ULTRALIFE SENIOR CARE PLANNING: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ULTRALIFE SENIOR CARE PLANNING (EIN 95-4580317)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-21
IRS object ID
201302959349300000
Schema version
2012v2.2
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)
Timestamp2013-10-21T11:40:45-00:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Stanley Shih CPABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line116946 Ridge Park DrAddressLine1
CityHacienda HeightsCity
StateCAState
ZIP Code91745ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN954580317EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Ultralife Senior Care Planning ConcilBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlULTRNameControl
Phone6262155489Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11022 1024 E Garvey AveAddressLine1
CityMonterey ParkCity
StateCAState
ZIP Code917543013ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCybele Lee LinName
TitlePresidentTitle
Phone6262155489Phone
Date Signed2013-10-18DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameChung Hsin Stanley ShihName
Phone6268104955Phone
Date Prepared2013-10-21DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonCybele LinNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1101 S New AveAddressLine1
CityMonterey ParkCity
StateCAState
ZIP Code91744ZIPCode
FieldValueIRS element (for citing)
Gross Receipts363051GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1996YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionProviding day health care, therapy services to senior and disabled adults 18 years above with day treatment programs. Services included medical, nursing, psycosocial consultation, occupational, physcial therapy with meals provided.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees20TotalNbrEmployees
Total Gross UBI4350TotalGrossUBI
Net Unrelated Business Txbl Income3350NetUnrelatedBusinessTxblIncome
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year598531ProgramServiceRevenuePriorYear
Program Service Revenue CY358403ProgramServiceRevenueCY
Investment Income Current Year298InvestmentIncomeCurrentYear
Other Revenue Prior Year596OtherRevenuePriorYear
Other Revenue Current Year4350OtherRevenueCurrentYear
Total Revenue Prior Year599127TotalRevenuePriorYear
Total Revenue Current Year363051TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year286223SalariesEtcPriorYear
Salaries Etc Current Year268591SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year345338OtherExpensePriorYear
Other Expenses Current Year236629OtherExpensesCurrentYear
Total Expenses Prior Year631561TotalExpensesPriorYear
Total Expenses Current Year505220TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-32434RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-142169RevenuesLessExpensesCY
Total Assets BOY292294TotalAssetsBOY
Total Assets EOY145840TotalAssetsEOY
Total Liabilities BOY50827TotalLiabilitiesBOY
Total Liabilities EOY0TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY241467NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY145840NetAssetsOrFundBalancesEOY
Mission DescriptionProviding day health care, therapy services to senior and disabled adults 18 years above with day treatment programs. Services included medical, nursing, psycosocial consultation, occupational, physcial therapy with meals provided.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense411071Expense
Revenue357707Revenue
DescriptionProviding day health care, therapy services to senior and disabled adults 18 years above with day treatment programs. Services included medical, nursing, psycosocial consultation, occupational, physcial therapy with meals provided.Description
Total Program Service Expense411071TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With10964NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees20NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodyfalseMinutesOfGoverningBody
Minutes Of CommitteesfalseMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicyfalseConflictOfInterestPolicy
Whistleblower PolicyfalseWhistleblowerPolicy
Document Retention PolicyfalseDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCybele Lee LinNamePerson
Telephone Number6262155489TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 S New AveAddressLine1
CityMonterey ParkCity
StateCAState
ZIP Code91744ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (2 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
George Lin
CEO040.00040.00XXXXX7200000
Cybele Lee Lin
President040.00040.00XXXXX4650000
FieldValueIRS element (for citing)
Total Reportable Comp From Org118500TotalReportableCompFromOrg
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Receipts from MED-CAL290899290899
Nutritional3537035370
L.A. Regional3213432134
FieldValueIRS element (for citing)
Total Program Service Revenue358403TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column298TotalRevenueColumn
Related Or Exempt Function Income298RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionBus SellDescription
Total Revenue Column4350TotalRevenueColumn
Unrelated Business Revenue4350UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Other Revenue4350TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column363051TotalRevenueColumn
Related Or Exempt Function Income358701RelatedOrExemptFunctionIncome
Unrelated Business Revenue4350UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total118500Total
Program Services94800ProgramServices
Management And General23700ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total121794Total
Program Services97435ProgramServices
Management And General24359ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total500Total
Program Services400ProgramServices
Management And General100ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total27797Total
Program Services22238ProgramServices
Management And General5559ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2000Total
Management And General2000ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total4807Total
Management And General4807ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total175Total
Program Services175ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8810Total
Program Services7048ProgramServices
Management And General1762ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total78000Total
Program Services62400ProgramServices
Management And General15600ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total262Total
Program Services209ProgramServices
Management And General53ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total17801Total
Program Services17801ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Outside Contractors5129651296
Repair Maintenance30063006
Licensis Property Tax44614461
Utilities567845421136

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total60333Total
Program Services48266ProgramServices
Management And General12067ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total505220Total
Program Services411071ProgramServices
Management And General94149ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY99353BOY
EOY59569EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY179961BOY
EOY84758EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2593BOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9640BOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis308033LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec306520LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY747BOY
EOY1513EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY292294BOY
EOY145840EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY29841BOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY20986BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY50827BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY241467BOY
EOY145840EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY241467BOY
EOY145840EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY292294BOY
EOY145840EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-142169ReconcilationRevenueExpenses
Reconcilation Prior Adjustment46542ReconcilationPriorAdjustment
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi
Public Support Total1700PublicSupportTotal170
First5 Years170XFirst5Years170
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis148015OtherCostOrOtherBasis
Depreciation148015Depreciation

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis30671OtherCostOrOtherBasis
Depreciation29158Depreciation
Book Value1513BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis129347OtherCostOrOtherBasis
Depreciation129347Depreciation
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1513TotalOfBookValueLandBuildings

Other Securities OtherSecurities (2 entries)

DescriptionDescription
Financial derivatives and other financial products
Closely-held equity interests

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionFederal income taxesDescription

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredfalseSubstantiationRequired
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
George Lin
CEO7200072000
Cybele Lee Lin
President4650046500

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

ExplanationExplanation
Form 990 Part VI Section B Line 11b No review was or will be conducted
Form 990 Part VI Section C Line 19 No ducuments available to the public
Form 990 Part IX Line 24e Auto Expenses 26,064 Disposal 1,296 Training 818 Meals 2,608 Nutritiobal Program 18,393 Purchase Ride 2,955 Sanitation 3,639 Security 161 Telephone 4,399
Form 990 Part XI Line 8 Adjusted Prior years Prepared Expenses, Accounts Payable and Accrued Expenses, adn Grants Payable balances.

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