonstrated that it has defined
policy, procedures, and strategies for all five of its information security function areas.

0..2 Please provide an overall assessment of the agency's information security program. The narrative should include a description of the
assessment scope, a summary on why the information security program was deemed effective/ineffective and any recommendations
on next steps. Please note that OMB will include this information in the publicly available Annual FISMA Report to Congress to provide
additional context for the Inspector General's effectiveness rating of the agency's information security program. OMB may modify the
response to conform with the grammatical and narrative structure of the Annual Report.

The U.S. Chemical Safety and Hazard Investigation Board's Information Security Program has demonstrated that it has defined
policy, procedures, and strategies for all five of its information security function areas. The Office Cybersecurity Framework function
areas and concluded that CSB has achieved a Level 2, "Defined", which denotes that the Agency has defined policies, procedures
and strategies in adherence to the Fiscal Year 2021 Inspector General Federal Information Security Modernization Act reporting
metrics. While CSB has policies, procedures and strategies for these function areas and domains, improvements are still needed in
the configuration Management area; CSB has not published its Risk Assessment or Systems and Information Integrity procedures to
meet the U.S> Department of Homeland Security Binding Operational Directive 19-02, "Vulnerability Remediation Requirements for
Internet-Accessible Systems", a federal requirement for remediating critical vulnerabilities within 15 calendar of initial detection.

Function 1A: Identify - Risk Management

1 ¦ To what extent does the organization maintain a comprehensive and accurate inventory of its information systems (including cloud
systems, public facing websites, and third-party systems), and system interconnections (NIST SP 800-53. Rev. 4: CA-3, PM-5, and
CM-8; NIST 800-161; NIST Cybersecurity Framework (CSF): ID.AM-1 - 4; FY 2021 CIO FISMA Metrics: 1.1, 1.1.5 and 1.4, OMB A-
130, NIST SP 800-37, Rev. 2: Task P-18).

Defined (Level 2)

Comments: CSB has a defined process to maintain a comprehensive inventory of its information systems.

2. To what extent does the organization use standard data elements/taxonomy to develop and maintain an up-to-date inventory of

hardware assets (including GFE and Bring Your Own Device (BYOD) mobile devices) connected to the organization's network with
the detailed information necessary for tracking and reporting (NIST SP 800-53 Rev. 4: CA-7 and CM-8; NIST SP 800-137; NISTIR
8011;

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Function 1A: Identify - Risk Management

Federal Enterprise Architecture (FEA) Framework, v2; FY 2021 CIO FISMA Metrics: 1.2, 1.3, 2.2, 3.9, CSF: ID.AM-1; NIST SP 800-
37, Rev. 2: Task P-10).

Defined (Level 2)

Comments: CSB has a defined process to maintain a comprehensive inventory of its information systems.

3. To what extent does the organization use standard data elements/taxonomy to develop and maintain an up-to-date inventory of the
software and associated licenses used within the organization with the detailed information necessary for tracking and reporting
(NIST SP 800-53 Rev. 4: CA-7, CM-8, and CM-10; NIST SP 800-137; NISTIR 8011; FEA Framework, v2; FY 2021 CIO FISMA
Metrics: 1.2.5, 1.3.3, 1.3.9, 1.3.10, 3.10; CSF: ID.AM-2; NIST SP 800-37, Rev. 2: Task P-10)?

Defined (Level 2)

Comments: CSB has a defined process for using standard data elements and taxonomy to develop and maintain an up-to-
date inventory of software assets and licenses used in the organization's environment with the detailed information necessary
for tracking and reporting.

4. To what extent has the organization categorized and communicated the importance/priority of information systems in enabling its
missions and business functions, including for high value assets (NIST SP 800-53 Rev. 4: RA-2, PM-7, and PM-11; NIST SP 800-
60; NIST SP 800-37 (Rev. 2); CSF: ID.BE-3, ID.AM-5, and ID.SC-2; FIPS 199; FY 2021 CIO FISMA Metrics: 1.1; OMB M-19-03;
NIST SP 800-37, Rev. 2: Task C-2, C-3, P-12, P-13, S-1 - S-3 )?

Defined (Level 2)

Comments: CSB has categorized and communicated the importance and priority of information systems in enabling its milestone
mission and business functions, including for high-value assets.

5. To what extent does the organization ensure that information system security risks are adequately managed at the organizational,

mission/business process, and information system levels (NIST SP 800-39; NIST SP 800-53 Rev. 4: RA-3, PM-9; NISTIR 8286, CSF:
ID RM-1 - ID.RM-3; OMB A-123; OMB M-16-17; Green Book (Principle #6); OMB M-17-25; NIST SP 800-37 (Rev. 2): TasksR-2, R-3,
P-14?

Defined (Level 2)

Comments: CSB has defined and communicated the policies, procedures and processes it uses to manage the cybersecurity risk associated with
operating and maintaining its information systems.

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Function 1A: Identify - Risk Management

6. To what extent does the organization utilize an information security architecture to provide a disciplined and structured methodology
for managing risk, including risk from the organization's supply chain (Federal Information Technology Acquisition Reform Act
(FITARA), NIST SP 800-39; NIST SP 800-160; NIST SP 800-37 (Rev. 2) Task P-16; OMB M-19-03; OMB M-15-14, FEA Framework;
NIST SP 800-53 Rev. 4: PL-8, SA-3, SA-8, SA-9, SA-12, and PM-9; NIST SP 800-161; NIST SP 800-163, Rev. 1 CSF: ID.SC-1 and
PR.IP-2; SECURE Technology Act: s. 1326)?

Defined (Level 2)

Comments: CSB has defined the information security architecture and described how that architecture is integrated into and supports CSB's
enterprise architecture.

7. To what degree have roles and responsibilities of internal and external stakeholders involved in cyber security risk management
processes been defined and communicated across the organization (NIST SP 800-39: Section 2.3.1, 2.3.2, and Appendix D; NIST
SP 800-53 Rev. 4: RA-1; CSF: ID.AM-6, ID.RM-1, and ID.GV-2; NISTIR 8286, Section 3.1.1, OMB A-123;; NIST SP 800-37 (Rev. 2)
Section 2.8 and Task P-1; OMB M-19-03)?

Defined (Level 2)

Comments: The roles and responsibilities of stakeholders involved in cybersecurity risk management have been defined and communicated
across CSB.

8. To what extent has the organization ensured that plans of action and milestones (POA&Ms) are utilized for effectively mitigating

security weaknesses (NIST SP 800-53 Rev. 4: CA-5; NIST SP 800-37 (Rev. 2) Task A-6, R-3; OMB M-19-03, CSF v1.1, ID.RA-6)?
Ad Hoc (Level 1)

Comments: CSB has implemented an information technology for its plan of action and milestones monitoring with defined time frames for
remediating security weaknesses; however, there is not a documented procedure in place that defines how the results from the monitored
tracking sheets will be used to mitigate any security weakness identified, defined the information security architecture and described how
that architecture is integrated into and supports CSB's enterprise architecture.

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Function 1A: Identify - Risk Management

9. To what extent does the organization ensure that information about cyber security risks is communicated in a timely manner to all
necessary internal and external stakeholders (OMB A-123; OMB Circular A-11; Green Book (Principles #9, #14 and #15); OMB M-
19-03; CSF: Section 3.3; NIST SP 800-37 (Rev. 2) Task M-5; SECURE Technology Act: s. 1326, NISTIR 8286)?

Defined (Level 2)

Comments: CSB has defined how cybersecurity risks are communicated in a timely and effective manner to appropriate internal and
external stakeholders.

10. To what extent does the organization utilize technology/ automation to provide a centralized, enterprise wide (portfolio) view of

cybersecurity risk management activities across the organization, including risk control and remediation activities, dependencies, risk
scores/levels, and management dashboards (NIST SP 800-39; OMB A-123; CFO Council ERM Playbook)?

Ad Hoc (Level 1)

Comments: While a risk assessment process is in place, a risk assessment has not been performed in the last 12 months due to the ongoing
effects of the pandemic.

11.1. Please provide the assessed maturity level for the agency's Identify - Risk Management program.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Risk Management, the domain is concluded as "Defined."

11.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Risk Management program
that was not noted in the questions above. Taking into consideration the overall maturity level generated from the questions
above and based on all testing performed, is the risk management program effective?

Based on the maturity level of the individual areas within Risk Management, the overall maturity level is concluded as
"Defined". We limited our testing to those questions with criteria added to the metric that would materially change our Fiscal
Year 2020 response. For those metrics whose; policies, procedures, and strategies were documented, we rated the CSB at
Level 2, "Defined". However, we did not test to determine what additional steps the Agency needs to complete to achieve a
higher maturity level.

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Function IB: Identify - Supply Chain Risk Management

12. To what extent does the organization utilize wide supply chain risk management policies and procedures to manage SCRM activities
at all organizational tiers (NIST SP 800-37 Rev. 2, Section 2.8, NIST 800-53, SR-1, NIST CSF v1.1, ID.SC-1, NIST 800-161)?
Ad Hoc (Level 1)

Comments: Due to the size and resources of the organization, processes related to supply chain risk management are not formerly
document

13. To what extent does the organization utilize a supply chain risk management plan(s) to ensure the integrity, security, resilience, and
quality of services, system components, and systems (OMB A-130, NIST SP 800-37 Rev. 2, Section 2.8, NIST 800-53, SR-2, SR-3;
NIST 800-161, section 2.2.4 and Appendix E)?

Ad Hoc (Level 1)

Comments: Due to the size and resources of the organization, processes related to supply chain risk management are not formerly
document

14. To what extent does the organization ensure that products, system components, systems, and services of external providers are

consistent with the organization's cybersecurity and supply chain requirements. (NIST SP 800-53 REV. 5: SA-4, SR-3 - 6; NIST SP
800-152; NIST SP 800-37 Rev. 2, Section 2.8; FedRAMP standard contract clauses; Cloud Computing Contract Best Practices; OMB
M-19-03; OMB A-130; CSF: ID.SC-2 through 4).

Ad Hoc (Level 1)

Comments: Due to the size and resources of the organization, processes related to supply chain risk management are not formerly
document

15. To what extent does the organization maintain and monitor the provenance and logistical information of the systems and system
components it acquires? (NIST SP 800-53 REV. 5: SR-4 and NIST SP 800-161, Provenance (PV) family)?

Ad Hoc (Level 1)

Comments: Due to the size and resources of the organization, processes related to supply chain risk management are not formerly
document

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Function IB: Identify - Supply Chain Risk Management

16.1. Please provide the assessed maturity level for the agency's Identify - Supply Chain Risk Management program.

Ad Hoc (Level 1)

Comments: Based on the maturity level of the individual areas within Supply Chain Risk Management, the domain is concluded as "Ad
Hoc."

16.2. Please provide the assessed maturity level for the agency's Identify Function.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within the Risk Management and Supply Chain Risk Management
domains, the Identify function is concluded as "Defined."

16.3. Provide any additional information on the effectiveness (positive or negative) of the organization's Supply Chain Risk Management
domains, program that was not noted in the questions above. Taking into consideration the overall maturity level generated from the
questions above and based on all testing performed, is the risk management program effective?

Based on the maturity level of the individuals areas within the Risk Management and Supply Chain Risk Management domains,
the identity function is concluded as "Defined". We limited our testing to those questions with criteria added to the metric that would
materially change our FY2929 responses. For those metrics whose policies, procedures, and strategies were documented, we
rated the CSB at Level 2, "Defined". However, we did not test to determine what additional steps the Agency needs to complete to
activate a higher maturity level.

Function 2A: Protect - Configuration Management

17. To what degree have the roles and responsibilities of configuration management stakeholders been defined, communicated across
the agency, and appropriately resourced (NIST SP 800-53 REV. 4: CM-1; NIST SP 800-128: Section 2.4)?

Defined (Level 2)

Comments: CBS has defined and communicated across the organization the roles and responsibilities at the organizational and
information system levels for stakeholders involved in information system configuration management.

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Function 2A: Protect - Configuration Management

18. To what extent does the organization utilize an enterprise wide configuration management plan that includes, at a minimum, the
following components: roles and responsibilities, including establishment of a Change Control Board (CCB) or related body;
configuration management processes, including processes for: identifying and managing configuration items during the appropriate
phase within an organization's SDLC; configuration monitoring; and applying configuration management requirements to contractor
operated systems (NIST SP 800-128: Section 2.3.2; NIST SP 800-53 REV. 4: CM-9)?

Defined (Level 2)

Comments: CBS Configuration Management policy defines roles and responsibility for configuration management. The policy also defines
processes included in change management and the system development life cycle, communicated across the organization the roles and

19. To what extent does the organization utilize baseline configurations for its information systems and maintain inventories of related
components at a level of granularity necessary for tracking and reporting (NIST SP 800-53 REV. 4: CM-2 and CM-8; FY 2021 CIO
FISMA Metrics: 2.2, 3.9.2, and 3.10.1; CSF: DE.CM-7 and PR.IP-1)?

Defined (Level 2)

Comments: CBS has developed, documented and disseminated its baseline configuration and component inventory policies and
procedures.

20. To what extent does the organization utilize configuration settings/common secure configurations for its information systems? (NIST
SP 800-53 REV. 4: CM-6, CM-7, RA-5, and SI-2; NIST SP 800-70, Rev. 4, FY 2021 CIO FISMA Metrics: 2.1, 2.2, 4.3; SANS/CIS Top
20 Security Controls 3.7; CSF: ID.RA-1 and DE.CM-8)?

Defined (Level 2)

Comments: CBS has developed, documented and disseminated its policies and procedures for configuration settings and common secure
configurations. In addition, CSB has developed, documented and disseminated common secure configurations (hardening guides) that are
tailored to its environment.

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Function 2A: Protect - Configuration Management

21. To what extent does the organization utilize flaw remediation processes, including patch management, to manage software

vulnerabilities (NIST SP 800-53 REV. 4: CM-3, RA-5, SI-2, and SI-3; NIST SP 800-40, Rev. 3; SANS/CIS Top 20, Control 4.5; FY
2021 CIO FISMA Metrics: 1.3.7, 1.3.8, 2.13, 2.14; CSF: ID.RA-1; DHS Binding Operational Directive (BOD) 15-01; DHS BOD18-02)?
Ad Hoc (Level 1)

Comments: CBS has implemented an Information Technology Plan of Actions and Milestone monitoring tracking sheet including patch
management, with a defined time frame for remediation security weaknesses; however, there is not a documented procedure in place that
defines how the monitoring tracking sheet will be used to mitigate any security weaknesses identified and the policies and procedures for
flaw remediation have not been disseminated across the organization.

22. To what extent has the organization adopted the Trusted Internet Connection (TIC) program to assist in protecting its network (OMB M-19-
26)?

Defined (Level 2)

Comments: CBS has adopted the Trusted Internet Connection program utilizing a Verizon Managed Trusted Internet Protocol Services
monitored by the Department of Homeland Security.

23. To what extent has the organization defined and implemented configuration change control activities including: determination of the
types of changes that are configuration controlled; review and approval/disapproval of proposed changes with explicit consideration
of security impacts and security classification of the system; documentation of configuration change decisions; implementation of
approved configuration changes; retaining records of implemented changes; auditing and review of configuration changes; and
coordination and oversight of changes by the CCB, as appropriate (NIST SP 800-53 REV. 4: CM-2, CM-3 and CM-4; CSF: PR.IP-3).
Defined (Level 2)

Comments: CBS has developed, documented, and disseminated its policies and procedures for managing configuration change control.
The policies and procedures address the review and approval and disapproval of proposed changes, retaining records of implemented
changes, and coordination and oversight of changes by CSB.

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Function 2B: Protect - Identity and Access Management

24. To what degree does the organization utilize a vulnerability disclosure policy (VDP) as part of its vulnerability management
program for internet-accessible federal systems (OMB M-20-32 and DHS BOD 20-01)?

Ad Hoc (Level 1)

Comments: CBS has not developed or deployed a Vulnerability Disclosure to the Agency's public-facing website.

25.1. Please provide the assessed maturity level for the agency's Protect - Configuration Management program.
Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Configuration Management, the domain is concluded as
"Defined."

25.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Configuration Management
program that was not noted in the questions above. Taking into consideration the maturity level generated from the questions
above and based on all testing performed, is the configuration management program effective?

Based on the maturity level of the individual areas within Configuration Management, the domain is concluded as "Defined."
We limited our testing to those questions with criteria added to the metric that would materially change our FY2020 response.
I f the policies, procedures and strategies were documented, we rated the CSB at Level 2, "Defined". However, we did not test
to determine what additional steps the Agency needs to complete to achieve higher maturity level.

26. To what extent have the roles and responsibilities of identity, credential, and access management (ICAM) stakeholders been defined,
communicated across the agency, and appropriately resourced (NIST SP 800-53 REV. 4: AC-1, IA-1, and PS-1; NIST SP 800-63-3
and 800-63A, B, and C; Federal Identity, Credential, and Access Management Roadmap and Implementation Guidance (FICAM),
OMB M-19-17)?

Consistently Implemented (Level 3)

Comments: The CSB has defined, communicated, and appropriately resourced the roles and responsibilities for indent, credential, and
access management.

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Function 2B: Protect - Identity and Access Management

27. To what extent does the organization utilize a comprehensive ICAM policy, strategy, process, and technology solution roadmap to
guide its ICAM processes and activities (FICAM, OMB M-19-17; NIST SP 800-53 REV. 4: AC-1 and IA-1; OMB M-19-17,
Cybersecurity Strategy and Implementation Plan (CSIP); SANS/CIS Top 20: 14.1; DHS ED 19-01; CSF: PR.AC-4 and 5)?
Consistently Implemented (Level 3)

Comments: CSB has developed, documented, and disseminated its policies and procedures for identity, Credential and Access

28. To what extent has the organization developed and implemented processes for assigning position risk designations and performing
appropriate personnel screening prior to granting access to its systems (NIST SP 800-53 REV. 4: PS-2 and PS-3; National Insider
threat Policy; CSF: PR.IP-11, OMB M-19-17)?

Defined (Level 2)

Comments: CSB has defined its processes for ensuring that all personnel are assigned risk designation, and appropriately screened
prior to being granted access to its systems.

29. To what extent does the organization ensure that access agreements, including nondisclosure agreements, acceptable use
agreements, and rules of behavior, as appropriate, for individuals (both privileged and non-privileged users) that access its
systems are completed and maintained (NIST SP 800-53 REV. 4: AC-8, PL-4, and PS-6)?

Defined (Level 2)

Comments: CSB has defined its processes for developing, documenting, and maintaining access agreements for individuals that
access its systems.

30. To what extent has the organization implemented strong authentication mechanisms (PIV or an Identity Assurance Level
(IAL)3/Authenticator Assurance Level (AAL) 3 credential) for non-privileged users to access the organization's facilities
[organization-defined entry/exit points], networks, and systems, including for remote access (CSIP; HSPD-12; NIST SP 800-
53 REV. 4: AC-17, IA-2, IA-5, IA-8, and PE-3; NIST SP 800-128; FIPS 201-2; NIST SP 800-63, 800-157; FY 2021 CIO FISMA
Metrics: 2.4, 2.7, CSF: PR.AC-1 and 6; OMB M-19-17, and NIST SP 800-157,)?

Defined (Level 2)

Comments: CSB has implemented strong authentication mechanisms in the use of virtual private network to remotely access the
internal internet. The VPN tunnel is defined on points into the network. In addition, the user must be added to the VPN group on the
Active Directory to access the CSB ne Multifactor authentication is used to secure access for individuals with escalated permissions.

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Function 2B: Protect - Identity and Access Management

31. To what extent has the organization implemented strong authentication mechanisms (PIV or a Level of Assurance 4 credential) for
privileged users to access the organization's facilities [organization-defined entry/exit points], networks, and systems, including for
remote access (CSIP; HSPD-12; NIST SP 800-53 REV. 4: AC-17, PE-3; NIST SP 800-128; FIPS 201-2; NIST SP 800-63, 800-157;
OMB M-19-17, FY 2021 CIO FISMA Metrics: 2.3, 2.5, and 2.7; CSF: PR.AC-1 and 6; and DHS ED 19-01)?

Defined (Level 2)

Comments: CSB has implemented multifactor authentication for all users including privileged users with escalated permissions.

32. To what extent does the organization ensure that privileged accounts are provisioned, managed, and reviewed in accordance with
the principles of least privilege and separation of duties? Specifically, this includes processes for periodic review and adjustment of
privileged user accounts and permissions, inventorying and validating the scope and number of privileged accounts, and ensuring
that privileged user account activities are logged and periodically reviewed (FY 2021 CIO FISMA Metrics: 2.3, 2.5, 2.6, and 2.7;
OMB M-19-17, NIST SP 800-53 REV. 4: AC-1, AC-2, AC-5, AC-6, AC-17; AU-2, AU-3, AU-6, and IA-4; CSIP; DHS ED 19-01; CSF:
PR.AC-4).

Defined (Level 2)

Comments: CSB has defined its processes for provisioning, managing, and reviewing privileged accounts.

33. To what extent does the organization ensure that appropriate configuration/connection requirements are maintained for remote

access connections? This includes the use of appropriate cryptographic modules, system time-outs, and the monitoring and control
of remote access sessions (NIST SP 800-53 REV. 4: AC-11, AC-12, AC-17, AC-19, AU-2, IA-7, SC-10, SC-13, and SI-4; CSF:
PR.AC-3; and FY 2021 CIO FISMA Metrics: 2.10 and 2.11).

Defined (Level 2)

Comments: CSB uses VPN Connection to provide remote access. CSB has defined its configuration and connection requirements
for remote access connections, including the use of cryptographic modules, system time-outs, and the monitoring and controls of
remote access sessions.

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Function 2B: Protect - Identity and Access Management

34.1. Please provide the assessed maturity level for the agency's Protect - Identity and Access Management program.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Identity and Access Management, the domain is concluded
as "Defined."

34.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Identity and Access

Management program that was not noted in the questions above. Taking into consideration the maturity level generated from
the questions above and based on all testing performed, is the identity and access management program effective?

Based on the maturity level of the individual areas within identity and Access Management, the domain is concluded as
"Defined". We limited our testing to those questions with criteria added to the metric that would materially change our
FY2020 response. For those metrics whose policies, procedures, and strategies were documented, we rated the CSB at
Level 2, "Defined". However, we did not test to determine what additional steps the Agency needs to complete to achieve a
higher maturity level.

Function 2C: Protect - Data Protection and Privacy

35. To what extent has the organization developed a privacy program for the protection of personally identifiable information (P11) that is
collected, used, maintained, shared, and disposed of by information systems (NIST SP 800-122; NIST SP 800-37 (Rev. 2) Section
2.3, Task P-1 ; OMB M-20-04; OMB M-19-03; OMB A-130, Appendix I; CSF: ID.GV-3; NIST SP 800-53 REV. 4: AR-4 and Appendix
J, FY 2020 SAOP FISMA metrics, Sections 1 through 4, 5(b))?

Defined (Level 2)

Comments: CSB has defined and communicated its privacy program plan and related policies and procedures for the protection of
personal identifiable information that is collected, used, maintained, shared and disposed of by its information systems. In addition,
roles and responsibilities for the effective implementation of CSB's privacy program have been defined and CSB has determined the
resources and optimal governance structure needed to effectively implement its privacy program.

36. To what extent has the organization implemented the following security controls to protect its Pll and other agency sensitive data, as
appropriate, throughout the data lifecycle. (NIST SP 800-53 REV. 4; Appendix J, SC-8, SC-28, MP-3, and MP-6; NIST SP 800-37
(Rev. 2); FY 2021 CIO FISMA Metrics: 2.8, 2.12; DHS BOD 18-02; CSF: PR.DS-1, PR.DS-2, PR.PT-2, and PR.IP-6)?

Encryption of data at rest
Encryption of data in transit
Limitation of transfer to removable media

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Function 2C: Protect - Data Protection and Privacy

Sanitization of digital media prior to disposal or reuse
Defined (Level 2)

Comments: CSB's policies and procedures have been defined and communicated for the specified areas.

37. To what extent has the organization implemented security controls to prevent data exfiltration and enhance network defenses?

(NIST SP 800-53 REV. 4: SI-3, SI-7(8), SI-4(4) and (18), SC-7(10), and SC-18; FY 2021 CIO FISMA Metrics: 3.8; DHS BOD 18-01;
DHS ED 19-01; CSF: PR.DS-5)?

Defined (Level 2)

Comments: CSB has implemented security controls to prevent data exfiltration and enhance network defenses.

38. To what extent has the organization developed and implemented a Data Breach Response Plan, as appropriate, to respond to

privacy events? (NIST SP 800-122; NIST SP 800-53 REV. 4: Appendix J, SE-2; FY 2020 SAOP FISMA metrics, Section 12; OMB
M-17-12; and OMB M-17-25)?

Defined (Level 2)

Comments: CSB has defined and communicated its Data Breach Response Plan, including its processes and procedures for
data breach notification.

39. To what degree does the organization ensure that privacy awareness training is provided to all individuals, including role-based
privacy training (NIST SP 800-53 REV. 4: AR-5, FY 2020 SAOP FISMA Metrics, Sections 9 10, and 11)

Defined (Level 2)

Comments: CSB has defined its privacy awareness training program based on organizational requirements, culture and the
types of Personal Identifiable Information and Protected Health Information that its user have access to.

40.1. Please provide the assessed maturity level for the agency's Protect - Data Protection and Privacy program.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Data Protection and Privacy, the domain is concluded «
"Defined."

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Function 2C: Protect - Data Protection and Privacy

40.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Data Protection and Privacy
program that was not noted in the questions above. Taking into consideration the maturity level generated from the questions
above and based on all testing performed, is the data protection and privacy program effective?

Based on the maturity level of the individual areas within Data Protection and Privacy, the domain is concluded as "Defined".
We limited our testing to those questions with criteria added to the metric that would materially change our FY2020 response.
For those metrics whose policies, procedures, and strategies were documented, we rated the CSB at Level 2, "Defined."
However, we did not test to determine what additional steps the Agency needs to complete to achieve a higher maturity level.

Function 2D: Protect - Security Training

41.	To what degree have the roles and responsibilities of security awareness and training program stakeholders been defined, and
communicated across the agency, and appropriately resourced? (Note: this includes the roles and responsibilities for the effective
establishment and maintenance of an organization wide security awareness and training program as well as the awareness and
training related roles and responsibilities of system users and those with significant security responsibilities (NIST SP 800-53 REV.
4: AT-1; and NISTSP 800-50).

Defined (Level 2)

Comments: The roles and responsibilities for security awareness and training program stakeholders have been defined and
communicated across CSB and resource requirements have been established.

42.	To what extent does the organization utilize an assessment of the skills, knowledge, and abilities of its workforce to provide tailored
awareness and specialized security training within the functional areas of: identify, protect, detect, respond, and recover (NIST SP
800-53 REV. 4: AT-2 and AT-3; NIST SP 800-50: Section 3.2; Federal Cybersecurity Workforce Assessment Act of 2015; National
Cybersecurity Workforce Framework v1.0; NIST SP 800-181; and CIS/SANS Top 20: 17.1)?

Defined (Level 2)

Comments: CSB has defined its process for assessing the knowledge, skills, and abilities of its workforce to determine its awareness
and specialized training, and periodically updating its assessment to account for the changing risk environment.

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Function 2D: Protect-Security Training

43. To what extent does the organization utilize a security awareness and training strategy/plan that leverages its organizational skills
assessment and is adapted to its culture? (Note: the strategy/plan should include the following components: the structure of the
awareness and training program, priorities, funding, the goals of the program, target audiences, types of courses/material for each
audience, use of technologies (such as email advisories, intranet updates/wiki pages/social media, web based training, phishing
simulation tools), frequency of training, and deployment methods (NIST SP 800-53 REV. 4: AT-1; NIST SP 800-50: Section 3; CSF:
PR.AT-1).

Defined (Level 2)

Comments: CSB has implemented and continues to perform organization-wide security awareness and training planning.

44.	To what degree does the organization ensure that security awareness training is provided to all system users and is tailored based
on its organizational requirements, culture, and types of information systems? (Note: awareness training topics should include, as
appropriate: consideration of organizational policies, roles and responsibilities, secure e-mail, browsing, and remote access
practices, mobile device security, secure use of social media, phishing, malware, physical security, and security incident reporting
(NIST SP 800-53 REV. 4: AT-2; (FY 2021 CIO FISMA Metrics: 2.15; NIST SP 800-50: 6.2; CSF: PR.AT-2; SANS Top 20: 17.4).

Defined (Level 2)

Comments: Processes are in place for tracking completion of security awareness training. This includes employee attestation to
completion of the security awareness training and follow-up identify individuals have not completed training requirements.

45.	To what degree does the organization ensure that specialized security training is provided to all individuals with significant security
responsibilities (as defined in the organization's security policies and procedures) (NIST SP 800-53 REV. 4: AT-3 and AT-4; FY 2021
CIO FISMA Metrics: 2.15)?

Ad Hoc (Level 1)

Comments: Specialized security training is normally provided; however, training individuals I specialized IT support areas has not been
conducted in the last 12 months.

46.1. Please provide the assessed maturity level for the aqency's Protect - Security Traininq proqram.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Security Training, the domain is concluded as "Defined."

46.2. Please provide the assessed maturity level for the agency's Protect function.
Defined (Level 2)

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Function 2D: Protect-Security Training

Based on the maturity level of the individual areas within the Configuration Management, Identity and Access Management, Data
Protection and Privacy, and Security Training domains the Protection function is concluded as "Defined."

46.3. Provide any additional information on the effectiveness (positive or negative) of the organization's Security Training program that was not
noted in the questions above. Taking into consideration the maturity level generated from the questions above and based on all testing
performed, is the security training program effective?

Based on the maturity level of the individual areas within the Configuration Management, Identity and Access Management,

Data Protection and Privacy, and Security Training domains, the Protect function is concluded as Defined". We limited our
testing to those questions with criteria added to the metric that would materially change our FY2020 response. For those metrics
whose policies, procedures, and strategies were documented, we rated the CSB at Level 2, "Defined." However, we did not test
to determine what additional steps the Agency needs to complete to achieve a higher maturity level.

Function 3: Detect - ISCM

47. To what extent does the organization utilize information security continuous monitoring (ISCM) policies and an ISCM strategy that
addresses ISCM requirements and activities at each organizational tier (NIST SP 800-37 (Rev. 2) Task P-7; NIST SP 800-137:
Sections 3.1 and 3.6)?

Defined (Level 2)

Comments: The CSB Technology Security Plan contains the CSB Information Security Continuous strategy and [policies and identifies
how the information security continuous monitoring strategy is communicated for the specified areas.

48. To what extent have ISCM stakeholders and their roles, responsibilities, levels of authority, and dependencies been defined and
communicated across the organization (NIST SP 800-53 REV. 4: CA-1; NIST SP 800-137; CSF: DE.DP-1; NIST 800-37, Rev. 2 Task
P-7 and S-5).

Defined (Level 2)

Comments: CSB has defined the roles and responsibility Information Security Continuous Monitoring.

49. How mature are the organization's processes for performing ongoing information system assessments, granting system

authorizations, including developing and maintaining system security plans, and monitoring system security controls (OMB A-130,
NIST SP 800-137: Section 2.2; NIST SP 800-53 REV. 4: CA-2, CA-6, and CA-7; NIST Supplemental Guidance on Ongoing
Authorization; NIST SP 800-37 (Rev. 2) Task S-5; NIST SP 800-18, Rev. 1, NISTIR 8011; OMB M-14-03; OMB M-19-03)

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Function 3: Detect - ISCM

Defined (Level 2)

Comments: CSB has defined its processes for performing ongoing security controls assessments; granting systems authorizations,
including developing and maintaining system security plans; and monitoring security controls for individual systems.

50. How mature is the organization's process for collecting and analyzing ISCM performance measures and reporting findings
(NISTSP 800-137)?

Consistently Implemented (Level 2)

Comments: CSB's process for collecting and analyzing ISCM performance measures and reporting findings is systemic and allows,
through the use of tools, automatic notification of threats or attempts to exploit attack vectors on CSB network.

51.1. Please provide the assessed maturity level for the agency's Detect - ISCM domain/function.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Detect - ISCM, the domain/function is concluded as
"Defined."

51.2. Provide any additional information on the effectiveness (positive or negative) of the organization's ISCM program that was not
noted in the questions above. Taking into consideration the maturity level generated from the questions above and based on
all testing performed, is the ISCM program effective?

Based on the maturity level of the individual areas within Detect- ISCM, the domain/function is concluded as Defined". We
limited our testing to those questions with criteria added to the metric that would materially change our FY2020 response. For
those metrics whose policies, procedures, and strategies were documented, we rated the CSB at Level 2, "Defined." However,
we did not test to determine what additional steps the Agency needs to complete to achieve a higher maturity level.

Function 4: Respond - Incident Response

52. To what extent does the organization utilize an incident response plan to provide a formal, focused, and coordinated approach to
responding to incidents (NIST SP 800-53 REV. 4: IR-8; NIST SP 800-61 Rev. 2, section 2.3.2; CSF, RS.RP-1, Presidential Policy
Directive (PPD) 8 - National Preparedness)?

Defined (Level 2)

Comments: CSB's incident response policies, procedures, plans, and strategies have been defined and communicated across the
organization.

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Function 4: Respond - Incident Response

53. To what extent have incident response team structures/models, stakeholders, and their roles, responsibilities, levels of authority, and
dependencies been defined and communicated across the organization (NIST SP 800-53 REV. 4: IR-7; NIST SP 800-83; NIST SP
800-61 Rev. 2; CSF, RS.CO-1, OMB M-20-04; FY 2021 CIO FISMA Metrics: Section 4; CSF: RS.CO-1; and US-CERT Federal
Incident Notification Guidelines)?

Defined (Level 2)

Comments: CSB has defined and communicated the structures of its incident response teams, roles, and responsibilities of incident
' response stakeholders and associated levels of authority and discrepancies.

54. How mature are the organization's processes for incident detection and analysis? (NIST 800-53: IR-4 and IR-6; NIST SP 800-61
Rev. 2; OMB M-20-04; CSF: DE.AE-1, DE.AE-2 -5, PR.DS-6, RS.AN-1 and 4, and PR.DS-8; and US-CERT Incident Response
Guidelines)

Defined (Level 2)

Comments: CSB has defined its processes and supporting technologies for detecting and analyzing incidents, including the types of
precursors and indicators and how they are generated and reviewed, and for prioritizing incidents.

55. How mature are the organization's processes for incident handling (NIST 800-53: IR-4; NIST SP 800-61, Rev. 2; CSF: RS.MI-1 and 2)
Defined (Level 2)

Comments: CSB has developed containment and eradication strategies for each major incident type. In developing its strategies, the
organization has taken into consideration the potential damage to and theft of resources, the need for evidence preservation, service
availability, time and resources needed to implement the strategy, effectiveness of the strategy, and duration of the solution.

56. To what extent does the organization ensure that incident response information is shared with individuals with significant security

responsibilities and reported to external stakeholders in a timely manner (FISMA; OMB M-20-04; NIST SP 800-53 REV. 4: IR-6; US-
CERT Incident Notification Guidelines; PPD-41; CSF: RS.CO-2 through 5; DHS Cyber Incident Reporting Unified Message)

Defined (Level 2)

Comments: CSB has defined its requirements for personnel to report suspected security incidents to the CSB's chief information
officer, within CSB's defined time frames. In addition, CSB has defined its processes for reporting security incident information to the
United States

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Function 4: Respond - Incident Response

57. To what extent does the organization collaborate with stakeholders to ensure on-site, technical assistance/surge capabilities can be
leveraged for quickly responding to incidents, including through contracts/agreements, as appropriate, for incident response support
(NIST SP 800-86; NIST SP 800-53 REV. 4: IR-4; OMB M-20-04; PPD-41).

Comments: CSB has defined its processes and supporting technologies for detecting and analyzing incidents, including the types of
precursors and indicators and how they are generated and reviewed, and for prioritizing incidents.

Consistently Implemented (Level 3)

58. To what degree does the organization utilize the following technology to support its incident response program?

•	Web application protections, such as web application firewalls

•	Event and incident management, such as intrusion detection and prevention tools, and incident tracking and reporting tools

•	Aggregation and analysis, such as security information and event management (SIEM) products

•	IVblware detection, such as antivirus and antispam software technologies

•	Information management, such as data loss prevention

•	File integrity and endpoint and server security tools (NIST SP 800-137; NIST SP 800-61, Rev. 2; NIST SP 800-44)

Defined (Level 2)

Comments: CSB has identified and fully defined its requirements for the responses technologies it uses in the specified areas.

59.1. Please provide the assessed maturity level for the agency's Respond - Incident Response domain/function.

Defined (Level 2)

Comments: Based on the maturity level of the individual areas within Respond - Incident Response, the domain/function is
concluded as "Defined."

59.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Incident Response
program that was not noted in the questions above. Taking into consideration the maturity level generated from the
questions above and based on all testing performed, is the incident response program effective?

Based on the maturity level of the individual areas within Respond - Incident Response, the domain function is concluded as
Defined". We limited our testing to those questions with criteria added to the metric that would materially change our FY2020
response. For those metrics whose policies, procedures, and strategies were documented, we rated the CSB at Level 2,
"Defined." However, we did not test to determine what additional steps the Agency needs to complete to achieve a higher
maturity level

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Function 5: Recover - Contingency Planning

60 To what extent have roles and responsibilities of stakeholders involved in information systems contingency planning been defined
and communicated across the organization, including appropriate delegations of authority (NIST SP 800-53 REV. 4: CP-1, CP-2,
and CP-3; NIST SP 800-34; NIST SP 800-84; FCD-1: Annex B)?

Consistently Implemented (Level 3)

Comments: CSB has identified the roles and responsibilities of stakeholders involved in information systems contingency planning
across the organization.

61 To what degree does the organization ensure that the results of business impact analyses are used to guide contingency planning
efforts (NIST SP 800-53 REV. 4: CP-2; NIST SP 800-34, Rev. 1, 3.2; NIST IR 8286; FIPS 199; FCD-1; OMB M-19-03; FY 2021 CIO
FISMA Metrics, Section 5; CSF:ID.RA-4)?

Defined (Level 2)

Comments: CSB uses the results of business impact analyses to guide contingency planning efforts.

62 To what extent does the organization ensure that information system contingency plans are developed, maintained, and integrated
with other continuity plans (NIST SP 800-53 REV. 4: CP-2; NIST SP 800-34; FY 2021 CIO FISMA Metrics: 5.1; OMB M-19-03; CSF:
PR.IP-9)?

Defined (Level 2)

Comments: CSB has defined procedures to ensure that processes for information system contingency plan development, maintenance
and integration with other continuity areas have been defined and include the following phases: activation and notification recovery,
and reconstitution.

63 To what extent does the organization perform tests/exercises of its information system contingency planning processes (NIST SP
800-34; NIST SP 800-53 REV. 4: CP-3 and CP-4; FY 2021 CIO FISMA Metrics, Section 5; CSF: ID.SC-5 and CSF: PR.IP-10)?
Ad Hoc (Level 1)

Comments: CSB has not defined processes for information system contingency plan testing and exercises.

64 To what extent does the organization perform information system backup and storage, including use of alternate storage and

processing sites, as appropriate (NIST SP 800-53 REV. 4: CP-6, CP-7, CP-8, and CP-9; NIST SP 800-34: 3.4.1, 3.4.2, 3.4.3; FCD-1;
NIST CSF: PR.IP-4; FY 2021 CIO FISMA Metrics, Section 5; and NARA guidance on information systems security records)?

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Function 5: Recover - Contingency Planning

Defined (Level 2)

Comments: The organization has defined procedures to ensure that CSB performs information system backup and storage, including
use of alternate storage and processing sites. CSB has not defined processes for information system contingency plan testing and
exercises.

65 To what level does the organization ensure that information on the planning and performance of recovery activities is communicated
to internal stakeholders and executive management teams and used to make risk based decisions (CSF: RC.CO-3; NIST SP 800-53
REV. 4: CP-2 and IR-4)?

Defined Level 2)

Comments: CSB has defined procedures to ensure that information on the planning and performance of recovery activities is
communicated to internal stakeholders and executive management teams and used to make risk-based decisions.

66.1. Please provide the assessed maturity level for the aqency's Recover - Contingency Planninq domain/function.

Defined (Level 2)

Comments Based on the maturity level of the individual areas within Recover - Contingency Planning, the domain/function is
concluded as "Defined."

66.2. Provide any additional information on the effectiveness (positive or negative) of the organization's Contingency Planning
program that was not noted in the questions above. Taking into consideration the maturity level generated from the
questions above and based on all testing performed, is the contingency program effective?

Based on the maturity level of the individual areas within Respond - Incident Response, the domain function is concluded as
Defined". We limited our testing to those questions with criteria added to the metric that would materially change our FY2020
response. For those metrics whose policies, procedures, and strategies were documented, we rated the CSB at Level 2,
"Defined." However, we did not test to determine what additional steps the Agency needs to complete to achieve a higher
maturity level.

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APPENDIX A: Maturity Model Scoring

A.1.	Please provide the assessed maturity level for the agency's Overall status.

Function 1 A: Identify - Risk Management

Function

Count



Ad-Hoc



2

Defined



8

Consistently Implemented



0

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Define (Level 2)





Function 1B: Identify - Supply Chain Risk Management

Function

Count



Ad-Hoc



4

Defined



0

Consistently Implemented



0

Managed and Measurable



0

Optimized



0

Calculated Rating: Ad Hoc (Level 1)
Assessed Rating: Ad Hoc (Level 1)





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APPENDIX A: Maturity Model Scoring

Function 2A: Protect - Configuration Management

Function

Count



Ad-Hoc



2

Defined



6

Consistently Implemented



0

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





Function 2B: Protect - Identity and Access Management

Function

Count



Ad-Hoc



0

Defined



6

Consistently Implemented



2

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





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APPENDIX A: Maturity Model Scoring

Function 2C: Protect - Data Protection and Privacy

Function

Count



Ad-Hoc



0

Defined



5

Consistently Implemented



0

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





Function 2D: Protect - Security Training

Function

Count



Ad-Hoc



1

Defined



4

Consistently Implemented



0

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





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APPENDIX A: Maturity Model Scoring

Function 3: Detect - ISCM

Function

Count



Ad-Hoc



0

Defined



3

Consistently Implemented



1

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





Function 4: Respond - Incident Response

Function

Count



Ad-Hoc



0

Defined



6

Consistently Implemented



1

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





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APPENDIX A: Maturity Model Scoring

Function 5: Recover - Contingency Planning



¦gjJJ



Ad-Hoc



1

Defined



4

Consistently Implemented



1

Managed and Measurable



0

Optimized



0

Calculated Rating: Defined (Level 2)
Assessed Rating: Defined (Level 2)





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APPENDIX A: Maturity Model Scoring

Overall

Function

Calculated Maturity Level

Assessed Maturity Level

Explanation

Function 1: Identify - Risk Management/
Supply Chain RiskManagement

Defined (Level 2)

Defined (Level 2)

Based on the maturity level of the individual areas
within the Risk Management and Supply Chain Risk
Management domains, the overall maturity level of the
Identify function is concluded as "Defined".

Function 2: Protect - Configuration
Management / Identity & Access
Management / Data Protection & Privacy /
Security Training

Defined (Level 2)

Defined (Level 2)

Based on the maturity level of the individual areas
within the Configuration Management, Identity and
Access Management, Data Protection and Privacy,
and Security Training domains, the overall maturity
level of the Protect function is concluded as "Defined".

Function 3: Detect - ISCM

Defined (Level 2)

Defined (Level 2)

Based on the maturity level of the individual areas
within Detect - ISCM, the overall maturity level of the
domain/function is concluded as "Defined."

Function 4: Respond - Incident Response

Defined (Level 2)

Defined (Level 2)

Based on the maturity level of the individual areas
within Respond - Incident Response, the overall
maturity level of the domain/function is concluded as
"Defined."

Function 5: Recover - Contingency
Planning

Defined (Level 2)

Defined (Level 2)

Based on the maturity level of the individual areas
within Recover - Contingency Planning, the overall
maturity level of the domain/function is concluded as
"Defined."

Overall

Not Effective

Effective

The U.S. Chemical Safety and Hazard Investigation
Board's Information Security Program has
demonstrated that it has defined policy, procedures,
and strategies for all five of its Information security
function areas.

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Appendix B

Status of CSB Corrective Actions for FY 2018, FY 2019, and
FY 2020 FISMA Report Recommendations

The table below describes the recommendations from previous FISMA evaluations that remained
unimplemented as of February 2021.

OIG Report

Recommendation

Corrective action

OIG analysis of
corrective action status

CSB Still
Needs to
Improve Its
'Incident
Response'
and 'Identity
and Access
Management'
Information
Security
Functions,
Report No.
19-P-0147

1

Define and implement
processes for the use of
Personal Identity
Verification cards for logical
access.

Multifactor authentication has
been implemented for all Virtual
Private Network users.

Completed in FY 2021.

CSB's
Information
Security
Program Is
Not

Consistently
Implemented;
Improvements
Are Needed
to Address
Four

Weaknesses,
Report No.
21-E-0071

2

Complete the risk
assessment process as
required by National
Institute of Standards and
Technology 800-37,
reevaluate the Risk
Management Framework to
make it more fluent to
leverage day-to-day
processes in place for
completing the risk
assessment, and determine
how to best implement an
organizationwide
governance process for
monitoring and reporting on
risks.

Based on a follow-up
discussion with CSB
information technology
management, while a risk
assessment process is in place,
one has not been performed
since FY 2020 due to the
coronavirus pandemic.

In addition, due to the size and
resources of the organization,
processes related to
governance and process
management are handled
through manual processes.
There is no automated solution
that provides a centralized,
enterprisewide view of
cybersecurity risks across the
organization. However, there
are documented procedures in
place for implementing an
organizationwide governance
process for monitoring and
reporting risks.

Corrective action in
process.

Planned completion date is
FY 2022.



3

Document the process in
place to monitor required
flaw remediation to
resolution and enhance the
flaw remediation process to
require approvals if risks
cannot be mitigated to an
acceptable level in a timely
manner. In addition, develop

The CSB has implemented an
information technology Plans of
Actions & Milestones tracking
sheet with a defined time frame
for remediating security
weaknesses; however, there is
not a documented procedure in
place that defines how the
tracking sheet will be used to

Corrective action in
process.

Planned completion date is
FY 2022.

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OIG Report

Recommendation

Corrective action

OIG analysis of
corrective action status





time frames and monitoring
on the timeliness of applying
patch updates.

mitigate any security weakness
identified.





4

Implement a process to
ensure that privacy
awareness training is
provided to all individuals,
including role-based training
where needed.

The CSB has developed and
provided annual privacy
awareness training to all
employees.

Completed in FY 2021.



5

Implement information
security awareness and
specialized security training
policies and procedures to
provide exposure to areas
specific to individuals that
have a role in supporting
information security or
technology-related areas.
In addition, document an
information security
awareness and training
strategy that leverages its
organizational skills
assessment and factors the
training program priorities,
funding, the goals ofthe
program, and targeted
audiences.

Based on discussions with the
CSB information technology
management, specialized
security training is normally
provided; however, training for
individuals in specialized
information technology support
areas has not been conducted
since FY 2020.

Corrective action in
process.

Planned completion date is
FY 2022.



6

Perform disaster recovery
testing on an annual basis.
In addition, evaluate
alternate methods to store
backup media off-site.

Processes for information
system contingency plan
testing and exercises have not
been defined. Contingency plan
tests for systems are performed
in an ad-hoc, reactive manner
due to the impact of
coronavirus pandemic and lack
of resources.

Additionally, based on
discussions with the CSB
information technology
management, the backups are
not being consistently rotated
off-site.

Corrective action in
process.

Planned completion date is
the third quarter of
FY 2022.

Source: OIG analysis of CSB corrective actions. (EPA OIG table)

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Appendix C

CSB Response to Report

U.S. Chemical Safety and
Hazard Investigation Board

1750 Pennsylvania Avenue NW, Suite 910 | Washington. DC 20006

Phone: (202) 261-7600 ) Fax: (202) 261-7650

wwwxsb.gov

Honorable Katherine A. Lemos
Chairman and CEO

March 9. 2022

Re: Draft IRM Contractor Produced Report

The CSB welcomes the opportunity to improve upon areas vulnerable to exploitation and
thanks the audit staff for their work in these areas.

The CSB concurs with the first recommendation and lias approved and published a
Vulnerability Disclosure Policy to the CSB website in accordance with the
recommendation for improvement. A VDP will provide ethical hackers instruction on
how to report vulnerabilities that they have identified and promote cooperation between
internal and external stakeholders pertaining to vulnerabilities.

The CSB also concurs with the second recommendation regarding the need improve its
cybersecurity program by consistently storing system backups at an offsite location a
sufficient distance from its headquarters. Offsite manual backup procedures have
resumed, a new agency purchasing officer has joined the agency and has conducted
preliminary market research, and the CSB is curr ently undergoing a survey to understand
our needs for cloud services. The anticipated goal date for award is 30 June 2022 with
realized outcomes by 15 July 2022.

David LaC'erte

Senior Advisor and Executive Counsel

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Appendix D

Distribution

Chairperson and Chief Executive Officer
Senior Advisor and General Counsel
EPA OIG Liaison

Information Technology Director/Chief Information Officer

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