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    <Timestamp>2012-05-12T13:24:27-07:00</Timestamp>
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        <City>Sacramento</City>
        <State>CA</State>
        <ZIPCode>95825</ZIPCode>
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        <BusinessNameLine1>Community Services Solutions</BusinessNameLine1>
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        <AddressLine1>26 HFU Cir</AddressLine1>
        <City>Coleville</City>
        <State>CA</State>
        <ZIPCode>96107</ZIPCode>
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      <Name>Carolyn Williams</Name>
      <Title>Exec. Director &amp; CFO</Title>
      <DateSigned>2012-05-12</DateSigned>
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      <Name>Linda E Killick</Name>
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        <NamePerson>Carolyn Williams</NamePerson>
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        <CurrentTaxYear>246251</CurrentTaxYear>
        <Total>1347650</Total>
      </GiftsGrantsContribReceived170>
      <TaxRevLeviedForOrgBenefit170>
        <Total>0</Total>
      </TaxRevLeviedForOrgBenefit170>
      <ValueSrvcFcltsFurnishedByGovt>
        <Total>0</Total>
      </ValueSrvcFcltsFurnishedByGovt>
      <Total170>
        <CurrentTaxYearMinus4Years>349386</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>269525</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>233415</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>249073</CurrentTaxYearMinus1Year>
        <CurrentTaxYear>246251</CurrentTaxYear>
        <Total>1347650</Total>
      </Total170>
      <AmountsSubstContributorsTotal>0</AmountsSubstContributorsTotal>
      <PublicSupportTotal170>1347650</PublicSupportTotal170>
      <GrossInvestmentIncome170>
        <CurrentTaxYearMinus4Years>406</CurrentTaxYearMinus4Years>
        <CurrentTaxYearMinus3Years>402</CurrentTaxYearMinus3Years>
        <CurrentTaxYearMinus2Years>362</CurrentTaxYearMinus2Years>
        <CurrentTaxYearMinus1Year>376</CurrentTaxYearMinus1Year>
        <Total>1546</Total>
      </GrossInvestmentIncome170>
      <NetUBI>
        <Total>0</Total>
      </NetUBI>
      <OtherIncome170>
        <Total>0</Total>
      </OtherIncome170>
      <TotalSupport>1349196</TotalSupport>
      <PublicSupportPertcentage170>0.99890</PublicSupportPertcentage170>
      <PublicSupportPertcentPriorYear>0.99870</PublicSupportPertcentPriorYear>
      <ThirtyThreePercntTestsCY170>X</ThirtyThreePercntTestsCY170>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="IRS990ScheduleD" softwareId="11000144" softwareVersion="2011v1.2">
      <Equipment>
        <OtherCostOrOtherBasis>26887</OtherCostOrOtherBasis>
        <Depreciation>24642</Depreciation>
        <BookValue>2245</BookValue>
      </Equipment>
      <OtherLandBuildings>
        <OtherCostOrOtherBasis>1249</OtherCostOrOtherBasis>
        <Depreciation>1036</Depreciation>
        <BookValue>213</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>2458</TotalOfBookValueLandBuildings>
    </IRS990ScheduleD>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="11000144" softwareVersion="2011v1.2">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>No documents available to the public.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11: Form 990 Review Process</ReturnReference>
        <Explanation>No review was or will be conducted.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part III, Line 4d</Identifier>
        <ReturnReference>Form 990, Part III, Line 4d : Other Program Services Description</ReturnReference>
        <Explanation>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 &amp; 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 &amp; 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 &amp; 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.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
  </ReturnData>
</Return>