2012-08-10T10:40:24-05:00 2011-12-31 381357951 PLANTE & MORAN PLLC 65 EAST STATE ST STE 600 COLUMBUS OH 43215 990 2011-01-01 311190446 FRIENDS OF GOOD SHEPHERD MANOR INC FRIE 7402892861 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 ROBERT GRUNDEY 7402892861 2012-06-13 1 BERNIE OSTROWSKI P00366367 6148493000 2011 2016-02-24 21:20:13Z ROBERT L GRUNDEY 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 6522769 0 X WWW.FGSMO.COM X 1985 OH PROVIDING RESIDENTIAL SUPPORT & SERVICES TO ADULT MEN WHO ARE DISABLED MENTALLY. X 12 11 159 11 0 0 63402 45087 4951258 4998152 -21050 20031 68346 26008 5061956 5089278 0 0 0 0 3161576 3225325 0 0 0 1612886 1684005 4774462 4909330 287494 179948 2657142 1797949 544670 5850 2112472 1792099 X TO PROVIDE A SAFE AND NURTURING HOME FOR ADULT MEN WHO HAVE MRDD WHERE EACH INDIVIDUAL CAN LEAD A LIFE OF DIGNITY, DEVELOPMENT AND PURPOSE. 0 1 4001698 0 4998152 THE ORGANIZATION PROVIDES RESIDENTIAL CARE, ACTIVITIES AND HABILITATION PROGRAMS TO ITS RESIDENTS WHO HAVE MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES. THE ORGANIZATION ALSO PROVIDES VOCATIONAL TRAINING. 4001698 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 1 5 0 1 159 1 0 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 OH X JACKIE BOWLING 7402892861 374 GOOD MANOR RD LUCASVILLE OH 45648 X MICHAEL LUKOWSKI 1.00 X X 0 0 0 ROBERT KAMMER 1.00 X X 0 0 0 LINDA KAMMER 1.00 X X 0 0 0 ROBERT GRUNDEY 1.00 X X 0 0 0 JUDY LAWRENCE 1.00 X 0 0 0 JOSEPH LUKOWSKI 1.00 X 0 0 0 ED MONDE 1.00 X 0 0 0 SUZANNE PAHLS 1.00 X 0 0 0 JERRY KURSBAN 1.00 X 0 0 0 DALE TARASCO 1.00 X 0 0 0 SCOTT SHER 1.00 X 0 0 0 STEVE JUDGE 1.00 X 0 0 0 JACKIE BOWLING 30.00 X 91591 0 0 DAVID PHIPPS 32.00 X 73276 0 11729 164867 0 11729 0 0 0 0 0 45087 45087 RESIDENTS ROOM & BOARD 623000 4998152 4998152 4998152 7285 7285 3500 3975 -475 -475 -475 1442262 1429516 12746 12746 12746 VENDING 623000 15796 15796 MAINTENANCE 623000 9333 9333 SHREDDING 623000 897 897 457 457 26483 5089278 4998152 0 46039 176596 176596 2582528 2347015 235513 75914 64527 11387 162555 138172 24383 227732 193572 34160 18853 18853 18300 18300 58865 58865 470604 376483 94121 3980 3980 229397 183518 45879 92449 92449 217954 174364 43590 45806 43909 1897 13043 11087 1956 137458 116839 20619 53635 45590 8045 FRANCHISE TAX 210067 210067 FOOD EXPENSE 112934 95994 16940 SALE EXPENSE 660 561 99 4909330 4001698 907632 0 597770 920029 101123 1400 571007 809694 23296 15703 1316909 39670 45273 0 7367 0 0 5850 2657142 1797949 296187 0 224044 24439 5850 544670 5850 X 2112472 1792099 2112472 1792099 2657142 1797949 X 179948 -500321 X 0 0 0 X 177583 127981 77256 63402 45087 491309 177583 127981 77256 63402 45087 491309 186217 305092 55149 3084 6967 6927 10785 82912 67146 41358 108504 682725 26451119 0.44690 0.68510 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE REAL ESTATE TAX REFUND W/O OUTSTANDING CHECKS MAINTENANCE, VENDING RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DEFERRED COMPENSATION LIABILITY 5850 5850 KARLSBERGER ARCHITECTURE MR. GRUNDEY IS SENIOR VP & EXECUTIVE ARCHITECT AT KARLSBERGER ARCHITECTURE 110142 ARCHITECTURE SERVICES 0 BUILDING 2011-12-29 310000 CONSULTING VALUATION APPROVED BY ATTORNEY GENERAL 453781857 SCIOTO GROUP HOME REALTY LLC 25000 COUNTY CLUB BOULEVARD S NORTH OLMSTED OH 44070 LLC EQUIPMENT 2011-12-29 86000 CONSULTING VALUATION APPROVED BY ATTORNEY GENERAL 453781857 SCIOTO GROUP HOME REALTY LLC 25000 COUNTY CLUB BOULEVARD S NORTH OLMSTED OH 44070 LLC LAND 2011-12-29 50000 CONSULTING VALUATION APPROVED BY ATTORNEY GENERAL 453781857 SCIOTO GROUP HOME REALTY LLC 25000 COUNTY CLUB BOULEVARD S NORTH OLMSTED OH 44070 LLC OPERATING RIGHTS - 51 BEDS 2011-12-29 568000 CONSULTING VALUATION APPROVED BY ATTORNEY GENERAL 453781857 SCIOTO GROUP HOME REALTY LLC 25000 COUNTY CLUB BOULEVARD S NORTH OLMSTED OH 44070 LLC 0 1 0 0 PART II, LINE 2E: JACKIE BOWLING PART II, LINE 2E: JACKIE BOWLING, THE PREVIOUS EXECUTIVE DIRECTOR OF FRIENDS OF GOOD SHEPHERD, INC. BECAME AN EMPLOYEE (NOT AN OFFICER) OF SCIOTO GROUP HOME REALTY, LLC. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 FRIENDS OF GOOD SHEPHERD MANOR, INC., WAS SOLD ON DECEMBER 29, 2011. SEE SCHEDULE N, PART II. FORM 990, PART VI, SECTION A, LINE 2 BOARD MEMBER JOSEPH LUKOWSKI & BOARD PRESIDENT MICHAEL LUKOWSKI ARE FATHER & SON. BOARD MEMBERS JERRY KURSBAN & JUDY LAWRENCE ARE BROTHER & SISTER. BOARD TREASURER ROBERT KAMMER & BOARD SECRETARY LINDA KAMMER ARE HUSBAND & WIFE. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR WILL REVIEW A COPY OF FORM 990 PRIOR TO FILING. A COPY OF FORM 990 WILL BE PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS AND DIRECTORS REVIEW AND SIGN THE CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. IT IS THE RESPONSIBILTY OF OFFICERS AND DIRECTORS TO DISCLOSE THE EXISTENCE OF A CONFLICT AND SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF THE CONFLICT IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THOSE WITH CONFLICTS ARE SUBJECT TO VOTING AND PARTICIPATION RESTRICTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE EXECUTIVE DIRECTOR AND OTHER OFFICERS AND KEY EMPLOYEES WAS COMPARED WITH OTHERS IN COMPARABLE POSITIONS BY THE BOARD. IN ADDITION, THE BOARD CONSULTED AN EMPLOYMENT AGENCY FOR FURTHER REVIEW. THIS PROCESS IS DOCUMENTED AND COMPLETED ANNUALLY. THIS PROCESS WAS LAST PERFORMED IN 2010. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. 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 BY MAINTAINING THE FILES AT THE PRIMARY FACILITY AND MAKING THEM AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VII JACKIE BOWLING, EXECUTIVE DIRECTOR, WORKS AN AVERAGE OF 10 HOURS PER WEEK WITH RELATED ORGANIZATION FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION. DAVID PHIPPS, ASSOCIATE EXECUTIVE DIRECTOR, WORKS AN AVERAGE OF 8 HOURS PER WEEK WITH RELATED ORGANIZATION FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PAYOUT OF FUNDS RELATED TO SALE ON 12/29/2011 -500,321. TOTAL TO FORM 990, PART XI, LINE 5: -500,321. FRIENDS OF GOOD SHEPHERD MANOR HOUSING ORGANIZATION 374 GOOD MANOR ROAD PO BOX 1029 LUCASVILLE OH 45648 311315438 LICENSED GROUP HOMES OH 501(C)(3) LINE 9 FRIENDS OF GOOD SHEPHERD MANOR INC 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0 NO TRANSACTIONS OVER 50000