COMMUNITY SERVICE SOLUTIONS: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY SERVICE SOLUTIONS (EIN 01-0658352)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-05-12
IRS object ID: 201221339349300132
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 O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-05-12T13:24:27-07:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Killick Financial Services	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2321 Lloyd Ln	AddressLine1
City	Sacramento	City
State	CA	State
ZIP Code	95825	ZIPCode

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	010658352	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Services Solutions	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	COMM	NameControl
Phone	5304952700	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	26 HFU Cir	AddressLine1
City	Coleville	City
State	CA	State
ZIP Code	96107	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Carolyn Williams	Name
Title	Exec. Director & CFO	Title
Date Signed	2012-05-12	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Linda E Killick	Name
Phone	9164868985	Phone
Self Employed	X	SelfEmployed

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

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Carolyn Williams	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	PO Box 2087	AddressLine1
City	Port Townsend	City
State	WA	State
ZIP Code	98368	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	244143	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Activity Or Mission Description	Development of public services for the health and social benefit of the community. CSS acts as the non-profit consortium employer of record for in-home supportive services providers for the purposes of collective bargaining over wages, hours, and other terms and conditions of employment.Work with Child Welfare to increase communication betweeen county child welfare and families of detained children to better facilitate services between the affected families and social services.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	4	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	0	NbrIndependentVotingMembers
Total Nbr Employees	4	TotalNbrEmployees
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	249073	ContributionsGrantsPriorYear
Contributions Grants Current Year	243892	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	376	InvestmentIncomePriorYear
Investment Income Current Year	251	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	249449	TotalRevenuePriorYear
Total Revenue Current Year	244143	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	150866	SalariesEtcPriorYear
Salaries Etc Current Year	153615	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	109627	OtherExpensePriorYear
Other Expenses Current Year	92636	OtherExpensesCurrentYear
Total Expenses Prior Year	260493	TotalExpensesPriorYear
Total Expenses Current Year	246251	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-11044	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-2108	RevenuesLessExpensesCY
Total Assets BOY	155085	TotalAssetsBOY
Total Assets EOY	118011	TotalAssetsEOY
Total Liabilities BOY	645	TotalLiabilitiesBOY
Total Liabilities EOY	257	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	154440	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	117754	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	Development of public services for the health and social benefit of the community. CSS acts as the non-profit consortium employer of record for in-home supportive services providers for the purposes of collective bargaining over wages, hours, and other terms and conditions of employment.Work with Child Welfare to increase communication betweeen county child welfare and families of detained children to better facilitate services between the affected families and social services.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	10130	Expense
Revenue	18761	Revenue
Description	We provided service training to In Home Supportive Services homecare providers. Implemented and continue to serve the Quality Assurance Program for the In Home Supportive Services Programs in Modoc and Mono Counties.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	10130	Expense
Revenue	18760	Revenue
Description	Work with two different counties to quarterly review the Adult services case files for Quality Assurance purposes for the assurance state and federal regulations are being followed. Oversee adult services social workers for the purposes of training and supervision to assurance quality of program to consumers, reduction of fraud, provider time sheet training and routine training of new program updates.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	10129	Expense
Revenue	18765	Revenue
Description	We provide In-Home Supportive Services for two Communities, Modoc, and Mono counties in California. These services include but are not restricted to the operation of registeries to screen providers before they go into senior citizens homes so that abuse and neglect is reduced. Additionally, providers are screened for alcohol and drug use, and any prior history of elderly abuse.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	101290	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	187608	TotalOfOtherProgramServiceRev
Total Program Service Expense	131679	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	false	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	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	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	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
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	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	false	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	false	ComplianceWithBackupWitholding
Number Of Employees	4	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Form8886 T Filed	false	Form8886TFiled
Non Deductible Contributions	false	NonDeductibleContributions
Non Deductible Disclosure	false	NonDeductibleDisclosure
Quid Pro Quo Contributions	false	QuidProQuoContributions
Quid Pro Quo Disclosure	false	QuidProQuoDisclosure
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Form720 Filed	false	Form720Filed
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	4	NbrVotingGoverningBodyMembers
Number Independent Voting Members	0	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	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	false	MinutesOfGoverningBody
Minutes Of Committees	false	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Policies Reference Chapters	false	PoliciesReferenceChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	false	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	false	RegularMonitoringEnforcement
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Written Policy Or Procedure	false	WrittenPolicyOrProcedure

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Carolyn Williams	NamePerson
Telephone Number	3603799391	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO Box 2087	AddressLine1
City	Port Townsend	City
State	WA	State
ZIP Code	98368	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (4 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Individual Trustee Or DirectorIndividualTrusteeOrDirector
Sharon Krueger
Chairman	0.00	0	0	0
Ron McGill
Board Member	0.00	0	0	0
Barbara Noreen
Board Member	0.00	0	0	0
Carolyn Williams
Executive Direc	40.00	97475	0	0	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	97475	TotalReportableCompFromOrg
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
Government Grants	243892	GovernmentGrants
Total Contributions	243892	TotalContributions
Total Program Service Revenue	0	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	251	TotalRevenueColumn
Exclusion	$251	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	244143	TotalRevenueColumn
Exclusion	$251	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	97475	Total
Program Services	97475	ProgramServices

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	27567	Total
Management And General	27567	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	18000	Total
Management And General	18000	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	0	Total

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	10573	Total
Management And General	10573	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	1657	Total
Management And General	1657	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	9378	Total
Management And General	9378	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	5010	Total
Management And General	5010	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	1744	Total
Management And General	1744	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2454	Total
Management And General	2454	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3761	Total
Management And General	3761	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3000	Total
Management And General	3000	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	30104	Total
Program Services	18821	ProgramServices
Management And General	11283	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4184	Total
Management And General	4184	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	14302	Total
Management And General	14302	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
Utilities	1159	1159
Subcontractors	13200		13200
Registry Expense	2183		2183
Misc	440	440
License & Permits	60	60

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	246251	Total
Program Services	131679	ProgramServices
Management And General	114572	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	24680	BOY
EOY	51565	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	70142	BOY
EOY	43199	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	20493	BOY
EOY	20789	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
EOY	0	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	28136	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	25678	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	39770	BOY
EOY	2458	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
EOY	0	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	155085	BOY
EOY	118011	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	645	BOY
EOY	257	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	645	BOY
EOY	257	EOY

Field	Value	IRS element (for citing)
Do Not Follow SFAS117	X	DoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

Field	Value	IRS element (for citing)
BOY	154440	BOY
EOY	117754	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	154440	BOY
EOY	117754	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	155085	BOY
EOY	118011	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-2108	ReconcilationRevenueExpenses
Reconcilation Other Changes	-34578	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	false	FSAudited
Audit Committee	false	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired
Federal Grant Audit Performed	false	FederalGrantAuditPerformed

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	349386	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	269525	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	233415	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	249073	CurrentTaxYearMinus1Year
Current Tax Year	246251	CurrentTaxYear
Total	1347650	Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

Field	Value	IRS element (for citing)
Total	0	Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

Field	Value	IRS element (for citing)
Total	0	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	349386	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	269525	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	233415	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	249073	CurrentTaxYearMinus1Year
Current Tax Year	246251	CurrentTaxYear
Total	1347650	Total

Field	Value	IRS element (for citing)
Amounts Subst Contributors Total	0	AmountsSubstContributorsTotal
Public Support Total170	1347650	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	406	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	402	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	362	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	376	CurrentTaxYearMinus1Year
Total	1546	Total

Net UBI NetUBI

Field	Value	IRS element (for citing)
Total	0	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Total Support	1349196	TotalSupport
Public Support Pertcentage170	0.99890	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.99870	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170

Schedule D IRS990ScheduleD

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	26887	OtherCostOrOtherBasis
Depreciation	24642	Depreciation
Book Value	2245	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1249	OtherCostOrOtherBasis
Depreciation	1036	Depreciation
Book Value	213	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	2458	TotalOfBookValueLandBuildings

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	No documents available to the public.
Form 990, Part VI, Line 11	Form 990, Part VI, Line 11: Form 990 Review Process	No review was or will be conducted.
Form 990, Part III, Line 4d	Form 990, Part III, Line 4d : Other Program Services Description	OTHER PROGRAM SERVICES 4: We provide training and on-going education for the providers in Mono and Modoc County. That education includes instruction on how to provide services for seniors in their homes and how to help people with diseases, such as, Alzheimer's, dementia, and physical problems, such as, ambulation difficulties, eating disorders, and every day activies, such as, getting to doctors appointments and to the grocery store. OTHER PROGRAM SERVICES 5: Create and maintain quality assurance programs for two counties to enhance the quality of services received by in-home supportive services consumers. This includes policy & proceedures for county staff to administer the IHSS program, desk audits to prevent provider fraud and in-person IHSS consumer interviews to assure program quality. OTHER PROGRAM SERVICES 6: The organization established provider registries to assist the elderly and disabled in finding In-Home Support Services (IHSS). The organization investigated the qualifications and background of potential providers, developed a system to refer IHSS providers to recipients, DOJ background checks of providers and train providers and recipients. OTHER PROGRAM SERVICES 7: Prepared Children's Protective Services countywide assesment and the Childrens Protective Services System Improvement Plan(SIP)for Modoc and Mono Counties. OTHER PROGRAM SERVICES 8: We coordinated a Senior Health Fair for Mono County providing access to information to the elderly and disabled. OTHER PROGRAM SERVICES 9: We attended the four day Modoc County Fair to promote the IHSS program for seniors and the disabled, PSA's and newspaper adds coordinated the event. OTHER PROGRAM SERVICES 10: Help local county Child Welfare Services conduct (Modoc & Mono) countywide Self-Assessments of their Child Welfare systems so that child and adult services/plans can be created to create a county/state Three-Year Self Improvement Plans complete with yearly assessments of progress.Work with both the state and local counties(Modoc & Mono) to two Write Three-Year System Improvement Plans for Child Welfare Services. To reduce maltreatment of children, to reduce recurrence of maltreat of children, to create plans and strategies for parents to reunify with their children (parenting classes, drug and alcohol programs, family wellness programs etc.). OTHER PROGRAM SERVICES 11: Helped two counties work with the state to plan for the integration of new Adult services computer systems that will enable the social workers to create better and faster assessments, reduce consumer fraud to the adult services program, and to better monitor the services in-home providers give to seniors. The monitoring of providers would include DOJ fingerprinting, drug and alcohol checks of providers for state/federal adult services programs. Become trainers of county staff for fraud prevention in federal/state adult services programs. OTHER PROGRAM SERVICES 12: Work with two different counties to quarterly review the Adult services case files for Quality Assurance purposes for the assurance state and federal regulations are being followed. Oversee adult services social workers for the purposes of training and supervision to assurance quality of program to consumers, reduction of fraud, provider time sheet training and routine training of new program updates. OTHER PROGRAM SERVICES 13: Chair and facilitate two (different counties) In-Home Services Board of Supervisors In-Home Supportive Services Advisory Committee's for the purposes recommendations to the Boards of County Supervisors, efficient delivery of countywide service to consumers, program implementation, distribution of program service material through the media, local events, PSA's, local fraternal groups and professional organizations.