LOS ROBLES HOSPITAL VOLUNTEERS INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
LOS ROBLES HOSPITAL VOLUNTEERS INC (EIN 95-3263505)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-11
IRS object ID
201513159349301496
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)
Return2015-11-11T16:00:03-08:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Anthony M Salzman CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1325 Rolling Oaks Drive 201AddressLine1Txt
CityThousand OaksCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91361ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN953263505EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LOS ROBLES HOSPITAL VOLUNTEERS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLOSRBusinessNameControlTxt
Phone8053704685PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1215 W JANSS ROADAddressLine1Txt
CityTHOUSAND OAKSCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91360ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARGARITA HORWITZPersonNm
Person TitleVice PresidentPersonTitleTxt
Signature2015-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAnthony SalzmanPreparerPersonNm
PTINP00521089PTIN
Phone8054957458PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$358,598GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionPROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers600TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$934PYContributionsGrantsAmt
CY Contributions Grants$18,509CYContributionsGrantsAmt
PY Program Service Revenue$19,833PYProgramServiceRevenueAmt
CY Program Service Revenue$13,740CYProgramServiceRevenueAmt
PY Investment Income$17PYInvestmentIncomeAmt
CY Investment Income$16CYInvestmentIncomeAmt
PY Other Revenue$106,539PYOtherRevenueAmt
CY Other Revenue$89,829CYOtherRevenueAmt
PY Total Revenue$127,323PYTotalRevenueAmt
CY Total Revenue$122,094CYTotalRevenueAmt
PY Grants And Similar Paid$100,635PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$93,050CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$38,176PYOtherExpensesAmt
CY Other Expenses$41,408CYOtherExpensesAmt
PY Total Expenses$138,811PYTotalExpensesAmt
CY Total Expenses$134,458CYTotalExpensesAmt
PY Revenues Less Expenses-$11,488PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$12,364CYRevenuesLessExpensesAmt
Total Assets BOY$162,703TotalAssetsBOYAmt
Total Assets EOY$149,676TotalAssetsEOYAmt
Total Liabilities BOY$663TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$162,040NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$149,676NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionPROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$72,550ExpenseAmt
Grant$72,550GrantAmt
DescCHARITABLE CONTRIBUTIONS: MAKE CHARITABLE CONTRIBUTIONS TO IMPORTANT CHARITABLE CAUSES IN THE COMMUNITY.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$29,442ExpenseAmt
DescPATIENT SERVICES - PROVIDE SUPPLIES, NEWSPAPERS, MAGAZINES, ETC. TO INSURE PATIENT COMFORT FOR PATIENTS OF LOS ROBLES REGIONAL MEDICAL CENTER, ASSIST PATIENT ADMISSIION AND DISCHARGE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$20,500ExpenseAmt
Grant$20,500GrantAmt
DescCOLLEGE 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
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$8,496TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$130,988TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonANTHONY M SALZMAN CPAPersonNm
Phone8054957458PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1325 ROLLING OAKS DR 201AddressLine1Txt
CityTHOUSAND OAKSCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91361ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARGARITA HORWITZ
Vice President24.000.00Yes (X)Yes (X)$0$0$0
TERESA TARDIF
Secretary8.000.00Yes (X)Yes (X)$0$0$0
JUDITH WILLIAMS
Vice President16.000.00Yes (X)Yes (X)$0$0$0
BABS WILLIAMS
President16.000.00Yes (X)Yes (X)$0$0$0
GLENN KASSELL
Treasurer16.000.00Yes (X)Yes (X)$0$0$0
BETTE KARDOS
Secretary8.000.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$18,509AllOtherContributionsAmt
Total Contributions$18,509TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ORIENTATION COST PAYMENTS$6,025$6,025
UNIFORM COST PAYMENTS$7,715$7,715
FieldValueIRS element (for citing)
Total Program Service Revenue$13,740TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16TotalRevenueColumnAmt
Related Or Exempt Func Income$16RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$326,333GrossSalesOfInventoryAmt
Cost Of Goods Sold$236,504CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$89,829TotalRevenueColumnAmt
Exclusion$89,829ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$122,094TotalRevenueColumnAmt
Related Or Exempt Func Income$13,756RelatedOrExemptFuncIncomeAmt
Exclusion$89,829ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$72,550TotalAmt
Program Services$72,550ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$20,500TotalAmt
Program Services$20,500ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$2,275TotalAmt
Management And General$2,275ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PATIENT SERVICES$19,696$19,696
VOLUNTEER EXPENSES$9,746$9,746
UNIFORMS$8,496$8,496
OFFICE EXPENSE$845$845

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$350TotalAmt
Management And General$350ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$134,458TotalAmt
Program Services$130,988ProgramServicesAmt
Management And General$3,470ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$95,941BOYAmt
EOY$94,101EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$30,997BOYAmt
EOY$29,516EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$32,553BOYAmt
EOY$23,476EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$70,626LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$68,043LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,212BOYAmt
EOY$2,583EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$162,703BOYAmt
EOY$149,676EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$663BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$663BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$162,040BOYAmt
EOY$149,676EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$162,040BOYAmt
EOY$149,676EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$162,703BOYAmt
EOY$149,676EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$12,364ReconcilationRevenueExpnssAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewYes (true)AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
FS AuditedfalseFSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,202CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,744CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$934CurrentTaxYearMinus1YearAmt
Current Tax Year$18,509CurrentTaxYearAmt
Total$45,589TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,200CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,202CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,744CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$934CurrentTaxYearMinus1YearAmt
Current Tax Year$18,509CurrentTaxYearAmt
Total$45,589TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$45,589PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$65CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$88CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$66CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17CurrentTaxYearMinus1YearAmt
Current Tax Year$16CurrentTaxYearAmt
Total$252TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,520CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,099CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$17,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,833CurrentTaxYearMinus1YearAmt
Current Tax Year$13,756CurrentTaxYearAmt
Total$68,944TotalAmt
FieldValueIRS element (for citing)
Total Support$114,785TotalSupportAmt
Public Support CY1700.39720PublicSupportCY170Pct
Public Support PY1700.33170PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$59,155OtherCostOrOtherBasisAmt
Depreciation$56,572DepreciationAmt
Book Value$2,583BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,471OtherCostOrOtherBasisAmt
Depreciation$11,471DepreciationAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,583TotalBookValueLandBuildingsAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmt
CANCER SUPPORT COMMUNITY
530 HAMPSHIRE RDWESTLAKE VLGCA91361770205691501(C)(3)$9,000$0
Conejo Free Clinic
80 E Hillcrest DrThousand OaksCA91360953177953501(C)(3)$9,000$0
Hospice of the Conejo
80 E Hillcrest DrThousand OaksCA91360953219656501 (C)(3)$9,000$0
INTERFACE CHILDREN & FAMILY S
80 E HILLCREST RDTHOUSAND OAKSCA91360952944459501(C)(3)$6,000$0
MANNA - CONEJO VALLEY FOOD BK
3020 CRESCENT WAYTHOUSAND OAKSCA91362953413415501(C)(3)$9,750$0
Senior Concerns
401 HodencampThousand OaksCA91362952992927501(C)(3)$9,000$0
Westminster Free Clinic
32111 Watergate RdThousand OaksCA91361770563241501C)(3)$9,000$0
FieldValueIRS element (for citing)
Total501c3 Org5Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeCOLLEGE SCHOLARSHIPSGrantTypeTxt
Recipient28RecipientCnt
Cash Grant$20,500CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceGrantmaker's Description of How Grants are UsedFormAndLineReferenceDesc
ExplanationTHE 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4d: Other Program Services DescriptionOTHER 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 ShareholderMEMBERSHIP 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 ProcessForm 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 ConflictsEach 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 ManagementN/A
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesN/A
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTax 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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