2016-11-11T13:11:36-06:00 2015-12-31 450250958 EIDE BAILLY LLP 1850 N CENTRAL AVE SUITE 400 PHOENIX AZ 850044527 990 2015-01-01 270919033 CHRISTIAN CARE SURPRISE INC CHRI 6024435487 2002 W SUNNYSIDE DR PHOENIX AZ 85029 ALAN HIEB COO 6024435487 2016-11-08 1 BRENDA BLUNT CPA P00075126 6022645844 2016-11-02 2015 2017-02-10 21:41:12Z CHRISTIAN CARE MANAGEMENT III INC JOHN NORRIS 2002 W SUNNYSIDE DR PHOENIX AZ 85029 0 0 X WWW.CHRISTIANCARE.ORG X 2010 AZ AFFORDABLE RESIDENTIAL & ASSISTED LIVING FOR SENIORS 15 15 0 15 0 0 0 0 0 0 44 0 0 0 44 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44 0 4429479 5934283 4429435 5934239 44 44 MOTIVATED BY CHRISTIAN LOVE AND CONCERN, WE STRIVE TO PROVIDE QUALITY AND RESPONSIVE SENIOR HOUSING, HOSPITALITY AND HEALTHCARE SERVICES. 0 0 0 0 IN 2014 CHRISTIAN CARE SURPRISE ACQUIRED A PARCEL OF LAND SUITABLE FOR BUILDING A FELLOWSHIP SQUARE COMMUNITY IN SURPRISE ARIZONA. IN 2016 CHRISTIAN CARE SURPRISE IS FINALIZING BUILDING PLANS AND ACQUIRING FINANCING TO ENABLE FELLOWSHIP SQUARE SURPRISE TO BEGIN CONSTRUCTION. 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 AZ X KATHI CONDON 6024435487 PO BOX 83210 PHOENIX AZ 850713210 LARRY D DAILY DIRECTOR 0.10 0.40 X 0 0 0 JAY MIHALEK DIRECTOR 0.10 0.40 X 0 0 0 CHRISTINE GUERIN DIRECTOR 0.10 0.40 X 0 0 0 SHARON JOHNSON-SHANNON DIRECTOR 0.10 0.40 X 0 0 0 EARL KRUEGER DIRECTOR 0.10 0.40 X 0 0 0 ROGER BLUMENTHAL DIRECTOR 0.10 0.40 X 0 0 0 FRANK SUNG DIRECTOR 0.10 0.40 X 0 0 0 JACK MARTIN DIRECTOR 0.10 0.40 X 0 0 0 THOMAS HARTZLER DIRECTOR 0.10 0.90 X 0 0 0 JOHN MCKINDLES PAST PRESIDENT 0.10 0.40 X X 0 0 0 DONALD DEWITT PRESIDENT 0.10 0.90 X X 0 0 0 GEOFFREY LEWIS SECRETARY 0.10 0.90 X X 0 0 0 BARBARA CARR 1ST VICE PRESIDENT 0.10 0.90 X X 0 0 0 MARILYN METZGER 2ND VICE PRESIDENT 0.10 0.90 X X 0 0 0 ED FRENCH TREASURER 0.10 0.90 X X 0 0 0 JOHN S NORRIS CHIEF EXECUTIVE OFFICER 1.00 39.00 X 0 277353 93450 DAVID KLEMM CHIEF FINANCIAL OFFICER 1.00 49.00 X 0 154618 78494 ALAN HIEB CHIEF OPERATING OFFICER 1.00 39.00 X 0 218669 20152 0 650640 192096 0 0 1 0 REECE ANGEL ROWE 4343 E AVALON DRIVE PHOENIX AZ 85018 ARCHITECTURAL SERVICES 797950 1 0 0 0 0 0 0 0 0 4352 166385 56602 6598 5720300 0 4368524 5720300 1 41000 4429479 5934283 114847 82822 1075000 1275000 2952200 2886765 100000 287388 1589652 4429435 5934239 X 44 44 44 44 4429479 5934283 0 0 X 0 1 X 1 0 X 0 44 44 44 44 44 44 X 3734928 3734928 1985372 1985372 5720300 DUE TO RELATED PARTIES 1589652 1589652 X PART X, LINE 2: MANAGEMENT BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY INCOME TAX POSITIONS TAKEN, AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. 1 0 0 0 0 0 0 0 1 1 JOHN S NORRIS CHIEF EXECUTIVE OFFICER 0 257990 0 1218 0 18145 0 7950 0 85500 0 370803 0 0 DAVID KLEMM CHIEF FINANCIAL OFFICER 0 82671 0 0 0 71947 0 6135 0 72359 0 233112 0 0 ALAN HIEB CHIEF OPERATING OFFICER 0 218669 0 0 0 0 0 4659 0 15493 0 238821 0 0 PART I, LINE 4A SEVERANCE PAYMENT FOR DAVID KLEMM IN THE AMOUNT OF $29,645.56. PART I, LINE 8 ALAN HIEB'S COMPENSATION REPORTED ON PART VII WAS ALL PAID UNDER THE INITIAL CONTRACT PROVISIONS DESCRIBED IN REGULATIONS SECTION 53.4958-4(A)(3). SCHEDULE J, PART I, QUESTION 3: THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, CHRISTIAN CARE MANAGEMENT, INC., THAT USED THE FOLLOWING METHODS DESCRIBED IN QUESTION 3 TO ESTABLISH THE CEO'S COMPENSATION: COMPENSATION COMMITTEE (A.K.A. PERSONNEL COMMITTEE), FORM 990 OF OTHER ORGANIZATIONS, COMPENSATION SURVEY OR STUDY, WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY THE INDEPENDENT GOVERNING BOARD. SCHEDULE J, PART II: AS MINISTERS, PART OF THE COMPENSATION PAID TO JOHN NORRIS AND DAVID KLEMM INCLUDES A HOUSING ALLOWANCE, WHICH IS APPROVED BY THE BOARD AND INCLUDED IN OTHER COMPENSATION IN COLUMN D. TOTAL COMPENSATION TO THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES REMAINS MODEST COMPARED TO SIMILAR INDUSTRY POSITIONS. ED FRENCH BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 300000 300000 0 1 1 LIVING TRUST OF ESTHER FRENCH CONTROLLED ENTITY OF BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 300000 300000 0 1 1 JOHN NORRIS CEO FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 75000 75000 0 1 1 AGN DEVELOPMENT CORP CONTROLLED ENTITY OF OFFICER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 125000 125000 0 1 1 GEOFFREY LEWIS BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 175000 175000 0 1 1 BARBARA CARR BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 150000 150000 0 1 1 JAY MIHALEK BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 50000 50000 0 1 1 FRANK SUNG BOARD MEMBER FUND DEVELOPMENT OF A SENIOR HOUSING FACILITY X 100000 100000 0 1 1 1275000 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE, CONSISTING OF THE OFFICERS OF THE CORPORATION AND THE PAST CHAIRMAN OR PRESIDENT, ARE AUTHORIZED TO REPRESENT THE BOARD OF DIRECTORS IN NEGOTIATIONS WITH ANY AND ALL AGENTS REPRESENTING INTERESTED OR RELATED PARTIES. HOWEVER, THE COMMITTEE MAY NOT ENCUMBER OR OBLIGATE THE CORPORATION WITHOUT SPECIFIC CONFIRMATION FROM THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 3 THE CEO, CFO, COO, AND HUMAN RESOURCE OFFICER ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR PROVIDING OVERSIGHT OF THE DAILY MANAGEMENT OF THE ORGANIZATION. THE CORPORATION AND MANAGEMENT ENTERED INTO A MANAGEMENT AGREEMENT ON A MONTH-TO-MONTH BASIS UNDER WHICH THE CORPORATION IS TO PAY MANAGEMENT AND BOOKKEEPING FEES IN AN AMOUNT SPECIFIED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 THE MEMBERSHIP OF THE CORPORATION IS COMPOSED OF AND LIMITED TO THE INDEPENDENT CHRISTIAN CHURCHES OF ARIZONA. FORM 990, PART VI, SECTION A, LINE 7B THE FEDERAL HOUSING COMMISSIONER INSURES THE DEED OF TRUST AND MUST APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION B, LINE 11 THE CEO AND CFO WILL REVIEW COMPLETED FORM 990 AND PROVIDE A FINAL DRAFT TO THE GOVERNING BOARD ALLOWING FOR A COMMENT PERIOD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND ANY OTHER PERSON WITH SUBSTANTIAL INFLUENCE ARE REQUIRED TO FILL OUT A CONFLICT OF INTEREST DISCLOSURE STATEMENT. PART OF THIS STATEMENT REQUIRES THEM TO SIGN AND CONFIRM THAT THEY HAVE READ AND UNDERSTOOD THE COMPANY'S CONFLICT OF INTEREST POLICY. THEY ALSO AGREE TO NOTIFY THE CHAIR OF THE BOARD OR PRESIDENT AND/OR THE CEO IMMEDIATELY IF THEY BECOME AWARE OF ANY POTENTIAL CONFLICTS. IF AN INDIVIDUAL HAS A CONFLICT, THEY ARE REQUIRED TO RECUSE THEMSELVES FROM DISCUSSION OF THE ISSUE AND THE VOTING PROCESS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND COO ARE NOT COMPENSATED BY CHRISTIAN CARE SURPRISE, INC. THE CEO AND COO ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR THEIR SERVICES PROVIDED TO ALL CHRISTIAN CARE COMPANIES. THEIR COMPENSATION IS DETERMINED BY LOOKING AT COMPARABILITY DATA THROUGH REVIEW OF FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION SURVEYS AND STUDIES. THE CEO'S COMPENSATION IS REVIEWED BY THE PERSONNEL COMMITTEE AND RATIFIED BY THE INDEPENDENT GOVERNING BOARD. THE COO'S COMPENSATION IS REVIEWED ANNUALLY ON HIS ANNIVERSARY DATE AND APPROVED BY THE CEO. THEIR COMPENSATION ARRANGEMENTS ARE DOCUMENTED IN WRITTEN EMPLOYMENT CONTRACTS. THIS DOCUMENTATION IS PREPARED IN JANUARY OF EACH YEAR. THE CFO AND HUMAN RESOURCE OFFICER ARE NOT COMPENSATED BY CHRISTIAN CARE SURPRISE, INC. THE CFO AND HUMAN RESOURCE OFFICER ARE COMPENSATED BY CHRISTIAN CARE MANAGEMENT, INC. FOR THEIR SERVICES PROVIDED TO MULTIPLE CHRISTIAN CARE RELATED ENTITIES. THEIR COMPENSATION IS DETERMINED BY LOOKING AT COMPARABILITY DATA THROUGH REVIEW OF FORM 990 OF OTHER ORGANIZATIONS AND COMPENSATION SURVEYS AND STUDY. THEY DO NOT HAVE A WRITTEN EMPLOYMENT CONTRACT. THEIR COMPENSATION IS ALSO REVIEWED ANNUALLY ON THEIR ANNIVERSARY DATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. 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