2017-08-04T14:01:04-05:00 2016-09-30 264677183 DZH PHILLIPS LLP 135 MAIN STREET 9TH FLOOR SAN FRANCISCO CA 941051815 990 2015-10-01 941156461 ALDERSLY ALDE 4154537425 326 MISSION AVENUE SAN RAFAEL CA 949013484 GILBERT CARRASCO EXECUTIVE DIRECTOR 4154537425 2017-07-27 1 JANET L HOLLAND P00176450 4157812500 X 2015 2021-01-29 14:40:06Z GILBERT CARRASCO 326 MISSION AVENUE SAN RAFAEL CA 949013484 9045297 0 X WWW.ALDERSLY.COM X 1921 CA PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 10 10 112 75 0 0 98424 66781 8117572 7983682 1249771 1018443 -64369 -23609 9401398 9045297 0 0 0 0 3555068 3577588 0 51602 51602 4661813 5450962 8216881 9080152 1184517 -34855 34447374 34882843 15254455 14950019 19192919 19932824 PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 0 0 5991201 7946548 MAINTAINED RESIDENTIAL HEALTH CARE FACILITIES FOR SENIOR CITIZENS WHO HAVE ENTERED INTO A CONTINUING CARE AND LODGING AGREEMENT; MAINTAINED NURSING SERVICES HEALTH CARE/ASSISTED LIVING. APPROXIMATELY 100 SENIORS WERE SERVED. 5991201 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 1 66 0 1 112 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X GILBERT CARRASCO 4154537425 326 MISSION AVENUE SAN RAFAEL CA 94901 PETER SCHAKOW PRESIDENT 10.00 X X 0 0 0 ALBERT BORO SENIOR VICE PRESIDENT 10.00 X X 0 0 0 CYR MILLER FIRST VICE PRESIDENT 10.00 X X 0 0 0 GRANT HELLAR SECRETARY/TREASURER 8.00 X X 0 0 0 DAVID TORP SECOND VICE PRESIDENT 8.00 X 0 0 0 TORBEN O BJORN DIRECTOR 8.00 X 0 0 0 HERDIS VOGL DIRECTOR 8.00 X 0 0 0 BIRGIT JACOBSEN DIRECTOR 8.00 X 0 0 0 LEO PEDERSON DIRECTOR 8.00 X 0 0 0 LARRY DINGUS DIRECTOR 8.00 X 0 0 0 GILBERT CARRASCO EXECUTIVE DIRECTOR (AS OF JUNE 2016) 40.00 X 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR (UNTIL JUNE 2016) 40.00 X 263446 0 28664 263446 0 28664 4 0 1 0 LIFE CARE SERVICES LLC 400 LOCUST ST STE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 775247 SODEXHO INC & AFFILIATES DEPT 880328 LOS ANGELES CA 90088 DIETARY MANAGEMENT 708739 REHABCARE GROUP INC PO BOX 277365 ATLANTA GA 30384 REHAB SERVICE 199064 MATRIX HG INC 115 MASON CIRCLE STE B CONCORD CA 94520 HVAC SERVICES 116962 4 66781 66781 HEALTH CARE CENTER FEES 623000 2760267 2760267 RESIDENT CARE FEES 623000 2710509 2710509 ASSISTED LIVING FEES 623000 1764299 1764299 ENTRANCE FEES AMORTIZATION 623000 748607 748607 7983682 711928 711928 13525 0 13525 13525 13525 306515 0 306515 306515 306515 ASSET DISPOSAL LOSS 900099 -37134 -37134 -37134 9045297 7946548 0 1031968 X 3015005 2737872 277133 43020 31624 11396 287970 279812 8158 231593 210191 21402 304148 304148 46290 46290 51602 51602 97612 97612 1303058 651021 652037 272135 272135 245692 127300 118392 18238 18238 358818 263521 95297 58207 5950 52257 4245 4245 318095 318095 604037 450914 153123 393497 203957 189540 FOOD 420659 420659 MISCELLANEOUS 373338 37659 335679 THERAPY 209250 209250 REPAIRS AND MAINTENANCE 160279 117539 42740 263364 239687 23677 9080152 5991201 3037349 51602 262772 501345 421833 296216 140083 362291 362491 362521 20693128 11008296 9777339 9684832 18967968 18832676 942513 1121449 3572375 3721513 34447374 34882843 551978 730490 6635000 6480000 8067477 7739529 15254455 14950019 X 19112494 19851584 80425 81240 19192919 19932824 34447374 34882843 -34855 774760 0 X X 0 1 X 1 0 X 61865 1086165 850522 98424 66781 2163757 7495043 7551722 7903792 8137408 7997207 39085172 7556908 8637887 8754314 8235832 8063988 41248929 866004 800000 1666004 117938 117938 983942 800000 1783942 39464987 346010 411818 441147 527707 614662 2341344 346010 411818 441147 527707 614662 2341344 -12991 -64645 97612 19976 7889927 9049705 9130816 8763539 8776262 43610249 0.90490 0.89860 0.05370 0.04650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5461252 575955 504006 6541213 5242133 234865 -15745 5461253 4732894 6272 502967 5242133 4028256 123160 581478 4732894 3561674 9442 769060 -311920 4028256 1.00000 0 0 232822 232822 15464553 8115565 7348988 2587912 1062289 1525623 1520404 1211020 309384 887437 619422 268015 9684832 DEFERRED FINANCING COSTS - NET OF AMORTIZATION 323847 CONSTRUCTION IN PROGRESS 277431 INTEREST AND DIVIDENDS RECEIVABLE 1349 OTHER ASSETS 5582 INVESTMENTS IN RESIDENTIAL REALESTATE 825290 ASSETS WHOSE USE IS LIMITED OR RESTRICTED 2288014 3721513 DEPOSITS RECEIVED 42055 UNEARNED PORTION OF ACCOMMODATION FEES - EXHAUSTIBLE 2171577 UNEARNED PORTION OF ACCOMMODATION FEES - NON-REFUNDABLE 2605267 GUARANTEED REFUNDS 2240440 UNEARNED VENDOR CREDIT 52619 BOND PREMIUM 627571 7739529 X 9820058 774760 1 774761 9045297 0 9045297 9080153 0 9080153 -1 -1 9080152 PART V, LINE 4: THE ORGANIZATION HAS A BOARD DESIGNATED ENDOWMENT FUND TO PROVIDE FOR GENERAL SUPPORT OF THE ORGANIZATION. THESE FUNDS ARE CLASSIFIED AS UNRESTRICTED NET ASSETS. PART X, LINE 2: ALDERSLY IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE, SECTION 23701D EXCEPT AS NOTED FOR THE LLC. ACCORDINGLY, IT HAS NOT PROVIDED FOR INCOME TAXES IN THESE CONSOLIDATED FINANCIAL STATEMENTS. THE LLC'S NET EARNINGS (LOSSES) ARE REPORTED ON THE FEDERAL EXEMPT ORGANIZATION TAX RETURN OF ITS PARENT COMPANY. THE LLC FILES A SEPARATE STATE TAX RETURN IN CALIFORNIA AND IS SUBJECT TO AN $800 MINIMUM TAX. EACH YEAR, MANAGEMENT CONSIDERS WHETHER ANY MATERIAL TAX POSITION THE ORGANIZATION HAS TAKEN IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY. MANAGEMENT BELIEVES THAT ANY POSITIONS THE ORGANIZATION HAS TAKEN ARE SUPPORTED BY SUBSTANTIAL AUTHORITY AND, HENCE, DO NOT NEED TO BE MEASURED OR DISCLOSED IN THESE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 1. PART XII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -1. 1 JEFFREY LEIDALL 12 SANTA FE AVENUE PT RICHMOND CA 94801 FUNDRAISING 0 0 52105 -52105 52105 -52105 0 0 0 0 0 0 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR (UNTIL JUNE 2016) 208112 0 55334 0 0 0 23640 0 5024 0 292110 0 0 0 ADDITIONAL INFORMATION LIFE CARE SERVICES (LCS), AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION. THE ORGANIZATION'S EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES AND RECEIVES COMPENSATION ONLY FROM LCS. THE CONTRACTOR PAYMENTS TO LCS REPORTED IN PART VII-B INCLUDE THE EXECUTIVE DIRECTOR'S COMPENSATION. A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 13080SGG3 2015-02-24 7125288 BUILDING AND STRUCTURE UPDATES 0 0 0 A 4685472 7125288 468625 127200 53581 1843991 2040 0 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 0 0 0 0 0 A 1 JOANNE MAXWELL EXECUTIVE DIRECTOR (EMPLOYEE OF LIFE CARE SERVICES) 263446 LIFE CARE SERVICES, AN UNRELATED ORGANIZATION, PROVIDES MANAGEMENT SERVICES TO THE ORGANIZATION. THE ORGANIZATION'S EXECUTIVE DIRECTOR IS AN EMPLOYEE OF LIFE CARE SERVICES AND RECEIVES COMPENSATION ONLY FROM LIFE CARE SERVICES. PAYMENTS TO LIFE CARE SERVICES REPORTED IN PART VII-B INCLUDE THE EXECUTIVE DIRECTOR'S COMPENSATION. 0 FORM 990, PART VI, SECTION A, LINE 3 LIFE CARE SERVICES IS THE MANAGEMENT COMPANY CHOSEN BY THE BOARD OF DIRECTORS TO MANAGE THE COMMUNITY. LIFE CARE SERVICES, AND LCS COMPANY, IS ONE OF THE MOST WELL-ESTABLISHED SENIOR LIVING MANAGEMENT COMPANIES IN THE UNITED STATES. LEARN MORE AT HTTP://WWW.SENIOR-LIVING-MANAGEMENT.COM/ MANAGEMENT COMPENSATION PAYMENTS REPORTED IN PART VII-A ARE INCLUDED IN THE LCS CONTRACTOR PAYMENTS REPORTED IN PART VII-B. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE GOVERNING BODY ARE ELECTED AND VOTED FOR AT THE ANNUAL MEETING. THE BOARD MUST INCLUDE AT LEAST ONE ALDERSLY RESIDENT. FORM 990, PART VI, SECTION A, LINE 7B THE BOARD OF DIRECTORS SET POLICIES AND GOVERN THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN IS REVIEWED BY THE ACCOUNTANT OF THE ORGANIZATION'S MANAGEMENT COMPANY AND THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. A COPY OF THE 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY PREPARES AND FURNISHES EACH DIRECTOR A STATEMENT OF ANY TRANSACTION OR INDEMNIFICATION WITHIN ONE HUNDRED TWENTY (120) DAYS AFTER THE END OF THE ORGANIZATION'S FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 15 MANAGEMENT SERVICES ARE OUTSOURCED TO LIFE CARE SERVICES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 438,911. MANAGEMENT AND GENERAL EXPENSES 338,500. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 777,411. OTHER FEES: PROGRAM SERVICE EXPENSES 212,110. MANAGEMENT AND GENERAL EXPENSES 313,537. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 525,647. FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. HCANDERSEN PROPERTIES LLC 326 MISSION AVE SAN RAFAEL CA 94901 941156461 REAL ESTATE HOLDINGS CA 0 ALDERSLY