MY HOME INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: MY HOME INC (EIN 68-0201898)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-08
IRS object ID: 201343129349302459
Schema version: 2012v2.1
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 O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-08T17:48:53-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	941587502	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	G & J SEIBERLICH & CO LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3264 VILLA LANE	AddressLine1
City	NAPA	City
State	CA	State
ZIP Code	94558	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	680201898	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MY HOME INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MYHO	NameControl
Phone	7075397435	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1639 MANZANITA AVE	AddressLine1
City	SANTA ROSA	City
State	CA	State
ZIP Code	95404	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	BEVERLY LYNNE VAUGHAN	Name
Title	PRESIDENT	Title
Phone	7075397435	Phone
Date Signed	2013-10-30	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	WENDELL R COATS	Name
PTIN	P00375614	PTIN
Phone	7072247948	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	BEVERLY LYNNE VAUGHAN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1639 MANZANITA AVENUE	AddressLine1
City	SANTA ROSA	City
State	CA	State
ZIP Code	95404	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	564515	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1991	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	PROMOTE THE EDUCATION AND WELFARE OF DEVELOPMENTALLY DISABLED PERSONS AND FAMILIES OF DEVELOPMENTALLY DISABLED PERSONS AND TO DEVELOP AND OPERATE LIVING ARRANGEMENTS FOR DEVELOPMENTALLY DISABLED PERSONS.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	3	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	3	NbrIndependentVotingMembers
Total Nbr Employees	17	TotalNbrEmployees
Total Nbr Volunteers	0	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	6163	ContributionsGrantsPriorYear
Contributions Grants Current Year	7	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	659682	ProgramServiceRevenuePriorYear
Program Service Revenue CY	558426	ProgramServiceRevenueCY
Investment Income Prior Year	0	InvestmentIncomePriorYear
Investment Income Current Year	3	InvestmentIncomeCurrentYear
Other Revenue Prior Year	5000	OtherRevenuePriorYear
Other Revenue Current Year	6079	OtherRevenueCurrentYear
Total Revenue Prior Year	670845	TotalRevenuePriorYear
Total Revenue Current Year	564515	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	237307	SalariesEtcPriorYear
Salaries Etc Current Year	232978	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	411855	OtherExpensePriorYear
Other Expenses Current Year	325915	OtherExpensesCurrentYear
Total Expenses Prior Year	649162	TotalExpensesPriorYear
Total Expenses Current Year	558893	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	21683	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	5622	RevenuesLessExpensesCY
Total Assets BOY	101349	TotalAssetsBOY
Total Assets EOY	106971	TotalAssetsEOY
Total Liabilities BOY	0	TotalLiabilitiesBOY
Total Liabilities EOY	0	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	101349	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	106971	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO OFFER THE BEST IN DIGNIFIED AND PRODUCTIVE LIVING TO ADULTS WITH DEVELOPMENTAL DISABILITIES. TO PROVIDE A PROGRESSIVE LEARNING ENVIRONMENT THAT STIMULATES PERSONAL STRENGTHS AND REWARDS INDIVIDUAL DEVELOPMENT THROUGH STIMULATION, REASSURANCE, MOTIVATION AND ASSISTANCE. RESIDENTS ARE ABLE TO PARTICIPATE IN LIFE TO THEIR FULLEST ABILITY.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	439413	Expense
Revenue	564505	Revenue
Description	PROMOTE THE EDUCATION AND WELFARE OF DEVELOPMENTALLY DISABLED PERSONS AND FAMILIES OF DEVELOPMENTALLY DISABLED PERSONS, AND TO DEVELOP AND OPERATE LIVING ARRANGEMENTS FOR DEVELOPMENTALLY DISABLED PERSONS.	Description
Total Program Service Expense	439413	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	0	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	0	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	0	Hospital
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	0	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	0	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	23	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	17	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Form8899 Filed	0	Form8899Filed
Form1098 C Filed	0	Form1098CFiled
Excess Business Holdings	0	ExcessBusinessHoldings
Taxable Distributions	0	TaxableDistributions
Distribution To Donor	0	DistributionToDonor
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	3	NbrVotingGoverningBodyMembers
Number Independent Voting Members	3	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	0	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	0	CompensationProcessCEO
Compensation Process Other	0	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	7075397435	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1639 MANZANITA AVENUE	AddressLine1
City	SANTA ROSA	City
State	CA	State
ZIP Code	95404	ZIPCode

Field	Value	IRS element (for citing)
No Listed Persons Compensated	X	NoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (3 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation
BEVERLY LYNNE VAUGHAN
PRESIDENT	2.00	X	X	0	0	0
TERRY LONGORIA
SECRETARY	2.00	X	X	0	0	0
TONY APPOLLONI
TREASURER	2.00	X	X	0	0	0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	0	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	0	TotalOtherCompensation
Number Individuals GT100 K	0	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	0	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
All Other Contributions	7	AllOtherContributions
Total Contributions	7	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDI-CAL	624310	347256	347256
D.D.S.	624310	142513	142513
S.S.A. BENEFITS	624310	68657	68657

Field	Value	IRS element (for citing)
Total Program Service Revenue	558426	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	3	TotalRevenueColumn
Exclusion	$3	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	6050	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	0	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	6050	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	6050	TotalRevenueColumn
Related Or Exempt Function Income	6050	RelatedOrExemptFunctionIncome

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	29	TotalRevenueColumn
Related Or Exempt Function Income	29	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	29	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	564515	TotalRevenueColumn
Related Or Exempt Function Income	564505	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$3	ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	211126	Total
Program Services	154545	ProgramServices
Management And General	56581	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2710	Total
Program Services	2710	ProgramServices

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	19142	Total
Program Services	14012	ProgramServices
Management And General	5130	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	6298	Total
Program Services	6298	ProgramServices

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	14032	Total
Program Services	14032	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	38400	Total
Management And General	38400	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2800	Total
Program Services	2800	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	29925	Total
Program Services	25848	ProgramServices
Management And General	4077	ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
DAY PROGRAM SERVICES	132585	132585
OPERATING EXPENSE	49093	49093
DHCS - QUALITY ASSURANC	27385	27385

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	25397	Total
Program Services	10106	ProgramServices
Management And General	15291	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	558893	Total
Program Services	439413	ProgramServices
Management And General	119479	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	98549	BOY
EOY	106971	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	15996	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	15996	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	2800	BOY
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	101349	BOY
EOY	106971	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	101349	BOY
EOY	106971	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	101349	BOY
EOY	106971	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	101349	BOY
EOY	106971	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	5622	ReconcilationRevenueExpenses
Reconcilation Other Changes	0	ReconcilationOtherChanges
Method Of Accounting Cash	X	MethodOfAccountingCash
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	0	FSAudited
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	330943	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	355077	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	356181	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	604617	CurrentTaxYearMinus1Year
Current Tax Year	495826	CurrentTaxYear
Total	2142644	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	330943	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	355077	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	356181	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	604617	CurrentTaxYearMinus1Year
Current Tax Year	495826	CurrentTaxYear
Total	2142644	Total

Field	Value	IRS element (for citing)
Public Support Total170	2142644	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year	3	CurrentTaxYear
Total	3	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	60234	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	64719	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	60675	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	66228	CurrentTaxYearMinus1Year
Current Tax Year	68686	CurrentTaxYear
Total	320542	Total

Field	Value	IRS element (for citing)
Total Support	2463189	TotalSupport
Public Support Pertcentage170	0.86990	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.86440	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	15996	OtherCostOrOtherBasis
Depreciation	15996	Depreciation
Book Value	0	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	0	TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS REVIEWED BY THE TREASURER AND A COPY IS PROVIDED TO KEY MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO IT BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12	THE ORGANIZATION'S BOARD OF DIRECTORS APPROVED AND IMPLEMENTED A WRITTEN WHISTLEBLOWER POLICY AND DOCUMENT RETENTION AND DESTRUCTION POLICY AT THE MARCH 2011 ORGANIZATION BOARD MEETING.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND ON-SITE.