2019-01-14T12:49:43-06:00 2018-02-28 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-03-01 941485533 CHANNING HOUSE CHAN 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RHONDA BEKKEDAHL CHIEF OPERATING OFFICER 6503270950 2019-01-14 1 MICHAEL LUMSDEN P01262236 4159561500 2019-01-14 12.129.7.100 2019-01-14 11:56:33 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8C2C797611BE7DE264CDAEC452B76697E91497A7 2017 2019-02-21 02:37:17Z MELVIN MATSUMOTO 850 WEBSTER STREET PALO ALTO CA 94301 43966629 0 X WWW.CHANNINGHOUSE.ORG X 1960 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 12 12 129 70 0 4445 775968 173728 18892740 19201263 602292 798150 27632 30252 20298632 20203393 10169 2494 0 0 6159919 6838648 0 10000 10000 13470980 12789982 19641068 19641124 657564 562269 117371617 162178535 89359996 144111525 28011621 18067010 X THE MISSION OF CHANNING HOUSE IS TO PROVIDE A CONTINUING CARE RETIREMENT COMMUNITY THAT ENHANCES EACH RESIDENT'S INDEPENDENCE, WELL BEING, NEEDED CARE, AND SECURITY; AND TO DEVELOP AND STRENGTHEN CHANNING HOUSE'S CAPACITY TO REMAIN FOR FUTURE GENERATIONS A STABLE, HIGH-QUALITY, AND FORWARD-LOOKING LIFE CARE FACILITY. 0 0 16684331 2494 19201263 PROVIDE HOUSING, ASSISTED LIVING, AND SKILLED NURSING SERVICES WHICH INCLUDE DINING SERVICES, MAINTENANCE, HOUSEKEEPING, AND NURSING CARE. DURING FY2018 WE SERVED AN AVERAGE OF 220 RESIDENTS WITH A TOTAL OF 8,213 SERVICE DAYS OF SKILLED NURSING; 8,182 SERVICE DAYS OF ASSISTED LIVING; AND 63,997 DAYS OF RESIDENTIAL CARE SERVICES. IN ADDITION, CHANNING HOUSE IS A NEIGHBORHOOD POLLING LOCATION, HOSTS VARIOUS COMMUNITY MEETINGS, AND PARTNERS IN EMERGENCY PREPAREDNESS PROGRAMS. WE COORDINATE WITH THE CITY OF PALO ALTO AND WITH SANTA CLARA COUNTY TO PROVIDE EMERGENCY COMMUNICATIONS AND ACT AS A BACK-UP OPERATIONAL COMMAND CENTER IN THE EVENT OF A NATURAL (OR OTHER) DISASTER. WE ALSO PROVIDE THE USE OF OUR SWIMMING POOL TO A LOCAL NOT-FOR-PROFIT THAT SERVES DEVELOPMENTALLY DISABLED CHILDREN. SWIM LESSONS ARE HELD BY THIS GROUP 3 TIMES PER WEEK. OUR COMMUNITY ALSO TUTORS CHILDREN FROM DISADVANTAGED NEIGHBORHOODS, AND SUPPORTS MANY OTHER ORGANIZATIONS WITH THOUSANDS OF HOURS OF VOLUNTEER TIME. 16684331 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 28 0 1 129 1 1 1 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X RHONDA BEKKEDAHL 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 JEAN MCCOWN CHAIR OF THE BOARD 2.00 X X 0 0 0 HELENE BUTLER VICE CHAIR START 9/28/2017 2.00 X X 0 0 0 ANDY COE VICE CHAIR THROUGH 9/28/2017 2.00 X X 0 0 0 PATTY FISHER SECRETARY 2.00 X X 0 0 0 TOM HOFSTEDT TREASURER 2.00 X X 0 0 0 JOHN BOGGS MD BOARD MEMBER 1.00 X 0 0 0 TONY CARRASCO BOARD MEMBER 1.00 X 0 0 0 DAVID GOLDEN BOARD MEMBER 1.00 X 0 0 0 GLORIA HOM BOARD MEMBER 1.00 X 0 0 0 MARCIA PUGSLEY BOARD MEMBER 1.00 X 0 0 0 JOHN SCHNIEDWIND BOARD MEMBER 1.00 X 0 0 0 DAVID THORNTON BOARD MEMBER 1.00 X 0 0 0 PAMELA D VON WIEGAND BOARD MEMBER 1.00 X 0 0 0 MELVIN MATSUMOTO EXECUTIVE DIRECTOR 40.00 X 313949 0 28085 RHONDA BEKKEDAHL CHIEF OPERATING OFFICER 40.00 X 194400 0 18228 ARACELI ANTONIO DIRECTOR OF HEALTH SERVICE 40.00 X 152938 0 28076 MELVIN MENDOZA FACILITIES SUPERVISOR 40.00 X 115173 0 5659 JOY NAVA REGISTERED NURSE 40.00 X 125597 0 14634 ARTURO MIRANDA III FACILITIES DIRECTOR 40.00 X 106266 0 351 JULIA JONES ADMINISTRATOR 40.00 X 103705 0 18287 MYRNA CAMAR DIRECTOR OF NURSING 40.00 X 106494 0 22997 1218522 0 136317 9 0 1 0 HARDISON KOMATSU IVELICH & TUCKER 538 NINTH STREET 240 OAKLAND CA 94607 ARCHITECT 774941 PROVINET SOLUTIONS 18601 N CREEK DRIVE TINLEY PARK IL 60477 IT CONSULTANT 258609 2 173728 173728 MONTHLY CARE FEES 623000 13211723 13211723 RESIDENT ENTRANCE FEES 623000 5634221 5634221 SPECIAL SERVICES 623000 341819 341819 PROCESSING FEES 623000 13500 13500 19201263 244016 244016 186011 186011 39023 0 39023 39023 39023 24107403 23739280 368123 368123 368123 15185 23956 -8771 -8771 20203393 19201263 0 828402 X 2494 2494 742571 742571 4321558 3512569 808989 136573 132595 3978 1209331 928118 281213 428615 336929 91686 9216 9216 125841 125841 10000 10000 3000918 2952292 48626 41299 3120 38179 924335 384653 539682 57337 28669 28668 819500 776207 43293 29749 12210 17539 40913 28649 12264 2577079 2577079 4102202 4102202 525463 370415 155048 MAINT./HOUSEKEEPING 433354 433354 MEDICAL EXPENSES 102776 102776 19641124 16684331 2946793 10000 500 460 797171 2210222 23559 54162 2625 3000 230081 218075 137680582 35880281 92836980 101800301 23462249 57884522 18452 7793 117371617 162178535 3873769 5537252 36878010 36107505 48580288 102447601 27929 19167 89359996 144111525 X 27717207 17775205 294414 291805 28011621 18067010 117371617 162178535 X 562269 -270506 -10236374 X 0 1 X 1 0 X 72368 195099 483399 775968 173728 1700562 14243171 15415224 16260240 18892740 19201263 84012638 22235 20126 58531 19850 15185 135927 14337774 15630449 16802170 19688558 19390176 85849127 2500 10000 5000 1000 18500 3121718 3117776 4753499 6753128 2284861 20030982 3121718 3120276 4763499 6758128 2285861 20049482 65799645 629754 578776 611807 566803 469050 2856190 629754 578776 611807 566803 469050 2856190 14967528 16209225 17413977 20255361 19859226 88705317 0.74180 0.70310 0.03220 0.04390 X 0 1 0 1 1000 0 0 1 0 0 1000 0 PART II-B, LINE 1: LETTERS TO LEGISLATORS AND/OR THEIR STAFFS REGARDING LEGISLATION RELATED TO LONG-TERM CARE, LICENSING AGENCIES, AND OTHER RELATED TOPICS. 0 0 2551859 147548 169376 2868783 1645110 751488 183372 28111 2551859 1167420 375040 136079 33429 1645110 1061075 66793 64450 24898 1167420 974059 75004 21661 9649 1061075 1.00000 0.00000 0.00000 0 0 936951 936951 121295614 33600037 87695577 4169386 2280244 1889142 11278631 11278631 101800301 GIFT ANNUITY OBLIGATIONS 19167 19167 X 20087135 -270506 154248 -116258 20203393 0 20203393 30031746 10390622 10390622 19641124 0 19641124 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO ENHANCE THE WELL-BEING OF RESIDENTS AND TO PROVIDE ON-GOING SUPPORT FOR THE CHARITABLE NEEDS OF RESIDENTS. PART X, LINE 2: CHANNING HOUSE HAS BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. CHANNING HOUSE ADOPTED THE PROVISIONS OF FASB ASC TOPIC 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON MARCH 1, 2008. THEY HAD NO UNRECOGNIZED TAX BENEFITS WHICH WOULD REQUIRE AN ADJUSTMENT TO THE MARCH 1, 2016 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2018 AND 2017. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN MINIMUM PENSION LIABILITY 156,146. CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -1,898. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON REFINANCE OF BONDS PAYABLE 10,390,622. X X 0 0 0 0 0 0 0 0 0 MELVIN MATSUMOTO EXECUTIVE DIRECTOR 274719 0 0 0 39230 0 27518 0 567 0 342034 0 0 0 RHONDA BEKKEDAHL CHIEF OPERATING OFFICER 176900 0 0 0 17500 0 17740 0 488 0 212628 0 0 0 ARACELI ANTONIO DIRECTOR OF HEALTH SERVICE 152938 0 0 0 0 0 15338 0 12738 0 181014 0 0 0 A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TZ63 2017-04-18 58413722 REFUND BOND ISSUED 7/8/2010 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048T7N7 2017-10-25 50469360 CONSTRUCT, EQUIP, AND RENOVATE FACILITY 0 0 0 A 58428536 2058114 963278 1732948 53674196 0 1 1 1 B 50627035 1166625 912135 2735573 3231911 42580791 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART II, LINE 3 THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED IN SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN SCHEDULE K, PART II, LINE 3 PERTAINS TO INVESTMENT EARNINGS ON PROCEEDS IN RESERVE FUNDS. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS A DRAFT OF THE FORM 990 ON BEHALF OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. THE DRAFT, AS REVIEWED BY THE AUDIT COMMITTEE, IS THEN MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS AS WELL. THIS PROCESS INCLUDES DOCUMENTING WHO CONDUCTED THE REVIEW, WHEN IT WAS CONDUCTED, AND TO WHAT EXTENT (DETAIL OR SUMMARY) THE FORM WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS REVIEWED WITH BOARD MEMBERS AND KEY STAFF MEMBERS. POTENTIAL CONFLICTS ARE REVIEWED AT THE MANAGEMENT AND THE BOARD LEVEL; SHOULD A CONFLICT OF INTEREST ARISE, THE BOARD MEMBER / EMPLOYEE DOES NOT PARTICIPATE IN DECISIONS RELATED TO THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PERSONNEL COMMITTEE (A BOARD COMMITTEE COMPRISED OF 3 TRUSTEES) IS RESPONSIBLE FOR THE PERFORMANCE APPRAISAL OF THE EXECUTIVE DIRECTOR. THE PERFORMANCE APPRAISAL IS NORMALLY ON AN ANNUAL BASIS, WITH THE PERIOD UNDER REVIEW BASED ON THE EXECUTIVE DIRECTOR'S DATE OF HIRE. THE COMMITTEE, IN ITS EVALUATION, MAY SOLICIT INPUT FROM OTHER TRUSTEES, RESIDENTS, AND STAFF OF CHANNING HOUSE. THE SALARY AND BENEFITS OF THE EXECUTIVE DIRECTOR ARE ALSO REVIEWED ON AN ANNUAL BASIS. THE PERSONNEL COMMITTEE SUBMITS ANY RECOMMENDED CHANGES TO THE EXECUTIVE DIRECTOR'S SALARY/BENEFITS TO THE BOARD OF TRUSTEES FOR APPROVAL. SUCH RECOMMENDATION WILL BE SUBMITTED FOR REVIEW AND APPROVAL TO THE BOARD AT THE REGULARLY SCHEDULED MEETING PRIOR TO THE EXECUTIVE DIRECTOR'S HIRE DATE ANNIVERSARY. ANY ACTION TAKEN BY THE BOARD ON PERSONNEL COMMITTEE RECOMMENDATIONS IS RECORDED IN THE BOARD MINUTES. COMPENSATION ADJUSTMENTS FOR THE EXECUTIVE DIRECTOR IS ESTABLISHED IN CONJUNCTION WITH A REVIEW OF COMPENSATION STUDIES AVAILABLE FROM BOTH NATIONAL AND STATEWIDE SOURCES, AS WELL AS OTHER SOURCES AS AVAILABLE (SUCH AS FROM A CONSULTANT). THE EXECUTIVE DIRECTOR IS RESPONSIBLE FOR ANNUAL EVALUATIONS AND IMPLEMENTING ANY SALARY ADJUSTMENTS FOR THE CHIEF OPERATING OFFICER AND DIRECTOR OF HEALTH SERVICES. COMPENSATION ADJUSTMENTS FOR THESE KEY EMPLOYEES ARE BASED ON BUDGETED AMOUNTS AVAILABLE, AS WELL AS STATEWIDE COMPENSATION STUDIES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE POSTED IN THE RESIDENT LIBRARY, ATTACHED TO NEW RESIDENT CONTRACTS, AND ARE AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. ALL BOARD MINUTES AND CHANGES TO BYLAWS ARE POSTED IN THE CHANNING HOUSE RESIDENT LIBRARY. COPIES OF MEETING MINUTES ARE AVAILABLE FOR A PRIOR THREE YEAR PERIOD. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 2,952,292. MANAGEMENT AND GENERAL EXPENSES 48,626. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,000,918. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -1,898. CHANGE IN MINIMUM PENSION LIABILITY 156,146. LOSS ON REFINANCE OF BONDS PAYABLE -10,390,622.