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CHISAGO COUNTY LIFE CARE CENTER: Form 990EZ, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CHISAGO COUNTY LIFE CARE CENTER (EIN 41-1921727)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-05-13
IRS object ID
202221339349203507
Schema version
2021v4.0
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

FieldValueIRS element (for citing)
Return2022-05-13T13:56:09-04:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt
Return Type990EZReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN411921727EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHISAGO COUNTY LIFE CARE CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Ann OlsonInCareOfNm
Business Name ControlCHISBusinessNameControlTxt
Foreign Phone6516742121ForeignPhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 516AddressLine1Txt
CityNorth BranchCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55056ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBetty MitchellPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2022-05-13SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Website Addresswww.chisagolifecare.orgWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$103,069GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$83,092ContributionsGiftsGrantsEtcAmt
Investment Income$59InvestmentIncomeAmt
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Special Events Direct Expenses$9,247SpecialEventsDirectExpensesAmt
Special Events Net Income Loss-$9,247SpecialEventsNetIncomeLossAmt
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Gross Profit Loss Sls Of Invntry$0GrossProfitLossSlsOfInvntryAmt
Other Revenue Total$19,918OtherRevenueTotalAmt
Total Revenue$93,822TotalRevenueAmt
Salaries Other Comp Empl Bnft$43,974SalariesOtherCompEmplBnftAmt
Fees And Other Pymt To Ind Cntrct$4,400FeesAndOtherPymtToIndCntrctAmt
Occupancy Rent Utlts And Maint$35,929OccupancyRentUtltsAndMaintAmt
Printing Publications Postage$1,774PrintingPublicationsPostageAmt
Other Expenses Total$18,870OtherExpensesTotalAmt
Total Expenses$104,947TotalExpensesAmt
Excess Or Deficit For Year-$11,125ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$75,903NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$64,778NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIYes (X)InfoInScheduleOPartIIInd

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$61,332BOYAmt
EOY$82,501EOYAmt

Land And Buildings LandAndBuildingsGrp

FieldValueIRS element (for citing)
BOY$84,883BOYAmt
EOY$83,856EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$14,940BOYAmt
EOY$517EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$161,155BOYAmt
EOY$166,874EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$85,252BOYAmt
EOY$102,096EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$75,903BOYAmt
EOY$64,778EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposeProvide one-on-one mentoring to pregnant and parenting women & men on topics such as prenatal & postnatal infant development healthy life choices practical life skills such as budgeting & nutrition and information on STDs & healthy reproductive and sexual decision making.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxtGrants And AllocationsGrantsAndAllocationsAmtProgram Service ExpensesProgramServiceExpensesAmt
Education & Earn While You Learn Mentoring Program: Provide one-on-one mentoring to pregnant and parenting women & men on topics such as prenatal & postnatal infant development healthy life choices practical life skills such as budgeting & nutrition information on STDs & healthy reproductive and sexual decision-making$0$30,510
Social Service Baby Boutique & community program referrals: Provide intake assessments to determine the need. Provide practical & material assistance such as clothing diapers and baby equipment. Utilize resource database to provide information and referrals.$0$33,121
Outreach: Strengthen relationships with existing community partners and identify new community partners in order to identify potential referral sources for clients and increase capacity of programming.$0$17,577
FieldValueIRS element (for citing)
Total Program Service Expenses$81,208TotalProgramServiceExpensesAmt
Info In Schedule O Part IVYes (X)InfoInScheduleOPartIVInd

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (7 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
Ann Olson
President4$0$0$0
Jackie Scheldorf
Secretary2$0$0$0
Betty Mitchell
Treasurer20$0$0$0
Leah Lackas Anderson
Director0.2$0$0$0
Theresa Williams
Director0.2$0$0$0
Bob Williams
Director0.2$0$0$0
Sandra Blake
Director of Operations30$306$0$0
FieldValueIRS element (for citing)
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Form1120 Pol FiledfalseForm1120PolFiledInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Betty MitchellBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16344 Elm StAddressLine1Txt
CityNorth BranchCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55056ZIPCd
FieldValueIRS element (for citing)
Phone6516742121PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (true)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124,727CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$120,730CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$125,973CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$123,062CurrentTaxYearMinus1YearAmt
Current Tax Year$83,092CurrentTaxYearAmt
Total$577,584TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124,727CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$120,730CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$125,973CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$123,062CurrentTaxYearMinus1YearAmt
Current Tax Year$83,092CurrentTaxYearAmt
Total$577,584TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$577,584PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$19CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$33CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31CurrentTaxYearMinus1YearAmt
Current Tax Year$59CurrentTaxYearAmt
Total$146TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$19,918CurrentTaxYearAmt
Total$19,918TotalAmt
FieldValueIRS element (for citing)
Total Support$597,648TotalSupportAmt
Gross Receipts Rltd Activities$0GrossReceiptsRltdActivitiesAmt
Public Support CY1700.9664PublicSupportCY170Pct
Public Support PY1700.9729PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part IWe rely on contributions from individuals and businesses. We had a State Grant that ended 12-31-21
Part II, line 10| S.No:, Amount:, Description:| 1, $16918, PPP Loan Forgiven| 2, $3000, SBA Disaster Loan Forgiven|

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Annual BanquetEvent1Nm
Gross Receipts Event1$19,672GrossReceiptsEvent1Amt
Charitable Contri Event1$19,672CharitableContriEvent1Amt
Gross Revenue Event1$0GrossRevenueEvent1Amt
Cash Prizes Event1$0CashPrizesEvent1Amt
Non Cash Prizes Event1$0NonCashPrizesEvent1Amt
Rent Facility Costs Event1$0RentFacilityCostsEvent1Amt
Food And Beverage Event1$2,691FoodAndBeverageEvent1Amt
Entertainment Event1$0EntertainmentEvent1Amt
Other Direct Expenses Event1$789OtherDirectExpensesEvent1Amt
Event2Fish Lake PicnicEvent2Nm
Gross Receipts Event2$6,954GrossReceiptsEvent2Amt
Charitable Contri Event2$6,954CharitableContriEvent2Amt
Gross Revenue Event2$0GrossRevenueEvent2Amt
Cash Prizes Event2$0CashPrizesEvent2Amt
Non Cash Prizes Event2$0NonCashPrizesEvent2Amt
Rent Facility Costs Event2$0RentFacilityCostsEvent2Amt
Food And Beverage Event2$0FoodAndBeverageEvent2Amt
Entertainment Event2$0EntertainmentEvent2Amt
Other Direct Expenses Event2$999OtherDirectExpensesEvent2Amt
Gross Receipts Total$26,626GrossReceiptsTotalAmt
Charitable Contributions Tot$26,626CharitableContributionsTotAmt
Gross Revenue Total Events$0GrossRevenueTotalEventsAmt
Cash Prizes Total Events$0CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$0NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$0RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$2,691FoodAndBeverageTotalEventsAmt
Entertainment Total Events$0EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$1,788OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$4,479DirectExpenseSummaryEventsAmt
Net Income Summary-$4,479NetIncomeSummaryAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Doing Business As NamesOptions for Women of Chisago County
Part I, line 8| Other Revenues:, Amount:| PPP Loan Forgiven, $16918| SBA Disaster Loan Forgiven, $3000|
Part I, line 16| Other Expenses:, Amount:| Advertising & Marketing, $538.00| Computer Tech Services, $535.00| Copier Lease and usage, $1747.00| Software expense, $1020.00| Group email service, $56.00| Office Supplies, $600.00| merchant fees, $530.00| Outreach-affiliation dues booths website, $1190.00| Gift cards for Volunteers, $30.00| Insurance-Officer & Director and Workers Comp, $1299.00| Training-Fitness and Ultrasound, $3311.00| Travel mileage expense, $112.00| Other Miscellaneous Expense, $56.00| Depreciation Expense, $1839.00| Client Services, $6007.00|
Part II, line 24| Asset Name:, BOY Amount:, EOY Amount:| Grant Miscellaneous Receivables, $14920, 0| Petty Cash, $20, $100| Other Current Assets, 0, $417|
Part II, line 26| Liabilities Name:, BOY Amount:, EOY Amount:| Payroll Taxes Payable, $1640, $866| SBA Loan Payable, $3000, 0| Accounts Payable, $1411, $1572| Mortgages or other loans payable, $79201, $99658|
Part IV, List of Officers| Employee Name:, Description:| Sandra Blake, Sandra started in Dec 2021|

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