2021-05-17T16:38:33-05:00 2020-06-30 111986323 MARCUM LLP 185 ASYLUM ST 25TH FL CITYPLACE HARTFORD CT 06103 990 2019-07-01 383714954 ADELBROOK COMMUNITY SERVICES INC ADEL 8606350330 58 MISSIONARY ROAD CROMWELL CT 06416 ALYSSA GODUTI PRESIDENT AND CEO 8606350330 2021-05-17 1 MARY ANTONETTI P00431862 8607600600 2019 2022-09-23 18:48:47Z ALYSSA GODUTI 58 MISSIONARY ROAD CROMWELL CT 06416 10847059 0 2650 X N/A X 2005 CT TO SUPPORT INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS AND (SEE SCHEDULE O)OTHER INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AND BEHAVIORAL HEALTH NEEDS TO MEET THEIR GOALS AND LIVE LIVES OF HOPE, HEALTH, ACHIEVEMENT, DIGNITY, AND HAPPINESS. 11 10 255 25 0 0 4150 7171 12569156 10575728 2 0 9062 264160 12582370 10847059 0 0 0 0 8885631 7433999 0 0 0 3740519 3639441 12626150 11073440 -43780 -226381 2148509 2341332 1080756 1499960 1067753 841372 X ADELBROOK, CSI PROVIDES HOPE AND HEALING TO CHILDREN AND FAMILIES IN A CHRISTIAN ENVIRONMENT. (SEE SCHEDULE O)ADELBROOK IS THE PREMIER RESOURCE FOR CHILDREN, FAMILIES AND COMMUNITIES TO MEET THE NEEDS OF INDIVIDUALS WITH AUTISM SPECTRUM DISORDERS AND OTHER BEHAVIORAL AND DEVELOPMENTAL CHALLENGES THROUGH RESIDENTIAL, THERAPEUTIC, IN-HOME, AND COMMUNITY-BASED SERVICES. 0 0 6767794 7355342 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. 2342481 2735391 LEVEL II THERAPEUTIC GROUP HOMES PROVIDE TREATMENT, 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. TREATMENT IS TRAUMA-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 SKILL DEVELOPMENT. 522083 749155 OTHER ANCILLARY ACTIVITIES: IN-HOME AND COMMUNITY-BASED BEHAVIORAL SERVICES AND DAY PROGRAMS. 9632358 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 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 30 0 1 255 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 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 CO-CHAIRMAN 1.00 1.00 X X 0 0 0 HAROLD C SPOONER JR CO-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 (AS OF 9/2020) 1.00 1.00 X 0 0 0 ROGER A OXENDALE DIRECTOR 1.00 1.00 X 0 0 0 ALYSSA GODUTI PRESIDENT & CEO 1.00 40.00 X X 0 237563 9488 DR IVY RENTZ SECRETARY (FROM 7/18) 1.00 1.00 X 0 0 0 CHRISTINE URCIUOLI DIRECTOR (FROM 7/18) 1.00 1.00 X 0 0 0 DONNA LEWIS DIRECTOR (FROM 7/19) 1.00 1.00 X 0 0 0 MARTIN ZIBUDA DIRECTOR (FROM 7/19) 1.00 1.00 X 0 0 0 SALVATORE NESCI DIRECTOR (FROM 7/20) 1.00 1.00 X 0 0 0 TODD SLECHTA DIRECTOR (FROM 7/20) 1.00 1.00 X 0 0 0 ANTON A PETRAS CHAIRMAN (ROTATED OFF) 1.00 1.00 X X 0 0 0 JOYCE FISCUS MEMBER (ROTATED OFF) 1.00 1.00 X 0 0 0 SUSAN BROSSEAU CHIEF FINANCIAL OFFICER 20.00 20.00 X 0 111680 29230 SABRINA CAMERON EXECUTIVE VICE PRESIDENT 1.00 40.00 X 0 118358 4734 0 467601 43452 0 0 1 0 DELTA T GROUP HARTFORD INC PO BOX 884 BRYN MAWR PA 06457 TEMP STAFFING 549532 NE PSYCHIATRIC ASSOCIATES LLC 420 SOUTH MAIN STREET UNIT 4 CHESHIRE CT 06410 PSYCHIATRY 158400 PJW NURSING CONSULTANTS LLC 28 CUMBERLAND RD WEST HARTFORD CT 06119 NURSING SERVICES 107510 3 7171 7171 CONTINUOUS RESIDENTIAL SUPPORT 623990 7355342 7355342 THERAPEUTIC GROUP HOMES 623990 2735391 2735391 ANCILIARY PROGRAMS 623990 484995 484995 10575728 TRAINING ACADEMY 624310 264160 264160 264160 10847059 10839888 0 0 X 5772028 5588696 183332 46317 39717 6600 1187262 1094922 92340 428392 414342 14050 34480 33151 1329 37218 37218 2338602 1499943 838659 39391 10993 28398 36289 13992 22297 654366 511058 143308 189806 188826 980 23081 23081 143449 72072 71377 142759 141565 1194 11073440 9632358 1441082 0 293191 516882 792 3573 260937 446026 34815 5945 2182837 831431 1322009 1351406 236765 17500 2148509 2341332 413001 665491 517544 453912 150211 380557 1080756 1499960 X 1055857 836177 11896 5195 1067753 841372 2148509 2341332 -226381 0 X X 0 1 X 1 0 X 152853 173672 4150 7232 337907 152853 173672 4150 7232 337907 337907 4 8 3 2 0 17 31 6810 9062 7726 23629 361553 63343681 0.93460 0.93900 X 350666 350666 984076 334057 650019 593977 433844 160133 254118 63530 190588 1351406 ADVANCES PAYABLE TO STATE OF CONNECTICUT 241690 DUE TO AFFILIATE 138867 380557 X 10847059 0 10847059 0 10847059 11073440 0 11073440 0 11073440 PART X, LINE 2: BELOW IS AN EXCERPT FROM FOOTNOTE 1 OF THE AUDITED FINANCIAL STATEMENTS FOR ADELBROOK COMMUNITY SERVICES, INC. ADELBROOK CSI HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. IN ADDITION, ADELBROOK CSI QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VI) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(2). MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ADELBROOK CSI, AND HAS CONCLUDED THAT AS OF JUNE 30, 2020 AND 2019, 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. 0 0 0 0 0 0 0 0 0 ALYSSA GODUTI PRESIDENT & CEO 0 237200 0 0 0 363 0 0 0 9488 0 247051 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; TO APPROVE IN ADVANCE MERGERS OR DISSOLUTION 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 EXECUTIVE DIRECTORS 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 POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990, PART IX, LINE 11G CONTRACT TEMPORARY STAFFING: PROGRAM SERVICE EXPENSES 692,776. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 692,776. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 121,644. MANAGEMENT AND GENERAL EXPENSES 4,009. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,653. INTERCOMPANY STAFFING: PROGRAM SERVICE EXPENSES 349,854. MANAGEMENT AND GENERAL EXPENSES 756,916. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,106,770. CONTRACTED NURSING: PROGRAM SERVICE EXPENSES 113,021. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 113,021. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 222,648. MANAGEMENT AND GENERAL EXPENSES 77,734. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 300,382. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ADELBROOK INC 60 HICKSVILLE ROAD CROMWELL CT 06416 060646920 THE CARE OF CHILDREN. CONTROLLED BY COVENANT INITIATIVES FOR CARE CT 501(C)(3) LINE 7 N/A 0 COVENANT INITIATIVES FOR CARE 4055 W PETERSON AVENUE CHICAGO IL 60646 PARENT OF ADELBROOK, INC. CONTROLLED BY CONVENANT MINISTRIES OF BENEVOLENCE IL 501(C)(3) LINE 1 N/A 0 COVENANT MINISTRIES OF BENEVOLENCE 4055 W PETERSON AVENUE CHICAGO IL 60646 PARENT OF COVENANT INITIATIVES FOR CARE IL 501(C)(3) LINE 1 N/A 0 0 0 0 1 1 0 0 0 0 0 1 1 1 1 1 1 1 0 0 ADELBOOK INC K 229023 ACTUAL COST ADELBOOK INC L 184300 ACTUAL COST ADELBOOK INC M 877354 COST ALLOCATION PLAN ADELBOOK INC Q 358132 ACTUAL COST