CREATIVE LIVING SOLUTIONS INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- CREATIVE LIVING SOLUTIONS INC (EIN 46-5627443)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-17
- IRS object ID
- 202543219349312744
- Schema version
- 2024v5.2
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-11-17T13:34:40-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 WEMBLEY CT | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 465627443 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CREATIVE LIVING SOLUTIONS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CREA | BusinessNameControlTxt |
| Phone | 5184141943 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 WOLF ROAD 304 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12205 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TELBERTH FORDE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5184141943 | PhoneNum |
| Signature | 2025-11-14 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ASHLEY ROUBELAKIS | PreparerPersonNm |
| PTIN | P02283359 | PTIN |
| Phone | 5184644080 | PhoneNum |
| Preparation | 2025-11-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | TELBERTH FORDE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 WOLF ROAD 304 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12205 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,199,305 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CLSINC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2020 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION'S MISSION IS TO EMPOWER INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO "REALIZE WHAT'S POSSIBLE" IN THEIR EVERY-DAY LIVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 136 | TotalEmployeeCnt |
| Total Volunteers | 4 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,711,764 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,994,045 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $133,864 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $205,259 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3 | PYInvestmentIncomeAmt |
| CY Investment Income | $1 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,845,631 | PYTotalRevenueAmt |
| CY Total Revenue | $4,199,305 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $375,514 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $615,154 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,100,479 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,931,556 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $311,176 | PYOtherExpensesAmt |
| CY Other Expenses | $413,009 | CYOtherExpensesAmt |
| PY Total Expenses | $2,787,169 | PYTotalExpensesAmt |
| CY Total Expenses | $3,959,719 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $58,462 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $239,586 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $514,689 | TotalAssetsBOYAmt |
| Total Assets EOY | $727,237 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $172,615 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $145,577 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $342,074 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $581,660 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION'S MISSION IS TO EMPOWER INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES TO "REALIZE WHAT'S POSSIBLE" IN THEIR EVERY-DAY LIVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,823,652 | ExpenseAmt |
| Revenue | $205,259 | RevenueAmt |
| Desc | FISCAL INTERMEDIARY SERVICES THE ORGANIZATION IS A FISCAL INTERMEDIARY FOR INDIVIDUALS WHO HAVE CHOSEN SELF DIRECTED SERVICES. IT PROVIDES THE ADMINISTRATIVE AND BILLING SUPPORT TO A PERSON WHO CHOOSES SELF-DIRECTION. THIS INCLUDES: COMPLETING BACKGROUND CHECKS FOR SELF-HIRED STAFF, BILLING MEDICAID OR NEW YORK STATE FOR SERVICES IN THE BUDGET, PAYING STAFF, TRACKING EXPENDITURES, AND PROVIDING MONTHLY STATEMENTS TO THE INDIVIDUAL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $615,154 | ExpenseAmt |
| Grant | $615,154 | GrantAmt |
| Desc | COMMUNITY HABILITATION OUR PROFESSIONALLY TRAINED SPECIALISTS WORK ONE TO ONE OR IN GROUP SETTINGS TO ASSIST THE INDIVIDUAL(S) ON AN ARRAY OF OUTCOMES TO DEVELOP SKILLS SUCH AS: TRAVEL TRAINING, MONEY MANAGEMENT, ASSISTANCE WITH ACTIVITIES OF DAILY LIVING, COMMUNITY INCLUSION AND RELATIONSHIP BUILDING, DEVELOPMENT OF SOCIAL SKILLS, LEISURE SKILLS, SELF-ADVOCACY AND INFORMED CHOICE SKILLS ACQUIRING, RETAINING AND IMPROVING ADAPTIVE SKILLS AND SELF-HELP SKILLS NEEDED TO LIVE INDEPENDENTLY AT HOME AND IN COMMUNITY-BASED SETTINGS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,438,806 | 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 |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 136 | 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | 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 | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TELBERTH FORDE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5184141943 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 WOLF ROAD 304 | AddressLine1Txt |
| City | ALBANY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12205 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| CYNTHIA WILLIAMS-STEPHENS | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| AKUA GIBSON | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VALARIE MCGLOINE | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RAFAEL VERAS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TELBERTH FORDE | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | Yes (X) | $243,000 | $0 | $11,375 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $243,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $11,375 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,990,545 | GovernmentGrantsAmt |
| All Other Contributions | $3,500 | AllOtherContributionsAmt |
| Total Contributions | $3,994,045 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BROKER SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $205,259 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $205,259 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $205,259 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1 | TotalRevenueColumnAmt |
| Exclusion | $1 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,199,305 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $205,259 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $615,154 | TotalAmt |
| Program Services | $615,154 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,000 | TotalAmt |
| Program Services | $206,550 | ProgramServicesAmt |
| Management And General | $36,450 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,397,454 | TotalAmt |
| Program Services | $2,037,836 | ProgramServicesAmt |
| Management And General | $359,618 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,536 | TotalAmt |
| Program Services | $16,605 | ProgramServicesAmt |
| Management And General | $2,931 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,023 | TotalAmt |
| Program Services | $45,920 | ProgramServicesAmt |
| Management And General | $8,103 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,543 | TotalAmt |
| Program Services | $184,912 | ProgramServicesAmt |
| Management And General | $32,631 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,200 | TotalAmt |
| Management And General | $22,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,674 | TotalAmt |
| Program Services | $197,388 | ProgramServicesAmt |
| Management And General | $11,286 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721 | TotalAmt |
| Program Services | $721 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,571 | TotalAmt |
| Program Services | $19,928 | ProgramServicesAmt |
| Management And General | $6,643 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,338 | TotalAmt |
| Program Services | $49,004 | ProgramServicesAmt |
| Management And General | $16,334 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,177 | TotalAmt |
| Program Services | $29,365 | ProgramServicesAmt |
| Management And General | $15,812 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,540 | TotalAmt |
| Program Services | $11,540 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $798 | TotalAmt |
| Program Services | $519 | ProgramServicesAmt |
| Management And General | $279 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,960 | TotalAmt |
| Program Services | $7,124 | ProgramServicesAmt |
| Management And General | $3,836 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| OTHER | $20,175 | $15,385 | $4,790 |
| BANK CHARGES | $591 | $591 | |
| REPAIRS AND MAINTANCE | $264 | $264 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,959,719 | TotalAmt |
| Program Services | $3,438,806 | ProgramServicesAmt |
| Management And General | $520,913 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,272 | BOYAmt |
| EOY | $3,385 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,278 | BOYAmt |
| EOY | $18,925 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,392 | BOYAmt |
| EOY | $636,775 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,747 | BOYAmt |
| EOY | $68,152 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,689 | BOYAmt |
| EOY | $727,237 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,868 | BOYAmt |
| EOY | $73,949 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,747 | BOYAmt |
| EOY | $71,628 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,615 | BOYAmt |
| EOY | $145,577 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,074 | BOYAmt |
| EOY | $581,660 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,074 | BOYAmt |
| EOY | $581,660 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,689 | BOYAmt |
| EOY | $727,237 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $239,586 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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 | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $452,595 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $819,743 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,069,615 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,711,764 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,994,045 | CurrentTaxYearAmt |
| Total | $10,047,762 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,202 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $86,844 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $85,308 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $133,867 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $205,259 | CurrentTaxYearAmt |
| Total | $605,480 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $546,797 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $906,587 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,154,923 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,845,631 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,199,304 | CurrentTaxYearAmt |
| Total | $10,653,242 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,653,242 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1 | CurrentTaxYearAmt |
| Total | $13 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1 | CurrentTaxYearAmt |
| Total | $13 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $546,799 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $906,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,154,926 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,845,634 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,199,305 | CurrentTaxYearAmt |
| Total | $10,653,255 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $0 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| RIGHT OF USE ASSET | $66,103 |
| DUE FROM OFFICER | $2,049 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $68,152 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LEASE LIABILITY | $66,103 |
| PAYROLL LIABILITIES | $5,525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $71,628 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,199,305 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,199,305 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,199,305 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,959,719 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,959,719 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,959,719 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | GOVERNMENT GRANT | GrantTypeTxt |
| Recipient | 150 | RecipientCnt |
| Cash Grant | $615,154 | CashGrantAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV - ADDITIONAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF RECIPIENTS IS ESTIMATED BY NUMBER OF TOTAL ACTIVE MEDICAID PARTICIPANTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TELBERTH FORDE | PersonNm |
| Title | EXECUTIVE DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $243,000 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $11,375 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $254,375 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. A COPY OF THE FORM 990 IS REVIEWED BY THE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| PART XII, LINE 2C | THERE WERE NO CHANGES TO THE ORGANIZATION'S OVERSIGHT PROCESS DURING THE CURRENT YEAR. |
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