GENESIS HOUSE INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- GENESIS HOUSE INC (EIN 23-7297769)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-15
- IRS object ID
- 201911359349313396
- Schema version
- 2017v2.3
- 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 | 2019-05-15T18:44:29-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PATRICIA A WINTROATH CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2121 N CALIFORNIA BLVD SUITE 290 | AddressLine1Txt |
| City | WALNUT CREEK | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94596 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237297769 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GENESIS HOUSE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GENE | BusinessNameControlTxt |
| Phone | 7075525295 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVENUE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KESTER MCDONALD | PersonNm |
| Person Title | EXECUTIVE DIRECTOR/TREASURER | PersonTitleTxt |
| Phone | 7075525295 | PhoneNum |
| Signature | 2019-05-10 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PATRICIA A WINTROATH | PreparerPersonNm |
| PTIN | P00430440 | PTIN |
| Phone | 9259743310 | PhoneNum |
| Preparation | 2019-05-09 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.158.112.235 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-10 | IPDt |
| IP Tm | 12:42:30 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BC3104B43996F09987B2B6CBBEB15F1650D92628 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BC3104B43996F09987B2B6CBBEB15F1650D92628 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2020-01-14 16:20:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KESTER MCDONALD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVENUE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $777,934 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE IN-PATIENT ALCOHOL AND DRUG TREATMENT PROGRAMS, RELATED COUNSELING AND SUPPORT SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 17 | TotalEmployeeCnt |
| Total Volunteers | 30 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $279,323 | PYContributionsGrantsAmt |
| CY Contributions Grants | $368,645 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $178,045 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $201,750 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2 | PYInvestmentIncomeAmt |
| CY Investment Income | $21 | CYInvestmentIncomeAmt |
| PY Other Revenue | $131,661 | PYOtherRevenueAmt |
| CY Other Revenue | $126,756 | CYOtherRevenueAmt |
| PY Total Revenue | $589,031 | PYTotalRevenueAmt |
| CY Total Revenue | $697,172 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $445,134 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $409,403 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $22,819 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $211,184 | PYOtherExpensesAmt |
| CY Other Expenses | $216,838 | CYOtherExpensesAmt |
| PY Total Expenses | $656,318 | PYTotalExpensesAmt |
| CY Total Expenses | $626,241 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$67,287 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $70,931 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $580,295 | TotalAssetsBOYAmt |
| Total Assets EOY | $627,566 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $254,334 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $230,674 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $325,961 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $396,892 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE IN-PATIENT ALCOHOL AND DRUG TREATMENT PROGRAMS, RELATED COUNSELING AND SUPPORT SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $519,710 | ExpenseAmt |
| Revenue | $208,053 | RevenueAmt |
| Desc | LONG TERM RESIDENTIAL DRUG AND ALCOHOL TREATMENT AND REHABILITATION SERVICES - OVER 7,500 PATIENT DAYS | Desc |
| Total Program Service Expenses | $519,710 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 17 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARISSA AVEYTIA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7075525295 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1149 WARREN AVE | AddressLine1Txt |
| City | VALLEJO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94591 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| JIMMY SMITH | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| CLARISSA AVEYTIA | ||||||
| VICE PRESIDENT | 40.00 | Yes (X) | $53,040 | $0 | $9,660 | Yes (X) |
| KESTER MCDONALD | ||||||
| EXECUTIVE DIRECTOR/SECRETA | 40.00 | Yes (X) | $56,400 | $0 | $13,930 | Yes (X) |
| DANIEL BARWELA | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL PRITCHARD | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| LARS WOHLER | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| GEORGE MARISCAL | ||||||
| PRESIDENT | 0.30 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SHAWN CARTER | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| GAIL MOON | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| VIANN BARTLETT | ||||||
| DIRECTOR | 0.30 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $109,440 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $23,590 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $253,640 | GovernmentGrantsAmt |
| All Other Contributions | $115,005 | AllOtherContributionsAmt |
| Total Contributions | $368,645 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PROCEEDS FROM JOBS PER | 623990 | $121,026 | $121,026 |
| CLIENT DISABILITY BENE | 623990 | $30,018 | $30,018 |
| FOOD STAMPS | 623990 | $26,491 | $26,491 |
| SOBER LIVING FEE FOR S | 623990 | $14,320 | $14,320 |
| SERVICE FEES | 623990 | $9,895 | $9,895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $201,750 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21 | TotalRevenueColumnAmt |
| Exclusion | $21 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $201,215 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $80,762 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $120,453 | TotalRevenueColumnAmt |
| Exclusion | $120,453 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 623990 | BusinessCd |
| Total Revenue Column | $6,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,303 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,303 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $697,172 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $208,053 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $120,474 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,440 | TotalAmt |
| Program Services | $87,552 | ProgramServicesAmt |
| Management And General | $16,416 | ManagementAndGeneralAmt |
| Fundraising | $5,472 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,396 | TotalAmt |
| Program Services | $154,717 | ProgramServicesAmt |
| Management And General | $29,009 | ManagementAndGeneralAmt |
| Fundraising | $9,670 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,030 | TotalAmt |
| Program Services | $64,824 | ProgramServicesAmt |
| Management And General | $12,154 | ManagementAndGeneralAmt |
| Fundraising | $4,052 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,537 | TotalAmt |
| Program Services | $20,430 | ProgramServicesAmt |
| Management And General | $3,830 | ManagementAndGeneralAmt |
| Fundraising | $1,277 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,275 | TotalAmt |
| Program Services | $9,584 | ProgramServicesAmt |
| Management And General | $1,691 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,583 | TotalAmt |
| Program Services | $34,496 | ProgramServicesAmt |
| Management And General | $6,087 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,564 | TotalAmt |
| Program Services | $18,329 | ProgramServicesAmt |
| Management And General | $3,235 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,781 | TotalAmt |
| Program Services | $13,414 | ProgramServicesAmt |
| Management And General | $2,367 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,671 | TotalAmt |
| Program Services | $20,120 | ProgramServicesAmt |
| Management And General | $3,551 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,027 | TotalAmt |
| Program Services | $22,123 | ProgramServicesAmt |
| Management And General | $3,904 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DIRECT PATIENT CARE | $59,405 | $59,405 | ||
| REPAIRS & MAINTENANCE | $8,385 | $7,127 | $1,258 | |
| JOB COSTS | $6,353 | $6,353 | ||
| FUNDRAISING | $2,348 | $2,348 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,446 | TotalAmt |
| Program Services | $1,236 | ProgramServicesAmt |
| Management And General | $210 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626,241 | TotalAmt |
| Program Services | $519,710 | ProgramServicesAmt |
| Management And General | $83,712 | ManagementAndGeneralAmt |
| Fundraising | $22,819 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,515 | BOYAmt |
| EOY | $47,144 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,931 | BOYAmt |
| EOY | $67,928 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,240 | BOYAmt |
| EOY | $27,500 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,031 | BOYAmt |
| EOY | $8,024 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,007,894 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $530,924 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $498,578 | BOYAmt |
| EOY | $476,970 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,295 | BOYAmt |
| EOY | $627,566 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,303 | BOYAmt |
| EOY | $8,922 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $239,031 | BOYAmt |
| EOY | $221,752 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,334 | BOYAmt |
| EOY | $230,674 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,961 | BOYAmt |
| EOY | $396,892 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,961 | BOYAmt |
| EOY | $396,892 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,295 | BOYAmt |
| EOY | $627,566 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $70,931 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $290,233 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $296,612 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $305,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $279,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $368,645 | CurrentTaxYearAmt |
| Total | $1,540,702 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $290,233 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $296,612 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $305,889 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $279,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $368,645 | CurrentTaxYearAmt |
| Total | $1,540,702 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,540,702 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $32 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21 | CurrentTaxYearAmt |
| Total | $89 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $16,965 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,613 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,566 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,768 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,303 | CurrentTaxYearAmt |
| Total | $43,215 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $1,584,006 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $995,817 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97270 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97100 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,629 | OtherCostOrOtherBasisAmt |
| Book Value | $95,629 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $677,367 | OtherCostOrOtherBasisAmt |
| Depreciation | $307,686 | DepreciationAmt |
| Book Value | $369,681 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $230,189 | OtherCostOrOtherBasisAmt |
| Depreciation | $218,529 | DepreciationAmt |
| Book Value | $11,660 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,709 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,709 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $476,970 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $777,934 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $80,762 | OtherRevenueAmt |
| Revenue Not Reported | $80,762 | RevenueNotReportedAmt |
| Revenue Subtotal | $697,172 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $697,172 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $707,003 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $80,762 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $80,762 | ExpensesNotReportedAmt |
| Expenses Subtotal | $626,241 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $626,241 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES SHOWN ON FORM 990 WITH FUNDRAISING EVENT INCOME 80,762. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES SHOWN ON FORM 990 WITH FUNDRAISING EVENT INCOME 80,762. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CHRISTMAS TREE LOT | Event1Nm |
| Gross Receipts Event1 | $79,316 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $79,316 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $66,344 | OtherDirectExpensesEvent1Amt |
| Event2 | RAFFLE TICKET SALES | Event2Nm |
| Gross Receipts Event2 | $100,446 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $100,446 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $6,627 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 5 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $21,453 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $21,453 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $7,791 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $201,215 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $201,215 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $80,762 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $80,762 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $120,453 | NetIncomeSummaryAmt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CLARISSA AVEYTIA | PersonNm |
| Loan Purpose | SHORT TERM CASH LOAN WHILE LINE OF CREDIT IS RENEGOTIATED | LoanPurposeTxt |
| Loan To Organization | Yes (X) | LoanToOrganizationInd |
| Original Principal | $10,000 | OriginalPrincipalAmt |
| Balance Due | $0 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE EXECUTIVE DIRECTOR AND FISCAL OFFICER REVIEW THE FORM 990 PRIOR TO FILING THE FORM. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION NOTIFIES THE BOARD MEMBERS OF THE CONFLICT OF INTEREST POLICY AT A BOARD MEETING ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS DETERMINED BY COMPARISON WITH LIKE ORGAINZATIONS IN THE REGION, THROUGH SOURCES SUCH AS CALIFONRIA HEALTH CARE ALMANAC - EMPLOYER HEALTH BENEFITS SURVEY, AND A PERCENT OF INFLATION IS ALSO USED IN DETERMINING THE PAY RAISES, WHICH ARE SUBJECT TO BOARD APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATION'S FORM 1023 AND FORM 990 ARE AVAILABLE UPON REQUEST. THE FORM 990 IS AVAILABLE ON THE CALIFORNIA REGISTRY OF CHARITABLE TRUST'S WEBSITE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
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