LOS ROBLES HOSPITAL VOLUNTEERS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: LOS ROBLES HOSPITAL VOLUNTEERS INC (EIN 95-3263505)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-12-17
IRS object ID: 201843519349301224
Schema version: 2017v2.2
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
Form 990
Schedule A
Schedule D
Schedule I
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-12-17T15:17:35-08:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	202200016	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Anthony M Salzman CPA	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	325 Rolling Oaks Drive 201	AddressLine1Txt
City	Thousand Oaks	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91361	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	953263505	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LOS ROBLES HOSPITAL VOLUNTEERS INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	LOSR	BusinessNameControlTxt
Phone	8053704685	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	215 W JANSS ROAD	AddressLine1Txt
City	THOUSAND OAKS	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91360	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	GLENN KASSELL	PersonNm
Person Title	Treasurer	PersonTitleTxt
Phone	8054972727	PhoneNum
Signature	2018-11-14	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Anthony Salzman	PreparerPersonNm
PTIN	P00521089	PTIN
Phone	8054957458	PhoneNum
Self Employed	Yes (X)	SelfEmployedInd

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Gross Receipts	$311,423	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
All Affiliates Included	false	AllAffiliatesIncludedInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1978	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	PROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	600	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$572	PYContributionsGrantsAmt
CY Contributions Grants	$4,938	CYContributionsGrantsAmt
PY Program Service Revenue	$20,234	PYProgramServiceRevenueAmt
CY Program Service Revenue	$15,015	CYProgramServiceRevenueAmt
PY Investment Income	$14	PYInvestmentIncomeAmt
CY Investment Income	$16	CYInvestmentIncomeAmt
PY Other Revenue	$79,359	PYOtherRevenueAmt
CY Other Revenue	$89,729	CYOtherRevenueAmt
PY Total Revenue	$100,179	PYTotalRevenueAmt
CY Total Revenue	$109,698	CYTotalRevenueAmt
PY Grants And Similar Paid	$98,899	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$56,221	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$30,532	PYOtherExpensesAmt
CY Other Expenses	$43,712	CYOtherExpensesAmt
PY Total Expenses	$129,431	PYTotalExpensesAmt
CY Total Expenses	$99,933	CYTotalExpensesAmt
PY Revenues Less Expenses	-$29,252	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$9,765	CYRevenuesLessExpensesAmt
Total Assets BOY	$118,511	TotalAssetsBOYAmt
Total Assets EOY	$133,764	TotalAssetsEOYAmt
Total Liabilities BOY	$434	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$224	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$118,077	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$133,540	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	PROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$45,579	ExpenseAmt
Grant	$45,579	GrantAmt
Desc	CHARITABLE CONTRIBUTIONS: MAKE CHARITABLE CONTRIBUTIONS TO IMPORTANT CHARITABLE CAUSES IN THE COMMUNITY.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$18,603	ExpenseAmt
Desc	PROVIDE APPROPRIATE UNIFORMS FOR VOLUNTEERS AT THE HOSPITAL.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$15,000	ExpenseAmt
Grant	$15,000	GrantAmt
Desc	COLLEGE SCHOLARSHIPS: PROVIDE SCHOLARSHIPS OF $500 TO $1,000 EACH TO WORTHY CANDIDATES SELECTED FROM AMONG NUMEROUS HIGH SCHOOL SENIORS. CANDIDATES MUST BE VOLUNTEERS IN GOOD STANDING WITH HIGH QUALITY OF SERVICES.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$10,873	TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses	$90,055	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	Yes (true)	GrantsToIndividualsInd
Schedule J Required	false	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	2	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	0	EmployeeCnt
Employment Tax Returns Filed	false	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Form990 T Filed	false	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
DAF Excess Business Holdings	false	DAFExcessBusinessHoldingsInd
Taxable Distributions	false	TaxableDistributionsInd
Distribution To Donor	false	DistributionToDonorInd
Org Filed In Lieu Of Form1041	false	OrgFiledInLieuOfForm1041Ind
Licensed More Than One State	false	LicensedMoreThanOneStateInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ANTHONY M SALZMAN CPA	PersonNm
Phone	8054957458	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	325 ROLLING OAKS DR 201	AddressLine1Txt
City	THOUSAND OAKS	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91361	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (4 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt
MARGARITA HORWITZ
Vice President	24.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
DEB HURDLE
Secretary	8.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
MARK HORWITZ
President	16.00	0.00	Yes (X)	Yes (X)	$0	$0	$0
GLENN KASSELL
Treasurer	16.00	0.00	Yes (X)	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$4,938	AllOtherContributionsAmt
Total Contributions	$4,938	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ORIENTATION COST PAYMENTS	$5,589	$5,589
UNIFORM COST PAYMENTS	$9,426	$9,426

Field	Value	IRS element (for citing)
Total Program Service Revenue	$15,015	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16	TotalRevenueColumnAmt
Related Or Exempt Func Income	$16	RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$291,454	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$201,725	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$89,729	TotalRevenueColumnAmt
Exclusion	$89,729	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$109,698	TotalRevenueColumnAmt
Related Or Exempt Func Income	$15,031	RelatedOrExemptFuncIncomeAmt
Exclusion	$89,729	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$41,221	TotalAmt
Program Services	$41,221	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$15,000	TotalAmt
Program Services	$15,000	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$1,675	TotalAmt
Management And General	$1,675	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,200	TotalAmt
Management And General	$1,200	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
UNIFORMS	$18,603	$18,603
PATIENT SERVICES	$7,847	$7,847
VOLUNTEER EXPENSES	$4,235	$4,235
DIRECTORS EXPENSE	$3,928		$3,928

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$6,224	TotalAmt
Program Services	$3,149	ProgramServicesAmt
Management And General	$3,075	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$99,933	TotalAmt
Program Services	$90,055	ProgramServicesAmt
Management And General	$9,878	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$55,866	BOYAmt
EOY	$73,626	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$30,006	BOYAmt
EOY	$31,187	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$23,937	BOYAmt
EOY	$23,198	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$79,342	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$73,589	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$8,702	BOYAmt
EOY	$5,753	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$118,511	BOYAmt
EOY	$133,764	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$434	BOYAmt
EOY	$224	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$434	BOYAmt
EOY	$224	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$118,077	BOYAmt
EOY	$133,540	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$118,077	BOYAmt
EOY	$133,540	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$118,511	BOYAmt
EOY	$133,764	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$9,765	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$5,698	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	Yes (true)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	false	FSAuditedInd
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	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	$934	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$18,509	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,101	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$572	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,938	CurrentTaxYearAmt
Total	$27,054	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$934	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$18,509	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,101	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$572	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,938	CurrentTaxYearAmt
Total	$27,054	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$0	SubstantialContributorsTotAmt
Public Support Total170	$27,054	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$17	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$16	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$14	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$12	CurrentTaxYearMinus1YearAmt
Current Tax Year	$17	CurrentTaxYearAmt
Total	$76	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$19,833	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$13,756	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$8,345	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$572	CurrentTaxYearMinus1YearAmt
Current Tax Year	$4,938	CurrentTaxYearAmt
Total	$47,444	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$74,574	TotalSupportAmt
Public Support CY170	0.36280	PublicSupportCY170Pct
Public Support PY170	0.36160	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$63,047	OtherCostOrOtherBasisAmt
Depreciation	$59,294	DepreciationAmt
Book Value	$3,753	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,295	OtherCostOrOtherBasisAmt
Depreciation	$14,295	DepreciationAmt
Book Value	$2,000	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$5,753	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	SALES TAX LIABILITY	Desc
Amt	$224	Amt

Field	Value	IRS element (for citing)
Total Liability	$224	TotalLiabilityAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	Cash GrantCashGrantAmt	Non Cash AssistanceNonCashAssistanceAmt
Conejo Free Clinic
80 E Hillcrest Dr	Thousand Oaks	CA	91360	953177953	$8,000	$0
MANY MANSIONS
1259 E THOUSAND OAKS BLVD	THOUSAND OAKS	CA	91362		$5,500	$0
Westminster Free Clinic
32111 Watergate Rd	Thousand Oaks	CA	91361	770563241	$8,000	$0

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

Field	Value	IRS element (for citing)
Grant Type	COLLEGE SCHOLARSHIPS	GrantTypeTxt
Recipient	11	RecipientCnt
Cash Grant	$15,000	CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Grantmaker's Description of How Grants are Used	FormAndLineReferenceDesc
Explanation	THE BOARD OF DIRECTORS SELECTS THE ORGANIZATIONS THAT WILL RECEIVE GRANTS. (HISTORICALLY, ALL SUCH ORGANIZATIONS ARE PROMINENT IN THE COMMUNITY; THEIR USE OF FUNDS IS WIDELY RECOGNIZED.) QUESTIONS WITH RESPECT TO THE APPROPRIATE NATURE OF DONATIONS ARE FULLY CONSIDERED BEFORE DONATIONS ARE MADE.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Client Note 1	Client Note 1 - donee addresses:All addresses are complete as shown.
Form 990, Part III, Line 4d: Other Program Services Description	OTHER PROGRAM SERVICES 4: COLLEGE SCHOLARSHIPS: PROVIDE SCHOLARSHIPS OF $500 TO $1,000 EACH TO WORTHY CANDIDATES SELECTED FROM AMONG NUMEROUS HIGH SCHOOL SENIORS. CANDIDATES MUST BE VOLUNTEERS IN GOOD STANDING WITH HIGH QUALITY OF SERVICES. OTHER PROGRAM SERVICES 5: SENIOR COMMUNITY OUTREACH: PROVIDE HEALTH RELATED INFORATION, HEALTH FAIR, SENIOR ACTIVITIES, AND RELATED ITEMS FOR SENIOR CITIZENS IN THE COMMUNITY.
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	MEMBERSHIP OF THE ORGANIZATION CONSISTS OF ALL VOLUNTEERS AT LOS ROBLES REGIONAL MEDICAL CENTER WHO ARE UNDER THE DIRECTION OF THE LOS ROBLES REGIONAL MEDICAL CENTER VOLUNTEERS, INC.
Form 990, Part VI, Line 11b: Form 990 Review Process	Form 990 is distributed to each member of the Board of Directors (typically at a meeting of the Board of Directors) prior to the filing of the return. Items on the return are reviewed by the members. Questions are brought to the attention of the tax preparer for changes, if appropriate.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Each member of the Board of Directors is required to attest, annually, as to whether they have a conflict of interest.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	N/A
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	N/A
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Tax Returns, Governing documents, policies, and financial statements shall be made available upon reasonable request and disclosure shall not unreasonably be withheld. Such items shall be made available upon request to the President and Treasurer. If they feel that it is inappropriate to disclose such items to the parties making the request, the matter shall be brought to the attention of the entire Board of Directors. When appropriate, legal counsel shall be engaged to assist with decisions in this regard.
Other Changes In Net Assets Or Fund Balances - Other Increases	miscellaneoous adjustment = $5698