2020-01-14T16:26:36-06:00 2019-02-28 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2018-03-01 941485533 CHANNING HOUSE CHAN 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RHONDA BEKKEDAHL CEO 6503270950 2020-01-14 1 MICHAEL LUMSDEN P01262236 4159561500 2020-01-14 12.129.4.210 2020-01-14 12:32:51 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2018 2020-09-23 17:36:50Z RHONDA BEKKEDAHL 850 WEBSTER STREET PALO ALTO CA 94301 30684699 0 X WWW.CHANNINGHOUSE.ORG X 1960 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 15 15 140 70 0 39021 173728 149713 19201263 20233756 798150 958590 30252 60283 20203393 21402342 2494 1500 0 0 6838648 7994102 10000 8500 8500 12789982 14016980 19641124 22021082 562269 -618740 162178535 164117780 144111525 147237573 18067010 16880207 X THE MISSION OF CHANNING HOUSE, AS AN EXPRESSION OF ITS CHARITABLE PURPOSE, IS TO PROVIDE A HIGH QUALITY OF LIVING ENVIRONMENT THAT ENHANCES EACH RESIDENTS' INDEPEDENCE, WELL-BEING AND SECURITY. 0 0 16764168 1500 20233756 PROVIDE HOUSING, ASSISTED LIVING, AND SKILLED NURSING SERVICES WHICH INCLUDE DINING SERVICES, MAINTENANCE, HOUSEKEEPING, AND NURSING CARE. DURING FY2019 WE SERVED AN AVERAGE OF 223 RESIDENTS WITH A TOTAL OF 6,570 SERVICE DAYS OF SKILLED NURSING; 8,030 SERVICE DAYS OF ASSISTED LIVING; AND 66,649 DAYS OF RESIDENTIAL CARE SERVICES. IN ADDITION, CHANNING HOUSE IS A NEIGHBORHOOD POLLING LOCATION, HOSTS VARIOUS COMMUNITY MEETINGS, AND PARTNERS IN EMERGENCY PREPAREDNESS PROGRAMS. WE COORDINATE WITH THE CITY OF PALO ALTO AND WITH SANTA CLARA COUNTY TO PROVIDE EMERGENCY COMMUNICATIONS AND ACT AS A BACK-UP OPERATIONAL COMMAND CENTER IN THE EVENT OF A NATURAL (OR OTHER) DISASTER. WE ALSO PROVIDE THE USE OF OUR SWIMMING POOL TO A LOCAL NOT-FOR-PROFIT THAT SERVES DEVELOPMENTALLY DISABLED CHILDREN. SWIM LESSONS ARE HELD BY THIS GROUP 3 TIMES PER WEEK. OUR COMMUNITY ALSO TUTORS CHILDREN FROM DISADVANTAGED NEIGHBORHOODS, AND SUPPORTS MANY OTHER ORGANIZATIONS WITH THOUSANDS OF HOURS OF VOLUNTEER TIME. 16764168 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 24 0 1 140 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JAISIE LOZANO 6503247560 850 WEBSTER STREET PALO ALTO CA 94301 JEAN MCCOWN CHAIR 2.00 X X 0 0 0 HELENE BUTLER VICE CHAIR 2.00 X X 0 0 0 PATTY FISHER SECRETARY 2.00 X X 0 0 0 TOM HOFSTEDT TREASURER 2.00 X X 0 0 0 SOMITA BASU BOARD MEMBER 1.00 X 0 0 0 JOHN BOGGS MD BOARD MEMBER 1.00 X 0 0 0 CALVIN BRENNEMAN MD BOARD MEMBER 1.00 X 0 0 0 TONY CARRASCO BOARD MEMBER 1.00 X 0 0 0 ZENG YU CHEN BOARD MEMBER 1.00 X 0 0 0 DAVID GOLDEN BOARD MEMBER 1.00 X 0 0 0 GLORIA HOM BOARD MEMBER 1.00 X 0 0 0 MARCIA PUGSLEY BOARD MEMBER 1.00 X 0 0 0 ROBIN RIDDLE BOARD MEMBER 1.00 X 0 0 0 JOHN SINK BOARD MEMBER 1.00 X 0 0 0 PAMELA D VON WIEGAND BOARD MEMBER 1.00 X 0 0 0 MELVIN MATSUMOTO CEO 40.00 X 239253 0 17080 RHONDA BEKKEDAHL COO 40.00 X 215409 0 21994 ARTURO MIRANDA III FACILITIES DIRECTOR 40.00 X 152460 0 5171 ARACELI ANTONIO NURSING SNF - MGMT 40.00 X 124880 0 19030 JOY Q NAVA NURSING AL - RN 40.00 X 133789 0 15445 MARJORIE CALINAWAN NURSING IL - LVN 40.00 X 109001 0 9725 KIMBERLY KREBS MARKETING DIRECTOR 40.00 X 106997 0 9357 MELVIN MENDOZA FACILITIES SUPERVISOR 40.00 X 105144 0 5581 1186933 0 103383 11 0 1 0 VANCE BROWN INC 155 FILBERT STREET 230 OAKLAND CA 94607 CONSTRUCTION CONTRACTOR 10309632 SODEXO INC & AFFILIATES 1000 EL CAMINO REAL ATHERTON CA 94027 FOOD SERVICE PROVIDER 4267185 GENTLE TRANSITIONS OF CA INC 1726 MANHATTAN BEACH BLVD MANHATTAN BEACH CA 90266 RESIDENTIAL MOVE COORDINATORS 584515 PROVINET SOLUTIONS 18645 W CREEK DRIVE TINLEY PARK IL 60477 IT SERVICE PROVIDER 475000 ROBERT HALF MANAGEMENT SERVICES 3000 EL CAMINO REAL STE 250 PALO ALTO CA 94306 PROFESSIONAL SERVICES PROVIDER 163687 7 149713 149713 MONTHLY CARE FEES 623000 13687643 13687643 RESIDENT ENTRANCE FEES 623000 6204233 6204233 SPECIAL SERVICES 623000 328880 328880 PROCESSING FEES 623000 13000 13000 20233756 626328 626328 57268 57268 42793 0 42793 42793 42793 9541304 9168511 97799 372793 -97799 274994 274994 33537 16047 17490 17490 21402342 20233756 0 1018873 X 1500 1500 651366 651366 5754792 4794754 960038 184319 163103 21216 931759 772149 159610 471866 366850 105016 53496 1131 52365 112724 112724 8500 8500 18500 18500 4040810 3839636 201174 11646 11646 408445 177405 231040 55556 185 55371 1097420 1047421 49999 22446 282 22164 56166 16747 39419 2166684 1628797 537887 4811515 3617039 1194476 290746 290746 REPAIRS & MAINTENANCE 228334 217911 10423 LICENSES AGREEMENTS 113173 113173 HIRING/RECRUITMENT 79974 79974 UBI TAX EXPENSE 10710 10710 438635 119258 319377 22021082 16764168 5248414 8500 693965 2146754 1516717 1007955 54162 255243 3000 3000 218075 312482 148079381 38001248 101800301 110078133 57884522 50295614 7793 18599 162178535 164117780 5537252 5016480 36107505 40185499 102447601 102025189 19167 10405 144111525 147237573 X 17775205 16578402 291805 301805 18067010 16880207 162178535 164117780 X -618740 -669590 101527 X 0 1 X 1 0 X 195099 483399 775968 173728 149713 1777907 15415224 16260240 18892740 19201263 20233756 90003223 20126 58531 19850 15185 33537 147229 15630449 16802170 19688558 19390176 20417006 91928359 2500 10000 5000 1000 2500 21000 0 2500 10000 5000 1000 2500 21000 91907359 578776 611807 566803 469050 726389 2952825 578776 611807 566803 469050 726389 2952825 16209225 17413977 20255361 19859226 21143395 94881184 0.96870 0.74180 0.03110 0.03220 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 1000 0 0 1 0 0 1000 0 PART II-B, LINE 1: LETTERS TO LEGISLATORS AND/OR THEIR STAFFS REGARDING LEGISLATION RELATED TO LONG-TERM CARE, LICENSING AGENCIES, AND OTHER RELATED TOPICS. 2868783 139623 50464 59503 2999367 2551859 147548 169376 2868783 1645110 751488 183372 28111 2551859 1167420 375040 136079 33429 1645110 1061075 66793 64450 24898 1167420 1.00000 0.00000 0.00000 0 0 936951 936951 141181051 35296486 105884565 4357230 2704762 1652468 1604149 1604149 110078133 GIFT ANNUITY OBLIGATIONS 10405 10405 X 20932078 -669590 101527 -568063 21500141 -97799 -97799 21402342 22118881 97799 97799 22021082 0 22021082 PART V, LINE 4: THE INTENDED USE OF THE ENDOWMENT FUNDS IS TO ENHANCE THE WELL-BEING OF RESIDENTS AND TO PROVIDE ON-GOING SUPPORT FOR THE CHARITABLE NEEDS OF RESIDENTS. PART X, LINE 2: CHANNING HOUSE HAS BEEN GRANTED TAX-EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE FINANCIAL STATEMENTS. CHANNING HOUSE ADOPTED THE PROVISIONS OF FASB ASC TOPIC 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS ON MARCH 1, 2008. THEY HAD NO UNRECOGNIZED TAX BENEFITS WHICH WOULD REQUIRE AN ADJUSTMENT TO THE MARCH 1, 2017 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2019 AND 2018. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION OBLIGATION 103,255. CHANGE IN VALUE OF SPLIT INTEREST GIFTS -1,728. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -97,799. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS 97,799. X X 0 0 0 0 0 0 0 0 0 MELVIN MATSUMOTO CEO 234003 0 0 0 5250 0 16456 0 624 0 256333 0 0 0 RHONDA BEKKEDAHL COO 215409 0 0 0 0 0 15540 0 6454 0 237403 0 0 0 ARTURO MIRANDA III FACILITIES DIRECTOR 152460 0 0 0 0 0 4464 0 707 0 157631 0 0 0 A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048TZ63 2017-04-18 58413722 REFUND BOND ISSUED 7/8/2010 0 0 0 B CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048T7N7 2017-10-25 50469360 CONSTRUCT, EQUIP, AND RENOVATE FACILITY 0 0 0 A 285000 58445988 2075566 963278 1732948 53674196 0 1 1 1 B 51379181 1174892 2057487 912135 2735573 21105649 23393445 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 SCHEDULE K, PART II, LINE 3 THE DIFFERENCE BETWEEN THE ISSUE PRICE REPORTED IN SCHEDULE K, PART I, COLUMN (E) AND THE TOTAL PROCEEDS OF ISSUE IN SCHEDULE K, PART II, LINE 3 PERTAINS TO INVESTMENT EARNINGS ON PROCEEDS IN RESERVE FUNDS OR UNSPENT BOND FUNDS. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS A DRAFT OF THE FORM 990 ON BEHALF OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS. THE DRAFT, AS REVIEWED BY THE AUDIT COMMITTEE, IS THEN MADE AVAILABLE TO ALL MEMBERS OF THE BOARD OF TRUSTEES PRIOR TO FILING WITH THE IRS AS WELL. THIS PROCESS INCLUDES DOCUMENTING WHO CONDUCTED THE REVIEW, WHEN IT WAS CONDUCTED, AND TO WHAT EXTENT (DETAIL OR SUMMARY) THE FORM WAS REVIEWED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CONFLICT OF INTEREST POLICY IS REVIEWED WITH BOARD MEMBERS AND KEY STAFF MEMBERS. POTENTIAL CONFLICTS ARE REVIEWED AT THE MANAGEMENT AND THE BOARD LEVEL; SHOULD A CONFLICT OF INTEREST ARISE, THE BOARD MEMBER / EMPLOYEE DOES NOT PARTICIPATE IN DECISIONS RELATED TO THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 THE PERSONNEL COMMITTEE (A BOARD COMMITTEE COMPRISED OF 3 TRUSTEES) IS RESPONSIBLE FOR THE PERFORMANCE APPRAISAL OF THE EXECUTIVE DIRECTOR. THE PERFORMANCE APPRAISAL IS NORMALLY ON AN ANNUAL BASIS, WITH THE PERIOD UNDER REVIEW BASED ON THE EXECUTIVE DIRECTOR'S DATE OF HIRE. THE COMMITTEE, IN ITS EVALUATION, MAY SOLICIT INPUT FROM OTHER TRUSTEES, RESIDENTS, AND STAFF OF CHANNING HOUSE. THE SALARY AND BENEFITS OF THE CEO ARE ALSO REVIEWED ON AN ANNUAL BASIS. THE PERSONNEL COMMITTEE SUBMITS ANY RECOMMENDED CHANGES TO THE CEO'S SALARY/BENEFITS TO THE BOARD OF TRUSTEES FOR APPROVAL. SUCH RECOMMENDATION WILL BE SUBMITTED FOR REVIEW AND APPROVAL TO THE BOARD AT THE REGULARLY SCHEDULED MEETING PRIOR TO THE CEO'S HIRE DATE ANNIVERSARY. ANY ACTION TAKEN BY THE BOARD ON PERSONNEL COMMITTEE RECOMMENDATIONS IS RECORDED IN THE BOARD MINUTES. COMPENSATION ADJUSTMENTS FOR THE CEO IS ESTABLISHED IN CONJUNCTION WITH A REVIEW OF COMPENSATION STUDIES AVAILABLE FROM BOTH NATIONAL AND STATEWIDE SOURCES, AS WELL AS OTHER SOURCES AS AVAILABLE (SUCH AS FROM A CONSULTANT). THE CEO IS RESPONSIBLE FOR ANNUAL EVALUATIONS AND IMPLEMENTING ANY SALARY ADJUSTMENTS FOR OTHER OFFICERS AND KEY EMPLOYEES; COMPENSATION ADJUSTMENTS FOR THESE INDIVIDUALS ARE BASED ON BUDGETED AMOUNTS AVAILABLE, AS WELL AS STATEWIDE COMPENSATION STUDIES. FORM 990, PART VI, SECTION C, LINE 19 AUDITED FINANCIAL STATEMENTS ARE POSTED IN THE RESIDENT LIBRARY, ATTACHED TO NEW RESIDENT CONTRACTS, AND ARE AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. ALL BOARD MINUTES AND CHANGES TO BYLAWS ARE POSTED IN THE CHANNING HOUSE RESIDENT LIBRARY. COPIES OF MEETING MINUTES ARE AVAILABLE FOR A PRIOR THREE YEAR PERIOD. THE CONFLICT OF INTEREST POLICY IS AVAILABLE ON REQUEST FROM THE BUSINESS OFFICE. FORM 990, PART IX, LINE 11G FOOD SERVICE FEES: PROGRAM SERVICE EXPENSES 3,463,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,463,260. PAYROLL/HR SERVICES: PROGRAM SERVICE EXPENSES 433. MANAGEMENT AND GENERAL EXPENSES 88,112. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,545. REGISTRY: PROGRAM SERVICE EXPENSES 19,332. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,332. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 356,611. MANAGEMENT AND GENERAL EXPENSES 113,062. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 469,673. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST GIFTS -1,728. CHANGE IN PENSION OBLIGATION 103,255.