2016-03-14T14:59:02-05:00 2015-09-30 264677183 DZH PHILLIPS LLP 135 MAIN STREET 9TH FLOOR SAN FRANCISCO CA 941051815 990 2014-10-01 941156461 ALDERSLY ALDE 4154537425 326 MISSION AVENUE SAN RAFAEL CA 949013484 JOANNE MAXWELL EXECUTIVE DIRECTOR 4154537425 2016-02-11 1 JANET L HOLLAND P00176450 4157812500 X 2014 2016-08-17 19:52:53Z JOANNE MAXWELL 326 MISSION AVENUE SAN RAFAEL CA 949013484 17075369 0 X WWW.ALDERSLY.COM X 1921 CA PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 12 12 111 120 0 0 850522 98424 7884924 8117572 594680 1249771 -73673 -64369 9256453 9401398 0 0 0 0 3542877 3555068 0 0 0 4304207 4661813 7847084 8216881 1409369 1184517 33072131 34447374 13220985 15254455 19851146 19192919 PROVISION OF HOUSING AND NURSING SERVICES TO SENIOR CITIZENS. 0 0 5433779 8058579 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. 5433779 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 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 65 0 1 111 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 1 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X JOANNE MAXWELL 4154537425 326 MISSION AVENUE SAN RAFAEL CA 94901 PETER SCHAKOW PRESIDENT 10.00 X X 0 0 0 CYR MILLER SENIOR VICE PRESIDENT 10.00 X X 0 0 0 AL BORO VICE PRESIDENT 10.00 X X 0 0 0 W GRANT HELLAR III SECRETARY/TREASURER 8.00 X X 0 0 0 DR DAVID BERMAN DIRECTOR/MEDICAL DIRECTOR 8.00 X X 38208 0 0 TORBEN O BJORN DIRECTOR 8.00 X 0 0 0 DAVID TORP DIRECTOR 8.00 X 0 0 0 TAGE HANSEN DIRECTOR 8.00 X 0 0 0 OLE MIKKELSEN DIRECTOR 8.00 X 0 0 0 KRISTIAN SORENSEN DIRECTOR 8.00 X 0 0 0 HERDIS VOGL DIRECTOR 8.00 X 0 0 0 BIRGIT JACOBSEN DIRECTOR 10.00 X 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR 40.00 X 182482 0 30217 CATALINA MADRID DIRECTOR OF NURSING 40.00 X 112981 0 0 333671 0 30217 2 0 1 0 SODEXHO INC & AFFILIATES DEPT 880328 LOS ANGELES CA 90088 DIETARY MANAGEMENT/SUPPLIES 768402 LIFE CARE SERVICES LLC 400 LOCUST ST STE 820 DES MOINES IA 50309 MANAGEMENT SERVICES 657069 KAISER FOUNDATION HEALTH PLAN FILE NUMBER 5915 LOS ANGELES CA 90074 HEALTH INSURANCE 279208 REHABCARE GROUP INC PO BOX 277365 ATLANTA GA 30384 REHAB SERVICE 193618 HANSON BRIDGETT MARCUS VLAHOS RUDY LLP 425 MARKET STREET SAN FRANCISCO CA 94105 ATTORNEY 138131 5 19640 78784 98424 RESIDENT CARE FEES 623000 2719279 2719279 HEALTH CARE CENTER FEES 623000 2495076 2495076 ASSISTED LIVING FEES 623000 1877803 1877803 ENTRANCE FEES AMORTIZATION 623000 1025414 1025414 8117572 527707 527707 19836 0 19836 19836 19836 8370823 7648759 722064 722064 722064 0 19640 25212 -25212 -25212 LOSS ON DISPOSAL OF ASSETS 900099 -58993 -58993 -58993 9401398 8058579 0 1244395 X 3000252 2725091 275161 54183 42006 12177 273461 265305 8156 227172 206746 20426 310606 310606 41909 41909 995885 555445 440440 155302 155302 235160 147566 87594 25719 25719 351328 238284 113044 31331 8950 22381 26144 26144 234553 234553 633976 633976 364748 187539 177209 FOOD 415094 415094 MISCELLANEOUS 315284 124377 190907 THERAPY 201910 201910 REPAIRS AND MAINTENANCE 160606 127064 33542 162258 162258 8216881 5433779 2783102 0 348742 262772 466723 421833 800000 275303 140083 269874 362491 20218240 10440901 10002416 9777339 18686375 18967968 1487739 942513 734959 3572375 33072131 34447374 395878 551978 5593760 6635000 7231347 8067477 13220985 15254455 X 19770721 19112494 80425 80425 19851146 19192919 33072131 34447374 X 1184517 -1305794 -19541 -517411 X X 0 1 X 1 0 X 159729 61865 1086165 850522 98424 2256705 7290804 7495043 7551722 7903792 8137408 38378769 7450533 7556908 8637887 8754314 8235832 40635474 632344 866004 800000 2298348 117938 117938 632344 983942 800000 2416286 38219188 352486 346010 411818 441147 427707 1979168 352486 346010 411818 441147 427707 1979168 -5213 -12991 -64645 -82849 7797806 7889927 9049705 9130816 8663539 42531793 0.89860 0.89830 0.04650 0.04500 X 5242133 234865 -15745 5461253 4732894 6272 502967 5242133 4028256 123160 581478 4732894 3561674 9442 769060 -311920 4028256 3458347 218323 -20381 -94615 3561674 1.00000 0 0 232822 232822 15176934 7769691 7407243 2476540 913435 1563105 1448175 1171677 276498 883769 586098 297671 9777339 DEFERRED FINANCING COSTS - NET OF AMORTIZATION 337726 CONSTRUCTION IN PROGRESS 243528 INTEREST AND DIVIDENDS RECEIVABLE 4108 OTHER ASSETS 5582 INVESTMENTS IN RESIDENTIAL REALESTATE 705000 ASSETS WHOSE USE IS LIMITED OR RESTRICTED 2276431 3572375 DEPOSITS RECEIVED 185387 UNEARNED PORTION OF ACCOMMODATION FEES - EXHAUSTIBLE 1356437 UNEARNED PORTION OF ACCOMMODATION FEES - NON-REFUNDABLE 3411458 GUARANTEED REFUNDS 2386805 UNEARNED VENDOR CREDIT 72923 BOND PREMIUM 654467 8067477 X 7583864 -1305794 -536952 -1842746 9426610 -25212 -25212 9401398 8242091 25210 25210 8216881 0 8216881 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: MANAGEMENT HAS CONSIDERED POSSIBLE UNCERTAIN TAX POSITIONS AND CONCLUDED THAT THERE WERE NONE AS OF THE DATE THE FINANCIAL STATEMENTS WERE AVAILABLE FOR ISSUE. PART XI, LINE 2D - OTHER ADJUSTMENTS: WRITE OFF OF PRIOR BOND ISSUANCE COSTS -517,411. INVESTMENT PROPERTY EXPENSE -19,541. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING -25,212. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE 25,212. ROUNDING -2. FORM 990, SCHEDULE D, PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, IT HAS NOT PROVIDED FOR INCOME TAXES IN THESE FINANCIAL STATEMENTS. THE LLC'S NET EARNINGS ARE REPORTED ON THE FEDERAL AND STATE EXEMPT ORGANIZATION TAX RETURNS 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 THE FINANCIAL STATEMENTS. TAX RETURN FOR YEARS SUBSEQUENT TO SEPTEMBER 30, 2011 ARE SUBJECT TO EXAMINATION BY FEDERAL OR STATE TAX AUTHORITIES. TREE OF LIGHTS 10135 10135 TIVOLI 9505 9505 1450 2407 1550 19805 19640 19640 1450 2407 1550 19805 25212 -25212 0 0 0 0 0 0 0 0 0 JOANNE MAXWELL EXECUTIVE DIRECTOR 155813 0 26669 0 0 0 24017 0 6200 0 212699 0 0 0 ADDITIONAL INFORMATION 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. DAVID BERMAN IS A DOCTOR ACTING AS AN INDEPENDENT CONTRACTOR AND PROVIDES MEDICAL EXPERTISE TO ALDERSLY IN THE ROLE OF MEDICAL DIRECTOR. 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 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) 182482 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. 0 DAVID HAROLD BERMAN MD DIRECTOR/MEDICAL DIRECTOR 38208 DAVID BERMAN IS A DOCTOR ACTING AS AN INDEPENDENT CONTRACTOR AND PROVIDES MEDICAL EXPERTISE TO ALDERSLY IN THE ROLE OF MEDICAL DIRECTOR. 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/ FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OF THE GOVERNING BODY ARE ELECTED AND VOTED FOR AT THE ANNUAL MEETING. 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 89,763. MANAGEMENT AND GENERAL EXPENSES 197,980. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 287,743. OTHER FEES: PROGRAM SERVICE EXPENSES 465,682. MANAGEMENT AND GENERAL EXPENSES 242,460. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 708,142. FORM 990, PART XI, LINE 9: WRITE OFF OF PRIOR BOND ISSUANCE COSTS -517,411. 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