GENESIS HOUSE INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GENESIS HOUSE INC (EIN 23-7297769)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-16
- IRS object ID
- 202201369349316945
- Schema version
- 2020v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-05-16T19:56:25-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA A WINTROATH CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 N CALIFORNIA BLVD SUITE 290 | AddressLine1Txt |
| City | WALNUT CREEK | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94596 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237297769 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENESIS HOUSE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GENE | BusinessNameControlTxt |
| Phone | 7075525295 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVENUE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KESTER MCDONALD | PersonNm |
| Person Title | EXECUTIVE DIRECTOR/TREASURER | PersonTitleTxt |
| Phone | 7075525295 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KESTER | PersonFirstNm |
| Person Last | MCDONALD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PATRICIA A WINTROATH | PreparerPersonNm |
| PTIN | P00430440 | PTIN |
| Phone | 9259743310 | PhoneNum |
| Preparation | 2022-05-13 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KESTER MCDONALD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVENUE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $906,788 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE IN-PATIENT ALCOHOL AND DRUG TREATMENT PROGRAMS, RELATED COUNSELING AND SUPPORT SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 14 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $354,982 | PYContributionsGrantsAmt |
| CY Contributions Grants | $21,224 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $172,782 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $337,308 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3 | PYInvestmentIncomeAmt |
| CY Investment Income | $376,409 | CYInvestmentIncomeAmt |
| PY Other Revenue | $81,184 | PYOtherRevenueAmt |
| CY Other Revenue | $85,282 | CYOtherRevenueAmt |
| PY Total Revenue | $608,951 | PYTotalRevenueAmt |
| CY Total Revenue | $820,223 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $411,217 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $314,966 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $9,025 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $207,043 | PYOtherExpensesAmt |
| CY Other Expenses | $197,629 | CYOtherExpensesAmt |
| PY Total Expenses | $618,260 | PYTotalExpensesAmt |
| CY Total Expenses | $512,595 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,309 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $307,628 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $619,355 | TotalAssetsBOYAmt |
| Total Assets EOY | $823,654 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $267,986 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $164,657 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $351,369 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $658,997 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE IN-PATIENT ALCOHOL AND DRUG TREATMENT PROGRAMS, RELATED COUNSELING AND SUPPORT SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $427,084 | ExpenseAmt |
| Revenue | $417,418 | RevenueAmt |
| Desc | LONG TERM RESIDENTIAL DRUG AND ALCOHOL TREATMENT AND REHABILITATION SERVICES - OVER 7,500 PATIENT DAYS | Desc |
| Total Program Service Expenses | $427,084 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 14 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRITTANY CARDINALE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7075525295 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| JIMMY SMITH | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| VIANN BARTLETT | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| KESTER MCDONALD | ||||||
| EXECUTIVE DIRECTOR/SECRETA | 40.00 | Yes (X) | $57,300 | $0 | $2,100 | Yes (X) |
| DANIEL BARWELA | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL PRITCHARD | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| LARS WOHLER | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| GEORGE MARISCAL | ||||||
| PRESIDENT | 0.30 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| GAIL MOON | ||||||
| TREASURER | 0.30 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $57,300 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,100 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $21,224 | AllOtherContributionsAmt |
| Total Contributions | $21,224 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| SUBSTANCE USE TREATMEN | 623990 | $231,025 | $231,025 |
| PROCEEDS FROM JOBS | 623990 | $62,053 | $62,053 |
| SOBER LIVING FEE FOR S | 623990 | $26,271 | $26,271 |
| FOOD STAMPS | 623990 | $12,854 | $12,854 |
| SERVICE FEES | 623990 | $5,105 | $5,105 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $337,308 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5 | TotalRevenueColumnAmt |
| Exclusion | $5 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $462,969 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $86,565 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $376,404 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $376,404 | TotalRevenueColumnAmt |
| Exclusion | $376,404 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,172 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,172 | TotalRevenueColumnAmt |
| Exclusion | $5,172 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PPP LOAN FORGIVENESS | 623990 | $76,610 | $76,610 |
| MISCELLANEOUS | 623990 | $3,500 | $3,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $80,110 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $820,223 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $417,418 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $381,581 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,100 | TotalAmt |
| Program Services | $44,325 | ProgramServicesAmt |
| Management And General | $14,775 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,823 | TotalAmt |
| Program Services | $159,792 | ProgramServicesAmt |
| Management And General | $25,031 | ManagementAndGeneralAmt |
| Fundraising | $5,000 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,863 | TotalAmt |
| Program Services | $39,248 | ProgramServicesAmt |
| Management And General | $8,615 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,180 | TotalAmt |
| Program Services | $14,908 | ProgramServicesAmt |
| Management And General | $2,872 | ManagementAndGeneralAmt |
| Fundraising | $400 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,895 | TotalAmt |
| Program Services | $5,514 | ProgramServicesAmt |
| Management And General | $2,381 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,330 | TotalAmt |
| Program Services | $5,330 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,231 | TotalAmt |
| Program Services | $615 | ProgramServicesAmt |
| Fundraising | $616 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,769 | TotalAmt |
| Program Services | $7,191 | ProgramServicesAmt |
| Management And General | $1,578 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,903 | TotalAmt |
| Program Services | $27,800 | ProgramServicesAmt |
| Management And General | $4,603 | ManagementAndGeneralAmt |
| Fundraising | $1,500 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,901 | TotalAmt |
| Program Services | $14,679 | ProgramServicesAmt |
| Management And General | $3,222 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,411 | TotalAmt |
| Program Services | $11,817 | ProgramServicesAmt |
| Management And General | $2,594 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,582 | TotalAmt |
| Program Services | $16,877 | ProgramServicesAmt |
| Management And General | $3,705 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,462 | TotalAmt |
| Program Services | $26,619 | ProgramServicesAmt |
| Management And General | $4,843 | ManagementAndGeneralAmt |
| Fundraising | $1,000 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DIRECT PATIENT CARE | $37,887 | $37,887 | |
| REPAIRS & MAINTENANCE | $11,616 | $9,525 | $2,091 |
| JOB COSTS | $4,105 | $4,105 | |
| BANK CHARGES | $978 | $802 | $176 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559 | TotalAmt |
| Program Services | $50 | ProgramServicesAmt |
| Fundraising | $509 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,595 | TotalAmt |
| Program Services | $427,084 | ProgramServicesAmt |
| Management And General | $76,486 | ManagementAndGeneralAmt |
| Fundraising | $9,025 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,618 | BOYAmt |
| EOY | $192,145 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,453 | BOYAmt |
| EOY | $210,601 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,800 | BOYAmt |
| EOY | $17,680 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,715 | BOYAmt |
| EOY | $13,765 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $933,888 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $544,425 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $457,769 | BOYAmt |
| EOY | $389,463 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $619,355 | BOYAmt |
| EOY | $823,654 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,085 | BOYAmt |
| EOY | $3,232 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,901 | BOYAmt |
| EOY | $161,425 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $267,986 | BOYAmt |
| EOY | $164,657 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,369 | BOYAmt |
| EOY | $658,997 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,369 | BOYAmt |
| EOY | $658,997 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $619,355 | BOYAmt |
| EOY | $823,654 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $307,628 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $279,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $368,645 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $301,915 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $354,982 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,224 | CurrentTaxYearAmt |
| Total | $1,326,089 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $279,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $368,645 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $301,915 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $354,982 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,224 | CurrentTaxYearAmt |
| Total | $1,326,089 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,326,089 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $43 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5 | CurrentTaxYearAmt |
| Total | $74 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,768 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,303 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,540 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $80,110 | CurrentTaxYearAmt |
| Total | $114,630 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,440,793 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,067,071 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.92040 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97390 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $69,629 | OtherCostOrOtherBasisAmt |
| Book Value | $69,629 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $611,185 | OtherCostOrOtherBasisAmt |
| Depreciation | $305,644 | DepreciationAmt |
| Book Value | $305,541 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $253,074 | OtherCostOrOtherBasisAmt |
| Depreciation | $238,781 | DepreciationAmt |
| Book Value | $14,293 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $389,463 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $820,223 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $820,223 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $820,223 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $512,595 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $512,595 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $512,595 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE EXECUTIVE DIRECTOR AND FISCAL OFFICER REVIEW THE FORM 990 PRIOR TO FILING THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION NOTIFIES THE BOARD MEMBERS OF THE CONFLICT OF INTEREST POLICY AT A BOARD MEETING ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED BY COMPARISON WITH LIKE ORGAINZATIONS IN THE REGION, THROUGH SOURCES SUCH AS CALIFONRIA HEALTH CARE ALMANAC - EMPLOYER HEALTH BENEFITS SURVEY, AND A PERCENT OF INFLATION IS ALSO USED IN DETERMINING THE PAY RAISES, WHICH ARE SUBJECT TO BOARD APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. THE FORM 990 IS AVAILABLE ON THE CALIFORNIA REGISTRY OF CHARITABLE TRUST'S WEBSITE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
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