QUEEN OF ANGELS-HOLLYWOOD PRESBYTERIAN FOUNDATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: QUEEN OF ANGELS-HOLLYWOOD PRESBYTERIAN FOUNDATION (EIN 95-3403582)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-15
IRS object ID: 201331359349308538
Schema version: 2011v1.2
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
Form 990
Schedule A
Schedule D
Schedule I
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-15T15:02:17-07:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LUNDY FLEMING LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2 BALA PLZ STE 300	AddressLine1
City	BALA CYNWYD	City
State	PA	State
ZIP Code	190041512	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	953403582	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	QUEEN OF ANGELS HOLLYWOOD PRESBYTERIAN FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	QUEE	NameControl
Phone	3236694305	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1300 N VERMONT AVENUE	AddressLine1
City	LOS ANGELES	City
State	CA	State
ZIP Code	900276005	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	BARBARA B HINES	Name
Title	PRESIDENT/CEO	Title
Phone	3236694305	Phone
Date Signed	2013-05-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JOSEPH E LUNDY	Name
Phone	6106607788	Phone
Date Prepared	2013-05-15	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

Field	Value	IRS element (for citing)
Business Name Line1	BARBARA HINES	BusinessNameLine1

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1300 N VERMONT AVE STE 1002	AddressLine1
City	LOS ANGELES	City
State	CA	State
ZIP Code	900276005	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	1704161	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1978	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	The organization provides financial support to QueensCare, a California non-profit corporation, to further QueensCare's mission of providing accessible healthcare for uninsured and low-income working individuals and families.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	2	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	0	NbrIndependentVotingMembers
Total Nbr Employees	0	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	296962	InvestmentIncomePriorYear
Investment Income Current Year	449264	InvestmentIncomeCurrentYear
Other Revenue Prior Year	691658	OtherRevenuePriorYear
Other Revenue Current Year	-615038	OtherRevenueCurrentYear
Total Revenue Prior Year	988620	TotalRevenuePriorYear
Total Revenue Current Year	-165774	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	95550	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	93599	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Current Year	0	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	6123	OtherExpensePriorYear
Other Expenses Current Year	9211	OtherExpensesCurrentYear
Total Expenses Prior Year	101673	TotalExpensesPriorYear
Total Expenses Current Year	102810	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	886947	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-268584	RevenuesLessExpensesCY
Total Assets BOY	5694857	TotalAssetsBOY
Total Assets EOY	5520709	TotalAssetsEOY
Total Liabilities BOY	5000	TotalLiabilitiesBOY
Total Liabilities EOY	99436	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	5689857	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	5421273	NetAssetsOrFundBalancesEOY
Mission Description	Support to Queenscare a California	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	93599	Expense
Grants	93599	Grants
Description	SUPPORT TO QUEENSCARE A CALIFORNIA NON-PROFIT CORPORATION PROVIDING ACCESSIBLE HEALTHCARE FOR UNINSURED AND LOW INCOME WORKING INDIVIDUALS AND FAMILIES.	Description
Total Program Service Expense	93599	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	false	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	0	NumberOfEmployees
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Excess Business Holdings	false	ExcessBusinessHoldings
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	2	NbrVotingGoverningBodyMembers
Number Independent Voting Members	0	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	EMY DEALDAY	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	3236694309	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1300 N VERMONT AVE STE 508	AddressLine1
City	LOS ANGELES	City
State	CA	State
ZIP Code	90027	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (2 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
SISTER JUDY MURPHY
Secretary	0.00	X	0	113150	0
BARBARA B HINES
President	0.00	X	0	118643	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp Frm Rltd Orgs	231793	TotalReportableCompFrmRltdOrgs
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	114361	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	2204838	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	1869935	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	334903	Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	334903	TotalRevenueColumn
Related Or Exempt Function Income	334903	RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-615038	TotalRevenueColumn
Related Or Exempt Function Income	-615038	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	-615038	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	-165774	TotalRevenueColumn
Related Or Exempt Function Income	-165774	RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	93599	Total
Program Services	93599	ProgramServices

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	920	Total
Program Services	0	ProgramServices
Management And General	920	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	5000	Total
Program Services	0	ProgramServices
Management And General	5000	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	37	Total
Program Services	0	ProgramServices
Management And General	37	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1948	Total
Program Services	0	ProgramServices
Management And General	1948	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	1221	Total
Program Services	0	ProgramServices
Management And General	1221	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses

Field	Value	IRS element (for citing)
Description	Taxes & Licenses	Description
Total	85	Total
Program Services	0	ProgramServices
Management And General	85	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	102810	Total
Program Services	93599	ProgramServices
Management And General	9211	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	332469	BOY
EOY	326622	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	727329	BOY
EOY	368615	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	62788	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	58409	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	6327	BOY
EOY	4379	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	4616187	BOY
EOY	4810124	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	12545	BOY
EOY	10969	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	5694857	BOY
EOY	5520709	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	5000	BOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
EOY	99436	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	5000	BOY
EOY	99436	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4905820	BOY
EOY	4730835	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	784037	BOY
EOY	690438	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5689857	BOY
EOY	5421273	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	5694857	BOY
EOY	5520709	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-268584	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Supporting Organization509a3	X	SupportingOrganization509a3
Supporting Org509a3 Type3 Func Int	X	SupportingOrg509a3Type3FuncInt

Supported Org Information SupportedOrgInformation

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	QUEENSCARE	BusinessNameLine1

Field	Value	IRS element (for citing)
EIN	951644040	EIN
Type Of Organization	3	TypeOfOrganization
Listed In Governing Doc	true	ListedInGoverningDoc
Supported Organization Notified	true	SupportedOrganizationNotified
Organized In US	true	OrganizedInUS
Amount	$93,599	Amount

Field	Value	IRS element (for citing)
Total Number Of Supported Orgs	1	TotalNumberOfSupportedOrgs
Sum Of Amounts	93599	SumOfAmounts
Public Support Total170	0	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Public Support Pertcentage170	0	PublicSupportPertcentage170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4616187	BeginningOfYearBalance
Investment Earnings Or Losses	193937	InvestmentEarningsOrLosses
End Of Year Balance	4810124	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4013535	BeginningOfYearBalance
Investment Earnings Or Losses	602652	InvestmentEarningsOrLosses
End Of Year Balance	4616187	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3838873	BeginningOfYearBalance
Investment Earnings Or Losses	188852	InvestmentEarningsOrLosses
Administrative Expenses	14190	AdministrativeExpenses
End Of Year Balance	4013535	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.85000	BoardDesignatedEOYBalance
Term Endowment EOY Balance	0.15000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	62788	OtherCostOrOtherBasis
Depreciation	58409	Depreciation
Book Value	4379	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	4379	TotalOfBookValueLandBuildings

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	ExplanationExplanation
Pt V Line 4	The Foundation intends to use its endowment funds
	to continue its support of QueensCare, a California non-profit corporation providing accessible healthcare for uninsured and low income working individuals and families.
Pt X	As 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, 2009 THROUGH JUNE 30, 2012 FOR FEDERAL TAX PURPOSES AND THE YEARS ENDED JUNE 30, 2008 THROUGH JUNE 30, 2012 FOR CALIFORNIA TAX PURPOSES. THERE HAVE BEEN NO MATERIAL CHANGES IN UNRECOGNIZED BENEFITS AS OF JUNE 30, 2012, NOR ARE ANY MATERIAL CHANGES ANTICIPATED IN THE TWELVE MONTHS FOLLOWING JUNE 30, 2012.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	QUEENSCARE	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1300 N VERMONT AVE STE 1002	AddressLine1
City	LOS ANGELES	City
State	CA	State
ZIP Code	90027	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	951644040	EINOfRecipient
IRC Section	501(c)(3)	IRCSection
Amount Of Cash Grant	93599	AmountOfCashGrant
Purpose Of Grant	HEALTHCARE SUPPORT	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV (4 entries)

IdentifierIdentifier	ExplanationExplanation
Pt I Line 2	As 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 used for charitable purposes.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (33 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI, Line 11a	The 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 12c	The organization's Board members and corporate officer
	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 19	The 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 Form 990 for its three most recent
	years are also available on a third party's website,guidestar.org.
Pt VI, Line 3	The organization delegates control over management duties
	to QueensCare,a California non-profit corporation
	which it supports.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	QUEENSCARE	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1300 N VERMONT AVE SUITE 1002	AddressLine1
City	LOS ANGELES	City
State	CA	State
ZIP Code	900276005	ZIPCode

Field	Value	IRS element (for citing)
EIN	951644040	EIN
Primary Activities	HEALTHCARE FOR THE POOR	PrimaryActivities
Legal Domicile State	CA	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Public Charity Status	3	PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

Field	Value	IRS element (for citing)
Controlled Org	false	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	false	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
QUEENSCARE
b	93599	accrual
QUEENSCARE
o	5000	accrual