STRATEGY STUDIO / PUBLIC DATA EXPLORER

MOUNTAIN VALLEY HAVEN: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
MOUNTAIN VALLEY HAVEN (EIN 30-0064647)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201803199349306605
Schema version
2017v2.2
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

FieldValueIRS element (for citing)
Return2018-11-15T09:25:03-08:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN942771548PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Nicholson & Olson CPAsBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1729 Sunrise Avenue Suite 303AddressLine1Txt
CityRosevilleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95661ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN300064647EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MOUNTAIN VALLEY HAVENBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMOUNBusinessNameControlTxt
Phone9163340810PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15105 MANZANITA AVENUEAddressLine1Txt
CityCARMICHAELCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95608ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCAREY HOWELLPersonNm
Person TitleAssis TreasurerPersonTitleTxt
Signature2018-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCharles A NicholsonPreparerPersonNm
PTINP00410549PTIN
Phone9167867997PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMIKE WINESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line15105 MANZANITA AVEAddressLine1Txt
CityCARMICHAELCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95608ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$81,543GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.eskaton.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2001FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionORGANIZATION'S MISSION IS TO ENHANCE THE QUALITY OF LIFE OF SENIORS THROUGH INNOVATIVE HEALTH, HOUSING AND SOCIAL SERVICES.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$49,896PYContributionsGrantsAmt
CY Contributions Grants$52,397CYContributionsGrantsAmt
PY Program Service Revenue$28,254PYProgramServiceRevenueAmt
CY Program Service Revenue$28,373CYProgramServiceRevenueAmt
PY Investment Income$47PYInvestmentIncomeAmt
CY Investment Income$30CYInvestmentIncomeAmt
PY Other Revenue$1,481PYOtherRevenueAmt
CY Other Revenue$743CYOtherRevenueAmt
PY Total Revenue$79,678PYTotalRevenueAmt
CY Total Revenue$81,543CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,355PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,155CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$77,806PYOtherExpensesAmt
CY Other Expenses$69,298CYOtherExpensesAmt
PY Total Expenses$102,161PYTotalExpensesAmt
CY Total Expenses$94,453CYTotalExpensesAmt
PY Revenues Less Expenses-$22,483PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$12,910CYRevenuesLessExpensesAmt
Total Assets BOY$800,742TotalAssetsBOYAmt
Total Assets EOY$786,541TotalAssetsEOYAmt
Total Liabilities BOY$8,681TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,390TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$792,061NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$779,151NetAssetsOrFundBalancesEOYAmt
MissionORGANIZATION'S MISSION IS TO ENHANCE THE QUALITY OF LIFE OF SENIORS THROUGH INNOVATIVE HEALTH, HOUSING AND SOCIAL SERVICES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$60,177ExpenseAmt
Revenue$28,373RevenueAmt
DescPROVIDE AFFORDABLE APARTMENTS FOR INDEPENDENT OLDER ADULTS WITH LIMITED INCOME.PLEASE VISIT THE ESKATON WEBSITE (WWW.ESKATON.ORG) FOR THE ESKATON ANNUAL REPORT.Desc
Total Program Service Expenses$60,177TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonED BOOGAARDPersonNm
Phone9163340810PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15105 MANZANITA AVENUEAddressLine1Txt
CityCARMICHAELCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95608ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
KAREN ROBISON
Board Member0.080.68Yes (X)$0$0$0
JEFF CRAWFORD
Vice Chair0.080.68Yes (X)$0$0$0Yes (X)
LOUISE NAVARRETTE NORGAAR
Board Member0.030.06Yes (X)$0$0$0
BETSI HOWARD
Board Member0.080.68Yes (X)$0$0$0
MARTHA KUNKEL
Board Member0.080.68Yes (X)$0$0$0
JAMES H PHILLIPS
Board Member0.080.68Yes (X)$0$0$0
PAT ANDERSON
Board Member0.030.06Yes (X)$0$0$0
CINDY BLACKBURN
Board Member0.030.06Yes (X)$0$0$0
MIKE WINES
Chair0.030.06Yes (X)$0$0$0Yes (X)
CATHY SAILOR
Secretary1.9136.36$0$0$0Yes (X)
BILL PACE
CFO0.161.36$0$0$0Yes (X)
CAREY HOWELL
Assis Treasurer0.161.36$0$0$0Yes (X)
FieldValueIRS element (for citing)
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$52,397GovernmentGrantsAmt
Total Contributions$52,397TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRENTAL INCOMEDesc
Total Revenue Column$28,373TotalRevenueColumnAmt
Related Or Exempt Func Income$28,373RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$28,373TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$30TotalRevenueColumnAmt
Exclusion$30ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
LAUNDRY & TENANT CHARGES$718$718
MISCELLANEOUS INCOME$25$25
FieldValueIRS element (for citing)
Other Revenue Total$743OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,543TotalRevenueColumnAmt
Related Or Exempt Func Income$29,116RelatedOrExemptFuncIncomeAmt
Exclusion$30ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,096TotalAmt
Program Services$3,947ProgramServicesAmt
Management And General$16,149ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,317TotalAmt
Program Services$3,317ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,742TotalAmt
Program Services$1,742ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$7,920TotalAmt
Management And General$7,920ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21TotalAmt
Management And General$21ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$210TotalAmt
Management And General$210ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,350TotalAmt
Management And General$4,350ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$875TotalAmt
Management And General$875ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,590TotalAmt
Management And General$1,590ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,082TotalAmt
Program Services$10,082ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$28,801TotalAmt
Program Services$28,801ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,366TotalAmt
Program Services$2,366ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
REPAIRS & MAINTENANCE$4,720$4,720
CONTRACTS$3,315$3,315
MISC ADMIN EXPENSE$3,161$3,161
WORKERS COMP$1,082$1,082

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$805TotalAmt
Program Services$805ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$94,453TotalAmt
Program Services$60,177ProgramServicesAmt
Management And General$34,276ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$100EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,247BOYAmt
EOY$10,794EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$10EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$470BOYAmt
EOY$1,157EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,055,066LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$347,595LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$733,679BOYAmt
EOY$707,471EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$64,246BOYAmt
EOY$67,009EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$800,742BOYAmt
EOY$786,541EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$5,427BOYAmt
EOY$4,110EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$13BOYAmt
EOY$9EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,241BOYAmt
EOY$3,271EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,681BOYAmt
EOY$7,390EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$792,061BOYAmt
EOY$779,151EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$792,061BOYAmt
EOY$779,151EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$800,742BOYAmt
EOY$786,541EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$12,910ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,475CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$36,794CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,344CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$49,896CurrentTaxYearMinus1YearAmt
Current Tax Year$52,397CurrentTaxYearAmt
Total$219,906TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,475CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$36,794CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,344CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$49,896CurrentTaxYearMinus1YearAmt
Current Tax Year$52,397CurrentTaxYearAmt
Total$219,906TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$219,906PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$30CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$53CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$47CurrentTaxYearMinus1YearAmt
Current Tax Year$30CurrentTaxYearAmt
Total$192TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$220,098TotalSupportAmt
Gross Receipts Rltd Activities$148,250GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99910PublicSupportCY170Pct
Public Support PY1700.99900PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$25,000OtherCostOrOtherBasisAmt
Book Value$25,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,016,900OtherCostOrOtherBasisAmt
Depreciation$337,884DepreciationAmt
Book Value$679,016BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,827OtherCostOrOtherBasisAmt
Depreciation$4,850DepreciationAmt
Book Value$1,977BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,339OtherCostOrOtherBasisAmt
Depreciation$4,861DepreciationAmt
Book Value$1,478BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$707,471TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
RESTRICTED DEPOSITS$63,586
TENANT DEPOSITS HELD IN TRUST$3,423
FieldValueIRS element (for citing)
Total Book Value Other Assets$67,009TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
MISCELLANEOUS CURRENT LIABILITIES$222
TENANT DEPOSITS HELD IN TRUST$3,049
FieldValueIRS element (for citing)
Total Liability$3,271TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$81,543TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$81,543RevenueSubtotalAmt
Total Revenue Per Form990$81,543TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$94,453TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$94,453ExpensesSubtotalAmt
Total Expenses Per Form990$94,453TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessFORM 990 REVIEWED AND SIGNED BY THE ASSISTANT TREASURER OF THE CORPORATION.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsOFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY DISCLOSE THEIR POTENTIAL CONFLICTS OF INTEREST AND ARE REQUIRED TO ABSTAIN FROM ANY DISCUSSION OR VOTE RELATED TO THE POTENTIAL CONFLICT OF INTEREST.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementCOMPENSATION OF THE ADMINISTRATOR IS DETERMINED FROM DATA OBTAINED FROM A WIDE RANGE OF COMPARABLE ORGANIZATIONS.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableTHIS LIST OF DOCUMENTS IS MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
FRANK JACONETTI SENIOR MANOR
5105 MANZANITA AVENUECARMICHAELCA95608680219231SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
MOUNTAIN VALLEY HAVEN IIHAYFORK II
5105 MANZANITA AVENUECARMICHAELCA95608412131879SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
MOUNTAIN VALLEY HAVEN IIIHAYFORK III
5105 MANZANITA AVENUECARMICHAELCA95608202887101SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT JAMES MADISON MANORJEFFERSON
5105 MANZANITA AVENUECARMICHAELCA95608942494749SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
PRESIDENT JOHN F KENNEDY MANOR
5105 MANZANITA AVENUECARMICHAELCA95608942164867SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
LASSEN COUNTY SENIOR HOUSING COUNCIL INC
5105 MANZANITA AVENUECARMICHAELCA95608942861422SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT ANDREW JACKSON MANORLASSEN
5105 MANZANITA AVENUECARMICHAELCA95608600033365SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT HARRY S TRUMAN MANOR
5105 MANZANITA AVENUECARMICHAELCA95608943041300SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
LASSEN MANOR IV
5105 MANZANITA AVENUECARMICHAELCA95608680450882SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT ABRAHAM LINCOLN MANOR
5105 MANZANITA AVENUECARMICHAELCA95608680033361SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT ABRAHAM LINCOLN MANOR II
5105 MANZANITA AVENUECARMICHAELCA95608680450881SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
CASA NATOMASNATOMAS MANOR
5105 MANZANITA AVENUECARMICHAELCA95608680468416SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT GEORGE WASHINGTON MANOR I
5105 MANZANITA AVENUECARMICHAELCA95608943046045SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
PRESIDENT GEORGE WASHINGTON MANOR II
5105 MANZANITA AVENUECARMICHAELCA95608942666532SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT GROVER CLEVELAND MANOR
5105 MANZANITA AVENUECARMICHAELCA95608943203590SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
SHASTA MANOR
5105 MANZANITA AVENUECARMICHAELCA95608943319203SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
SHASTA MANOR II
5105 MANZANITA AVENUECARMICHAELCA95608680545825SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
PRESIDENT WOODROW WILSON MANOR
5105 MANZANITA AVENUECARMICHAELCA95608680033363SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
CLEARLAKE OAKS MANOR
5105 MANZANITA AVENUECARMICHAELCA95608202886754SENIOR RESIDENCES & SERVICESCA501(c)(3)7N/Afalse
ESKATON ROSEVILLE MANOR
5105 MANZANITA AVENUECARMICHAELCA95608331148888SENIOR RESIDENCES & SERVICESCA501(c)(3)10N/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd