2011-04-06T14:20:07-05:00 2010-06-30 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2009-07-01 131740041 SHIELD OF DAVID INC SHIE 7189398700 144-61 ROOSEVELT AVENUE FLUSHING NY 11354 dr susan provenzano 7189398700 2011-04-06 1 FREDERICK H ROTHMAN 2128674000 2009 2016-02-24 21:20:13Z THE SHIELD INSTITUTE Dr Susan Provenzano 144-61 ROOSEVELT AVENUE FLUSHING NY 11354 33524253 0 X http://www.shield.org/ X 1921 NY SHIELD OF DAVID,INC. PROVIDES EDUCATIONAL/OTHER SERVICES FOR DEVELOPMENTALLY DISABLED INDIVIDUALS. ALSO KNOWN AS "THE SHIELD INSTITUTE" - "A NOT FOR PROFIT CORPORATION". OUR MISSION IS TO WORK IN PARTNERSHIP WITH FAMILIES AND COMMUNITIES TO ENABLE CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES TO LEAD MEANINGFUL LIVES. OUR FOCUS IS ON FOSTERING EACH INDIVIDUAL'S INDEPENDENCE AS A FULL PLEDGED MEMBER OF HIS OR HER FAMILY AND COMMUNITY, AND COLLABORATING IN FAMILIES LIFE-LONG EFFORTS TO PROVIDE RICH LIVES FOR THEIR CHILDREN. 13 13 517 6 0 0 748817 938917 30404528 32447069 26506 18431 133521 109445 31313372 33513862 0 0 20247090 22424825 0 80419 10334693 10196079 30581783 32620904 731589 892958 8835976 10428013 13611003 15111057 -4775027 -4683044 ORGANIZED FOR THE PURPOSE OF PROVIDING EDUCATIONAL AND OTHER SERVICES TO INDIVIDUALS WHO ARE DEVELOPMENTALLY DISABLED. OUR MISSION-TO WORK IN PARTNERSHIP WITH FAMILIES AND COMMUNITIES TO ENABLE CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES TO LEAD MEANINGFUL LIVES.OUR FOCUS IS ON FOSTERING EACH INDIVIDUAL'S INDEPENDENCE AS A FULL PLEDGED MEMBER OF HIS OR HER FAMILY AND COMMUNITY, AND COLLABORATING IN FAMILIES LIFE-LONG EFFORTS TO PROVIDE RICH LIVES FOR THEIR CHILDREN. 0 0 14111362 15945453 DAY HABILITATION: Full time Adult day and evening programs serving over 500 clients where we provide a variety of group and individual activities based on an individuals interest and life goals. Center based and community activities provide life experiences to enhance independence and inclusion in the communities. Saturday services that provide enhanced opportunities for socialization, recreation and community inclusion. Supplemental services are provided for individuals who are involved in other day activities to enhance their ability to participate in the community. Also, part-time services are available for adolescents/young adults who are aging out of school services to support in their transition to adult life. 12621922 12381568 EDUCATION: Day school programs are provided to over 420 students. Preschool program provides multidisciplinary evaluations, monolingual and bilingual special education and related services to children, ages 3 to 5 in a child centered classroom setting. Specialized instruction for children who display characteristics on the autism spectrum, includes structured teaching, aided language, and PECS. Programs include integrated classes that provide an opportunity for children with special needs to learn and play with typically developing children. Also, our school age program provides special education programming, person centered planning, speech, counseling, occupational and physical therapy to children ages 6 to 21 who have been diagnosed with a developmental disability. Classroom instruction for children diagnosed on the autism spectrum includes structured teaching, augmentative and alternative communication, aided language, and picture exchange communication systems. 3480107 4120048 CLINIC: Services are provided to over 2000 children and adults with developmental delays/disabilities. Services provided include psychological, social work, speech and rehabilitative counseling, occupational and physical therapy and nutritional counseling to individual and groups. Specialty services include augmentive communication evaluation and treatment, eating and swallowing evaluation and treatment, and psychsexual assessment and treatment. 30213391 1 1 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 50 0 1 517 1 0 0 0 0 0 0 0 0 0 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 1 0 NY X KARL HERR - CONTROLLER 7182692023 144-61 ROOSEVELT AVENUE FLUSHING NY 11354 DAVID SWEET 2.00 X X 0 0 0 RON JACOBS 2.00 X X 0 0 0 RENEE J WARD 2.00 X X 0 0 0 MICHAEL KATZ 2.00 X X 0 0 0 LESLIE PEARSON 2.00 X X 0 0 0 ROBIN LANDOW 2.00 X 0 0 0 NORMAN LOWE 2.00 X 0 0 0 DAVID KLEGER 2.00 X 0 0 0 BIJAN SAFAI 2.00 X 0 0 0 RICHARD L SCHWARTZ 2.00 X 0 0 0 KEITH B STEIN 2.00 X 0 0 0 LAURA WEINKAM 2.00 X 0 0 0 LOUISE YOUNG 2.00 X 0 0 0 DR SUSAN PROVENZANO 35.00 X 213863 0 27152 KARL HERR 35.00 X 114125 0 20320 DR KAREN BIRNBAUM 35.00 X 150924 0 29369 MARK BRODY 35.00 X 137733 0 13787 616645 0 90628 4 0 1 0 PROFESSIONAL CHARTER 50 SNEDIKER AVENUE BROOKLYN NY 11207 TRANSPORTATION SERVICES 2213546 ULTIMATE PSYCHOLOGICAL 271 NORTH AVENUE STE 111 NEW ROCHELLE NY 10801 CLINICAL SERVICES 898329 MULTINLIGUAL THERAPY 8801 19TH AVENUE 2ND FLOOR BROOKLYN NY 11214 SPEECH THERAPY 270179 SUPERIOR DIRECT CARE 83 MAIDEN LANE 7TH FLOOR NEW YORK NY 10038 HABILITATIVE AIDS 158775 BRYAN CAVE LLP P O BOX 30491 NEW YORK NY 30491 LEGAL 158078 7 1995 840677 96245 938917 Medicare/Medicaid paym 624100 19941225 19941225 NYS/NYC Dept of Educat 624100 12257506 12257506 CONSUMER SELF PAY 624100 248338 248338 32447069 18431 18431 28355 10391 17964 17964 All other revenue 624100 91481 91481 91481 33513862 32447069 0 127876 778811 168021 610790 15243179 14624676 583150 35353 1185224 1127169 47909 10146 4057021 3952391 84337 20293 1160590 1104136 53825 2629 424122 249326 171761 3035 214827 6857 207970 70110 70110 2458802 2436154 22648 49516 49516 260226 212956 46979 291 45921 37580 8290 51 2128995 2095222 33733 40 2333730 2317912 15757 61 66155 49081 14007 3067 57330 10741 46475 114 490550 353344 136176 1030 117425 98886 17863 676 CONSUMABLE SUPPLIES 637707 628050 9657 REPAIRS AND MAINTENANCE 351974 294592 54267 3115 EQUIPMENT PURCHASE/ LEA 331759 287868 43553 338 BAD DEBT EXPENSE 97092 97092 DUES AND SUBSCRIPTIONS 27772 6571 21021 180 32066 5250 26816 32620904 30213391 2327094 80419 139419 171171 2525120 3408546 3278935 3545149 108362 148097 10233993 7096822 2766261 3137171 17879 17879 8835976 10428013 5499095 7594347 81404 160665 3742246 3538320 4288258 3817725 13611003 15111057 X -4775027 -4683044 -4775027 -4683044 8835976 10428013 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 307696 307696 5934838 4333709 1601129 3756925 2528579 1228346 234534 234534 0 3137171 DUE TO GOVERNMENT AGENCIES 677725 RESERVE FOR RATE ADJUSTMENT 850000 DUE TO JBFCS 2290000 3817725 33513862 32620904 892958 -800975 -800975 91983 33513862 0 33513862 0 33513862 32620904 0 32620904 0 32620904 Part XI, Line 8 - Other Adjustments: DECREASE IN PENSION FUNDED STATUS 1 1 0 THE SHIELD INSTITUTE DOES NOT HAVE A PERIOD OF SOLICITATION FOR STUDENTS OR A PERIOD OF REGISTRATION FOR STUDENTS. ALL STUDENTS ARE REFERRED THROUGH THE DEPARTMENT OF EDUCATION BY THE LOCAL PUBLIC SCHOOL DISTRICTS. 1 1 1 1 0 0 0 0 0 0 0 0 1 0 THE SHIELD RECEIVES FINANCIAL AID THRU TUITION RATES FROM THE STATE EDUCATION DEPARTMENT. 1 MARLBOROUGH EVENT 10000 10000 PARADISE FOUND 13955 13955 950 1315 1 4400 4400 1000 7126 28355 28355 1950 8441 10391 17964 X X X 0 0 0 0 0 0 0 0 0 DR SUSAN PROVENZANO 198401 0 0 0 15462 0 13969 0 13183 0 241015 0 0 0 DR KAREN BIRNBAUM 146660 0 4264 0 0 0 10619 0 18750 0 180293 0 0 0 MARK BRODY 129266 0 8467 0 0 0 9136 0 4651 0 151520 0 0 0 Form 990, Part VI, Section B, line 11 Management and the Audit Committee met with the Independent Accounting firm to review and discuss the 990. Subsequently, the completed draft of the 990 was sent to all Board Members prior to filing the final return with the IRS. Form 990, Part VI, Section B, line 12c The Shield Institute has the same policy as our parent company JBFCS. The Shield Institute compliance plan requires all members of the board and senior staff with agency wide responsibilites to complete a conflict of interest form each year. Any indications of potential or reported conflicts of interest are reviewed by the board of directors, discussed with individuals involved and resolved. If conflicts are evident, all steps are taken to remove the conflict whether it requires a change in staff person's responsibilities or position, or a Board member resigning or at a minimum excusing themselves from conflict issues. Form 990, Part VI, Section B, line 15 Compensation for the CEO is evaluated and reviewed by the President of the Board in conjunction with the Executive compensation committee. This was last done in July 2009. The CEO reviews and evaluates the compensation for all other officers and key employees in conjunction with the executive management team. (Associate Executive Director, Controller and Human Resource Manager). The Associate Executive Director and Controller review were last done in July 2009 and in January 2010 the Human Resource Manager was reviewed. Form 990, Part VI, Section C, line 19 Governing documents, conflict of interest policy and financial statements are made available to the public upon request. Part XI line 2 (c) The Shields' audit committee consists of the President, Chairman and Treasurer of the Board of Directors. It is their responsibility to engage the independent accounting firm to perform the year end audit and final review of the audited financial statements. Form 990 Part VI, section B, line 14 Currently the Shield Institute has in draft form a written policy for both the record retention and destruction of records. Every year whatever documents have by-passed the retention period, the documents are removed from storage and are shredded. The storage files have been mapped out and organized by year and by program. When documents become outdated they are then shredded. A directory is maintained showing what documents are on hand and records of the documents that have been destroyed. Our document and record retention schedules are based upon the help of the Interagency Council that The Shield Institute is associated with. SCHEDULE E LINE 3 The Shield admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, admission policies, scholarship and loan programs, and athletic and other school-administered programs. JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES 120 West 57th Street NEW YORK NY 10019 135564937 Provides a comprehensive network of mental health & social services NY 501(c)(3) 7 N/A 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES E 2290000 JEWISH BOARD OF FAMILY AND CHILDREN'S SERVICES Q 102491