2013-05-13T09:11:07-05:00 2012-06-30 593040705 RIVERO GORDIMER & COMPANY PA P O BOX 172359 TAMPA FL 33672 990 2011-07-01 311659302 CAMELOT COMMUNITY CARE INC CAME 7275930003 4910-D CREEKSIDE DRIVE CLEARWATER FL 33760 MICHAEL DIBRIZZI 7275930003 2013-05-09 1 SAM A LAZZARA P01342929 8138757774 2011 2016-02-24 21:20:13Z MICHAEL DIBRIZZI 4910-D CREEKSIDE DRIVE CLEARWATER FL 33760 51217258 0 X WWW.CAMELOTCOMMUNITYCARE.ORG X 1999 FL CAMELOT COMMUNITY CARE'S MISSION IS TO ENABLE CHILDREN AND FAMILIES TO REALIZE THEIR FULLEST POTENTIAL 5 5 652 15 0 0 36077745 40506597 14306402 10708223 1457 2438 0 0 50385604 51217258 22460111 23638035 0 0 18280320 17644375 0 0 0 9649424 10017935 50389855 51300345 -4251 -83087 9166545 9726360 7387140 8030042 1779405 1696318 X TO PROVIDE CHILD WELFARE AND BEHAVIORAL HEALTH SERVICES TO CHILDREN AND FAMILIES WHO ARE EXPERIENCING PROBLEMS WITH ABUSE, NEGLECT, DOMESTIC VIOLENCE, SUBSTANCE ABUSE, AND JUVENILE JUSTICE INVOLVMENT. CAMELOT'S GOAL IS TO DEVELOP AND PROVIDE SERVICES WHICH ENABLE CHILDREN AND FAMILIES TO REALIZE THEIR OWN POTENTIAL. 0 0 31621172 22346456 CHILD WELFARE SERVICES: CAMELOT COMMUNITY CARE (CAMELOT) IS A LEADING PROVIDER OF CHILD WELFARE SERVICES IN FLORIDA. THE GOAL OF OUR CHILD WELFARE PROGRAMS IS TO ACHIEVE PERMANENCY FOR THE CHILDREN WE SERVE, AND IF THE CHILD REMAINS IN THE FOSTER CARE SYSTEM, TO PREPARE THEM TO LIVE INDEPENDENTLY UPON REACHING ADULTHOOD. THESE GOALS ARE ACCOMPLISHED THROUGH A SERIES OF SERVICES MAINTAINED UNDER THE CHILD WELFARE SERVICES PROGRAM. THE CHILDREN'S NETWORK OF SOUTHWEST FLORIDA, LLC, A WHOLLY OWNED SUBSIDIARY OF CAMELOT, SERVES AS AN ADMINISTRATIVE SERVICE ORGANIZATION (LEAD AGENCY) THAT BUILDS A NETWORK OF CASE MANAGEMENT ORGANIZATIONS AND SPECIALTY PROVIDERS WITH THE CAPACITY TO PROVIDE A CONTINUUM OF SERVICES FOR CHILDREN AND FAMILIES. CHILD WELFARE CASE MANAGEMENT SERVICES ARE PROVIDED BY CAMELOT THROUGH SUB-CONTRACTS WITH OTHER LEAD AGENCIES. WE ARE RESPONSIBLE FOR THE CASE MANAGEMENT OF CHILDREN WHO HAVE BEEN ADJUDICATED TO THE CHILD WELFARE SYSTEM AND WORK WITH THESE CHILDREN AND FAMILIES FOR THE PURPOSE OF REUNIFYING THE CHILD WITH THE FAMILY. ADDITIONALLY, CAMELOT IS RESPONSIBLE FOR THE RECRUITMENT, TRAINING, LICENSING, AND SUPPORT OF FOSTER HOMES, AS WELL AS THE PROMOTION, COORDINATION AND FINALIZATION OF ADOPTIONS FOR CHILDREN IN THE CHILD WELFARE SYSTEM. 12831780 10708223 BEHAVIORAL HEALTH SERVICES: SERVICES ARE OFFERED TO CLIENTS UTILIZING A COMMUNITY BASED APPROACH IN FLORIDA, OHIO AND TEXAS. PROGRAMS PROVIDED ARE: THERAPEUTIC FOSTER CARE; IN-HOME COUNSELING; TARGET CASE MANAGEMENT; SUPPORTED/ENHANCED FOSTER CARE; AND COMPREHENSIVE ASSESSMENTS. THE LEVEL OF SERVICE PROVIDED TO EACH CLIENT AND/OR THEIR FAMILY IS BASED UPON INDIVIDUAL NEEDS OF THE CLIENT. 1374834 JUVENILE JUSTICE SERVICES: CAMELOT PROVIDES MENTAL HEALTH AND PSYCHIATRIC SERVICES IN STATE RUN JUVENILE DETENTION CENTERS. CAMELOT ALSO CONTRACT WITH THE DEPARTMENT OF JUVENILE JUSTICE TO PROVIDE MENTAL HEALTH, PSYCHIATRIC AND SUBSTANCE ABUSE SERVICES IN STATE RUN RESIDENTIAL PROGRAMS. SERVICES PROVIDED INCLUDE CRISIS INTERVENTION, INDIVIDUAL, GROUP AND FAMILY COUNSELING, MEDICATION MANAGEMENT, AND SUICIDE ASSESSMENT. 45827786 1 0 0 1 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 98 0 1 652 1 0 0 0 0 0 1 1 0 0 0 0 X 5 5 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X MICHAEL DIBRIZZI 7275930003 4910-D CREEKSIDE DRIVE CLEARWATER FL 33760 ALEXANDER ADDUCCI 1.00 X 0 0 0 RICHARD PINGEL 1.00 X 0 0 0 DAE SHERIDAN 1.00 X 0 0 0 RON SCHULTZ 1.00 X 0 0 0 DAVID LEVY 1.00 X 0 0 0 MICHAEL DIBRIZZI 40.00 X 159485 0 0 NADEREH SALIM 40.00 X 141363 0 0 LISA TACKUS 40.00 X 116531 0 0 MICHELE DISORBO 40.00 X 123617 0 0 540996 0 0 4 0 1 0 DR BORIS KAWLICHE 1601 NORTH EAST 25TH AVENUE SUITE 3 OCALA FL 34470 PSYCHIATRIC SERVICES 162236 1 29119797 11386800 41105 40506597 PATIENT SERVICES 624100 10708223 10708223 10708223 2438 2438 51217258 10708223 0 2438 15341417 15341417 8296618 8296618 540996 378696 162300 14180853 13261096 919757 30505 28263 2242 1630767 1510199 120568 1261254 1168552 92702 111758 32102 79656 68785 18429 50356 8061 8061 934076 909710 24366 62618 19211 43407 1270127 1107032 163095 1423991 1378322 45669 871458 770086 101372 114321 60630 53691 31983 31983 53798 28374 25424 446140 424825 21315 ADMINISTRATIVE SERVICES 3412963 0 3412963 TELEPHONE 361455 332940 28515 ADOPTION/FOSTER SUPPORT 198328 198328 CONTRIBUTIONS 166325 166325 481748 396631 85117 51300345 45827786 5472559 0 390460 677152 4837336 5016647 3150051 3207723 484748 523480 472618 385432 90142 87186 7909 7885 205899 206287 9166545 9726360 3079511 3053616 3544485 3944890 172069 763144 859467 7387140 8030042 X 1779405 1696318 1779405 1696318 9166545 9726360 -83087 0 X X 0 1 1 X 1 1 X 66834101 56459263 42225610 36077745 40506597 242103316 66834101 56459263 42225610 36077745 40506597 242103316 242103316 13914 172437 1585 1457 2438 191831 242295147 108931662 0.99920 0.99910 X 0 0 0 0 0 0 1 8061 0 0 8061 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: THE ORGANIZATION HIRED A LOBBYIST TO HELP NEGOTIATE WITH MEMBERS OF THE STATE EXECUTIVE BRANCH ON CONTRACTUAL MATTER. 0 0 1461361 1289292 172069 1 25270 19271 5999 377839 308346 69493 69509 57815 11694 87186 51217258 51300345 -83087 -83087 51217258 0 51217258 0 51217258 51300345 0 51300345 0 51300345 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) RELEASED FASB ASC 740-10, INCOME TAXES, THAT PROVIDES GUIDANCE FOR REPORTING UNCERTAINTY IN INCOME TAXES. FOR THE YEAR ENDED JUNE 30, 2012, THE ORGANIZATION HAS DOCUMENTED ITS CONSIDERATION OF FASB 740-10 AND DETERMINED THAT NO MATERIAL UNCERTAIN TAX POSITIONS QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS 1 BEHAVIORAL ANALYSIS AND THERAPY INC 8001 SW 36TH ST DAVIE FL 33328 650842110 501 C (3) 396249 CHILD WELFARE SERVICES BROOKWOOD FLORIDA INC 901 7TH AVE S ST PETERSBURG FL 33705 262287919 501 C (3) 18225 CHILD WELFARE SERVICES CHARLOTTE BEHAVIOR HEALTH 1700 EDUCATION AVE PUNTA GORDA FL 33950 591234922 501 C (3) 36538 CHILD WELFARE SERVICES CHILDREN ADVOCACY 3830 EVANS AVE STE 4B FT MEYERS FL 339019305 650007620 501 C (3) 52824 CHILD WELFARE SERVICES CHILDREN'S ADVOCACY COLLIER 1034 6TH AVE N NAPLES FL 34102 650049492 501 C (3) 39150 CHILD WELFARE SERVICES CHILDRENS HOME SOCIETY 1940 MARAVILA AVE FT MEYERS FL 33901 590192430 501 C (3) 260663 CHILD WELFARE SERVICES DEVEREUX 5850 TG LEE BLVD STE 400 ORLANDO FL 32882 231390618 501 C (3) 391804 CHILD WELFARE SERVICES FAMILY PRESERVATION SERVICES OF FLORIDA INC 4910D CREEKSIDE DR CLEARWATER FL 33760 650848685 501 C (3) 2985600 CHILD WELFARE SERVICES FLORIDA BAPTIST 4551 CAMION REAL WAY FT MEYERS FL 339121026 590657326 501 C (3) 237829 CHILD WELFARE SERVICES ISLAND COAST PRIMARY CARE 9800 S HEALTHPARK DR STE 410 FT MEYERS FL 33908 650489064 501 C (3) 265814 CHILD WELFARE SERVICES LUTHERAN SERVICES FLORIDA 3627A W WATERS AVE TAMPA FL 33614 592198911 501 C (3) 5468568 CHILD WELFARE SERVICES MEDICAL EXPRESS CORPORATION 4237 SALISBURY RD 304 JACKSONVILLE FL 32216 593001845 138915 CHILD WELFARE SERVICES NATIONAL MENTOR 7300 KENDALL DR STE 360 MIAMI FL 33156 042893910 501 C (3) 338407 CHILD WELFARE SERVICES OUR MOTHERS HOME 7438 CARRIER RD FT MEYERS FL 33967 650510103 501 C (3) 48578 CHILD WELFARE SERVICES QUALITY LIFE CENTER PO BOX 1290 FT MEYERS FL 339021290 650321309 501 C (3) 587400 CHILD WELFARE SERVICES SOURCE OF HOPE & LIGHT PO BOX 1892 FT MEYERS FL 339021892 650013240 501 C (3) 312660 CHILD WELFARE SERVICES THE HAVEN 21441 BOCA RIO RD BOCA RATON FL 334332604 591708452 501 C (3) 542824 CHILD WELFARE SERVICESCHILD WELFARE SERVICES YOUTH HAVEN 5867 WHITAKER RD NAPLES FL 34112 237065187 501 C (3) 87375 CHILD WELFARE SERVICES CHILDREN'S HOME SOCIETY SERVICES BROWARD 1485 S SEMORAN BLVD WINTER PARK FL 32792 650978991 501 C (3) 23712 CHILD WELFARE SERVICES HENDRY GLADES MENTAL HEALTH 601 W ALVERDEZ AVENUE CLEWISTON FL 33440 591558636 501 C (3) 16200 CHILD WELFARE SERVICES GULF COAST JEWISH FAMILY AND COMMUNITY 14041 ICOT BOULEVARD CLEARWATER FL 33760 591229354 501 C (3) 91469 CHILD WELFARE SERVICES PROVIDENCE MANAGEMENT OF FLORIDA 4910-I CREEKSIDE DRIVE CLEARWATER FL 33760 200991181 2052967 CHILD WELFARE SERVICES HOME SWEET HOME 5589 OKEECHOBEE BLVD WEST PALM BEACH FL 33417 999999999 501 C (3) 44997 CHILD WELFARE SERVICES FLORIDA UNITED METHODIST 51 CHILDRENS WAY ENTERPRISE FL 32725 590638479 501 C (3) 10325 CHILD WELFARE SERVICES CITRUS HEALTH NETWORK 4175 W 20TH AVE HIALEAH FL 33012 591865751 501 C (3) 5940 CHILD WELFARE SERVICES SHALIMARE GROUP HOME 613 CAROLINA AVE FT MEYERS FL 33905 201344455 501 C (3) 19156 CHILD WELFARE SERVICES LIFESHARE MANAGEMENT GROUP 155 DOW STREET SUITE 300 MANCHESTER NH 03101 205424176 26384 CHILD WELFARE SERVICES PELICAN HOME CARE LLC 2733 OAK RIDGE COURT 103 FORT MYERS FL 33901 800551199 28350 CHILD WELFARE SERVICES HENDRY COUNTY HEALTH PO BOX 70 LABELLE FL 33975 593502843 501 C (3) 83603 CHILD WELFARE SERVICES CHILD CARE OF SOUTHWAT FLORIDA INC 6831 PALISADES PARK COURT SUITE 6 FORT MYERS FL 33912 596198583 501 C (3) 50686 CHILD WELFARE SERVICES ECKERD YOUTH ALTERNATIVES 100 STARCREST DR CLEARWATER FL 33765 592551416 501 C (3) 154919 CHILD WELFARE SERVICES CHILDRENS PLACE AT HOME-LIBRA 2840 6TH AVE SOUTH LAKE WALES FL 33461 591935485 501 C (3) 53709 CHILD WELFARE SERVICES JUVENILE SERVICES PRG HARBINGER 15500 GEORGE BLVD CLEARWATER FL 33760 591717620 501 C (3) 6709 CHILD WELFARE SERVICES FLORIDA SHERIFF YOUTH RANCH 2486 CECIL WEBB PLACE LIVE OAK FL 32064 237303117 501 C (3) 115680 CHILD WELFARE SERVICES PREMIER BEHAVIORAL SOLUTIONS INC 367 S GULPH RD KING OF PRUSSIA PA 19406 630857352 40670 CHILD WELFARE SERVICES CARLTON MANOR GROUP HOME 45 WESTWOOD TERRACE ST PETERSBURG FL 33710 592058176 501 C (3) 59807 CHILD WELFARE SERVICES HEART OF FLORIDA YOUTH RANCH 15833 US HIGHWAY 301 CITRA FL 32113 592274734 501 C (3) 17520 CHILD WELFARE SERVICES PERSONAL ENRICHMENT THROUGH MENTAL HEALTH SERVICES 11254 58TH STREET NORTH PINELLAS PARK FL 33782 593153549 501 C (3) 6440 CHILD WELFARE SERVICES ALPHA HOUSE 6945 ABBOTT AVENUE MIAMI BEACH FL 33141 650763074 501 C (3) 7647 CHILD WELFARE SERVICES ELIZABETH KIEFER LLC 6681 DABNEY STREET FORT MYERS FL 33966 352336110 47078 CHILD WELFARE SERVICES CHILD WELFARE SERVICES 34 6 FOSTER CARE 430 3770614 ADOPTION SUBSIDY PAYMENTS 665 4481604 PSYCHOLOGICAL ASSESSMENTS 2 44400 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION RECEIVES AN EXPENDITURE REPORT EACH MONTH FROM THE SUBRECIPIENT'S. THE ORGANIZATION REVIEWS THESE REPORTS FOR ANY UNUSUAL OR QUESTIONABLE EXPENSES AND ALSO COMPARES THE EXPENSES TO PLANNED BUDGETED AMOUNTS. THE ORGANIZATION WILL THEN INQUIRE THE SUBRECIPIENT AGENCIES ABOUT ANY UNUSUAL OR QUESTIONABLE COSTS. ADDITIONALLY THE ORGANIZATION CONDUCTS CONTRACT COMPLIANCE REVIEWS FOR SUBRECIPIENTS ORGANIZATIONS. ALL SUBRECIPIENT ORGANIZATIONS ARE REQUIRED TO COMPLETE AN ANNUAL RISK ASSESSMENT THAT THE ORGANIZATION WILL THEN USE TO ASSIST IN THE SELECTION OF SUBRECIPIENT ORGANIZATIONS TO PERFORM A DETAILED CONTRACT COMPLIANCE REVIEW. EVERY AGENCY THAT THE ORGANIZATION SUBCONTRACTS WITH WILL BE SUBJECT TO THIS DETAIL CONTACT REVIEW AT LEAST ONCE EVERY THREE YEARS, IF NOT MORE OFTEN. THE DETAILED CONTRACT REVIEW INCLUDES TESTING OF THE SUBCONTRACTORS COMPLIANCE WITH CONTRACT AND GOVERNMENTAL REQUIREMENTS, TESTS OF EXPENDITURES IN ACCORDANCE WITH CONTRACT AND FEDERAL GUIDELINES, AND OVERALL OUTCOME RESULTS. X X X 0 0 0 0 0 0 0 0 0 MICHAEL DIBRIZZI 152555 0 0 0 6930 0 0 0 0 0 159485 0 0 0 X 41105 FAIR VALUE X 41105 0 1 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS FIRST REVIEWED BY MANAGEMENT THEN PRESENTED TO THE BOARD OF DIRECTORS FOR REVIEW AND FEEDBACK. ONCE APPROVED BY THE BOARD OF DIRECTORS, IT IS SIGNED BY MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 12C BESIDES REQUIRED ANNUAL DISCLOSURES, THE CONFLICT OF INTEREST POLICY IS REGULARLY DISCUSSED IN STAFF TRAINING AND LEADERSHIP MEETINGS. IF A CONFLICT OF INTEREST IS IDENTIFIED, IT IS REVIEWED BY MANAGEMENT AND/OR THE BOARD OF DIRECTORS AND WRITTEN PLANS ARE PUT IN PLACE TO ADDRESS THE CONFLICT AND IF NECESSARY, THE INDIVIDUAL WITH THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE CEO COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS WHERE INDUSTRY DATA AND COMPARABLE SALARIES ARE USED IN DETERMINING COMPENSATION. KEY EMPLOYEE SALARIES ARE DETERMINED BY THE CEO USING THE SAME COMPARABLE INFORMATION. THE BOARD OF DIRECTORS IS ADVISED OF KEY EMPLOYEE SALARIES AND GIVEN THE OPPORTUNITY TO PROVIDE FEEDBACK. 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 CHILDREN'S NETWORK OF SOUTHWEST FLORIDA LLC 2232 ALTAMOUNT AVENUE FT MYERS FL 33901 204968228 CHILD WEFARE AND CASE MANAGEMENT SERVICES IN FLORIDA FL 27460430 6080074 CAMELOT COMMUNITY CARE INC