2018-01-15T14:09:23-06:00 2017-02-28 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-03-01 941485533 Channing House CHAN 6503270950 850 Webster Street Palo Alto CA 94301 RHONDA BEKKEDAHL Director of Finance/IT 6503270950 2018-01-15 1 Joua V Lo P01225144 4159561500 2018-01-15 12.129.7.100 2018-01-15 12:23:11 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 5029E8FD9FE66385FA59B177B15FCADA276E8E0F 2016 2021-01-29 14:40:06Z MELVIN MATSUMOTO 850 Webster Street Palo Alto CA 94301 46581302 0 X www.channinghouse.org X 1960 CA PROVIDES HOUSING AND HEALTH CARE SERVICES WITHIN A LIFE CARE COMMUNITY. 14 14 134 70 0 0 483399 775968 16260240 18892740 775052 602292 44760 27632 17563451 20298632 9971 10169 0 0 5629383 6159919 0 0 0 13287425 13470980 18926779 19641068 -1363328 657564 124985168 120592522 98438324 92580901 26546844 28011621 X The mission of Channing House is to provide a continuing care retirement community that enhances each resident's independence, well being, needed care, and security; and to develop and strengthen Channing House's capacity to remain for future generations a stable, high-quality, and forward-looking life care facility. 0 0 16043518 10169 18892740 Provide housing, assisted living and skilled nursing services which include dining services, housekeeping, and nursing care. During FY2017 we served an average of 222 residents with a total of 6,965 service days of skilled nursing; 8,091 service days of assisted living; and 66,004 days of residential care services. 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 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. 16043518 1 1 0 1 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 29 0 1 134 1 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 RHONDA BEKKEDAHL 6503270950 850 WEBSTER STREET PALO ALTO CA 94301 David Thornton Chair of the Board 8.00 X X 0 0 0 Jean McCown Vice Chair of the Board 8.00 X X 0 0 0 Andy Coe Secretary 8.00 X X 0 0 0 John Schniedwind Treasurer 8.00 X X 0 0 0 John Boggs MD Board Member 4.00 X 0 0 0 Helene Butler Board Member 4.00 X 0 0 0 Tony Carrasco Board Member 4.00 X 0 0 0 Patty Fisher Board Member 4.00 X 0 0 0 David Golden Board Member 4.00 X 0 0 0 Robert Harrington Board Member 4.00 X 0 0 0 Tom Hofstedt board Member 4.00 X 0 0 0 Gloria Hom Board Member 4.00 X 0 0 0 Patty Irish Board Member 4.00 X 0 0 0 Marlene Prendergast Board Member through 11/2016 4.00 X 0 0 0 Pamela D Von Wiegand Board Member 4.00 X 0 0 0 Melvin Matsumoto Executive Director 40.00 X 307088 0 29108 Rhonda Bekkedahl Director of Finance/IT 40.00 X 166100 0 15779 Araceli Antonio Director of Health Services 40.00 X 144827 0 26474 Julia Jones ADMINISTRATOR 40.00 X 144752 0 33766 Joy Nava Registered Nurse 40.00 X 112841 0 14259 Myrna Camar Director of Nursing 40.00 X 106266 0 21426 981874 0 140812 6 0 1 0 Vance Brown Inc 3197 Park Blvd Palo Alto CA 94306 Construction Contractor 7601182 Provinet Solutions 18601 N Creek Drive Tinley Park IL 60477 IT Consultant 371335 Hardison Komatsu Ivelich & Tucker 538 Ninth St 240 Oakland CA 94607 Architect 185028 Hanson Bridgett LLP 425 Market St 26th floor San Francisco CA 94102 Attorney 145421 3 775968 775968 MONTHLY CARE FEES 623000 12805410 12805410 RESIDENT ENTRANCE Fees 623000 5700231 5700231 SPECIAL SERVICES 623000 371599 371599 PROCESSING FEES 623000 15500 15500 18892740 515645 515645 17678 17678 33480 0 33480 33480 33480 26325941 26256972 68969 68969 68969 19850 25698 -5848 -5848 20298632 18892740 0 629924 X 10169 10169 522320 522320 3936840 2440973 1495867 169920 147145 22775 1156652 873116 283536 374187 293204 80983 33320 33320 53144 53144 2000 2000 2905986 2797749 108237 44406 3691 40715 849863 288297 561566 144533 72267 72266 788321 738654 49667 30231 11177 19054 27251 9610 17641 3205198 3205198 4105431 4105431 636260 402027 234233 Maint./Housekeeping 395095 395095 Amortization of Debt 156585 156585 Medical Expenses 93130 93130 226 226 19641068 16043518 3597550 0 3412354 500 975214 797171 12555 23559 2625 2625 234332 230081 124615060 31778080 89863059 92836980 27116647 23462249 29150 18452 3339232 3220905 124985168 120592522 4860620 3873769 32073962 36878010 60491837 51801193 975214 0 36691 27929 98438324 92580901 X 25525484 27717207 1021360 294414 26546844 28011621 124985168 120592522 X 657564 827629 -20416 X 0 1 X 1 0 X 280832 72368 195099 483399 775968 1807666 13604814 14243171 15415224 16260240 18892740 78416189 22914 22235 20126 58531 19850 143656 13908560 14337774 15630449 16802170 19688558 80367511 2500 10000 5000 17500 3499758 3121718 3117776 4753499 6753128 21245879 3499758 3121718 3120276 4763499 6758128 21263379 59104132 1304110 629754 578776 611807 566803 3691250 1304110 629754 578776 611807 566803 3691250 15212670 14967528 16209225 17413977 20255361 84058761 0.70310 0.72440 0.04390 0.05400 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 1000 0 0 1 1000 0 0 2000 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. 0 1 X 1645110 751488 183372 28111 2551859 1167420 375040 136079 33429 1645110 1061075 66793 64450 24898 1167420 974059 75004 21661 9649 1061075 138437 832847 2775 974059 1.00000 0 0 936951 936951 119282705 29970463 89312242 3987477 1807617 2179860 407927 407927 92836980 Gift Annuity Obligations 27929 27929 X 21105845 827629 -20416 807213 20298632 0 20298632 19641068 0 19641068 0 19641068 Part IV, Line 2b: The organization held an escrow account for 10% entrance fee deposits for certain residents who are reserving apartments. The balance in this account went down to $0 during the 2/28/2017 tax year. 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 ACCOUNTING STANDARDS CODIFICATION ("ASC") 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, 2016 BEGINNING BALANCE OF NET ASSETS AND HAD NO UNRECOGNIZED TAX BENEFITS AT FEBRUARY 28, 2017. CHANNING HOUSE FILES FEDERAL AND CALIFORNIA EXEMPT ORGANIZATION RETURNS. THEY ARE NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2008 FOR ITS FEDERAL TAX FILINGS AND 2007 FOR ITS STATE TAX FILINGS. Part XI, Line 2d - Other Adjustments: Change in Minimum Pension Liability -19,314. Change in Value of Split Interest Agreements -1,102. 1 RESIDENT ASSISTANCE 1 8669 EDUCATIONAL Scholarship 1 1500 Part I, Line 2: Residence Assistance: If a resident becomes unable to afford his/her monthly care fees, he/she may request financial assistance from Channing House. The resident completes an application for assistance and meets with the Administrator to review his/her financial resources. The Administrator and Executive Director review and approve any applications for assistance. Educational Scholarship: Employees who wish to continue their education may apply for scholarship funding. The employee completes an application for scholarship. That application is reviewed by the employee's manager and the HR manager. It is then presented to the executive director for approval. X X 0 0 0 0 0 0 0 0 0 Melvin Matsumoto Executive Director 307088 0 0 0 0 0 28588 0 520 0 336196 0 0 0 Rhonda Bekkedahl Director of Finance/IT 166100 0 0 0 0 0 15421 0 358 0 181879 0 0 0 Araceli Antonio Director of Health Services 144827 0 0 0 0 0 14952 0 11522 0 171301 0 0 0 Julia Jones ADMINISTRATOR 144752 0 0 0 0 0 14436 0 19330 0 178518 0 0 0 A ABAG Finance Authority For Nonprofit Corporations 941485533 0037CQP80 2010-07-08 64066348 Health Center Construction, Remodel 14 Units, & Refund Bond Dated 3/24/1999 0 0 0 A 11770000 64092429 4194254 4564881 1031002 3782180 30845214 17471427 2203471 2016 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 Date Rebate Computation Performed Issuer Name: ABAG Finance Authority For Nonprofit Corporations Date the Rebate Computation was Performed: 07/08/2015 Schedule K, Part II, Line 3: The difference between the total proceeds of issue in Schedule K, Part II, Line 3 and the issue price in Schedule K, Part I, Column (e) represents investment income on proceeds of the tax-exempt bond held in reserve 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 Executive Director are also reviewed on an annual basis. The Personnel Committee submits any recommended changes to the Executive Director'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 Executive Director's hire date anniversary. Any action taken by the Board on Personnel Committee recommendations is recorded in the Board minutes. Compensation adjustments for the Executive Director 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 Executive Director is responsible for annual evaluations and implementing any salary adjustments for the Administrator, Director of Finance/IT, Marketing Director, and Facilities Director. The Administrator conducts the annual reviews for the Director of Health Services and the Director of Environmental Services. Compensation adjustments for key Management Staff 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 SERVICES: Program service expenses 2,694,838. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,694,838. MEDICAL SERVICES: Program service expenses 81,083. Management and general expenses 0. Fundraising expenses 0. Total expenses 81,083. ADMINISTRATIVE: Program service expenses 21,828. Management and general expenses 108,237. Fundraising expenses 0. Total expenses 130,065. Form 990, Part XI, line 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS -1,102. CHANGE IN MINIMUM PENSION LIABILITY -19,314.