2026-05-18T11:53:25-05:00 2025-12-31 410746749 CLIFTONLARSONALLEN LLP 1188 PADRE DRIVE STE 101 SALINAS CA 93901 990 2025-01-01 863477976 JERRY RUBIN FOUNDATION FOR CANCER CARE JERR 8316424041 5 HARRIS COURT BUILDING T 201 MONTEREY CA 939405750 VALERIA WAREHAM EXECUTIVE DIR. 8316424041 2026-05-15 1 KIELY HOLCOMB CPA P01430569 8317596300 2026-05-15 2025 2025-03-06 01:10:19Z VALERIA WAREHAM 5 HARRIS COURT BUILDING T 201 MONTEREY CA 939405750 427578 0 X WWW.JERRYRUBINFOUNDATIONFORCANCERCARE.ORG X 2021 CA TO PROVIDE FINANCIAL AND OTHER ASSISTANCE AND SUPPORT TO CANCER PATIENTS. 2 2 3 14 0 0 386737 423515 0 0 0 4063 25 -9058 386762 418520 183049 211447 0 0 62608 101178 0 0 0 24582 46895 270239 359520 116523 59000 210289 269289 0 0 210289 269289 X THE FOUNDATION IS FORMED (I) TO PROVIDE FINANCIAL AND OTHER ASSISTANCE AND SUPPORT TO CANCER PATIENTS, INCLUDING, WITHOUT LIMITATION, PROGRAMS DESIGNED TO MEET THE PSYCHOLOGICAL AND EMOTIONAL NEEDS OF CANCER PATIENTS; (II) TO PROVIDE EDUCATIONAL PROGRAMS FOR MEDICAL PROFESSIONALS WITH RESPECT TO THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF CANCER; (III) TO ESTABLISH COMMUNITY-BASED EDUCATIONAL INITIATIVES TO PROMOTE THE EARLY DETECTION OF CANCER AND AN INTEGRATED APPROACH TO CANCER TREATMENT; (IV) TO PROVIDE SUPPORT GROUPS FOCUSED ON CANCER PATIENTS, CAREGIVERS AND THE BEREAVED, AND (V) TO PROVIDE SUCH OTHER PROGRAMS AS WILL ASSIST CANCER PATIENTS DURING THEIR BATTLE WITH CANCER AND WITH END OF LIFE. 0 0 340504 211447 0 JERRY'S PLACE IS A SOCIAL MODEL HOSPICE HOME WHICH IS COMMUNITY SUPPORTED. WE PROVIDE 24-HOUR CARE FOR THE TERMINALLY ILL INDIVIDUALS WHEN DYING AT HOME BECOMES UNMANAGEABLE, OR THERE IS NO HOME. RESIDENTS ALL STAY FOR FREE. WE ARE NOT COVERED BY MEDICARE, MEDICAID, OR PRIVATE INSURANCE. WE ARE A UNIQUE SERVICE WHICH DOES NOT DUPLICATE EXISTING COMMUNITY RESOURCES. OUR RESIDENTS REPRESENTED A RICH AND DIVERSE COMMUNITY, INCLUDING A PASTOR, EDUCATORS, PUBLIC SERVANTS, HEALTHCARE PROVIDERS, LAW ENFORCEMENT OFFICERS, UNHOUSED INDIVIDUALS, AND FOUR U.S. VETERANS, ONE OF WHOM SERVED AS A GREEN BERET. DIAGNOSES AMONG RESIDENTS INCLUDED PARKINSON'S DISEASE, CANCER, HEART DISEASE, LEWY BODY DEMENTIA, STROKE, SEPSIS, AND ASPIRATION PNEUMONIA-UNDERSCORING THE BREADTH AND COMPLEXITY OF THOSE WE SERVE. THE NEED: MANY OF THOSE WE SERVE FACE A LACK OF FAMILY OR CAREGIVER SUPPORT, INABILITY TO AFFORD IN-HOME HOSPICE, HOSPITAL DISCHARGE WITH NO SAFE PLACE TO GO, AND EMOTIONAL DISTRESS FROM ISOLATION AND UNCERTAINTY. JERRY'S PLACE IS THE ONLY SOCIAL-MODEL HOSPICE HOME IN THE REGION, FILLING A CRITICAL GAP FOR THOSE WITH NOWHERE ELSE TO TURN.PATIENTS AND RESIDENTS SERVED AT JERRY'S PLACE: -TOTAL RESIDENTS SERVED THIS YEAR: 21 -TOTAL RESIDENTS SERVED SINCE INCEPTION: 50 -AVERAGE LENGTH OF STAY: 30.8 DAYS -HOUSING SUPPORT (RENT FOR JERRY'S PLACE): $192,000 340504 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 1 3 1 0 0 0 0 0 0 0 0 0 0 0 0 X 2 2 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 CA X X VALERIA WAREHAM 8316424041 5 HARRIS COURT BUILDING T SUITE 201 MONTEREY CA 939405750 JOHN HAUSDORFF MD PRESIDENT 1.00 X X 0 0 0 ZACH KOONTZ MD SECRETARY 2.00 X X 0 0 0 VALERIA WAREHAM EXECUTIVE DIRECTOR 30.00 X 30769 0 0 30769 0 0 0 0 0 0 0 19000 404515 423515 4063 4063 0 19000 9058 -9058 -9058 418520 0 0 -4995 211447 211447 30769 30769 61397 61397 1016 1016 7996 7996 8393 3750 4643 936 936 11488 2584 8904 348 295 53 231 231 3592 3592 SUPPLIES 11054 10658 396 MISCELLANEOUS 8058 8002 56 EQUIPMENT 2270 2270 DUES AND SUBSCRIPTIONS 525 400 125 359520 340504 19016 0 210289 269289 210289 269289 0 0 X 210289 151777 117512 210289 269289 210289 269289 59000 0 X 1 X 0 0 0 X 750 72050 210808 386712 423515 1093835 750 72050 210808 386712 423515 1093835 13281 1080554 4063 4063 25 25 1097923 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE - 2024 AMOUNT: $ 25. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED PURE GOLF CHAMPIONSHIP 19000 19000 9058 19000 19000 9058 9058 -9058 1 RENT ASSISTANCE TO PATIENTS 21 190500 N/A N/A GIFT CARDS AND UTILITIES PAID FOR PATIENTS 16 20947 N/A N/A PART I, LINE 2: WE GIVE OUT GRANTS IN THE FORM OF GIFT CARDS FOR GAS OR GROCERIES; WE PAY RENTS, UTILITY BILLS OR OTHER LIVING EXPENSES DIRECTLY. NO CASH IS GIVEN TO ANY OF THE RECIPIENTS AND NO MEDICAL BILLS ARE COVERED BY OUR GRANTS. WE CONFIRM WITH THEM AT TIME OF AWARD WHICH FORM OF ASSISTANCE WOULD BE MOST HELPFUL AND THEN WE SEND THE CARDS TO THEM OR PAYMENTS DIRECTLY TO THE UTILITY COMPANIES OR LANDLORDS. FORM 990, PART VI, SECTION A, LINE 8B THERE WERE NO COMMITTEES IN EXISTENCE WITH AUTHORITY TO ACT ON BEHALF OF THE BOARD FORM 990, PART VI, SECTION B, LINE 11B THE PRESIDENT AND TREASURER ARE HEREBY APPOINTED AS A COMMITTEE OF THE BOARD WITH AUTHORITY OF THE BOARD TO REVIEW THE IRS FORM 990, FTB FORM 199, AG FORM RRF-1 AND ANY OTHER REQUIRED FILINGS TO BE FILED BY THE CORPORATION ON AN ANNUAL BASIS, AND SUCH COMMITTEE IS AUTHORIZED AND DIRECTED TO REVIEW SUCH FORMS (AS MAY BE PREPARED BY THE CERTIFIED PUBLIC ACCOUNTANTS ENGAGED BY THE CORPORATION) ON AN ANNUAL BASIS PRIOR TO THE FILING OF SUCH FORMS. ALL BOARD MEMBERS RECEIVE A COPY OF THE FORM 990 PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C INTERESTED PERSON - AN "INTERESTED PERSON" SHALL MEAN ANY DIRECTOR, OFFICER, KEY EMPLOYEE OR ANY COMMITTEE MEMBER REGARDLESS OF WHETHER SUCH PERSON IS A DIRECTOR, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST IN A CONTEMPLATED TRANSACTION OR ARRANGEMENT. EACH DIRECTOR, OFFICER, KEY EMPLOYEE AND MEMBER OF ANY COMMITTEE SHALL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, HAS READ AND UNDERSTANDS THIS CONFLICT OF INTEREST POLICY, HAS AGREED TO COMPLY WITH THIS CONFLICT OF INTEREST POLICY, AND AGREED TO PROMPTLY DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST. CONFLICT OF INTEREST. A CONFLICT OF INTEREST MAY EXIST WHEN AN INTERESTED PERSON HAS, DIRECTLY OR INDIRECTLY, A FINANCIAL INTEREST IN ANY TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION BY ANY OFFICER, THE BOARD OR ANY COMMITTEE. DUTY TO DISCLOSE. A. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST FULLY DISCLOSE ALL MATERIAL FACTS RELATED TO THE RELATIONSHIPS AND/OR FINANCIAL OR OTHER INTERESTS THAT GIVE RISE TO THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE MADE TO THE BOARD OR ANY OFFICER(S) CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. B. IF A DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER BECOMES AWARE OF ANY POTENTIAL CONFLICT OF INTEREST RELATED TO ANOTHER DIRECTOR, OFFICER, KEY EMPLOYEE OR COMMITTEE MEMBER, HE OR SHE SHALL BRING IT TO THE ATTENTION OF THE PRESIDENT, TREASURER/CHIEF FINANCIAL OFFICER OR THE SECRETARY IMMEDIATELY. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. THE BOARD MAY DETERMINE THAT THE FINANCIAL OR OTHER INTEREST IS NOT MATERIAL AND THAT, THEREFORE, THERE IS NO ACTUAL OR POTENTIAL CONFLICT OF INTEREST. IF THE BOARD DETERMINES THAT THERE IS NO ACTUAL OR POTENTIAL CONFLICT OF INTEREST, NO VOTE OF THE BOARD SHALL BE REQUIRED TO PROCEED WITH THE TRANSACTION OR ARRANGEMENT. IF THE BOARD DETERMINES THAT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE BOARD MAY AUTHORIZE OR APPROVE THE TRANSACTION OR ARRANGEMENT PURSUANT TO THE PROCEDURES SET FORTH IN THE NEXT SECTION. PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST. IF THE BOARD DETERMINES THAT THERE IS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST, THE BOARD SHALL PROCEED AS FOLLOWS: A. THE INTERESTED PERSON(S) SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT, PROVIDED THAT SUCH INTERESTED PERSON(S) SHALL BE GIVEN THE OPPORTUNITY TO ADDRESS THE MEETING WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT BEFORE LEAVING THE MEETING. B. THE BOARD MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT BEFORE VOTING ON SUCH TRANSACTION OR ARRANGEMENT. C. THE BOARD, ACTING IN GOOD FAITH, MAY AUTHORIZE OR APPROVE THE TRANSACTION OR ARRANGEMENT BY VOTE OF A MAJORITY OF THE DIRECTORS THEN IN OFFICE WITHOUT COUNTING THE VOTE OF ANY DIRECTOR WHO HAS A MATERIAL FINANCIAL INTEREST IN THE TRANSACTION OR ARRANGEMENT (ALTHOUGH SUCH DIRECTOR(S) MAY BE COUNTED IN DETERMINING THE PRESENCE OF A QUORUM) AFTER DETERMINING THE FOLLOWING: I. THAT THE BOARD HAS KNOWLEDGE OF ALL MATERIAL FACTS CONCERNING THE TRANSACTION OR ARRANGEMENT AND THE FINANCIAL INTEREST OF ANY INTERESTED PERSON IN SUCH TRANSACTION OR ARRANGEMENT; II. THAT THE BOARD IS ACTING IN GOOD FAITH; III. THAT THE CORPORATION IS ENTERING INTO THE TRANSACTION FOR ITS OWN BENEFIT; IV. THAT THE TRANSACTION IS (OR WAS) FAIR AND REASONABLE TO THE CORPORATION AT THE TIME THE CORPORATION WILL (OR DID) ENTER INTO IT; AND, V. THAT, AFTER REASONABLE INVESTIGATION UNDER THE CIRCUMSTANCES, THE CORPORATION CANNOT OBTAIN A MORE ADVANTAGEOUS ARRANGEMENT WITH REASONABLE EFFORT UNDER THE CIRCUMSTANCES. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION'S GOVERNING DOCUMENTS AND ITS IRS FORM 990 ARE AVAILABLE ON THE WEBSITE OF THE OFFICE OF THE CALIFORNIA ATTORNEY GENERAL.