2022-09-21T14:28:13-05:00 2021-12-31 390974031 WEGNER CPAS LLP 2921 LANDMARK PL STE 300 MADISON WI 537134236 990 2021-01-01 391195540 CREATIVE COMMUNITY LIVING SERVICES INCORPORATED CREA 8002362257 314 EAST MAIN STREET WATERTOWN WI 53094 JAMES ZACHE CHIEF EXECUTIVE OFFICER 8002362257 2022-09-15 1 JAMES ZACHE 999009999 TIM SEIDEL CPA P01284559 6082744020 2022-09-12 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JAMES ZACHE 314 EAST MAIN STREET WATERTOWN WI 53094 21345989 0 X CCLSWI.ORG X 1973 WI CREATIVE COMMUNITY LIVING SERVICES IS A PROVIDER OF SERVICES AND SUPPORTS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, MENTAL ILLNESS, PHYSICAL DISABILITIES, OR FUNCTIONAL LIMITATIONS OF ADVANCED AGING. OUR COMMUINITY SUPPORTS ARE INDIVIDUALIZED AND PERSON-CENTERED. WE WORK WITH THE INDIVIDUAL TO BUILD THE NECESSARY SUPPORTS BASED ON THEIR NEEDS, STRENGTHS, AND WISHES. 6 6 623 0 954129 2015 1607815 3218455 15557095 17159140 21340 10885 821190 956005 18007440 21344485 0 0 0 0 12998347 13856123 0 0 48160 4312543 4558033 17310890 18414156 696550 2930329 7254591 7269281 6033232 3074019 1221359 4195262 OUR MISSION IS TO ESTABLISH INDIVIDUALIZED COMMUNITY SUPPORTS THAT WILL PRESERVE AND ENHANCE THE DIGNITY AND RIGHTS OF THOSE WHO RELY ON OTHERS WHILE SEEKING THEIR OWN LEVEL OF INDEPENDENCE. 0 0 11261615 0 14003198 DEVELOPMENTALLY DISABLED CARE - PROVIDING RESIDENTIAL HOUSING AND NONRESIDENTIAL SERVICES AND SUPPORTS FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, MENTAL ILLNESS, PHYSICAL DISABILITIES AND/OR TRAUMATIC BRAIN INJURIES. SERVICES INCLUDE COMMUNITY SUPPORTED LIVING, SUPPORTIVE HOME CARE, SKILLS TEACHING/TRAINING, INDEPENDENT LIVING PROGRAMS, RESPITE, NON-MEDICAL TRANSPORTATION, SUPPORTED EMPLOYMENT, AND PRE-VOCATION, RECREATIONAL, NURSE AND DAY SERVICES. ALL SERVICES AND SUPPORTS ARE INDIVIDUALIZED AND PERSON-CENTERED AND DESIGNED TO PRESERVE AND ENHANCE THE DIGNITY AND RIGHTS OF THOSE WHO RELY ON OTHERS WHILE SEEKING THEIR OWN LEVEL OF INDEPENDENCE. 2414697 0 3155942 ELDER CARE - PROVIDING RESIDENTIAL HOUSING AND SUPPORTS FOR INDIVIDUALS WITH FUNCTIONAL LIMITATIONS OF ADVANCED AGING. SERVICES INCLUDE COMMUNITY SUPPORTED LIVING, SKILLS RE-TEACHING/RE-TRAINING, NON-MEDICAL TRANSPORTATION, AND NURSE. ALL SERVICES AND SUPPORTS ARE INDIVIDUALIZED AND PERSON-CENTERED AND DESIGNED TO PRESERVE AND ENHANCE THE DIGNITY AND RIGHTS OF THOSE WHO RELY ON OTHERS WHILE SEEKING THEIR OWN LEVEL OF INDEPENDENCE. 13676312 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 64 0 623 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X DWAN SCHUCK 8002362257 314 EAST MAIN STREET WATERTOWN WI 53094 RANDY RADTKE CHAIR/INTERIM TREASURER 0.75 0.50 X X 1500 0 0 DAVE MORSTAD VICE CHAIR 0.50 X X 1300 0 0 KAREN FOELKER SECRETARY 0.50 X X 1450 0 0 ELLEN HAINES DIRECTOR 0.50 X 1550 0 0 BARB LEDUC DIRECTOR 0.50 0.50 X 1450 0 0 SHERI BERG DIRECTOR 0.50 X 1100 0 0 JAMES ZACHE CHIEF EXECUTIVE OFFICER 34.00 6.00 X 167167 0 1016 DWAN SCHUCK CHIEF FINANCIAL OFFICER 34.00 6.00 X 125596 0 673 SHERYL MARSHALL VICE PRESIDENT OF HUMAN RESOURCES 34.00 6.00 X 119144 0 8561 TAMMY BINKLEY PROGRAM DIRECTOR 40.00 X 154754 0 15158 MARGARET HIBBARD PROGRAM LEAD 40.00 X 131479 0 476 RYAN FARKAS PROGRAM MANAGER 40.00 X 120981 0 9074 BRICE WEIGEL PROGRAM MANAGER 40.00 X 108741 0 9024 936212 0 43982 7 0 1 0 0 3199447 19008 3218455 CONTRACT INCOME 624100 16932268 16932268 TRAINING 611430 226872 226872 17159140 6295 6295 3380 1504 1876 1876 1876 4590 0 4590 4590 4590 RESIDENTIAL MANAGEMENT FEES 623990 954129 954129 954129 21344485 17159140 954129 12761 294452 294452 11380157 8610806 2740120 29231 30681 23658 6943 80 1353794 997691 352712 3391 797039 587272 207771 1996 13984 13984 57796 57796 922615 763140 159400 75 346623 266989 78392 1242 203378 104593 98527 258 1860105 1477993 376454 5658 307450 260558 46838 54 2188 735 1124 329 33736 12533 21203 138436 100209 38227 161999 83164 78835 FOOD 361526 356559 4967 DUES, FEES, SUBSCRIPTIO 118502 20439 96685 1378 BAD DEBT EXPENSE 1022 1022 28673 9973 14232 4468 18414156 13676312 4689684 48160 2898911 46700 473130 3050417 546553 0 1488573 1819287 32524 28678 4050308 2501332 1485423 1548976 329477 775223 7254591 7269281 1235032 984004 0 262949 1491514 1296167 2685000 0 621686 530899 6033232 3074019 X 1100863 4075966 120496 119296 1221359 4195262 7254591 7269281 X 2930329 43574 X 0 1 X 1 0 X 2400 122031 1607815 3218455 4950701 2400 122031 1607815 3218455 4950701 4950701 3325 6299 9510 9675 28809 1814 1814 4981324 69948626 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 300717 300717 2081140 1098006 983134 1174950 909825 265125 493501 493501 0 1548976 SECURITY DEPOSITS 49493 DUE FROM FAST PACE MEDICAL STAFFING, INC. 725730 775223 DEFICIENCY IN ASSETS OF SUBSIDIARY 181417 CAPITAL LEASE OBLIGATION 272552 PROVISION FOR CONTRACT REPAYMENTS 76930 530899 X X X 0 0 0 0 0 0 0 0 0 TAMMY BINKLEY PROGRAM DIRECTOR 152519 0 2235 0 0 0 622 0 14536 0 169912 0 0 0 JAMES ZACHE CHIEF EXECUTIVE OFFICER 165777 0 1390 0 0 0 831 0 185 0 168183 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B CCLS HIRES A CPA FIRM TO COMPILE FORM 990. THE CFO AND CEO REVIEW FOR ACCURACY BEFORE SIGNATURE AND SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY ALL DIRECTORS AND OFFICERS COMPLETE AND SIGN A STATEMENT THAT PROVIDES INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS. THE MEMBERS OF THE GOVERNING BODY MAKE DETERMINATIONS OF WHETHER A CONFLICT EXISTS AND REVIEW ACTUAL CONFLICTS. ANY PERSON WITH A CONFLICT IS PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 MARKET DATA ANALYSIS FOR SIMILAR INDUSTRIES/CPA FIRM INPUT. HUMAN RESOURCES, CEO, AND REGIONAL DIRECTOR DISCUSS AND DECIDE AFTER 1ST AND 2ND PANEL INTERVIEWS (AND RECOMMENDATIONS) WHAT TO OFFER. INTERVIEW PANEL OFTEN INCLUDES A BOARD MEMBER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: EQUITY IN NET INCOME OF FAST PACE MEDICAL STAFFING, INC. 43,574. FAST PACE MEDICAL STAFFING INC 314 EAST MAIN STREET WATERTOWN WI 53094 842704067 TEMPORARY STAFFING WI CREATIVE COMMUNITY LIVING SERVICES INC C 2405443 636779 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 FAST PACE MEDICAL STAFFING INC Q 725730 FACE AMOUNT