LOS ROBLES HOSPITAL VOLUNTEERS INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- LOS ROBLES HOSPITAL VOLUNTEERS INC (EIN 95-3263505)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201633209349307188
- Schema version
- 2015v2.0
- 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 | 2016-11-15T10:49:14-08:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | 2015-01-01 | 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 |
| Signature | 2016-11-14 | 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 | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $325,874 | 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 | $18,509 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,102 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,740 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,345 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16 | PYInvestmentIncomeAmt |
| CY Investment Income | $14 | CYInvestmentIncomeAmt |
| PY Other Revenue | $89,829 | PYOtherRevenueAmt |
| CY Other Revenue | $105,603 | CYOtherRevenueAmt |
| PY Total Revenue | $122,094 | PYTotalRevenueAmt |
| CY Total Revenue | $116,064 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $93,050 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $92,099 | 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 | $41,408 | PYOtherExpensesAmt |
| CY Other Expenses | $27,652 | CYOtherExpensesAmt |
| PY Total Expenses | $134,458 | PYTotalExpensesAmt |
| CY Total Expenses | $119,751 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,364 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,687 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $149,676 | TotalAssetsBOYAmt |
| Total Assets EOY | $145,989 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $149,676 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $145,989 | 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 | $74,599 | ExpenseAmt |
| Grant | $74,599 | 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 | $17,500 | ExpenseAmt |
| Grant | $17,500 | 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 |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $16,964 | ExpenseAmt |
| Desc | PATIENT SERVICES - PROVIDE SUPPLIES, NEWSPAPERS, MAGAZINES, ETC. TO INSURE PATIENT COMFORT FOR PATIENTS OF LOS ROBLES REGIONAL MEDICAL CENTER, ASSIST PATIENT ADMISSIION AND DISCHARGE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $8,489 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $117,552 | 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 | false | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| 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 | false | 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 (6 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 |
| TERESA TARDIF | |||||||
| Secretary | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JUDITH WILLIAMS | |||||||
| Vice President | 16.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BABS WILLIAMS | |||||||
| 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 |
| BETTE KARDOS | |||||||
| Secretary | 8.00 | 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 | $2,102 | AllOtherContributionsAmt |
| Total Contributions | $2,102 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| ORIENTATION COST PAYMENTS | $2,832 | $2,832 |
| UNIFORM COST PAYMENTS | $5,513 | $5,513 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,345 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14 | TotalRevenueColumnAmt |
| Exclusion | $14 | ExclusionAmt |
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 | $315,413 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $209,810 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $105,603 | TotalRevenueColumnAmt |
| Exclusion | $105,603 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $116,064 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,345 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $105,617 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,599 | TotalAmt |
| Program Services | $74,599 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,500 | TotalAmt |
| Program Services | $17,500 | 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 | $400 | TotalAmt |
| Management And General | $400 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $725 | TotalAmt |
| Management And General | $725 | 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 |
|---|---|---|---|
| PATIENT SERVICES | $9,951 | $9,951 | |
| UNIFORMS | $8,489 | $8,489 | |
| VOLUNTEER EXPENSES | $7,013 | $7,013 | |
| OFFICE EXPENSE | $588 | $588 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $486 | TotalAmt |
| Management And General | $486 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,751 | TotalAmt |
| Program Services | $117,552 | ProgramServicesAmt |
| Management And General | $2,199 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,101 | BOYAmt |
| EOY | $89,309 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,516 | BOYAmt |
| EOY | $29,626 | 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 | $23,476 | BOYAmt |
| EOY | $25,000 | 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 | $70,627 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $68,576 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,583 | BOYAmt |
| EOY | $2,051 | 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 | $3 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,676 | BOYAmt |
| EOY | $145,989 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,676 | BOYAmt |
| EOY | $145,989 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,676 | BOYAmt |
| EOY | $145,989 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,676 | BOYAmt |
| EOY | $145,989 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$3,687 | ReconcilationRevenueExpnssAmt |
| 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 | $7,202 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,744 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $934 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,509 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,101 | CurrentTaxYearAmt |
| Total | $40,490 | 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 | $7,202 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,744 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $934 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,509 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,101 | CurrentTaxYearAmt |
| Total | $40,490 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $40,490 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $88 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $66 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14 | CurrentTaxYearAmt |
| Total | $201 | 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 | $9,099 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,736 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,833 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,756 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,345 | CurrentTaxYearAmt |
| Total | $68,769 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $109,460 | TotalSupportAmt |
| Public Support CY170 | 0.36990 | PublicSupportCY170Pct |
| Public Support PY170 | 0.39720 | 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 | $54,332 | OtherCostOrOtherBasisAmt |
| Depreciation | $56,755 | DepreciationAmt |
| Book Value | -$2,423 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,295 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,821 | DepreciationAmt |
| Book Value | $4,474 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,051 | TotalBookValueLandBuildingsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | IRC SectionIRCSectionDesc |
|---|---|---|---|---|---|---|---|
| CANCER SUPPORT COMMUNITY | |||||||
| 530 HAMPSHIRE RD | WESTLAKE VLG | CA | 91361 | 770205691 | $8,000 | $0 | |
| Conejo Free Clinic | |||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 953177953 | $9,500 | $0 | |
| HOPE FUND | |||||||
| 1 PARK PLAZA | NASHVILLE | TN | 37023 | $11,000 | $0 | ||
| HOSPICE OF THE CONEJO | |||||||
| 80 E HILLCREST DR | THOUSAND OAKS | CA | 91360 | 953219656 | $9,500 | $0 | 501(C)(3) |
| INTERFACE CHILDREN & FAMILY S | |||||||
| 80 E HILLCREST RD | THOUSAND OAKS | CA | 91360 | 952944459 | $8,000 | $0 | |
| Sarahs House | |||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 952265201 | $9,500 | $0 | |
| Senior Concerns | |||||||
| 401 Hodencamp | Thousand Oaks | CA | 91362 | 952992927 | $8,000 | $0 | |
| Westminster Free Clinic | |||||||
| 32111 Watergate Rd | Thousand Oaks | CA | 91361 | 770563241 | $8,000 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 3 | TotalOtherOrgCnt |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | COLLEGE SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 18 | RecipientCnt |
| Cash Grant | $17,500 | 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 (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
| 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. |
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