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QUEEN OF ANGELS-HOLLYWOOD PRESBYTERIAN FOUNDATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
QUEEN OF ANGELS-HOLLYWOOD PRESBYTERIAN FOUNDATION (EIN 95-3403582)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-03-21
IRS object ID
201420809349300017
Schema version
2012v2.0
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)
Timestamp2014-03-21T14:13:32-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1LUNDY FLEMING LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12 BALA PLZ STE 300AddressLine1
CityBALA CYNWYDCity
StatePAState
ZIP Code190041512ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN953403582EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlQUEENameControl
Phone3236694305Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 N VERMONT AVENUEAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900276005ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBARBARA B HINESName
TitlePRESIDENT/CEOTitle
Phone3236694305Phone
Date Signed2014-02-26DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameNOEL A FLEMINGName
Phone6106607788Phone
Date Prepared2014-03-21DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

FieldValueIRS element (for citing)
Business Name Line1BARBARA HINESBusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11300 N VERMONT AVE STE 1002AddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900276005ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6606046GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1978YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionThe organization provides financial support to QueensCare, a California non-profit public benefit corporation, to further QueensCare's mission of providing accessible healthcare for uninsured and low-income working individuals and families.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year449264InvestmentIncomePriorYear
Investment Income Current Year980028InvestmentIncomeCurrentYear
Other Revenue Prior Year-615038OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year-165774TotalRevenuePriorYear
Total Revenue Current Year980028TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year93599GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY102273GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year9211OtherExpensePriorYear
Other Expenses Current Year12278OtherExpensesCurrentYear
Total Expenses Prior Year102810TotalExpensesPriorYear
Total Expenses Current Year114551TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-268584RevenuesLessExpensesPriorYear
Revenues Less Expenses CY865477RevenuesLessExpensesCY
Total Assets BOY5520709TotalAssetsBOY
Total Assets EOY5897329TotalAssetsEOY
Total Liabilities BOY99436TotalLiabilitiesBOY
Total Liabilities EOY108338TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5421273NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5788991NetAssetsOrFundBalancesEOY
Mission DescriptionThe organization provides financialMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense102273Expense
Grants102273Grants
DescriptionSUPPORT TO QUEENSCARE A CALIFORNIA NON-PROFIT CORPORATION PROVIDING ACCESSIBLE HEALTHCARE FOR UNINSURED AND LOW INCOME WORKING INDIVIDUALS AND FAMILIES.Description
Total Program Service Expense102273TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ARTHUR V DOIBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3236694317TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 N VERMONT AVE STE 508AddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90027ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (2 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
SISTER JUDY MURPHY
Secretary1.00XX01131500
BARBARA B HINES
President1.00XX01216190
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs234769TotalReportableCompFrmRltdOrgs
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column169174TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities6436872Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5626018Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities810854Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column810854TotalRevenueColumn
Related Or Exempt Function Income810854RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column980028TotalRevenueColumn
Related Or Exempt Function Income980028RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total102273Total
Program Services102273ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3409Total
Program Services0ProgramServices
Management And General3409ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total5000Total
Program Services0ProgramServices
Management And General5000ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1057Total
Program Services0ProgramServices
Management And General1057ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1038Total
Program Services0ProgramServices
Management And General1038ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1722Total
Program Services0ProgramServices
Management And General1722ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Taxes & Licenses200200
Postage & Filing Fees320320

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total114551Total
Program Services102273ProgramServices
Management And General12278ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY326622BOY
EOY222184EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY368615BOY
EOY41018EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis62788LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec59446LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4379BOY
EOY3342EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY4810124BOY
EOY5628917EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10969BOY
EOY1868EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5520709BOY
EOY5897329EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY6065EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY99436BOY
EOY102273EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY99436BOY
EOY108338EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4730835BOY
EOY5200826EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY690438BOY
EOY588165EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5421273BOY
EOY5788991EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5520709BOY
EOY5897329EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses865477ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-497759ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1QUEENSCAREBusinessNameLine1
FieldValueIRS element (for citing)
EIN951644040EIN
Type Of Organization3TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$102,273Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts102273SumOfAmounts
Public Support Total1700PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Pertcentage1700PublicSupportPertcentage170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4810124BeginningOfYearBalance
Investment Earnings Or Losses818793InvestmentEarningsOrLosses
End Of Year Balance5628917EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance4616187BeginningOfYearBalance
Investment Earnings Or Losses193937InvestmentEarningsOrLosses
End Of Year Balance4810124EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4013535BeginningOfYearBalance
Investment Earnings Or Losses602652InvestmentEarningsOrLosses
End Of Year Balance4616187EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3838873BeginningOfYearBalance
Investment Earnings Or Losses188852InvestmentEarningsOrLosses
Administrative Expenses14190AdministrativeExpenses
End Of Year Balance4013535EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4271775BeginningOfYearBalance
Investment Earnings Or Losses-418884InvestmentEarningsOrLosses
Administrative Expenses14018AdministrativeExpenses
End Of Year Balance3838873EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.90000BoardDesignatedEOYBalance
Term Endowment EOY Balance0.10000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis62788OtherCostOrOtherBasis
Depreciation59446Depreciation
Book Value3342BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings3342TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierExplanationExplanation
Pt V Line 4The Foundation intends to use its endowment funds
to continue its support of QueensCare, a California non-profit public benefit corporation providing accessible healthcare for uninsured and low income working individuals and families.
Pt X Line 2As required by U.S. GAAP, the organization has identified
AND EVALUATED ITS SIGNIFICANT TAX POSITIONS FOR WHICH THE STATUTE OF LIMITATIONS REMAIN OPEN AND HAS
DETERMINED THAT THERE IS NO MATERIAL UNRECOGNIZED BENEFIT OR LIABILITY TO BE RECORDED. THE OPEN TAX YEARS ARE THE YEARS ENDED JUNE 30, 2010 THROUGH JUNE 30, 2013 FOR FEDERAL TAX PURPOSES AND THE YEARS ENDED JUNE 30, 2009 THROUGH JUNE 30, 2013 FOR CALIFORNIA TAX PURPOSES. THERE HAVE BEEN NO MATERIAL CHANGES IN UNRECOGNIZED BENEFITS AS OF JUNE 30, 2013, NOR ARE ANY MATERIAL CHANGES ANTICIPATED IN THE TWELVE MONTHS FOLLOWING JUNE 30, 2013.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1QUEENSCAREBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 N VERMONT AVE STE 1002AddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code90027ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient951644040EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant102273AmountOfCashGrant
Purpose Of GrantHEALTHCARE SUPPORTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV (5 entries)

IdentifierIdentifierExplanationExplanation
Pt I Line 2As a supporting organization of QueensCare, Queen of Angels Hollywood
Presbyterian Foundation is very familiar with that organization's
charitable activities and periodically reviews financial reports and other
information to ensure that grant monies are being used for their intended
charitable purposes.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (40 entries)

IdentifierIdentifierExplanationExplanation
Pt VI, Line 11bThe final draft of the organization's Form 990
is reviewed for accuracy and completeness by the
organization's CEO and by the CFO of
QueensCare, its supported organization.
Details of the return are discussed at the
organization's next regularly scheduled Board meeting.
Pt VI, Line 12cThe organization's Board members and corporate officers
are subject to a conflict of interest policy.
Pursuant to that policy, each such person is required
to identify any transaction with the organization in
which the person has (or may have) a financial interest.
If a conflict (or potential conflict) is identified, the
Board, excluding any involved Board members carefully
reviews the terms of the transaction and makes a
determination as to whether the transactions is fair and
reasonable to the organization under all the facts and
circumstances. The organization monitors and enforces
compliance with this policy by: (i) discussing such
issues at its annual meeting; (ii) requiring all
covered persons to annually provide written certifica-
tion of their compliance with the policy; and
(iii) carefully reviewing all material transactions to
identify potential or real conflicts.
Pt VI, Line 19The organization's annual financial report is available
upon request. The organization provides copies
of its governing documents, its conflict of interest
policy, as well as its three most recent Forms 990
to any interested person that makes a request for such documents.
The organization's Forms 990 for its three most recent
years are also available on a third party's website,guidestar.org.
Pt VI, Line 3The organization delegates control over management duties
to QueensCare,a California non-profit corporation
which is its sole corporate member and which it supports.
Pt VI, Line 6QueensCare, a California non-profit, public benefit
corporation is the organization's sole corporate member.
Pt VI, Line 7aAs its sole member, QueensCare has the power and authority
to appoint the organization's Board of Directors
Pt VI, Line 7bIn addition to the power to elect its Board of Directors
QueensCare has the authority to amend the organization's Bylaws
and to oversee and approve other corporate actions.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1QUEENSCAREBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 N VERMONT AVE SUITE 1002AddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900276005ZIPCode
FieldValueIRS element (for citing)
EIN951644040EIN
Primary ActivitiesHEALTHCARE FOR THE POORPrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ST JOSEPH'S HEALTH SUPPORT ALLIANCEBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
QUEENSCARE
b102273accrual
QUEENSCARE
p10992accrual