2022-11-11T09:31:17-06:00 2021-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2021-01-01 680201024 O'CONNOR WOODS HOUSING CORPORATION OCON 2094676500 3400 WAGNER HEIGHTS ROAD STOCKTON CA 95209 MARGARET STEPHENS BOARD CHAIR 2094676500 2022-11-01 1 MARGARET STEPHENS XXX-XX-XXXX TRACY S PAGLIA P00366884 2099556100 2022-11-01 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z MARGARET STEPHENS 3400 WAGNER HEIGHTS ROAD STOCKTON CA 95209 44228617 0 X WWW.OCONNORWOODS.ORG X 1988 CA TO PROVIDE EXCEPTIONAL LIVING AND A NETWORK OF SERVICES FOR SENIORS IN OUR REGION TO SUPPORT AND INSPIRE THE HUMAN SPIRIT BY NURTURING WELL-BEING, INDEPENDENCE AND A SENSE OF COMMUNITY. 11 11 432 11 0 0 5839540 308079 30897267 30272290 2274128 2435188 112188 37990 39123123 33053547 50668 16750 0 0 16649521 16138395 0 0 48483 17753754 18926111 34453943 35081256 4669180 -2027709 92248827 90240253 61373801 60333718 30875026 29906535 X TO PROVIDE EXCEPTIONAL LIVING AND A NETWORK OF SERVICES FOR SENIORS IN OUR REGION TO SUPPORT AND INSPIRE THE HUMAN SPIRIT BY NURTURING WELL-BEING, INDEPENDENCE AND A SENSE OF COMMUNITY. 0 0 12852638 0 10995738 SKILLED NURSING - LICENSED BY THE CALIFORNIA DEPT OF PUBLIC HEALTH AND CERTIFIED BY THE FEDERAL GOVERNMENT FOR PARTICIPATION IN MEDICARE. EXTENSIVE IN-PATIENT AND OUT-PATIENT THERAPIES ARE PROVIDED IN ORDER TO RETURN RESIDENTS TO THEIR HOME OR ALLOW THEM TO BE AS INDEPENDENT AS POSSIBLE. 8668745 8600 10269227 INDEPENDENT LIVING - PROVIDES PHYSICAL, CIVIC, CULTURAL, SOCIAL AND RECREATIONAL ACTIVITIES AND AN OVERALL ENVIRONMENT CONDUCIVE TO DIGNITY AND INDEPENDENCE. SERVICES PROVIDED INCLUDE: HOUSING, MEALS, HOUSEKEEPING, AND VARIOUS WELLNESS, FITNESS, HEALTH, SOCIAL, SPIRITUAL AND RECREATIONAL PROGRAMS AND ACTIVITIES. THE COMMUNITY IS SPECIALLY DESIGNED TO ENHANCE THE OLDER ADULT'S ABILITY TO REMAIN AS INDEPENDENT AS POSSIBLE. 8545693 0 8584142 ASSISTED LIVING - LICENSED BY THE STATE OF CALIFORNIA AS A RESIDENTIAL CARE FACILITY FOR THE ELDERLY, THE ASSISTED LIVING FACILITIES PROVIDE 24 HOUR CARE AND SUPERVISION IN A RESIDENTIAL ENVIRONMENT.MEMORY CARE - LICENSED BY THE STATE OF CALIFORNIA AS A RESIDENTIAL CARE FACILITY FOR THE ELDERLY TO PROVIDE 24 HOUR MEMORY SUPPORT SERVICES FOR THOSE WHO HAVE AGE-RELATED DEMENTIA OR ALZHEIMER'S DISEASES; A-DAY-AWAY - LICENSED BY THE STATE OF CALIFORNIA TO PROVIDE A SAFE, ENGAGING PLACE FOR LOVED ONES FOR A FEW HOURS OR EVEN A FULL DAY. 8150 8150 423183 OTHER PROGRAMS 8150 8150 423183 30075226 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 27 0 1 432 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 0 0 0 CA X DAN SEILER - ESKATON PROPERTIES INC 9163340810 5105 MANZANITA AVENUE CARMICHAEL CA 95608 TOM BOWE CHAIR 1.00 X X 0 0 0 MARGARET STEPHENS VICE CHAIR 1.00 X X 0 0 0 BOB FAY TREASURER 1.00 X X 0 0 0 MARK ORNELLAS SECRETARY 1.00 X X 0 0 0 RUDY CROCE BOARD MEMBER 1.00 X 0 0 0 GREG DOE BOARD MEMBER 1.00 X 0 0 0 KRISTIN FLETCHER BOARD MEMBER 1.00 X 0 0 0 SISTER KATHERINE HAMILTON BOARD MEMBER 1.00 X 0 0 0 JERILYN RATTO BOARD MEMBER 1.00 X 0 0 0 GARY SPAUGH BOARD MEMBER 1.00 X 0 0 0 ANITRA WILLIAMS BOARD MEMBER 1.00 X 0 0 0 PENNY MALLETTE EXECUTIVE DIRECTOR 40.00 X 186000 0 34040 MICHELLE SMITH SNF ADMINISTRATOR 40.00 X 172898 0 10999 TAMMY NGUYEN DIRECTOR OF NURSING 40.00 X 156040 0 9202 RIMPLE SINGH REGISTERED NURSE 40.00 X 104801 0 12876 HECTOR VARGAS CASE MANAGER 40.00 X 103846 0 13210 LEAH ELEMEN LICENSED VOCATIONAL NURSE 40.00 X 104556 0 11240 ALISHA MERCER DIR. OF STAFF DEVELOPMENT 40.00 X 108717 0 6977 936858 0 98544 7 0 1 1 UNIDINE CORPORATION 1000 WASHINGTON STREET SUITE 510 BOSTON MA 02118 DINING SERVICES 2817983 ESKATON PROPERTIES INC 5105 MANZANITA AVENUE CARMICHAEL CA 95608 MANAGEMENT FEES 1994682 DESCOR BUILDERS 3164 GOLD CAMP DRIVE SUITE 250 RANCHO CORDOVA CA 95670 CONSTRUCTION 1824033 THERAPY SPECIALISTS PO BOX 69268 BALTIMORE MD 21264 CONTRACT THERAPY 861351 MILLER & KNESS INC 3500 FOUR SPRINGS DRIVE RESCUE CA 95762 CONSTRUCTION 779840 11 284697 23382 308079 CCRC HOUSING/ASSISTED LIVING 623311 18853369 18853369 CCRC PATIENT SERVICES 623311 10995738 10995738 CCRC ANCILLARY REVENUE 623311 423183 423183 30272290 656962 656962 12953296 11175070 1778226 1778226 1778226 CAFETERIA/FOOD/MEALS 722300 27246 27246 NON-PATIENT ROOM RENTALS 721199 10744 10744 37990 33053547 30272290 0 2473178 16750 16750 403937 403937 12450274 11319630 1087384 43260 78012 75361 2651 2318194 2094665 223350 179 887978 837047 47699 3232 1531527 1530179 1348 233 233 68999 68999 181489 181489 2737949 2341659 396290 157971 1140 156831 814178 535263 278451 464 101754 81404 20350 1866591 1692257 174334 30003 14930 15073 10289 204 10085 1997815 1997815 4883670 4835725 47945 231607 20177 211430 FOOD SERVICES CONTRACTO 2783440 2783440 ANCILLARY COSTS 654893 654893 COVID-19 EXPENSE 348410 348410 BAD DEBT 183939 183939 341354 240517 100837 35081256 30075226 4957547 48483 6223485 4653491 6384199 2986845 1137688 1272637 374500 98600 132680 159633 762564 603416 107223787 59279982 49155117 47943805 26216136 29962585 0 0 1862458 2559241 92248827 90240253 3372365 3034834 2177365 2256756 43275000 42230000 12549071 12812128 61373801 60333718 X 27683824 26368578 3191202 3537957 30875026 29906535 92248827 90240253 X -2027709 1048266 874 10078 X 0 1 X 1 1 1 X 122005 29539 259745 5839540 308079 6558908 32095540 32867187 32779747 30897267 30272290 158912031 10202 5000 15202 32227747 32901726 33039492 36736807 30580369 165486141 1510516 1510516 0 1510516 1510516 163975625 347653 476670 586966 507520 656962 2575771 347653 476670 586966 507520 656962 2575771 211081 179318 157323 112188 37990 697900 32786481 33557714 33783781 37356515 31275321 168759812 0.97170 0.97240 0.01530 0.01360 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CAFETERIA - 2017 AMOUNT: $ 162,735. 2018 AMOUNT: $ 122,831. 2019 AMOUNT: $ 105,263. 2020 AMOUNT: $ 43,366. 2021 AMOUNT: $ 27,246. NON-PATIENT ROOM RENTAL - 2017 AMOUNT: $ 48,346. 2018 AMOUNT: $ 56,487. 2019 AMOUNT: $ 52,060. 2020 AMOUNT: $ 13,812. 2021 AMOUNT: $ 10,744. MISCELLANEOUS REVENUE - 2020 AMOUNT: $ 55,010. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2893923 3616 367306 8600 3256245 1228385 1564672 147634 46768 2893923 915260 230939 128638 46452 1228385 925973 9936 -20649 915260 0.00000 1.00000 0.00000 0 0 4325171 4325171 87508091 48364085 39144006 3833544 2499444 1334100 10368193 8416453 1951740 1188788 1188788 47943805 UNAMORTIZED BOND PREMIUM 1809214 REFUNDABLE CCRC ENTRANCE FEES 10075259 CHARITABLE TRUST LIABILITY 27469 DEPOSITS 900186 12812128 33939002 1048266 18678 1066944 32872058 181489 181489 33053547 34662390 0 34662390 181489 237377 418866 35081256 PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO PROVIDE RESIDENT ASSISTANCE. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHARITABLE ANNUITY TRUST VALUATION ADJUSTMENT 10,078. RESIDENT ASSISTANCE 8,600. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 183,939. GRANTS EXPENSE AND GRANT RELATED EXPENSES 53,438. 1 RESIDENT ASSISTANCE 1 8600 SCHOLARSHIPS 9 7550 CARING CLUB 1 600 PART I, LINE 2: RESIDENT ASSISTANCE IS APPLIED DIRECTLY TO THE RESIDENT ACCOUNT. NO FORMAL MONITORING IS REQUIRED. 0 0 0 0 0 0 0 1 0 PENNY MALLETTE EXECUTIVE DIRECTOR 186000 0 0 0 0 0 4338 0 29702 0 220040 0 0 0 MICHELLE SMITH SNF ADMINISTRATOR 156473 0 16425 0 0 0 3340 0 7659 0 183897 0 0 0 TAMMY NGUYEN DIRECTOR OF NURSING 153615 0 2425 0 0 0 1571 0 7631 0 165242 0 0 0 PART I, LINE 7 MICHELLE SMITH, TAMMY NGUYEN, ALISHA MERCER, RIMPLE SINGH, LEAH ELEMEN, AND HECTOR VARGAS, RECEIVED EXTRA DUTY AND/OR YEAR-END PERFORMANCE BONUSES IN 2021. SCHEDULE J, PART II: PENNY MALLETTE SERVED IN THE EXECUTIVE DIRECTOR POSITION FOR THE ORGANIZATION FOR THE TAX YEAR. PENNY MALLETTE WAS PAID BY AN UNRELATED ORGANIZATION, ESKATON PROPERTIES, INC. (EPI), WHICH HAS A MANAGEMENT SERVICES CONTRACT IN PLACE. PENNY MALLETTE'S COMPENSATION WAS 100% REIMBURSED BY THE FILING ORGANIZATION TO EPI. PENNY MALLETTE'S COMPENSATION PAID DIRECTLY BY THE FILING ORGANIZATION AND REIMBURSED TO EPI FOR SERVICE IN THE EXECUTIVE DIRECTOR POSITION IS REPORTED IN SCHEDULE J, PART II. A ABAG FINANCE AUTHORITY FOR NONPROFIT CORPORATIONS 943130123 00037CVC1 2013-06-12 52495809 TO REFUND PRIOR ISSUES, AND FOR NEW CONSTRUCTION 0 0 0 A 6885000 52619715 3204226 600399 2946720 10525075 35208506 1409 2016 1 1 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 1 0 0 0 0 1 A 1 PART II, LINE 3: THE DIFFERENCE BETWEEN PART II, LINE 3 AND ISSUE PRICE IN PART I IS DUE TO INVESTMENT INCOME. FORM 990, PART VI, SECTION A, LINE 3 ESKATON PROPERTIES, INC. IS THE MANAGEMENT AGENT FOR O'CONNOR WOODS. FORM 990, PART VI, SECTION B, LINE 11B DATA TO PREPARE THE FORM 990 IS GATHERED BY THE MANAGEMENT AGENT. A DRAFT IS PREPARED BY A PROFESSIONAL ACCOUNTING FIRM AND IS REVIEWED BY THE MANAGEMENT AGENT CFO, THEN BY THE BOARD CHAIR AND AUDIT COMMITTEE. THE FINAL RETURN IS REVIEWED AND SIGNED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS, OFFICERS, AND CERTAIN KEY MANAGEMENT EMPLOYEES. COVERED PERSONS MUST COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON THE OCCURRENCE OF AN EVENT WHERE THE INDIVIDUAL IS COVERED BY THE POLICY AND ANNUALLY, THEREAFTER. COVERED PERSONS HAVE A DUTY TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST THAT ARISE BETWEEN DISCLOSURES. THE COVERED PERSON MAY, WITH THE APPROVAL OF THE BOARD CHAIR, PARTICIPATE IN DISCUSSIONS REGARDING THE AFFECTED BUSINESS TRANSACTION, SO LONG AS THEY ARE EXCUSED FROM THE MEETING PRIOR TO COMPLETION OF THE DISCUSSION, AND DO NOT RETURN UNTIL DISCUSSION AND VOTING ON THE MATTER HAVE BEEN CONCLUDED. THE BOARD WILL MAKE DETERMINATIONS AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND MUST AUTHORIZE THE TRANSACTION IN GOOD FAITH BY A MAJORITY VOTE OF THE DIRECTORS WITHOUT COUNTING THE VOTE OF THE COVERED PERSON WITH A CONFLICT. 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: CHARITABLE ANNUITY TRUST VALUATION ADJUSTMENT 10,078. CHARITABLE REMAINDER UNITRUST (1) INVESTMENT CA O'CONNOR WOODS HOUSING CORPORATION T 1 CHARITABLE REMAINDER ANNUITY TRUST (4) INVESTMENT CA O'CONNOR WOODS HOUSING CORPORATION T 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0