2012-08-07T14:05:56-05:00 2011-12-31 561215661 THE DANIEL PROFESSIONAL GRP INC 4400 SILAS CREEK PKY SUITE 200 WINSTONSALEM NC 27104 990 2011-01-01 581403699 COMMUNITY CARE CENTER FOR FORSTYH COUNTY COMM 3367601235 2135 NEW WALKERTOWN ROAD WINSTON SALEM NC 27101 JAMES T ROBINSON 3367601235 2012-08-15 1 JOSEPH P SILLS P00194921 3367683290 2011 2016-02-24 21:20:13Z JAMES T ROBINSON 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 2291563 0 X WWW.CCCFORSYTH.ORG X 1980 NC TO PROVIDE FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES. 21 21 37 431 0 0 3326800 2210073 0 0 4893 1395 35604 57361 3367297 2268829 0 0 0 0 959795 943599 18932 0 0 2409349 1419603 3388076 2363202 -20779 -94373 1232539 1141075 53399 54981 1179140 1086094 TO PROVIDE FREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES. 0 0 2203631 COMMUNITY CARE CENTER OF FORSYTH COUNTY, INC. IS A FREEMEDICAL CLINIC FOR FAMILIES WHO EARN LESS THAN 200% OF THEFEDERAL POVERTY LEVEL AND ARE NOT ELIGIBLE FOR GOVERNMENTPROGRAMS AND HAVE NO MEDICAL INSURANCE. THE CENTER PROVIDESFREE ON-SITE MEDICAL AND DENTAL CARE TO LOW-INCOME FAMILIES,AS THE SOLE PROGRAM. 2203631 1 1 0 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 1 3 0 1 37 1 0 0 0 0 0 0 0 0 0 0 X 21 21 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 1 1 1 0 X X JAMES T ROBINSON 3367601235 2135 NEW WALKERTOWN ROAD WINSTON SALEM NC 27101 X X DR WILLIAM M SATTERWHITE JR 0.00 X X 0 0 0 JAMES T ROBINSON 0.00 X X 0 0 0 DR CARL S PHIPPS 0.00 X 0 0 0 FANNY STRONACH 0.00 X 0 0 0 MARY ANNE SQUIRE 0.00 X 0 0 0 HAMPDEN D KENAN 0.00 X 0 0 0 RAMON VELEZ MD 0.00 X 0 0 0 DUDLEY C CHANDLER DDS 0.00 X 0 0 0 MICHAEL CLEMENTS 0.00 X 0 0 0 DR ERNESTO DE LA TORRE 0.00 X X 0 0 0 ANN FLYNT 0.00 X X 0 0 0 MURRAY C GREASON 0.00 X 0 0 0 KATHY KENNEDY 0.00 X 0 0 0 WARD B MILLER 0.00 X 0 0 0 DR ROBERT V FORD 0.00 X 0 0 0 DAVID L MOUNT 0.00 X 0 0 0 DAVID BURKE 0.00 X X 0 0 0 ANTHONY H BRETT 0.00 X 0 0 0 SHERRI Y MURRRELL 0.00 X 0 0 0 SYLVIA I OBERLE 0.00 X 0 0 0 DR R TED TOBORG 0.00 X 0 0 0 0 0 0 0 0 0 0 ROBINSON ASSOCIATION MGMT SVCS INC 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 MANAGEMENT COMPANY 136000 1 267350 330519 1612204 813395 2210073 1395 1395 19600 0 19600 19600 19600 27760 22734 5026 5026 MISCELLANEOUS 900099 32735 32735 32735 2268829 52335 0 6421 788627 788627 82974 82974 71998 71998 136000 136000 17000 7820 9180 43691 29300 14391 1194 1194 38873 38873 2636 2636 46782 46782 27604 27604 DONATED MEDICINE 786677 786677 FEES, MEDICINES, SUPPLI 133157 133157 UTILITIES 49636 49636 REPAIRS & MAINTENANCE 47777 47777 88576 88576 2363202 2203631 159571 0 258965 353616 184530 127480 425571 354704 19766 19766 27834 14130 633665 469453 204866 164212 111007 107167 1232539 1141075 53399 54981 53399 54981 X 620611 578390 558529 507704 1179140 1086094 1232539 1141075 X -94373 1327 X X 0 1 1 X 0 X 955142 1374943 2423346 3326800 2237833 10318064 955142 1374943 2423346 3326800 2237833 10318064 10318064 12725 12032 8798 4893 1395 39843 17636 13380 31535 35603 52335 150489 10508396 0.98190 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 111007 10061 11297 2604 107167 103629 12303 4168 757 111007 80625 10000 16989 3454 531 103629 69210 35000 -23097 488 80625 1.00000 1 0 0 585994 459460 126534 40776 6957 33819 6895 3036 3859 164212 ENDOWMENT FUND 107167 107167 2268829 2363202 -94373 1327 1327 -93046 7274059 1327 4981169 4982496 2291563 -22734 -22734 2268829 7367105 4981169 4981169 2385936 -22734 -22734 2363202 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PURPOSE OF THE ENDOWMENT FUND IS TO PROVIDE A PERMANENT FUND WHICH MAY BE USED BY THE ORGANIZATION TO SUPPORT THE PROVISION OF HEALTHCARE SERVICES TO THE MEDICALLY UNINSURED AND UNDERSERVED WHO MEET THE ELIGIBILITY REQUIREMENT GUIDELINES OF THE ORGANIZATION. SCHEDULE D PART XII LINE 4B FUNRAISING EXPENSES NETTED WITH REVENUES FOR TAX BUT NOT ON AUDIT REPORT TOTALING 22,734 SCHEDULE D PART XIII LINE 4B FUNRAISING EXPENSES NETTED WITH REVENUES FOR TAX BUT NOT ON AUDIT REPORT TOTALING 22,734 X 1 EVENT EXPERTS 1317 WEST 1ST ST WINSTONSALEM NC 27101 EVENT PLANNER 0 27760 8140 19620 27760 8140 19620 FUNDRAISER 27760 27760 0 0 3283 4918 900 13633 27760 27760 3283 4918 900 13633 22734 5026 ROBINSON ASSOCIATION MGMT SVC INC OWNED BY EXECUTIVE DIRECTOR 136000 MANAGEMENT FEES 0 X 3 786677 DONOR PROVIDED X FOOD FOR VOLUNTEERS 18400 COST X DONATED MISCELLANEOUS SUPPLIES 8318 COST 0 1 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION RECEIVES MANAGEMENT SERVICES UNDER A BOARD APPROVED CONTRACT FROM ROBINSON ASSOCIATION MANAGEMENT SERVICES, INC., AN ENTITY OWNED BY JAMES T. ROBINSON THE EXECUTIVE DIRECTOR. MANAGEMENT FEES FOR 2011 TOTALED $136,000. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE 990 IS PROVIDED TO THE EXECUTIVE DIRECTOR AND TREASURER FOR THEIR REVIEW PRIOR TO THE RETURN BEING FILED. THE 990 IS SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 SALARIES AND MANAGEMENT CONTRACTS ARE REVIEWED AND RECOMMENDATIONS MADE BY THE PERSONNEL COMMITTEE WHICH IS MADE UP OF INDEPENDENT PERSONS. THOSE RECOMMENDATIONS THEN GO TO THE FINANCE COMMITTEE FOR REVIEW AND FINALLY TO THE BOARD FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAIALBLE TO ANYONE THAT REQUEST A COPY OF THE INFORMATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 1,327. AUDIT OVERSIGHT AND REPORT REVIEW FORM 990 PART XII LINE 2C THE ORGANIZATION HAS NOT CHANGED THE OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE CURRENT YEAR. FORSYTH-STOKES-DAVIE COUNTY MEDICAL SOCI 2135 NEW WALKERTOWN ROAD WINSTONSALEM NC 27101 566047612 MEDICAL NC 501(C)(6) N/A N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0