2020-11-16T17:47:24-06:00 2019-12-31 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2019-01-01 680201024 O'CONNOR WOODS HOUSING CORPORATION OCON 2094676500 3400 WAGNER HEIGHTS ROAD STOCKTON CA 95209 GARY SPAUGH BOARD CHAIR 2094676500 2020-11-13 1 TRACY S PAGLIA P00366884 2099556100 2020-11-13 172.9.161.112 2020-11-13 17:48:43 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2019 2021-01-29 14:40:06Z GARY SPAUGH 3400 WAGNER HEIGHTS ROAD STOCKTON CA 95209 46202478 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 11 475 41 0 0 29539 259745 32867187 32779747 1073346 743383 179319 157323 34149391 33940198 0 46452 0 0 15550189 16356753 0 0 55022 17274802 18240251 32824991 34643456 1324400 -703258 83470943 87271861 60343157 62133296 23127786 25138565 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 13367716 0 12976079 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. 8225917 13634 10220291 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. 8001955 32818 8774559 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. 0 0 808818 ANCILLARY FACILITIES ENHANCE A SENSE OF COMMUNITY BY PROVIDING ENRICHMENT ACTIVITIES AND SUPPORT SERVICES FOR RESIDENTS. AMENITIES INCLUDE PRIVATE DINING AND ACTIVITY ROOMS, A CHAPEL, NATURE PATHS, A MULTI-PURPOSE HEALTH CLUB, SWIMMING POOL AND SPA, A GREENHOUSE, WOOD-WORKING AND CERAMIC ACTIVITIES, BEAUTY AND BARBER SHOPS, ON-PREMISES BANKING, A LIBRARY, A HEALTH CLINIC, AND TRANSPORTATION AND EMERGENCY RESPONSE SERVICES. 0 0 808818 29595588 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 54 0 1 475 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 PENNY MALLETTE - EXECUTIVE DIR INTERIM EXEC DIR/ASSISTANT EXEC DIR 40.00 X 172500 0 16814 MICHELLE SMITH SNF ADMINISTRATOR 40.00 X 154174 0 10737 TAMMY NGUYEN COORD OF RESIDENT ASSESSMENT 40.00 X 123693 0 9260 GEMMA CARINO REGISTERED NURSE 40.00 X 111907 0 11472 LIZZETTE EASTER DIRECTOR OF NURSING 40.00 X 106194 0 1815 ALISHA MERCER DIRECTOR OF STAFF DEVELOPMENT 40.00 X 103615 0 1247 RAY FITCHETTE EXECUTIVE DIRECTOR 40.00 X 63964 0 3734 GARY SPAUGH CHAIR 1.00 X X 0 0 0 TOM BOWE VICE CHAIR 1.00 X X 0 0 0 JOE SERRA SECRETARY 1.00 X X 0 0 0 BOB FAY TREASURER 1.00 X X 0 0 0 JOHN BERNADICOU BOARD MEMBER 1.00 X 0 0 0 GREG DOE BOARD MEMBER 1.00 X 0 0 0 SISTER KATHERINE HAMILTON BOARD MEMBER 1.00 X 0 0 0 LOU MEYER BOARD MEMBER 1.00 X 0 0 0 MARK ORNELLAS BOARD MEMBER 1.00 X 0 0 0 JERILYN RATTO BOARD MEMBER 1.00 X 0 0 0 MARGARET STEPHENS BOARD MEMBER 1.00 X 0 0 0 836047 0 55079 6 0 1 1 UNIDINE CORPORATION 1000 WASHINGTON STREET SUITE 510 BOSTON MA 02118 DINING SERVICES 3056666 ESKATON PROPERTIES INC 5105 MANZANITA AVENUE CARMICHAEL CA 95608 MANAGEMENT FEES 1981376 THERAPY SPECIALISTS 3760 CONVOY STREET SUITE 204 SAN DIEGO CA 92111 CONTRACT THERAPY 1273426 A TO Z CONSTRUCTION 7405 GREENBACK LANE 198 CITRUS HEIGHTS CA 95610 CONSTRUCTION 718687 LEGACY MECHANICAL & ENERGY SERVICES INC 3130 CROW CANYON PLACE SUITE 410 SAN RAMON CA 94583 REPAIR AND MAINTENANCE 287198 12 259745 259745 CCRC HOUSING/ASSISTED LIVING 623311 18994850 18994850 CCRC PATIENT SERVICES 623311 12976079 12976079 CCRC ANCILLARY REVENUE 623311 808818 808818 32779747 586966 586966 12418697 12262280 156417 156417 156417 CAFETERIA/FOOD/MEALS 722300 105263 105263 NON-PATIENT ROOM RENTALS 721199 52060 52060 157323 33940198 32779747 0 900706 46452 46452 421923 421923 12387365 11497835 889530 80816 75983 4833 2489897 2269563 220334 976752 905207 71545 1645255 1645255 75163 75163 58697 58697 114734 114734 2997616 2678938 317538 1140 140688 10484 130204 944427 568181 374479 1767 60006 48005 12001 1730765 1602988 127777 54849 21689 33160 13478 2787 10691 2065121 2065121 4088919 4044748 44171 259977 17793 242184 FOOD SERVICES CONTRACTO 2703126 2703126 ANCILLARY COSTS 772072 772072 BAD DEBT 143494 143494 371864 121122 198627 52115 34643456 29595588 4992846 55022 3841689 6071867 3911589 4782145 1761795 1668021 0 731500 0 27679 376356 624974 100359879 50647064 51330401 49712815 18965501 21626250 3283612 2026610 83470943 87271861 3566090 3753283 1431926 1937397 45225000 44270000 10120141 12172616 60343157 62133296 X 21934713 23595151 1193073 1543414 23127786 25138565 83470943 87271861 X -703258 2647367 45629 21041 X 0 1 X 1 0 X 524093 138559 122005 29539 259745 1073941 29984311 30919286 32095540 32867187 32779747 158646071 23750 10202 5000 38952 30532154 31057845 32227747 32901726 33039492 159758964 0 0 0 159758964 389974 385852 347653 476670 586966 2187115 389974 385852 347653 476670 586966 2187115 179728 184849 211081 179318 157323 912299 31101856 31628546 32786481 33557714 33783781 162858378 0.98100 0.98180 0.01340 0.01210 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: CAFETERIA - 2015 AMOUNT: $ 141,118. 2016 AMOUNT: $ 139,362. 2017 AMOUNT: $ 162,735. 2018 AMOUNT: $ 122,831. 2019 AMOUNT: $ 105,263. NON-PATIENT ROOM RENTAL - 2015 AMOUNT: $ 38,610. 2016 AMOUNT: $ 45,487. 2017 AMOUNT: $ 48,346. 2018 AMOUNT: $ 56,487. 2019 AMOUNT: $ 52,060. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 915260 230939 128638 46452 1228385 925973 9936 -20649 915260 0.00000 1.00000 0.00000 0 0 4325171 4325171 80324122 40870143 39453979 3530961 2232521 1298440 9620939 7544400 2076539 2558686 2558686 49712815 UNAMORTIZED BOND PREMIUM 2075528 REFUNDABLE CCRC ENTRANCE FEES 9144697 CHARITABLE TRUST LIABILITY 31071 DEPOSITS 921320 12172616 36350378 2647367 2647367 33703011 114734 122453 237187 33940198 34338776 0 34338776 114734 189946 304680 34643456 PART V, LINE 4: ENDOWMENT FUNDS ARE USED TO PROVIDE RESIDENT ASSISTANCE. PART XI, LINE 4B - OTHER ADJUSTMENTS: CHARITABLE ANNUITY TRUST VALUATION ADJUSTMENT -21,041. PROVISION FOR UNCOLLECTIBLE ACCOUNTS 143,494. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR UNCOLLECTIBLE ACCOUNTS 143,494. GRANT EXPENSES 46,452. 1 RESIDENT ASSISTANCE 2 46452 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 DIR INTERIM EXEC DIR/ASSISTANT EXEC DIR 172500 0 0 0 0 0 2026 0 14788 0 189314 0 0 0 MICHELLE SMITH SNF ADMINISTRATOR 153674 0 500 0 0 0 2389 0 8348 0 164911 0 0 0 RAY FITCHETTE EXECUTIVE DIRECTOR 63964 0 0 0 0 0 0 0 3734 0 67698 0 0 0 PART I, LINE 7 GEMMA CARINO, TAMMY NGUYEN, AND ALISHA MERCER RECEIVED EXTRA DUTY BONUSES FOR SERVING IN INTERIM POSITIONS IN 2019. SCHEDULE J, PART II: RAY FITCHETTE AND PENNY MALLETTE SERVED IN THE EXECUTIVE DIRECTOR POSITION FOR THE ORGANIZATION FOR PORTIONS OF THE TAX YEAR. RAY FITCHETTE WAS PAID BY AN UNRELATED ORGANIZATION, ESKATON PROPERTIES, INC. (EPI), WHICH HAS A MANAGEMENT SERVICES CONTRACT IN PLACE. RAY FITCHETTE'S COMPENSATION WAS 100% REIMBURSED BY THE FILING ORGANIZATION TO EPI. PENNY MALLETTE'S COMPENSATION WAS PAID BY THE FILING ORGANIZATION FOR A PORTION OF THE TAX YEAR FOR SERVING IN THE ASSISTANT EXECUTIVE DIRECTOR ROLE AND 100% REIMBURSED BY THE FILING ORGANIZATION TO EPI FOR A PORTION OF THE YEAR FOR SERVING IN THE EXECUTIVE DIRECTOR ROLE. PENNY MALLETTE'S EMPLOYMENT SHIFTED TO EPI UPON ASSUMPTION OF THE EXECUTIVE DIRECTOR ROLE. ALL COMPENSATION FOR BOTH INDIVIDUALS 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 REFUND PRIOR ISSUES AND NEW CONSTRUCTIONS 0 0 0 A 4845000 52619715 3367207 600399 10254997 2946720 10525075 24963509 1409 2016 0 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 AVAILABLE UPON REQUEST FORM 990, PART XI, LINE 9: CHARITABLE ANNUITY TRUST VALUATION ADJUSTMENT 21,041. CHARITABLE REMAINDER UNITRUST (1) INVESTMENT CA O'CONNOR WOODS HOUSING CORPORATION T 1 CHARITABLE REMAINDER ANNUITY TRUST (5) 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