2020-10-19T22:19:09-05:00 2020-02-29 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2019-03-01 941485533 CHANNING HOUSE CHAN 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 RHONDA BEKKEDAHL CEO 6503270950 2020-09-22 1 MICHAEL LUMSDEN P01262236 4159561500 2020-09-22 76.14.38.113 2020-09-22 22:07:04 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 00C4359F54289D19625D58AABAD73364CEA05A5F 2019 2021-01-29 14:40:06Z RHONDA BEKKEDAHL 850 WEBSTER STREET PALO ALTO CA 94301 20983071 0 X WWW.CHANNINGHOUSE.ORG X 1960 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 14 14 150 70 0 0 149713 598127 20233756 18990387 958590 694912 60283 37779 21402342 20321205 1500 0 0 0 7994102 8717352 8500 8000 8000 14016980 15374324 22021082 24099676 -618740 -3778471 164117780 166868441 147237573 153313023 16880207 13555418 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' INDEPENDENCE, WELL-BEING AND SECURITY. 0 0 19738962 0 18990387 PROVIDE HOUSING, ASSISTED LIVING, AND SKILLED NURSING SERVICES WHICH INCLUDE DINING SERVICES, MAINTENANCE, HOUSEKEEPING, AND NURSING CARE. DURING FY2020 WE SERVED AN AVERAGE OF 253 RESIDENTS WITH A TOTAL OF 7,665 SERVICE DAYS OF SKILLED NURSING; 9,125 SERVICE DAYS OF ASSISTED LIVING; AND 75,555 DAYS OF RESIDENTIAL CARE SERVICES. 0 0 0 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. EXPENSES PERTAINING TO THESE PROGRAMS ARE NEGLIGIBLE, AND COULD NOT BE REASONABLY QUANTIFIED. 19738962 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 1 150 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 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 HELENE BUTLER CHAIR 2.00 X X 0 0 0 PATTY FISHER VICE CHAIR 2.00 X X 0 0 0 ROBIN RIDDLE 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 ZENG YU CHEN BOARD MEMBER 1.00 X 0 0 0 DAVID GOLDEN BOARD MEMBER 1.00 X 0 0 0 VICKIE GROVE BOARD MEMBER 1.00 X 0 0 0 GLORIA HOM BOARD MEMBER THROUGH 1/2020 1.00 X 0 0 0 JEAN MCCOWN BOARD MEMBER 1.00 X 0 0 0 MARCIA PUGSLEY 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 THROUGH 4/2019 40.00 X 121676 0 8866 RHONDA BEKKEDAHL COO THROUGH 4/2019/CEO START 5/2019 40.00 X 218802 0 18333 JAISIE LOZANO FINANCE DIRECTOR 40.00 X 122110 0 3155 KIMBERLY KURTIS HR DIRECTOR 40.00 X 155222 0 26763 PAUL ROMERO IT DIRECTOR THROUGH 11/2019 40.00 X 150809 0 8845 YADIRA ALDANA DIRECTOR OF OPERATIONS 40.00 X 138586 0 21387 ANGELA LAMOTHE PROJECT MANAGER 40.00 X 137538 0 18748 KIMBERLY KREBS MARKETING DIRECTOR 40.00 X 133753 0 13662 JOY NAVA NURSING AL-RN 40.00 X 130044 0 18434 IZVETH LEON ASSISTANT DIRECTOR OF NURSING 40.00 X 117754 0 8523 1426294 0 146716 13 0 1 0 VANCE BROWN INC 3197 PARK BLVD PALO ALTO CA 943062233 CONSTRUCTION CONTRACTOR 7521013 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 152516170 FOOD SERVICE PROVIDER 3547998 GENTLE TRANSITIONS OF CA INC 1726 MAHATTAN BEACH BLVD G MANHATTAN BEACH CA 90266 RESIDENTIAL MOVE COORDINATORS 533722 PROVINET SOLUTIONS 18601 NORTH CREEK DRIVE TINLEY PARK IL 60477 IT SERVICE PROVIDER 348993 LAWSON BROS DRAPERIES 748 VERA AVENUE REDWOOD CITY CA 94061 GOOD & SERVICES PROVIDER 189387 8 598127 598127 MONTHLY CARE FEES 623000 15054471 15054471 RESIDENT ENTRANCE FEES 623000 3528276 3528276 SPECIAL SERVICES 623000 390140 390140 PROCESSING FEES 623000 17500 17500 18990387 649451 649451 59499 59499 44077 0 44077 44077 44077 600053 614091 -14038 -14038 -14038 41477 47775 -6298 -6298 20321205 18990387 0 732691 X 714420 714420 6347516 5126070 1221446 242380 192422 49958 856032 661757 194275 557004 257322 299682 91389 30865 60524 47540 47540 8000 8000 4403232 4078153 325079 9415 9415 508728 267043 241685 53951 1761 52190 1166554 1051226 115328 31164 4232 26932 95925 53480 42445 2216042 2115352 100690 5411141 5165277 245864 328952 328952 REPAIRS & MAINTENANCE 384867 382242 2625 LICENSES AGREEMENTS 114024 114024 HIRING/RECRUITMENT 97695 97695 DUES AND SUBSCRIPTIONS 56387 5959 50428 357318 345801 11517 24099676 19738962 4352714 8000 2146754 1764102 1007955 0 255243 71433 3000 3429 312482 475316 160431721 43412389 110078133 117019332 50295614 47526702 18599 8127 164117780 166868441 5016480 5670079 37921660 43996384 102025189 101381078 2274244 2265482 147237573 153313023 X 16578402 13147800 301805 407618 16880207 13555418 164117780 166868441 X -3778471 527299 -73617 X 0 1 X 1 0 X 483399 775968 173728 149713 598127 2180935 16260240 18892740 19201263 20233756 18900387 93488386 58531 19850 15185 33537 41477 168580 16802170 19688558 19390176 20417006 19539991 95837901 10000 5000 1000 2500 100 18600 0 10000 5000 1000 2500 100 18600 95819301 611807 566803 469050 726389 753027 3127076 611807 566803 469050 726389 753027 3127076 17413977 20255361 19859226 21143395 20293018 98964977 0.96820 0.96870 0.03160 0.03110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 1000 0 0 0 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. 2999367 557334 137469 76140 8951 3609079 2868783 139623 50464 59503 2999367 2551859 147548 169376 2868783 1645110 751488 183372 28111 2551859 1167420 375040 136079 33429 1645110 1.00000 0.00000 0.00000 0 0 936951 936951 151555232 40182878 111372354 4870286 3229511 1640775 3069252 3069252 117019332 GIFT ANNUITY OBLIGATIONS 1643 ENTRANCE FEES REFUNDABLE UPON REOCCUPANCY 2263839 2265482 X 20774887 527299 -73617 453682 20321205 0 20321205 24099676 0 24099676 0 24099676 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 AT FEBRUARY 29, 2020 AND FEBRUARY 28, 2019. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION OBLIGATION -71,907. CHANGE IN VALUE OF SPLIT INTEREST GIFTS -1,710. X X 1 0 0 0 0 0 0 0 0 RHONDA BEKKEDAHL COO THROUGH 4/2019/CEO START 5/2019 218802 0 0 0 0 0 12032 0 6301 0 237135 0 0 0 KIMBERLY KURTIS HR DIRECTOR 150222 0 5000 0 0 0 1292 0 25471 0 181985 0 0 0 PAUL ROMERO IT DIRECTOR THROUGH 11/2019 105990 0 0 0 44819 0 1154 0 7691 0 159654 0 0 0 YADIRA ALDANA DIRECTOR OF OPERATIONS 133586 0 5000 0 0 0 6813 0 14574 0 159973 0 0 0 ANGELA LAMOTHE PROJECT MANAGER 130987 0 6551 0 0 0 6580 0 12168 0 156286 0 0 0 PART I, LINE 4A PAUL ROMERO RECEIVED A SEVERANCE PAYMENT OF $40,000 DURING THE 2019 CALENDAR YEAR, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III). 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 765000 58493391 2122969 963278 1732948 53674196 0 1 1 1 B 51379181 1213373 2248619 912135 2735573 32714509 11554972 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 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 3,469,963. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,469,963. PAYROLL/HR SERVICES: PROGRAM SERVICE EXPENSES 29,226. MANAGEMENT AND GENERAL EXPENSES 50,894. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 80,120. REGISTRY: PROGRAM SERVICE EXPENSES 62,649. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,649. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 516,315. MANAGEMENT AND GENERAL EXPENSES 273,725. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 790,040. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 460. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 460. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST GIFTS -1,710. CHANGE IN PENSION OBLIGATION -71,907.