CHISAGO COUNTY LIFE CARE CENTER: Form 990EZ, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- CHISAGO COUNTY LIFE CARE CENTER (EIN 41-1921727)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-07-30
- IRS object ID
- 202022129349200407
- Schema version
- 2019v5.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-30T10:59:20-04:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 411921727 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHISAGO COUNTY LIFE CARE CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Ann Olson | InCareOfNm |
| Business Name Control | CHIS | BusinessNameControlTxt |
| Phone | 6516742121 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 516 | AddressLine1Txt |
| City | North Branch | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55056 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Betty Mitchell | PersonNm |
| Person Title | Secretary Treasurer | PersonTitleTxt |
| Phone | 6516742121 | PhoneNum |
| Signature | 2020-07-30 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 75.168.194.30 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-30 | IPDt |
| IP Timezone | ES | IPTimezoneCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Website Address | www.chisagolifecare.org | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $126,006 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $125,973 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $33 | InvestmentIncomeAmt |
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $4,569 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | -$4,569 | SpecialEventsNetIncomeLossAmt |
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
| Gross Profit Loss Sls Of Invntry | $0 | GrossProfitLossSlsOfInvntryAmt |
| Total Revenue | $121,437 | TotalRevenueAmt |
| Salaries Other Comp Empl Bnft | $73,581 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $8,000 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $7,626 | OccupancyRentUtltsAndMaintAmt |
| Printing Publications Postage | $719 | PrintingPublicationsPostageAmt |
| Other Expenses Total | $23,464 | OtherExpensesTotalAmt |
| Total Expenses | $113,390 | TotalExpensesAmt |
| Excess Or Deficit For Year | $8,047 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $77,736 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $85,783 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,449 | BOYAmt |
| EOY | $45,679 | EOYAmt |
Land And Buildings LandAndBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,937 | BOYAmt |
| EOY | $85,910 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,094 | BOYAmt |
| EOY | $6,664 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,480 | BOYAmt |
| EOY | $138,253 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,744 | BOYAmt |
| EOY | $52,470 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,736 | BOYAmt |
| EOY | $85,783 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Exempt Purpose | Support and Education Resource Center | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (3 entries)
| Description Program Srvc AccomDescriptionProgramSrvcAccomTxt | Grants And AllocationsGrantsAndAllocationsAmt | Program 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 STIs & healthy reproductive and sexual decision-making. | $0 | $31,695 |
| Social service (Baby Boutique) & community program referrals: Provide intake assessments to determine need. Provide practical & material assistance such as clothing, diapers and baby equipment. Utilize resource database to provide information and referrals | $0 | $20,867 |
| 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 | $35,936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $88,498 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (9 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| Ann Olson | ||||
| President | 4 | $0 | $0 | $0 |
| Jackie Scheldorf | ||||
| Vice President | 2 | $0 | $0 | $0 |
| Betty Mitchell | ||||
| Secretary Treasurer | 20 | $0 | $0 | $0 |
| Scott Johnson | ||||
| Executive Director Sept through Dec | 30 | $33,660 | $0 | $0 |
| Leah Lackas | ||||
| Board Director | 0.5 | $0 | $0 | $0 |
| Daniel Gnau | ||||
| Board Director | 0.2 | $0 | $0 | $0 |
| Angie Gnau | ||||
| Board Director | 0.2 | $0 | $0 | $0 |
| Rachel Hosch | ||||
| Client Advocate | 20 | $16,784 | $0 | $0 |
| Sandra Blake | ||||
| Client Advocate Asst | 20 | $13,373 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | false | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | false | OrganizationHadUBIInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Form1120 Pol Filed | false | Form1120PolFiledInd |
| Made Loans To From Officers | false | MadeLoansToFromOfficersInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Betty Mitchell | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6344 Elm St | AddressLine1Txt |
| City | North Branch | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55056 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6516742121 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Foreign Office | false | ForeignOfficeInd |
| Donor Advised Fnds | false | DonorAdvisedFndsInd |
| Operate Hospital | false | OperateHospitalInd |
| Tanning Services Provided | false | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| School Operating | false | SchoolOperatingInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (true) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,596 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,727 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $120,730 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $125,973 | CurrentTaxYearAmt |
| Total | $420,026 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $48,596 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,727 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $120,730 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $125,973 | CurrentTaxYearAmt |
| Total | $420,026 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $420,026 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $601 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $601 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $601 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $601 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $20 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $49,197 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,747 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $120,730 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $125,973 | CurrentTaxYearAmt |
| Total | $420,647 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99852 | PublicSupportCY509Pct |
| Public Support PY509 | 0.9979 | PublicSupportPY509Pct |
| Investment Income CY | 0.00143 | InvestmentIncomeCYPct |
| Investment Income PY | 0.002 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Annual Banquet | Event1Nm |
| Gross Receipts Event1 | $15,165 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,165 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $0 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $0 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $1,603 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $50 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,701 | OtherDirectExpensesEvent1Amt |
| Event2 | Baby Bottle Coin Fundraiser | Event2Nm |
| Gross Receipts Event2 | $5,066 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $5,066 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $0 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $0 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $0 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $0 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $0 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $0 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $0 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $20,231 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $20,231 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $0 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $0 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $0 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $0 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $1,603 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $50 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,701 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $3,354 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$3,354 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Doing Business As Names | Options for Women of Chisago County |
| Part I, line 16 | | Other Expenses:, Amount:| Client services, $2599.00| Meals for meetings, $38.00| Office and General Administrative Expenses, $5405.00| Outreach expenses, $7430.00| Officer & Director Insurance, $1004.00| Workers Comp Insurance, $390.00| MDH Training Cost Mileage, $120.00| Miscellaneous Expense, $198.00| Depreciation, $1027.00| Building Miscellaneous, $574.00| Mortgage Interest, $3125.00| Property Insurance, $1544.00| Property Taxes, $10.00| |
| Part II, line 24 | | Asset Name:, BOY Amount:, EOY Amount:| Grant Receivable, $11094, $5891| Miscellaneous Receivable, 0, $773| |
| Part II, line 26 | | Liabilities Name:, BOY Amount:, EOY Amount:| Payroll Taxes Payable, $1291, $904| TLC Loan Payable, $3000, 0| Accounts Payable, $236, $74| Mortgages or other loans payable, $55217, $51492| |
| Part IV, List of Officers | | Employee Name:, Description:| Scott Johnson, Wages| Rachel Hosch, Wages| Sandra Blake, Wages| |
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