BETA

CHILDSERVE MEDICAL EQUIPMENT & SUPPLY INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
CHILDSERVE MEDICAL EQUIPMENT & SUPPLY INC (EIN 42-1264666)
Tax period
2014-07-01 to 2015-06-30
Filed
2015-12-04
IRS object ID
201503389349300710
Schema version
2014v5.0
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

FieldValueIRS element (for citing)
Return2015-12-04T08:56:59-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN421229486PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BROOKS LODDEN PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11441 29TH STREET STE 305AddressLine1Txt
CityWEST DES MOINESCityNm
State AbbreviationIAStateAbbreviationCd
ZIP502661357ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN421264666EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHILDSERVE MEDICAL EQUIPMENT & SUPPLY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHILBusinessNameControlTxt
Phone5157278750PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 707AddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP501310707ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLLOYD VANDER KWAAKPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone5157278750PhoneNum
Signature2015-12-03SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRENT L ALEXANDERPreparerPersonNm
PTINP00075113PTIN
Phone5152237300PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLLOYD VANDER KWAAKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 707AddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP501310707ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,328,896GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHILDSERVE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionWE PARTNER WITH FAMILIES TO HELP CHILDREN WITH SPECIAL HEALTH CARE NEEDS LIVE A GREAT LIFE.ActivityOrMissionDesc
Voting Members Governing Body6VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee5TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,801PYContributionsGrantsAmt
CY Contributions Grants$7,123CYContributionsGrantsAmt
PY Program Service Revenue$1,296,716PYProgramServiceRevenueAmt
CY Program Service Revenue$1,321,710CYProgramServiceRevenueAmt
PY Investment Income$1PYInvestmentIncomeAmt
CY Investment Income$14CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$49CYOtherRevenueAmt
PY Total Revenue$1,300,518PYTotalRevenueAmt
CY Total Revenue$1,328,896CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$231,459PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$300,843CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$968,930PYOtherExpensesAmt
CY Other Expenses$998,666CYOtherExpensesAmt
PY Total Expenses$1,200,389PYTotalExpensesAmt
CY Total Expenses$1,299,509CYTotalExpensesAmt
PY Revenues Less Expenses$100,129PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$29,387CYRevenuesLessExpensesAmt
Total Assets BOY$1,282,110TotalAssetsBOYAmt
Total Assets EOY$1,334,120TotalAssetsEOYAmt
Total Liabilities BOY$61,463TotalLiabilitiesBOYAmt
Total Liabilities EOY$84,086TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,220,647NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,250,034NetAssetsOrFundBalancesEOYAmt
MissionTO ENHANCE THE WELL BEING OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS BY PROVIDING MOBILITY EQUIPMENT, SPECIALTY MEDICAL SUPPLIES AND SERVICES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$983,784ExpenseAmt
Revenue$1,321,759RevenueAmt
DescPROVIDES MEDICAL SUPPLIES AND ADAPTS EQUIPMENT FOR USE BY PERSONS WITH PHYSICAL DISABILITIES IN THE COMMUNITY AND WITHIN THE CHILDSERVE RESIDENTIAL FACILITIES.Desc
Total Program Service Expenses$983,784TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee5EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members6GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHILDSERVEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5157278750PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 707AddressLine1Txt
CityJOHNSTONCityNm
State AbbreviationIAStateAbbreviationCd
ZIP501310707ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
JOEL NELSON
PAST CHAIR2.00Yes (X)Yes (X)$0$0$0
KIP ALBERTSON
CHAIR2.00Yes (X)Yes (X)$0$0$0
LLOYD VANDER KWAAK
PRESIDENT/CEO1.00Yes (X)Yes (X)$8,058$358,239$57,62739.00
SHIRLEY POERTNER
SECRETARY2.00Yes (X)Yes (X)$0$0$0
DOUG DORNACKER
VICE CHAIR2.00Yes (X)Yes (X)$0$0$0
DAVID MACKAMAN
TREASURER2.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,058TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$358,239TotReportableCompRltdOrgAmt
Total Other Compensation$57,627TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$7,123FederatedCampaignsAmt
Total Contributions$7,123TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ADAPTIVE EQUIPMENT621300$894,892$894,892
MEDICAL SUPPLIES621300$426,818$426,818
FieldValueIRS element (for citing)
Total Program Service Revenue$1,321,710TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14TotalRevenueColumnAmt
Exclusion$14ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$49TotalRevenueColumnAmt
Related Or Exempt Func Income$49RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$49OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,328,896TotalRevenueColumnAmt
Related Or Exempt Func Income$1,321,759RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$14ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$10,539TotalAmt
Management And General$10,539ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$243,913TotalAmt
Program Services$170,602ProgramServicesAmt
Management And General$73,311ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$3,163TotalAmt
Program Services$2,616ProgramServicesAmt
Management And General$547ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$25,065TotalAmt
Program Services$13,208ProgramServicesAmt
Management And General$11,857ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$18,163TotalAmt
Program Services$12,479ProgramServicesAmt
Management And General$5,684ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$756,677TotalAmt
Program Services$749,947ProgramServicesAmt
Management And General$6,730ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$76,365TotalAmt
Management And General$76,365ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,249TotalAmt
Program Services$4,442ProgramServicesAmt
Management And General$807ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$1,386TotalAmt
Program Services$487ProgramServicesAmt
Management And General$899ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,139TotalAmt
Program Services$1,139ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,639TotalAmt
Program Services$101ProgramServicesAmt
Management And General$4,538ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
ADMINISTRATION SUPPORT$110,741$110,741
BAD DEBT EXPENSE$17,153$17,153
DUES AND SUBSCRIPTIONS$8,746$4,625$4,121
WORKERS COMPENSATION EX$6,711$524$6,187

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$9,860TotalAmt
Program Services$1,302ProgramServicesAmt
Management And General$8,558ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,299,509TotalAmt
Program Services$983,784ProgramServicesAmt
Management And General$315,725ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$40,553BOYAmt
EOY$39,743EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$263,577BOYAmt
EOY$248,574EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$73,714BOYAmt
EOY$96,716EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$50,056LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$47,869LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,326BOYAmt
EOY$2,187EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$900,940BOYAmt
EOY$946,900EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,282,110BOYAmt
EOY$1,334,120EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$61,463BOYAmt
EOY$84,086EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$61,463BOYAmt
EOY$84,086EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,220,647BOYAmt
EOY$1,250,034EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,220,647BOYAmt
EOY$1,250,034EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,282,110BOYAmt
EOY$1,334,120EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$29,387ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,544CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$78,244CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,039CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,801CurrentTaxYearMinus1YearAmt
Current Tax Year$7,123CurrentTaxYearAmt
Total$114,751TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,065,294CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,083,758CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,120,243CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,296,716CurrentTaxYearMinus1YearAmt
Current Tax Year$1,321,710CurrentTaxYearAmt
Total$5,887,721TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,084,838CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,162,002CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,126,282CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,300,517CurrentTaxYearMinus1YearAmt
Current Tax Year$1,328,833CurrentTaxYearAmt
Total$6,002,472TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,002,472PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$243CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$45CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1CurrentTaxYearMinus1YearAmt
Current Tax Year$14CurrentTaxYearAmt
Total$320TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$17CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$243CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$45CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1CurrentTaxYearMinus1YearAmt
Current Tax Year$14CurrentTaxYearAmt
Total$320TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year$49CurrentTaxYearAmt
Total$49TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,084,855CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,162,245CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,126,327CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,300,518CurrentTaxYearMinus1YearAmt
Current Tax Year$1,328,896CurrentTaxYearAmt
Total$6,002,841TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99990PublicSupportCY509Pct
Public Support PY5090.99990PublicSupportPY509Pct
Investment Income CY0.00010InvestmentIncomeCYPct
Investment Income PY0.00010InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,098OtherCostOrOtherBasisAmt
Depreciation$22,911DepreciationAmt
Book Value$2,187BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,958OtherCostOrOtherBasisAmt
Depreciation$24,958DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,187TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM AFFILIATEDesc
Book Value$946,900BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$946,900TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationACCOUNTING FOR UNCERTAIN TAX POSITIONS: CHILDSERVE, INC. AND SUBSIDIARIES HAVE DETERMINATION LETTERS FROM THE IRS WITH VARIOUS DATES STATING THE ORGANIZATION AND ITS SUBSIDIARIES ARE EXEMPT FROM INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. CHILDSERVE, INC. AND SUBSIDIARIES ALL FILE FORM 990 TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. MANAGEMENT OF THE ORGANIZATION BELIEVES IT HAS NO MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, WILL NOT RECOGNIZE ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. ANY INTEREST AND PENALTY PAYMENTS WOULD BE RECORDED IN SEPARATE ACCOUNTS IN THE OPERATING EXPENSES. THE ORGANIZATION'S REMAINING OPEN YEARS SUBJECT TO EXAMINATION INCLUDE THE YEARS ENDED JUNE 30, 2012 THROUGH JUNE 30, 2015.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgYes (1)CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsYes (1)CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonLLOYD VANDER KWAAKPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$6,389BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$284,027CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$1,130BonusFilingOrganizationAmount
Bonus Related Organizations$50,251BonusRelatedOrganizationsAmt
Other Compensation Filing Org$539OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$23,961OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$1,087DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$48,329DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$181NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$8,030NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$9,326TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$414,598TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3CHILDSERVE INC. (A RELATED ORGANIZATION) OBTAINS A COMPREHENSIVE MARKET BASED STUDY TO OBTAIN COMPENSATION DATA FOR EACH KEY EMPLOYEE FROM SIMILAR TYPE AGENCIES AND ORGANIZATIONS EVERY THREE YEARS. DURING THE YEARS WHEN THE STUDY IS NOT CONDUCTED, MARKET BASED INFORMATION SUCH AS CPI OR COMPARABLE DATA WILL BE USED ANNUALLY TO MAKE ADJUSTMENTS TO THE MIDPOINT. THE EXECUTIVE COMMITTEE OF CHILDSERVE INC.'S BOARD OF DIRECTORS HAS THE RESPONSIBILITY TO OVERSEE THE IMPLEMENTATION OF THE EXECUTIVE COMPENSATION POLICY. THE EXECUTIVE COMMITTEE WILL APPROVE THE COMPENSATION ARRANGEMENTS FOR THE PRESIDENT/CEO WITHOUT DISCUSSION OR VOTING PARTICIPATION OF THE PRESIDENT/CEO.
PART I, LINE 6INCENTIVE PAY IS BASED ON MEETING A BUDGETED ORGANIZATIONAL NET EARNINGS.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S POLICY FOR REVIEW OF THE FORM 990 RETURN INCLUDES REVIEW BY THE INDEPENDENT AUDIT SUBCOMMITTEE OF THE FINANCE COMMITTEE AND DISTRIBUTION TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CMEMBERS OF THE GOVERNING BOARD AND KEY EMPLOYEES ARE REQUIRED BY POLICY TO ACKNOWLEDGE IN WRITING THEIR UNDERSTANDING AND COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THIS IS DONE ANNUALLY WITH 100% RESPONSE RATE REQUIRED.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE CHILDSERVE INC. (A RELATED ORGANIZATION) BOARD OF DIRECTORS HAS THE RESPONSIBILITY TO OVERSEE THE IMPLEMENTATION OF THE EXECUTIVE COMPENSATION POLICY FOR THE THREE KEY EMPLOYEES: PRESIDENT/CEO, VICE PRESIDENT OF ADMINISTRATION, AND VICE PRESIDENT OF PROGRAMS. THE EXECUTIVE COMMITTEE WILL APPROVE THE COMPENSATION ARRANGEMENTS FOR THE PRESIDENT/CEO WITHOUT DISCUSSION OR VOTING PARTICIPATION OF THE PRESIDENT/CEO. THE EXECUTIVE COMMITTEE WILL DOCUMENT THE BASIS FOR EXECUTIVE COMPENSATION DETERMINATIONS CONCURRENTLY WITH APPROVAL. THE DOCUMENTATION CONTAINS THE COMPARABILITY DATA THAT WAS RELIED ON AND HOW THE DATA WAS OBTAINED. A COMPREHENSIVE MARKET BASED STUDY WILL OBTAIN COMPENSATION DATA FOR EACH KEY EMPLOYEE FROM SIMILAR TYPE AGENCIES AND ORGANIZATIONS EVERY THREE YEARS. DURING THE YEARS WHEN THE COMPREHENSIVE MARKET BASED STUDY IS NOT CONDUCTED, MARKET BASED INFORMATION SUCH AS THE CPI OR COMPARABLE DATA WILL BE USED ANNUALLY TO MAKE ADJUSTMENTS TO THE MIDPOINT.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CHILDSERVE HOMES INC
PO BOX 707JOHNSTONIA50131421264664SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
CHILDSERVE HABILITATION CENTER
PO BOX 707JOHNSTONIA50131420680245SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
CHILDSERVE THERAPY INC
PO BOX 707JOHNSTONIA50131420680420SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
CHILDSERVE INC
PO BOX 707JOHNSTONIA50131421271420PARENT COMPANY FOR BENEFIT & SUPPORT OF PROGRAMS/ SERVICES OF CHILDSERVEIA501(C)(3)LINE 90
CHILDSERVE COMMUNITY OPTIONS
PO BOX 707JOHNSTONIA50131421390033SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
CHILDSERVE HOMECARE INC
PO BOX 707JOHNSTONIA50131421478832SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
CHILDSERVE FOUNDATION INC
PO BOX 707JOHNSTONIA50131421157665DEVELOP, RECEIVE AND GRANT FINANCIAL ASSISTANCE TO CHILDSERVE ORGANIZATIONSIA501(C)(3)LINE 11A, ICHILDSERVE INC0
THE CHILDSERVE CLINIC INC
PO BOX 707JOHNSTONIA50131455327981SEE PART VII - SUPPLEMENTAL INFORMATIONIA501(C)(3)LINE 9CHILDSERVE INC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CHILDSERVE INC
P$110,741BASED ON PROPORTIONATE REVENUE
CHILDSERVE HABILITATION CENTER
K$69,628BASED ON SQUARE FOOTAGE

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II, IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS:FormAndLineReferenceDesc
ExplanationNAME OF RELATED ORGANIZATION: CHILDSERVE HOMES, INC. PRIMARY ACTIVITY: PROVIDE COMMUNITY BASED GROUP HOME LIVING FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS NAME OF RELATED ORGANIZATION: CHILDSERVE HABILITATION CENTER PRIMARY ACTIVITY: PROVIDE PEDIATRIC SKILLED NURSING AND SERVICES FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS AND CHRONIC HEALTH CONDITIONS NAME OF RELATED ORGANIZATION: CHILDSERVE THERAPY, INC. PRIMARY ACTIVITY: PROVIDE SKILLED THERAPY AND AUDIOLOGY SERVICES FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS NAME OF RELATED ORGANIZATION: CHILDSERVE COMMUNITY OPTIONS PRIMARY ACTIVITY: PROVIDE INTEGRATED SERVICES AND COMMUNITY CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS NAME OF RELATED ORGANIZATION: CHILDSERVE HOMECARE, INC. PRIMARY ACTIVITY: PROVIDE SPECIALTY HOME HEALTH CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS NAME OF RELATED ORGANIZATION: THE CHILDSERVE CLINIC, INC. PRIMARY ACTIVITY: IMPROVE ACCESS TO PEDIATRIC SUBSPECIALTY MEDICAL SERVICES, PEDIATRIC REHABILITATION SERVICES, AND IN-HOME FAMILY SUPPORT SERVICESExplanationTxt

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