LOS ROBLES HOSPITAL VOLUNTEERS INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- LOS ROBLES HOSPITAL VOLUNTEERS INC (EIN 95-3263505)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-10
- IRS object ID
- 201333169349300488
- Schema version
- 2012v2.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-10T09:57:06-08:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Anthony M Salzman CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 Rolling Oaks Drive 201 | AddressLine1 |
| City | Thousand Oaks | City |
| State | CA | State |
| ZIP Code | 91361 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953263505 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOS ROBLES HOSPITAL VOLUNTEERS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LOSR | NameControl |
| Phone | 8053704685 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 215 W JANSS ROAD | AddressLine1 |
| City | THOUSAND OAKS | City |
| State | CA | State |
| ZIP Code | 91360 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GLENN KASSELL | Name |
| Title | Treasurer | Title |
| Date Signed | 2013-11-09 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Anthony Salzman | Name |
| PTIN | P00521089 | PTIN |
| Phone | 8054957458 | Phone |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JUDITH WILLIAMS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 58 LA PALMA | AddressLine1 |
| City | THOUSAND OAKS | City |
| State | CA | State |
| ZIP Code | 91320 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 343327 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 600 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1897 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 11744 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14404 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17735 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 88 | InvestmentIncomePriorYear |
| Investment Income Current Year | 66 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 67399 | OtherRevenuePriorYear |
| Other Revenue Current Year | 83747 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 83788 | TotalRevenuePriorYear |
| Total Revenue Current Year | 113292 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 77550 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 84000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 21197 | OtherExpensePriorYear |
| Other Expenses Current Year | 33124 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 98747 | TotalExpensesPriorYear |
| Total Expenses Current Year | 117124 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -14959 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3832 | RevenuesLessExpensesCY |
| Total Assets BOY | 178036 | TotalAssetsBOY |
| Total Assets EOY | 175799 | TotalAssetsEOY |
| Total Liabilities BOY | 2467 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1779 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 175569 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 174020 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | PROVIDE VOLUNTEER HOSPITAL SERVICES, GIVE COLLEGE SCHOLARSHIPS FOR DESERVING HIGH SCHOOL SENIORS, & PROVIDE COMMUNITY CHARITABLE FUNDING. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 67000 | Expense |
| Description | CHARITABLE CONTRIBUTIONS: MADE CHARITABLE CONTRIBUTIONS TO IMPORTANT CHARITABLE CAUSES IN THE COMMUNITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 17000 | Expense |
| Description | COLLEGE SCHOLARSHIPS: PROVIDE SCHOLARSHIPS OF $500 TO $750 EACH TO WORTHY CANDIDATES SELECTED FROM AMONG NUMEROUS HIGH SCHOOL SENIORS. CANDIDATES MUST BE VOLUNTEERS IN GOOD STANDING WITH HIGH QUALITY OF SERVICES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10903 | Expense |
| Description | PROVIDE APPROPRIATE UNIFORMS FOR VOLUNTEERS AT THE HOSPITAL. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 6875 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 101778 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | ANTHONY M SALZMAN CPA | NamePerson |
| Telephone Number | 8054957458 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 325 ROLLING OAKS DR 201 | AddressLine1 |
| City | THOUSAND OAKS | City |
| State | CA | State |
| ZIP Code | 91361 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (7 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| JANET KOENIG | |||||
| Secretary | 0.00 | 0.00 | 0 | 0 | 0 |
| GLENN KASSELL | |||||
| Treasurer | 0.00 | 0.00 | 0 | 0 | 0 |
| BABS WILLIAMS | |||||
| Vice President | 0.00 | 0.00 | 0 | 0 | 0 |
| JOE SALVIEJO | |||||
| Vice President | 16.00 | 0.00 | 0 | 0 | 0 |
| JUDITH WILLIAMS | |||||
| President | 16.00 | 0.00 | 0 | 0 | 0 |
| TERESA TARDIF | |||||
| Secretary | 0.00 | 0.00 | 0 | 0 | 0 |
| MARGARITA HORWITZ | |||||
| Vice President | 16.00 | 0.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 1216 | RelatedOrganizations |
| All Other Contributions | 10528 | AllOtherContributions |
| Total Contributions | 11744 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| UNIFORM COST PAYMENTS | 10652 | 10652 |
| ORIENTATION COST PAYMENTS | 6253 | 6253 |
| DUES REFUNDS | 830 | 830 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17735 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 66 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66 | RelatedOrExemptFunctionIncome |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 313782 | GrossSalesOfInventory |
| Cost Of Goods Sold | 230035 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83747 | TotalRevenueColumn |
| Exclusion | $83,747 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 113292 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17801 | RelatedOrExemptFunctionIncome |
| Exclusion | $83,747 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67000 | Total |
| Program Services | 67000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17000 | Total |
| Program Services | 17000 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 900 | Total |
| Management And General | 900 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| OFFICE EXPENSE | 3188 | 3188 | |
| PATIENT SERVICES | 6875 | 6875 | |
| VOLUNTEER EXPENSES | 6934 | 6934 | |
| UNIFORMS | 10903 | 10903 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4324 | Total |
| Management And General | 4324 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117124 | Total |
| Program Services | 101778 | ProgramServices |
| Management And General | 15346 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70244 | BOY |
| EOY | 105977 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70913 | BOY |
| EOY | 30980 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35000 | BOY |
| EOY | 35000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 70626 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 68257 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1878 | BOY |
| EOY | 2369 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1 | BOY |
| EOY | 1473 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178036 | BOY |
| EOY | 175799 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2467 | BOY |
| EOY | 1779 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2467 | BOY |
| EOY | 1779 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 175569 | BOY |
| EOY | 174020 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 175569 | BOY |
| EOY | 174020 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 178036 | BOY |
| EOY | 175799 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -3832 | ReconcilationRevenueExpenses |
| Reconcilation Prior Adjustment | 2283 | ReconcilationPriorAdjustment |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | true | AccountantCompileOrReview |
Accountant Compile Or Review Basis AccountantCompileOrReviewBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAudited |
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20415 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3891 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7200 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7202 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11744 | CurrentTaxYear |
| Total | 50452 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20415 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3891 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7200 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7202 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11744 | CurrentTaxYear |
| Total | 50452 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 12933 | AmountsSubstContributorsTotal |
| Public Support Total170 | 37519 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 244 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 122 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 65 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 88 | CurrentTaxYearMinus1Year |
| Current Tax Year | 66 | CurrentTaxYear |
| Total | 585 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 8005 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6850 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8520 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9099 | CurrentTaxYearMinus1Year |
| Current Tax Year | 17736 | CurrentTaxYear |
| Total | 50210 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 101247 | TotalSupport |
| Public Support Pertcentage170 | 0.37060 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.32440 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 59155 | OtherCostOrOtherBasis |
| Depreciation | 56786 | Depreciation |
| Book Value | 2369 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 11471 | OtherCostOrOtherBasis |
| Depreciation | 11471 | Depreciation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2369 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| VENDOR SALES PAYABLE | $81 |
| VENDOR SALES PAYABLE | $1,698 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1779 | TotalOfAmounts |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance |
|---|---|---|---|---|---|---|
| Westminster Free Clini | ||||||
| 32111 Watergate Rd | Thousand Oaks | CA | 91361 | 770563241 | 7500 | 0 |
| The Wellness Community | ||||||
| 530 Hampshire Rd | Thousand Oaks | CA | 91361 | 770205691 | 7500 | 0 |
| Sarahs House | ||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 952265201 | 7500 | 0 |
| MANNA - CONEJO VALLEY FOOD BK | ||||||
| 3020 CRESCENT WAY | THOUSAND OAKS | CA | 91362 | 7500 | 0 | |
| INTERFACE CHILDREN & FAMILY S | ||||||
| 4001 MILLIONS OAKS BLVD | CAMARILLO | CA | 93012 | 6000 | 0 | |
| Hospice of the Conejo | ||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 953219656 | 7750 | 0 |
| Conejo Valley Womens | ||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 952265201 | 7500 | 0 |
| Conejo Free Clinic | ||||||
| 80 E Hillcrest Dr | Thousand Oaks | CA | 91360 | 953177953 | 7500 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 8 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | COLLEGE SCHOLARSHIPS | TypeOfGrant |
| Number Of Recipients | 22 | NumberOfRecipients |
| Amount Of Cash Grant | 17000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | THE 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. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Tax 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. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | N/A |
| Form 990, Part VI, Line 15a | Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | N/A |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Each 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 11b | Form 990, Part VI, Line 11b: Form 990 Review Process | Form 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 6 | Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | MEMBERSHIP 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 III, Line 4d | Form 990, Part III, Line 4d: Other Program Services Description | OTHER PROGRAM SERVICES 4: COLLEGE SCHOLARSHIPS: PROVIDE SCHOLARSHIPS OF $500 TO $750 EACH TO WORTHY CANDIDATES SELECTED FROM AMONG NUMEROUS HIGH SCHOOL SENIORS. CANDIDATES MUST BE VOLUNTEERS IN GOOD STANDING WITH HIGH QUALITY OF SERVICES. |
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