LAKE AREA FREE CLINIC INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LAKE AREA FREE CLINIC INC (EIN 39-2006388)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-01
- IRS object ID
- 202103059349301440
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-01T16:23:57-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 W INNOVATION DR STE 300 | AddressLine1Txt |
| City | WAUWATOSA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392006388 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE AREA FREE CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 2625694990 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR ROAD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PEG KOENIGS | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 2625694990 | PhoneNum |
| Signature | 2021-10-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PEG | PersonFirstNm |
| Person Last | KOENIGS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL SENGER | PreparerPersonNm |
| PTIN | P00005154 | PTIN |
| Phone | 4144761880 | PhoneNum |
| Preparation | 2021-10-20 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY REICH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR ROAD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,628,445 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEAREAFREECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | PROVIDES HIGH-QUALITY MEDICAL AND DENTAL CARE TO LOW-INCOME RESIDENTS OF WAUKESHA COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 21 | VotingMembersIndependentCnt |
| Total Employee | 29 | TotalEmployeeCnt |
| Total Volunteers | 260 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $992,565 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,447,006 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,880 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,314 | CYInvestmentIncomeAmt |
| PY Other Revenue | $164,608 | PYOtherRevenueAmt |
| CY Other Revenue | $177,811 | CYOtherRevenueAmt |
| PY Total Revenue | $1,159,053 | PYTotalRevenueAmt |
| CY Total Revenue | $1,626,131 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,195,260 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,061,871 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $103,066 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $435,515 | PYOtherExpensesAmt |
| CY Other Expenses | $421,551 | CYOtherExpensesAmt |
| PY Total Expenses | $1,630,775 | PYTotalExpensesAmt |
| CY Total Expenses | $1,483,422 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$471,722 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $142,709 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,312,695 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,578,126 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $35,680 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $46,762 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,277,015 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,531,364 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE LAKE AREA FREE CLINIC IS THE MEDICAL AND DENTAL HOME TO LOW-INCOME RESIDENTS OF WAUKESHA COUNTY. THE MISSION IS TO PROVIDE HIGH-QUALITY COMPREHENSIVE HEALTH CARE TO THOSE IN NEED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,267,674 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Desc | LAKE AREA FREE CLINIC IS THE MEDICAL HOME TO ADULTS AND PROVIDES ACUTE AND CHRONIC CARE SERVICES AND SPECIALITIES INCLUDE: CARDIOLOGY, DERMATOLOGY, INTERNAL MEDICINE, GYNECOLOGY, HEPATOLOGY, HEMATOLOGY, RHEUMATOLOGY, NEPHROLOGY, NEUROLOGY, PHYSICAL THERAPY, MENTAL HEALTH, ORTHOPEDICS, WELLNESS, AND COMPREHENSIVE DIABETES CLINIC. LAKE AREA FREE CLINIC IS THE 7-CHAIR DENTAL HOME TO ADULTS WHO ARE UNINSURED OR WHO HAVE MEDICAID. | Desc |
| Total Program Service Expenses | $1,267,674 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 29 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 21 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEG KOENIGS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2625694990 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR RD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BETH BOYER-RYAN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR ERIC RUIZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JAY PLUDEMAN | |||||||
| MEDICAL DIR | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| DR ROB PANTHER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR ROBERT SCHWADE | |||||||
| DENTAL DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE SORUM | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOYANN MCCHESNEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE JACKSON | |||||||
| PAST PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA MORONEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA DREW | |||||||
| PRESIDENT | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARY JO O'MALLEY | |||||||
| VICE PRESIDENT | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARY REICH | |||||||
| EXECUTIVE DIREC | 40.00 | Yes (X) | $94,260 | $0 | $0 | ||
| MARY RODE | |||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| MEGAN WELSH | |||||||
| DIRECTOR | 40.00 | Yes (X) | $78,780 | $0 | $0 | ||
| MICHAEL RODE | |||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| MITZI CASS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY BRADT | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PEG KOENIGS | |||||||
| TREASURER | 5.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RAMON AGUIRRE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SARAH BUTZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TERRY LADWIG | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VICKI DALLMANN-PAPKE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PABLO FERNANDEZ | |||||||
| EMPLOYEE | 40.00 | $215,579 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $388,619 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $164,500 | GovernmentGrantsAmt |
| All Other Contributions | $1,282,506 | AllOtherContributionsAmt |
| Noncash Contributions | $6,271 | NoncashContributionsAmt |
| Total Contributions | $1,447,006 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,314 | TotalRevenueColumnAmt |
| Exclusion | $1,314 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $177,832 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $2,314 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $175,518 | TotalRevenueColumnAmt |
| Exclusion | $175,518 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $2,293 | TotalRevenueColumnAmt |
| Exclusion | $2,293 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,293 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,626,131 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $179,125 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $973,525 | TotalAmt |
| Program Services | $842,117 | ProgramServicesAmt |
| Management And General | $65,635 | ManagementAndGeneralAmt |
| Fundraising | $65,773 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,328 | TotalAmt |
| Program Services | $6,164 | ProgramServicesAmt |
| Management And General | $6,164 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,018 | TotalAmt |
| Program Services | $65,757 | ProgramServicesAmt |
| Management And General | $5,125 | ManagementAndGeneralAmt |
| Fundraising | $5,136 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,590 | TotalAmt |
| Program Services | $53,005 | ProgramServicesAmt |
| Management And General | $17,668 | ManagementAndGeneralAmt |
| Fundraising | $8,917 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,901 | TotalAmt |
| Fundraising | $17,901 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,286 | TotalAmt |
| Program Services | $10,162 | ProgramServicesAmt |
| Management And General | $3,388 | ManagementAndGeneralAmt |
| Fundraising | $736 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,937 | TotalAmt |
| Program Services | $83,644 | ProgramServicesAmt |
| Management And General | $9,293 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428 | TotalAmt |
| Program Services | $428 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,905 | TotalAmt |
| Program Services | $64,905 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,716 | TotalAmt |
| Program Services | $8,037 | ProgramServicesAmt |
| Management And General | $2,679 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $106,446 | $106,446 | |
| REPAIRS & MAINTENANCE | $11,097 | $11,097 | |
| TRANSPORTATION | $9,537 | $9,537 | |
| MISCELLANEOUS | $4,306 | $2,806 | $1,500 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,402 | TotalAmt |
| Program Services | $3,569 | ProgramServicesAmt |
| Management And General | $2,730 | ManagementAndGeneralAmt |
| Fundraising | $3,103 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,483,422 | TotalAmt |
| Program Services | $1,267,674 | ProgramServicesAmt |
| Management And General | $112,682 | ManagementAndGeneralAmt |
| Fundraising | $103,066 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $629,090 | BOYAmt |
| EOY | $990,464 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,931 | BOYAmt |
| EOY | $105,706 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,869 | BOYAmt |
| EOY | $4,297 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,126 | BOYAmt |
| EOY | $24,777 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,141 | BOYAmt |
| EOY | $15,249 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $669,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $232,044 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $502,538 | BOYAmt |
| EOY | $437,633 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,312,695 | BOYAmt |
| EOY | $1,578,126 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,680 | BOYAmt |
| EOY | $46,762 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,680 | BOYAmt |
| EOY | $46,762 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,260,293 | BOYAmt |
| EOY | $1,468,389 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,722 | BOYAmt |
| EOY | $62,975 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,277,015 | BOYAmt |
| EOY | $1,531,364 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,312,695 | BOYAmt |
| EOY | $1,578,126 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $142,709 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | $86,955 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $24,685 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $930,796 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $459,959 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $945,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $890,732 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,230,498 | CurrentTaxYearAmt |
| Total | $4,457,195 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $930,796 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $459,959 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $945,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $890,732 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,230,498 | CurrentTaxYearAmt |
| Total | $4,457,195 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $60,382 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,396,813 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,670 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,053 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,898 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,314 | CurrentTaxYearAmt |
| Total | $16,466 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $4,958 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,293 | CurrentTaxYearAmt |
| Total | $7,251 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,480,912 | TotalSupportAmt |
| Public Support CY170 | 0.98120 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95410 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $470,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $155,629 | DepreciationAmt |
| Book Value | $315,142 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $198,906 | OtherCostOrOtherBasisAmt |
| Depreciation | $76,415 | DepreciationAmt |
| Book Value | $122,491 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $437,633 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,713,086 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $86,955 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $86,955 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,626,131 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,626,131 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,483,421 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,483,421 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,483,421 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $153,221 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $153,221 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $16,636 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $153,221 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $153,221 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $16,636 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $16,636 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $136,585 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PABLO FERNANDEZ | PersonNm |
| Title | EMPLOYEE | TitleTxt |
| Base Compensation Filing Org | $215,579 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $215,579 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS SUBMITTED TO & REVIEWED BY THE GOVERNING BODY AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICTS ARE ADDRESSED AT EVERY BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15 | EVERY EMPLOYEE RECEIVES A REVIEW. THE EXECUTIVE DIRECTOR MAKES THE SALARY RECOMMENDATIONS WITH INPUT FROM THE MANAGEMENT TEAM. THE EXECUTIVE DIRECTORS PERFORMANCE AND SALARY IS REVIEWED BY THE PRESIDENT OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 18 | ALL DOCUMENTS & STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS & STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PRIOR PERIOD ADJUSTMENT 24,685. |