2022-03-29T08:49:50-05:00 2021-06-30 221478099 COHNREZNICK LLP 350 CHURCH STREET 12TH FLOOR HARTFORD CT 06103 990 2020-07-01 383714954 ADELBROOK COMMUNITY SERVICES INC ADEL 8606350330 58 MISSIONARY ROAD CROMWELL CT 06416 ALYSSA GODUTI PRESIDENT AND CEO 8606350330 2022-03-08 1 ALYSSA GODUTI 999009999 PAUL BALLASY P00852868 9592007000 2022-03-07 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z ALYSSA GODUTI 58 MISSIONARY ROAD CROMWELL CT 06416 10519415 0 X N/A X 2005 CT TO SUPPORT INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS AND OTHER INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AND BEHAVIORAL HEALTH NEEDS TO MEET THEIR GOALS AND LIVE LIVES OF HOPE, HEALTH, ACHIEVEMENT, DIGNITY, AND HAPPINESS. 12 12 206 25 0 0 7171 3100 10839888 10479815 0 36500 0 0 10847059 10519415 0 0 0 0 7433999 6797687 0 0 0 3639441 3669217 11073440 10466904 -226381 52511 2341332 2925804 1499960 2031921 841372 893883 ADELBROOK, CSI PROVIDES HOPE AND HEALING TO CHILDREN AND FAMILIES IN A CHRISTIAN ENVIRONMENT. 0 0 6434719 7544446 ADELBROOK, CSI MANAGES CONTINUOUS RESIDENTIAL SUPPORT AND COMMUNITY LIVING ARRANGEMENT PROGRAMS FOR INDIVIDUALS WITH INTELLECTUAL OR DEVELOPMENTAL DISABILITIES IN ALL THREE SERVICE REGIONS UNDER CONTRACT WITH THE STATE OF CT'S DEPARTMENT OF DEVELOPMENTAL SERVICES. THESE 3 OR 4 PERSON HOMES ARE SUPPORTED WITH 24 HOUR A DAY DIRECT CARE SUPPORTS, NURSING COVERAGE, BEHAVIORAL SUPPORTS THROUGH EXPERT BEHAVIORAL STAFF, COMMUNITY ENGAGEMENT ACTIVITIES, AND INDIVIDUALIZED PROGRAMMING TO HELP INDIVIDUALS MEET THEIR PERSONAL GOALS. SERVICE LEVELS ARE BASED ON THE INDIVIDUAL'S UNIQUE LEVEL OF NEED. INDIVIDUALS TYPICALLY ATTEND SCHOOL OR DAY PROGRAMS IN THE COMMUNITY. 2670811 2670811 LEVEL II THERAPEAUTIC GROUP HOMES PROVIDE TREATEMENT, SUPPORT, AND RESIDENTIAL CARE FOR GIRLS, AGES 13-18. CLINICAL AND SUPPORT STAFF WORK WITH EACH RESIDENT TO ADDRESS CLINICAL NEEDS, PLAN FOR HER FUTURE, AND IMPLEMENT PLANNING TOWARDS HER INDIVIDUAL GOALS. TREATEMENT IS TRAMA-INFORMED AND LED BY A CLINICAL EXPERT WITHIN EACH PROGRAM. WE HAVE A SPECIFIC EXPERTISE IN WORKING WITH YOUTH WITH AUTISM SPECTRUM DISORDERS OR INTELLECTUAL/ DEVELOPMENTAL DISABILITIES. ADELBROOK USES EVIDENCE-BASED MODELS OF CARE TO SUPPORT YOUTH THROUGH INDIVIDUAL AND FAMILY THERAPY, LIFE-SKILLS DEVELOPMENT, COMMUNITY ENGAGEMENT, AND INDEPENDENT-LIVING SKILLS DEVELOPMENT. 264558 OTHER ANCILLARY ACTIVITIES: IN-HOME AND COMMUNITY-BASED BEHAVIORAL SERVICES, CONSULTATION AND PROFESSIONAL DEVELOPMENT, AND EDUCATION AND TRAINING PROGRAMS. 9105530 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 1 0 0 0 1 26 0 1 206 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CT X SUSAN BROSSEAU 8606350330 600 CORPORATE ROW CROMWELL CT 06416 REVEREND HOWARD BURGOYNE VICE CHAIR 1.00 1.00 X X 0 0 0 HAROLD C SPOONER JR CHAIRMAN 1.00 1.00 X X 0 0 0 SCOTT HANSON TREASURER 1.00 1.00 X X 0 0 0 REVEREND CONWAY BOYCE MEMBER 1.00 1.00 X 0 0 0 REVEREND RICHARD CUDMORE MEMBER 1.00 1.00 X 0 0 0 LINDA D REILLY-BLUE MEMBER 1.00 1.00 X 0 0 0 ROGER A OXENDALE MEMBER 1.00 1.00 X 0 0 0 DR IVY RENTZ SECRETARY 1.00 1.00 X X 0 0 0 CHRISTINE URCIUOLI DIRECTOR 1.00 1.00 X 0 0 0 DONNA LEWIS DIRECTOR 1.00 1.00 X 0 0 0 MARTIN ZIBUDA DIRECTOR 1.00 1.00 X 0 0 0 SALVATORE NESCI DIRECTOR 1.00 1.00 X 0 0 0 ALYSSA GODUTI PRESIDENT & CEO 10.00 30.00 X 0 257709 8423 SUSAN BROSSEAU CHIEF FINANCIAL OFFICER 20.00 20.00 X 0 115826 26889 SABRINA CAMERON EXECUTIVE VICE PRESIDENT 10.00 30.00 X 0 130333 5206 0 503868 40518 0 0 1 0 DELTA T GROUP HARTFORD INC PO BOX 884 BRYN MAWR PA 06457 TEMP STAFFING 855177 NE PSYCHIATRIC ASSOCIATES LLC 420 SOUTH MAIN STREET UNIT 4 CHESHIRE CT 06410 PSYCHIATRY 170100 PJW NURSING CONSULTANTS LLC 28 CUMBERLAND ROAD WEST HARTFORD CT 06119 NURSING SERVICES 122086 3 3100 3100 CONTINUOUS RESIDENTIAL SUPPORT 623990 7544446 7544446 THERAPUEUTIC GROUP HOMES 623990 2670811 2670811 TRAINING ACADEMY 624310 193689 193689 ANCILIARY PROGRAMS 623990 70869 70869 10479815 36500 0 36500 36500 36500 10519415 10479815 0 36500 X 5416569 5320607 95962 43338 42570 768 932381 915863 16518 405399 398217 7182 43493 36774 6719 36417 36417 2283164 1338117 945047 176512 117732 58780 581527 474739 106788 144821 129728 15093 22444 22444 156366 85299 71067 139444 138411 1033 ASSISTANCE TO CHILDREN 45029 45029 MEDICAID SETTLEMENT 40000 40000 10466904 9105530 1361374 0 516882 798014 3573 14322 446026 340583 5945 2726236 966951 1351406 1759285 17500 13600 2341332 2925804 665491 718161 241690 201779 453912 554806 138867 557175 1499960 2031921 X 836177 893883 5195 0 841372 893883 2341332 2925804 52511 0 X X 0 1 X 1 0 X 152853 173672 4150 7171 3100 340946 152853 173672 4150 7171 3100 340946 340946 8 3 2 0 13 340959 47291175 1.00000 0.93460 X 350666 350666 1324486 372886 951600 436651 391429 45222 614433 202636 411797 1759285 DUE TO AFFILIATE 557175 557175 X 10519415 0 10519415 0 10519415 10466904 0 10466904 0 10466904 PART X, LINE 2: MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ADELBROOK CSI, AND HAS CONCLUDED THAT AS OF JUNE 30, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. ADELBROOK CSI IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS PENDING OR IN PROGRESS. X X X X X 0 0 0 0 0 0 0 0 0 ALYSSA GODUTI PRESIDENT & CEO 0 210329 0 40000 0 7380 0 8423 0 0 0 266132 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER IS ADELBROOK, INC. FORM 990, PART VI, SECTION A, LINE 7A ADELBROOK INC., THE SOLE MEMBER, HAS THE RIGHT TO ELECT THE DIRECTORS OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7B PURSUANT TO SECTION II.A OF THE BYLAWS, THE SOLE MEMBER HAS THE FOLLOWING RIGHTS AND POWERS: (I) TO APPOINT AND REMOVE THE PRESIDENT OF THE CORPORATION; (II) TO APPROVE IN ADVANCE STRATEGIC PLANS, MISSION STATEMENTS, AND MAJOR CHANGES OF POLICY OF THE CORPORATION RECOMMENDED BY THE BOARD OF DIRECTORS; (III) TO APPROVE IN ADVANCE ANY MAJOR BORROWING RECOMMENDED BY THE BOARD OF DIRECTORS; (IV) TO APPROVE IN ADVANCE ANY DISPOSITION, PURCHASE, LEASE, SALE OR ENCUMBRANCE OF REAL PROPERTY BY OR TO THE CORPORATION THAT IS USED IN ITS MINISTRY AS RECOMMENDED BY THE BOARD OF DIRECTORS; (V) TO APPROVE IN ADVANCE MERGERS OR DISSOLUTIONS OF THE CORPORATION AND THE PLAN FOR DISTRIBUTION OF ASSETS; (VI) TO APPROVE IN ADVANCE THE CREATION OF NEW AFFILIATES AND OTHER RELATED ENTITIES RECOMMENDED BY THE BOARD OF DIRECTORS; AND (VII) TO APPROVE IN ADVANCE AMENDMENTS TO THE CERTIFICATE OF INCORPORATION OR BY-LAWS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS. ANY CONFLICTS ARE REVIEWED BY THE PRESIDENT AND INDIVIDUALS INVOLVED WOULD RECUSE THEMSELVES FROM DISCUSSION OF THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS DETERMINED BY THE BOARD COMMITTEE. OTHER COMPENSATION ADJUSTMENTS ARE ACROSS THE BOARD COST OF LIVING INCREASES IF DETERMINED FOR THE YEAR. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLOCY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,338,117. MANAGEMENT AND GENERAL EXPENSES 945,047. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,283,164. FORM 990, PART XII, LINE 2C: THERE HAVE BEEN NO CHANGES MADE TO THE ORGANIZATION'S OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. NATIONAL COVENANT PROPERTIES 8303 WEST HIGGINS ROAD CHICAGO IL 60631 237091306 RELIGION IL 501(C)(3) LINE 1 N/A 0 ADELBROOK INC 60 HICKSVILLE ROAD CROMWELL CT 06416 060646920 THE CARE OF CHILDREN CT 501(C)(3) LINE 1 N/A 0 COVENANT INITIATIVES FOR CARE 4055 W PETERSON AVENUE CHICAGO IL 60646 271841721 PARENT OF ADELBROOK, INC. IL 501(C)(3) N/A 0 COVENANT MINISTRIES OF BENEVOLENCE 4055 W PETERSON AVENUE CHICAGO IL 60625 363486813 SUPPORT EVANGELICAL COVENANT CHURCH IL 501(C)(3) LINE 12A, I N/A 0 0 1 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 0 0