2012-11-07T14:55:52-06:00 2011-12-31 911194016 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2011-01-01 910567261 WELLSPRING FAMILY SERVICES WELL 2068263050 1900 RAINIER AVENUE SOUTH SEATTLE WA 98144 SUSAN SHANNON 2068263050 2012-11-06 1 SARA ELIZABETH J HYRE P00235495 4254544919 2011 2016-02-24 21:20:13Z RUTHANN HOWELL 1900 RAINIER AVENUE SOUTH SEATTLE WA 98144 13174451 0 X WWW.WELLSPRINGFS.ORG X 1892 WA TO BUILD EMOTIONALLY HEALTHY SELF-SUFFICIENT FAMILIES AND A NON-VIOLENT COMMUNITY IN WHICH THEY CAN THRIVE. 30 30 159 100 0 0 5015728 5645059 7715702 7456852 9768 11040 26582 -4672 12767780 13108279 1556110 1816741 0 0 7646495 7768966 0 0 513069 4164830 3869074 13367435 13454781 -599655 -346502 20359495 19877708 7312973 7189697 13046522 12688011 X TO BUILD EMOTIONALLY HEALTHY SELF-SUFFICIENT FAMILIES & A NON-VIOLENT COMMUNITY IN WHICH THEY CAN THRIVE. 0 0 7999929 1595419 SERVICES FOR HOMELESS AND AT-RISK FAMILIES INCLUDING SPECIALIZED CHILDCARE, CLOTHING AND OTHER ESSENTIAL ITEMS FOR HOMELESS CHILDREN. SUPPORTIVE SERVICES, INCLUDING CASE MANAGEMENT, COUNSELING AND ASSISTANCE WITH BASIC NEEDS TO ASSIST THE HOMELESS IN MOVING FROM DEPENDENCY TO SELF-SUFFICIENCY. SERVED 2,107 FAMILIES IN 2011. 2695693 3492944 EMPLOYEE ASSISTANCE PROGRAM PROVIDES EMPLOYEE ASSESSMENT, COUNSELING, WORK-LIFE BALANCE SERVICES, WORKPLACE SEMINARS AND CONSULTATION. SERVED 130,541 CLIENTS IN 2011. 221322 221322 3695342 PROFESSIONAL COUNSELING, EDUCATION AND SUPPORT FOR FAMILIES AND PARENTS OF NEWBORNS AND INDIVIDUALS FROM A VARIETY OF CULTURES WITH RELATIONSHIP, JOB/CAREER AND EMOTIONAL/BEHAVIORAL PROBLEMS. SERVED 1,708 CLIENTS IN 2011. 363563 268566 DOMESTIC VIOLENCE INTERVENTION AND PREVENTION SERVICES PROVIDE STATE CERTIFIED DOMESTIC VIOLENCE INTERVENTION FOR BATTERERS AND RESPECTFUL PARENTING SKILLS TRAINING. SERVED 166 CLIENTS IN 2011. 363563 268566 11280507 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 1 617 0 1 159 1 0 0 0 0 0 0 0 0 0 0 X 30 30 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X TINA DRAUGHON 2068263041 1900 RAINIER AVENUE SOUTH SEATTLE WA 98144 BRAD MCKEOWN 2.00 X X 0 0 0 RUSSELL YOUNG 2.00 X X 0 0 0 PAMELA CONE 2.00 X X 0 0 0 WILLIAM WEIGAND 2.00 X X 0 0 0 CHRIS AGGERHOLM 2.00 X X 0 0 0 BRIAN BUCKLEY 2.00 X 0 0 0 JESSICA CANTLIN 2.00 X 0 0 0 JEFF CORDICK 2.00 X 0 0 0 THERESA DALURIA 2.00 X 0 0 0 EMELIA EAST 2.00 X 0 0 0 FAITH HAVICK 2.00 X 0 0 0 AMY HUMPHREYS 2.00 X 0 0 0 SUSANNA HURLEY 2.00 X 0 0 0 STEVEN LOSLEBEN 2.00 X 0 0 0 KATHY LOWER 2.00 X 0 0 0 JILL MACKIE 2.00 X 0 0 0 NICOLE MATUSKA 2.00 X 0 0 0 TRACY MCPHEE 2.00 X 0 0 0 GEOFFREY MELROSE 2.00 X 0 0 0 MARK METCALF 2.00 X 0 0 0 NANCY MYLES 2.00 X 0 0 0 ANNE NIELSEN 2.00 X 0 0 0 KEVIN OSBORNE 2.00 X 0 0 0 BETH PEARSON 2.00 X 0 0 0 MARY PEDERSEN 2.00 X 0 0 0 JONATHAN PERRINO 2.00 X 0 0 0 CHRISTIAN SCHILLER 2.00 X 0 0 0 SCOTT SHAPIRO 2.00 X 0 0 0 BARNETT SILVER 2.00 X 0 0 0 RICHARD WAGNER 2.00 X 0 0 0 RUTHANN HOWELL 50.00 X 131408 0 12839 SUSAN SHANNON 40.00 X 112281 0 10955 243689 0 23794 2 0 0 0 0 847808 498261 3035068 1263922 425419 5645059 COUNSELING SERVICES 621300 3695342 3695342 EMPLOYEE ASSISTANCE 624100 3456187 3456187 COMMUNITY SERVICES 621300 268566 268566 TRAINING SERVICES 624100 36757 36757 7456852 5368 5368 5672 0 5672 5672 5672 18172 498261 66172 -48000 -48000 NON EAP & OTHER FEES 900099 37228 37228 INTER-AGENCY RECEIPTS 900099 6100 6100 43328 13108279 7456852 0 6368 1816741 1816741 267483 267483 6002224 5130115 627868 244241 312295 256505 43578 12212 633370 588437 34131 10802 553594 460593 71000 22001 109017 54410 54607 64024 64024 1425445 1388719 36726 103515 45479 57366 670 355413 263437 71820 20156 287517 190016 72098 25403 495931 419126 71936 4869 536197 433539 89832 12826 245533 180783 43997 20753 TRAINING AND HR 144072 52607 91465 VOLUNTEER AND DONOR EXP 102410 102410 13454781 11280507 1661205 513069 1430667 1535513 462261 445697 1243886 931247 902227 1035744 443706 347958 17460037 2064194 15626020 15395843 250728 185706 20359495 19877708 1018156 1086579 6294817 6103118 7312973 7189697 X 12109302 12092260 894720 553251 42500 42500 13046522 12688011 20359495 19877708 X -346502 -12009 X 0 1 1 X 1 1 X 6009164 5880704 9409981 5015728 5645059 31960636 14400 14400 14400 14400 14400 72000 6023564 5895104 9424381 5030128 5659459 32032636 829298 31203338 82322 46434 53984 7155 5368 195263 28119 93210 43328 164657 32392556 36938354 0.96330 0.94760 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: INTER-AGENCY RECEIPTS TRAINING REVENUE MISCELLANEOUS NON EAP & OTHER FEES RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 42500 42500 42500 42500 32250 10250 42500 5750 26500 32250 0.00000 1.00000 0.00000 0 0 2456349 2456349 13588083 1120626 12467457 436954 361048 75906 717912 582520 135392 260739 260739 15395843 13108279 13454781 -346502 -12009 -12009 -358511 13332276 -12009 169834 157825 13174451 -66172 -66172 13108279 13690787 169834 66172 236006 13454781 0 13454781 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: ENDOWMENT FUNDS WERE ESTABLISHED UNDER THE CAPITAL CAMPAIGN AND THE FUNDS ARE TO BE USED FOR CREATING A FUTURE FUNDING SOURCE FOR THE ORGANIZATION AND THE PROGRAMS THAT SERVE CLIENTS. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -66,172. PART XIII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 66,172. LUNCHEON 516433 498261 18172 66172 516433 498261 18172 66172 66172 -48000 1 HOUSING ASSISTANCE 325 0 1595419 FAIR MARKET VALUE HOUSING ASSISTANCE, INCLUDING PAYMENTS FOR RENT, UTILITIES, GROCERY DEBIT CARDS, OR IDENTIFICATION REPLACEMENT ON BEHALF OF CLIENTS. DOMESTIC VIOLENCE INTERVENTION AND PREVENTION 150 221322 0 N/A N/A PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ALL GRANTS TO INDIVIDUALS ARE AWARDED AND DOCUMENTED THROUGH A PROCESS THAT IS MANAGED BY AGENCY CASE WORKERS. ONCE APPROVED, FUNDS ARE DISBURSED IN ACCORDANCE WITH AUTHORIZED DOCUMENTATION. EXAMPLES INCLUDE PAYMENT OF RENT ON BEHALF OF CLIENTS, PAYMENTS TO GOVERNMENT OFFICES FOR REPLACEMENT OF LEGAL IDENTIFICATION OR GIFT CARDS FOR PURCHASE OF FOOD. GRANTS ARE BUDGETED AT THE FUNDING SOURCE AND PROGRAM LEVEL TO ENSURE THAT OVERALL GRANT EXPENDITURES MEET THE REQUIREMENTS OF THE FUNDING SOURCES AS WELL AS THE FINANCIAL RESOURCES OF THE AGENCY. X 164680 FAIR MARKET VALUE X SOFTWARE 300 260739 FAIR MARKET VALUE 0 0 1 0 METHOD FOR DETERMINING NUMBER OF CONTRIBUTORS: PART I, COLUMN (B): THE NUMBER OF CONTRIBUTORS IS BASED ON THE NUMBER OF ITEMS RECEIVED. FORM 990, PART I, LINE 6: NUMBER OF VOLUNTEERS THE NUMBER OF VOLUNTEERS IS TRACKED BY THE HOUSING PROGRAM, BABY BOUTIQUE AND FUND DEVELOPMENT PROGRAMS. 22% VOLUNTEER IN HOUSING SERVICES, ASSISTING FAMILIES IN THE PREVENTION AND INTERVENTION HOUSING PROGRAMS. 63% VOLUNTEER IN BABY BOUTIQUE, SETTING UP AND STORING THE DONATIONS FOR FAMILIES TO GET FREE BABY SUPPLIES, CLOTHES AND TOYS. 15% HELP WITH THE ANNUAL LUNCHEON. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY THE OUTSIDE CPA FIRM. BOARD MEMBERS ARE PROVIDED COPIES OF THE FORM 990 PRIOR TO FILING WITH THE IRS. IN ADDITION, THE FORM 990 IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE, WHO THEN PRESENT IT TO THE FULL BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST ANNUALLY. THE POLICY IS MONITORED AND ENFORCED AS A PART OF THE FISCAL AUDIT PROCESS. THE AUDIT COMMITTEE ADDRESSES ANY FINDINGS IF THERE ARE ANY. IF A CONFLICT ARISES, THE BOARD MEMBER RECUSES HIM/HERSELF FROM VOTING AND DISCUSSIONS ON THE RELEVANT MATTER WITH THE AUDIT COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 ANNUALLY, IF THERE IS A SALARY INCREASE, THE BOARD EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE SALARIES OF THE CEO AND SENIOR EXECUTIVES. THE APPROVAL INCLUDES VERIFICATION BY THE APPROVING MEMBERS THAT THEY ARE INDEPENDENT AND UNRELATED TO THE EXECUTIVES. COMPENSATION MARKET DATA IS USED TO MAKE THE DECISION. THE LAST REVIEW WAS DONE IN DECEMBER 2009. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -12,009. FAMILY SERVICES PROPERTY LLC 1900 RAINIER AVENUE SOUTH SEATTLE WA 98144 260217889 OWNERSHIP OF FACILITY USED BY WELLSPRING FAMILY SERVICES WA 520000 15307881 WELLSPRING FAMILY SERVICES 1