2021-11-15T16:25:40-06:00 2020-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2020-01-01 941635654 ROSS VALLEY HOMES INC ROSS 4152027800 501 VIA CASITAS GREENBRAE CA 94904 CHARLIE SHOEMAKE CFO 4152027800 2021-11-12 1 CHARLIE SHOEMAKE XXX-XX-XXXX LESLIE VAN P01294411 4159561500 2021-11-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z X SARA MCVEY 1525 POST STREET SAN FRANCISCO CA 94109 11196745 0 X WWW.SEQUOIALIVING.ORG X 1965 CA RVH PROVIDES ORGANIZATIONAL STRUCTURE AND LEADERSHIP TO MEET THE NEEDS AND IMPROVE THE QUALITY OF LIFE OF OLDER PERSONS BY OFFERING HOUSING AND PROGRAMS. X 13 13 210 11 0 0 322482 147827 27225027 10994317 0 0 57218 54601 27604727 11196745 0 0 0 0 15257492 6600738 0 0 0 13388195 4835243 28645687 11435981 -1040960 -239236 37849477 0 42590680 0 -4741203 0 X ROSS VALLEY HOMES WILL, WITHIN ITS HUMAN RESOURCES AND FINANCIAL CAPABILITIES, PROVIDE ORGANIZATIONAL STRUCTURE AND LEADERSHIP TO MEET THE NEEDS AND IMPROVE THE QUALITY OF LIFE OF OLDER PERSONS FROM ALL ECONOMIC LEVELS AND VARIED CULTURAL BACKGROUNDS THROUGH DIVERSIFIED OPERATIONS, WHICH OFFER HOUSING AND PROGRAMS OF PHYSICAL, SOCIAL, HEALTH, AND SPIRITUAL CARE. 0 0 10204570 10994317 ROSS VALLEY HOMES IS A CONTINUING CARE RETIREMENT COMMUNITY THAT PROVIDES HOUSING, HEALTH CARE, AND OTHER SERVICES TO APPROXIMATELY 306 RESIDENTS. MOST OF THE RESIDENTS HAVE EXECUTED LIFE CARE RESIDENCE AND CARE AGREEMENTS THAT GIVE THEM ACCESS TO ASSISTED LIVING, DEMENTIA CARE, AND SKILLED NURSING, IF NEEDED. 10204570 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 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 1 0 0 1 1 1 0 0 1 35 0 1 210 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X CHARLIE SHOEMAKE 4152027800 1525 POST STREET SAN FRANCISCO CA 94109 MICHELE STRATTON CHAIR 0.10 0.90 X X 0 0 0 GARY FREEMAN BOARD MEMBER 0.10 0.90 X 0 0 0 GAYLE S GEARY BOARD MEMBER 0.10 0.90 X 0 0 0 STEVEN H HERMAN BOARD MEMBER 0.10 0.90 X 0 0 0 DIANNE J SPAULDING VICE CHAIR 0.20 0.80 X X 0 0 0 DAVID JAMISON BOARD MEMBER 0.10 0.90 X 0 0 0 REX JAMISON MD BOARD MEMBER 0.10 0.90 X 0 0 0 PATRICIA LYNN BOARD MEMBER 0.10 0.90 X 0 0 0 NANCY HIROKO MAYEDA BOARD MEMBER 0.20 0.80 X 0 0 0 NEAL MCNAMARA BOARD MEMBER 0.10 0.90 X 0 0 0 PHILIP R PLACIER BOARD MEMBER 0.20 0.80 X 0 0 0 MARIANNE LIM BOARD MEMBER 0.10 0.90 X 0 0 0 GORDON HOWIE BOARD MEMBER 0.10 0.90 X 0 0 0 SARA MCVEY CEO 0.50 39.50 X 0 464650 12621 NAN BOYD CFO (THRU 8/20) 1.00 39.00 X 0 315268 20819 CHARLES SHOEMAKE CFO 1.00 39.00 X 0 66436 5747 MARTHA ATWOOD VP OF HR & COMPLIANCE 3.00 37.00 X 0 242172 40649 DAVID LATINA VP OF BUSINESS DEVELOPMENT 3.00 37.00 X 0 274700 30759 STEVEN HIEGER VP OF INFORMATION SYSTEMS 3.00 37.00 X 0 224189 26101 0 1587415 136696 65 0 1 0 MORRISON MANAGEMENT SPECIALISTS PO BOX 102289 ATLANTA GA 30368 MANAGEMENT SERVICES 2039439 PINNACLE BUILDING & DESIGN- SPV 5055 BUSINESS CENTER DRIVE SUITE 1 FAIRFIELD CA 94535 BUILDING & DESIGN 992063 ORYX CAPITAL PARTNERS LP 1796 18TH STREET SUITE C SAN FRANCISCO CA 94107 CONSTRUCTION 960994 C J REED CONSTRUCTION 1658 SEQUOIA DRIVE PETALUMA CA 94954 CONSTRUCTION 862869 ONR INC 8500 BLUFFSTONE COVE SUITE A201 AUSTIN TX 78759 THERAPY SERVICES 862825 63 135227 12600 147827 MONTHLY CARE FEES 623000 7719068 7719068 AMORTIZATION OF ENTRANCE FEES 623000 2235815 2235815 FEES FOR SERVICE TO RESIDENTS 900099 1039434 1039434 10994317 OTHER INCOME 900099 54601 54601 54601 11196745 10994317 0 54601 102075 102075 4881181 4519635 361546 228205 199527 28678 1026399 957492 68907 362878 336036 26842 224294 224294 22683 22683 57080 57080 573374 569801 3573 49306 42219 7087 486003 385264 100739 123695 72865 50830 377047 335726 41321 7708 6791 917 3929 3780 149 336960 336960 1325227 1325227 131975 7364 124611 FOOD 507366 507366 REPAIRS AND MAINTENANCE 379902 370596 9306 OTHER TAXES AND LICENSE 32637 3643 28994 PUBLIC RELATIONS 26536 2136 24400 169521 120067 49454 11435981 10204570 1231411 0 0 7097222 0 0 989998 0 0 0 0 0 93038 0 0 0 29669219 0 0 0 0 0 0 37849477 0 1007442 0 36973128 0 4610110 0 42590680 0 X -4741203 0 -4741203 0 37849477 0 X -239236 4980439 X 0 1 X 1 0 X 237613 279333 279013 322482 147827 1266268 24145161 24222234 25743818 27225027 11068951 112405191 24382774 24501567 26022831 27547509 11216778 113671459 237613 279333 279013 322482 147827 1266268 0 237613 279333 279013 322482 147827 1266268 112405191 51536 31259 -34323 57218 54601 160291 24434310 24532826 25988508 27604727 11271379 113831750 0.98750 0.99010 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 51,536. 2017 AMOUNT: $ 31,259. 2018 AMOUNT: $ -34,323. 2019 AMOUNT: $ 57,218. 2020 AMOUNT: $ 54,601. SCHEDULE A, PART III, LINE 13, EXPLANATION FOR SHORT YEAR: ROSS VALLEY HOMES, INC. IS REPORTING A SHORT YEAR, FINAL TAX RETURN FOR THE 2020 TAX YEAR. THE ENTITY MERGED WITH SEQUOIA LIVING, INC. (EIN: 94-1437728) ON MAY 31, 2020 AND TRANSFERRED ALL OF ITS ASSETS AND LIABILITIES TO THAT ENTITY ACCORDINGLY. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 0 0 0 0 0 0 0 0 SARA MCVEY CEO 0 463510 0 0 0 1140 0 2932 0 9689 0 477271 0 0 NAN BOYD CFO (THRU 8/20) 0 214904 0 0 0 100364 0 5763 0 15056 0 336087 0 0 DAVID LATINA VP OF BUSINESS DEVELOPMENT 0 247867 0 22378 0 4455 0 6625 0 24134 0 305459 0 0 MARTHA ATWOOD VP OF HR & COMPLIANCE 0 235480 0 499 0 6193 0 6169 0 34480 0 282821 0 0 STEVEN HIEGER VP OF INFORMATION SYSTEMS 0 212823 0 0 0 11366 0 5885 0 20216 0 250290 0 0 PART I, LINE 3 ROSS VALLEY HOMES DOES NOT COMPENSATE ANY DIRECTOR, OFFICER, OR EMPLOYEE. COMPENSATION IS PROVIDED BY A RELATED ORGANIZATION. IN DETERMINING THE COMPENSATION OF THE CEO, THE RELATED ORGANIZATION USES SEVERAL METHODS INCLUDING REVIEW BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, INDEPENDENT CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD. PART I, LINE 4A NAN BOYD RECEIVED A SEVERANCE PAYMENT DURING THE YEAR OF $92,837. NET ASSET TRANSFER OF RVH INTERESTS TO SEQUOIA LIVING, INC. 2020-05-31 -4980439 END OF YEAR VALUE 941437728 SEQUOIA LIVING INC 1525 POST STREET SAN FRANCISCO CA 94109 501(C)(3) 0 1 0 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: WESLEY BARD, RVH EXECUTIVE DIRECTOR IS STILL THE EXECUTIVE DIRECTOR AFTER MERGER. FORM 990, PART VI, SECTION A, LINE 6 SEQUOIA LIVING, INC., A CALIFORNIA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF ROSS VALLEY HOMES, INC. FORM 990, PART VI, SECTION A, LINE 7A SEQUOIA LIVING, INC. HAS THE RIGHT TO APPOINT AND REMOVE A MAJORITY OF DIRECTORS OF ROSS VALLEY HOMES, INC. BOARD. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS OF ROSS VALLEY HOMES, INC. SHALL NOT BE IMPLEMENTED WITHOUT THE APPROVAL OF THE CORPORATE MEMBER: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (C) APPROVAL OF AGGREGATE OPERATING AND CAPITAL BUDGETS; (D) AGGREGATE BORROWING FOR PERIODS OF ONE (1) YEAR OR LESS FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME; AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE (1) YEAR FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME. (E) PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; (F) APPOINTMENT OF THE INDEPENDENT AUDITOR AND CORPORATE COUNSEL; (G) APPOINTMENT OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER; (H) ADOPTION OF ORGANIZATIONAL STRATEGIC PLANS, CORPORATE OBJECTIVES AND PROGRAMS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY MOSS ADAMS LLP, BASED ON THE INFORMATION PROVIDED BY THE ORGANIZATION'S STAFF. PRIOR TO FILING, THE FORM 990 IS DISTRIBUTED TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND REVIEWED BY THE AUDIT & COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. ONCE THE FORM 990 IS APPROVED BY THE COMMITTEE, MOSS ADAMS LLP SIGNS AS PREPARER AND THE CHIEF FINANCIAL OFFICER SIGNS ON BEHALF OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 12C ROSS VALLEY HOMES, INC. ANNUALLY REVIEWS ANY CONFLICTS DISCLOSED BY ITS BOARD MEMBERS. ANY QUESTIONS THAT ARISE REGARDING POTENTIAL CONFLICTS ARE ADDRESSED IMMEDIATELY. BOARD MEMBERS WHO HAVE A CONFLICT OF INTEREST DO NOT VOTE ON ANY MATTER RELATED TO THE ISSUE FOR WHICH THEY HAVE THE CONFLICT. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND THE FORM 990 ARE MADE AVAILABLE TO THE PUBLIC UPON RQEUEST. THE FINANCIAL STATEMENTS AND FORM 990 ARE ALSO AVAILABLE THROUGH THE SEQUOIA LIVING, INC'S WEBSITE. FORM 990, PART XI, LINE 9: TRANSFER OF NET ASSETS TO SEQUOIA LIVING, INC. 4,980,439. SENIOR SERVICES FOR NORTHERN CALIFORNIA 1525 POST STREET SAN FRANCISCO CA 94109 946615829 SUPPORT SEQUOIA LIVING CA 501(C)(3) LINE 12A, I SEQUOIA LIVING INC 1 SL COMMUNITY SERVICES 1525 POST STREET SAN FRANCISCO CA 94109 452355370 COMMUNITY SERVICE CA 501(C)(3) LINE 12A, I SEQUOIA LIVING INC 1 SAN FRANCISCO SENIOR CENTER 890 BEACH STREET SAN FRANCISCO CA 94109 941212136 COMMUNITY SERVICE CA 501(C)(3) LINE 7 SEQUOIA LIVING INC 1 VIAMONTE SENIOR LIVING 1 INC 1525 POST STREET SAN FRANCISCO CA 94109 812951897 ELDERLY CARE CA 501(C)(3) LINE 10 SEQUOIA LIVING INC 1 SEQUOIA LIVING INC 1525 POST STREET SAN FRANCISCO CA 94109 941437728 ELDERLY CARE CA 501(C)(3) LINE 10 N/A 0 SL SENIOR VENTURES LLC 1525 POST STREET SAN FRANCISCO CA 94109 261847720 PROPERTY MGMT CA N/A C 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 SENIOR SERVICES FOR NORTHERN CALIFORNIA C 135227 FMV