2026-05-07T13:33:14-05:00 2025-06-30 410746749 CLIFTONLARSONALLEN LLP 420 SOUTH ORANGE AVENUE SUITE 900 ORLANDO FL 32801 990 2024-07-01 710876594 HOLLENBECK PALMS HOLL 3232636195 573 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 JOHNNY YOUNG CFO 3232636195 2026-05-06 1 1 TINA HENTON P00630282 4078021200 2026-05-06 2024 2025-03-06 01:10:19Z JOHNNY YOUNG 573 SOUTH BOYLE AVENUE LOS ANGELES CA 90033 44615526 0 X WWW.HOLLENBECKPALMS.COM X 2001 CA THE VERY FIRST NON-PROFIT, LICENSED CONTINUING CARE RETIREMENT COMMUNITY IN CALIFORNIA, HOLLENBECK PALMS PROVIDES FOR AND SERVES ITS ELDERLY RESIDENTS WITH GREAT COMPASSION, HONEST DIGNITY AND GENUINE LOVE THROUGH RESIDENTIAL, ASSISTED MEMORY ENHANCEMENT AND SKILLED NURSING LIVING. WE OFFER A REWARDING AND GRATIFYING LIFESTYLE, FULL OF ACTIVITIES, PROGRAMS AND SERVICES, AND ALL LEVELS OF CARE THEY MAY NEED AT VARIOUS STAGES OF THEIR LIVES. 8 8 256 10 0 0 602648 945039 21272243 22228341 4375610 4235076 201231 188433 26451732 27596889 0 0 0 0 13931971 14334112 0 0 210219 11773148 12020924 25705119 26355036 746613 1241853 86206813 85263002 39214775 37602717 46992038 47660285 HOLLENBECK PALMS IS COMMITTED TO PROVIDING A RESIDENCE FOR THOSE IN THE LATER YEARS OF THEIR LIVES THAT ENCOMPASSES A HEALTHY ENVIRONMENT OF COMFORT, SAFETY, AND ENJOYMENT; THAT ATTENDS TO THEIR PHYSICAL, MENTAL, AND SPIRITUAL NEEDS. 0 0 21347464 0 22228341 HOLLENBECK PALMS PROVIDES CARE FOR THE AGING, INCLUDING RESIDENTIAL, ASSISTED LIVING, MEMORY ENHANCEMENT AND SKILLED NURSING CARE LIVING ARRANGEMENTS FOR THEIR MEMBERS. DURING THE YEAR, SERVICES WERE PROVIDED TO APPROXIMATELY 220 MEMBERS. 21347464 1 1 0 0 0 0 0 0 0 1 1 1 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 42 0 1 256 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X X JOHNNY YOUNG 3232636195 573 S BOYLE AVE LOS ANGELES CA 90033 CAROL JOHNSTON BOARD CHAIR 1.00 X X 0 0 0 ERIKA CATILE VICE PRESIDENT 1.00 X X 0 0 0 MICHAEL DAVIS TRUSTEES(TERM END 12/31/24) 1.00 X 0 0 0 EDWARD GARLOCK TRUSTEES(TERM END 6/30/25) 1.00 X 0 0 0 KATHERINE A KIRCHHOFF TRUSTEES 1.00 X 0 0 0 WILLIAM KUMAGAI TRUSTEES 1.00 X 0 0 0 ALBERT RIZZO TRUSTEES 1.00 X 0 0 0 LINDA CHIAVAROLI-ROSENBLOOM RESIDENT REPRESENTATIVE 1.00 X 0 0 0 JANE NAKAMURA RESIDENT REPRESENTATIVE 1.00 X 0 0 0 MORRIS SHOCKLEY PRESIDENT & CEO 40.00 X 233848 0 27486 JOHNNY YOUNG CFO/SECRETARY/TREASURER 40.00 X 161943 0 29491 IVANIA RAMIREZ DIRECTOR OF NURSING 40.00 X 186695 0 83990 ZHANA DUBIN DIRECTOR OF ADMISSIONS 40.00 X 189817 0 1409 GARY ZUPPARDO CHIEF ENGINEER 40.00 X 201532 0 21912 AKHERE OSEZUA ASST. DIRECTOR OF NURSING 40.00 X 195384 0 33903 ODILY FRANKLIN ASST. LIVING COORDINATOR 40.00 X 157182 0 12101 1326401 0 210292 23 0 1 0 SODEXO INC & AFFILIATES PO BOX 360170 PITTSBURGH PA 15251 FOOD SERVICES AND HOUSEKEEPING 3079995 BELLE HOME CARE INC 10555 E COLORADO BLVD STE 500 PASADENA CA 91106 NURSING REGISTRY 1052138 SKILLED NURSING PHARMACY 16666 E JOHNSON DRIVE CITY OF INDUSTRY CA 91745 PRESCRIPTIONS, DME, & DRUG STORE 329028 TEAM REHAB INC 6531 SILENT HARBOR DRIVE HUNTINGTON BEACH CA 92648 THERAPY 326711 IMPRESSION THE SHADE DESIGN 777 E OCEAN BLVD UNIT 2904 LONG BEACH CA 90802 BUILDING IMPROVEMENT 243255 19 196302 748737 945039 SKILLED NURSING/RESIDE 623000 16084173 16084173 MEDICARE/MEDICAID 623000 6144168 6144168 22228341 1181799 1181799 38236 38236 87353 0 87353 87353 87353 20052399 16999122 3053277 3053277 3053277 7000 196302 19515 -12515 -12515 OTHER REVENUE 623000 75359 75359 75359 27596889 22228341 0 4423509 X 438010 350408 65701 21901 10269452 8898948 1246747 123757 161969 141995 18862 1112 2596141 2242694 319117 34330 868540 749786 107012 11742 160755 160755 157122 157122 95930 95930 3527596 2513711 997733 16152 266842 266842 74112 72944 1168 1048882 1048882 50455 24913 25542 20490 1098 19335 57 1243711 1243711 1942666 1942666 670657 670657 VARIOUS MEDICAL EXPENSE 1854521 1854521 FOOD EXPENSE 907185 907185 26355036 21347464 4797353 210219 1608428 2263248 2194708 2395174 2593804 2348310 101938 122067 400620 682905 69664870 31620176 37923868 38044694 30578181 31403062 10805266 8003542 86206813 85263002 3909977 4013885 5098008 5004620 21765702 20606947 4840861 4628981 3600227 3348284 39214775 37602717 X 44827486 45417924 2164552 2242361 46992038 47660285 86206813 85263002 X 1241853 -637220 63614 X X 0 1 X 1 0 X 3453587 739891 3869016 611773 945039 9619306 14618615 15467949 17045960 21272243 22228341 90633108 18072202 16207840 20914976 21884016 23173380 100252414 952516 109541 54541 37000 55238 1208836 0 952516 109541 54541 37000 55238 1208836 99043578 4247106 5217724 4050738 4521159 1307388 19344115 4247106 5217724 4050738 4521159 1307388 19344115 32361 53547 55509 64761 75359 281537 22351669 21479111 25021223 26469936 24556127 119878066 0.82620 0.79230 0.16140 0.19500 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: ICE CREAM AND GUEST MEALS AND ROOM - 2020 AMOUNT: $ 1,714. BAZAAR - 2020 AMOUNT: $ 4,451. BEAUTY AND BARBER SHOP - 2020 AMOUNT: $ 12,957. MISCELLANEOUS - 2020 AMOUNT: $ 13,239. 2021 AMOUNT: $ 53,547. 2022 AMOUNT: $ 55,509. 2023 AMOUNT: $ 64,761. 2024 AMOUNT: $ 75,359. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1926402 128030 2054432 1672799 253603 1926402 1507608 165191 1672799 3121288 -1013680 600000 1507608 2737479 683809 300000 3121288 0.00000 0.37642 0.62358 0 0 11086 11086 62461980 26736152 35725828 7150063 4884024 2266039 41741 41741 38044694 CORPORATE BONDS 4932822 F MORTGAGE-BACKED SECURITIES 2942311 F ANNUITY AND LIFE INSURANCE POLICIES 126578 F OIL INTEREST 1831 F 8003542 ASSIGNED ASSETS, NET 3348284 3348284 X 26883254 -637220 -637220 27520474 95930 -19515 76415 27596889 26278621 0 26278621 95930 -19515 76415 26355036 PART V, LINE 4: THE PALMS' ENDOWMENT CONSISTS OF FUNDS ESTABLISHED TO PROVIDE LIFE CARE MEMBERSHIP FOR SENIORS WHOSE LIMITED RESOURCES PREVENT THEIR ENTRY INTO THE PALMS WITHOUT SUCH ASSISTANCE. PART X, LINE 2: HOLLENBECK IS A NONPROFIT CORPORATION AND IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (IRC) AND IS EXEMPT FROM CALIFORNIA FRANCHISE TAXES SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE. HOLLENBECK IS DESCRIBED IN SECTION 501(C)(3) OF THE IRC AND IS LISTED IN INTERNAL REVENUE SERVICE PUBLICATION 78 AS A CHARITABLE ORGANIZATION QUALIFIED TO RECEIVE DONATIONS. HOLLENBECK MAINTAINS ITS TAX-EXEMPT STATUS THROUGH DEVOTING ITS RESOURCES TO MEET THE PRIMARY NEEDS OF AGED PERSONS. THESE NEEDS ARE FOR HOUSING, HEALTH CARE, AND FINANCIAL SECURITY. HOLLENBECK HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO HOLLENBECKS CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. HOLLENBECK FILES INFORMATIONAL RETURNS IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. THE STATUTE OF LIMITATIONS FOR FEDERAL AND CALIFORNIA STATE PURPOSES IS GENERALLY THREE AND FOUR YEARS, RESPECTIVELY. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE -19,515. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -19,515. SANTA ANITA RACE 203302 196302 7000 6500 13015 203302 196302 7000 6500 13015 19515 -12515 X X X 0 0 0 0 0 0 0 0 0 IVANIA RAMIREZ DIRECTOR OF NURSING 186695 0 0 0 0 0 10910 0 73080 0 270685 0 0 0 MORRIS SHOCKLEY PRESIDENT & CEO 233848 0 0 0 0 0 27486 0 0 0 261334 0 0 0 AKHERE OSEZUA ASST. DIRECTOR OF NURSING 195384 0 0 0 0 0 480 0 33423 0 229287 0 0 0 GARY ZUPPARDO CHIEF ENGINEER 201532 0 0 0 0 0 600 0 21312 0 223444 0 0 0 JOHNNY YOUNG CFO/SECRETARY/TREASURER 161943 0 0 0 0 0 19342 0 10149 0 191434 0 0 0 ZHANA DUBIN DIRECTOR OF ADMISSIONS 189817 0 0 0 0 0 1200 0 209 0 191226 0 0 0 ODILY FRANKLIN ASST. LIVING COORDINATOR 157182 0 0 0 0 0 960 0 11141 0 169283 0 0 0 A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2016-12-01 20435000 RETIRE SERIES 2007 BONDS 0 0 0 B CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 680164610 2014-07-01 10000000 CONSTRUCTION OF MEMORY CARE UNIT 0 0 0 A 7530000 20435000 304908 20130092 2017 1 0 1 1 B 1980000 10000000 1048521 200000 8751479 2023 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/26/2021 ISSUER NAME: CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 08/23/2020 FORM 990, PART VI, SECTION A, LINE 1A THE GOVERNING BODY HAS DELEGATED TO THE AUDIT COMMITTEE, CONSISTING OF MICHAEL DAVIS AND EDWARD GARLOCK, THE AUTHORITY TO OVERSEE THE FINANCIAL AND DISCLOSURE PROCESS, MONITOR ACCOUNTING POLICIES, AND THE HIRING AND PERFORMANCE OF THE EXTERNAL AUDITORS. FORM 990, PART VI, SECTION B, LINE 11B THE GOVERNING BODY HAS DELEGATED TO THE AUDIT COMMITTEE THE AUTHORITY TO REVIEW THE FORM 990. A COMPLETE COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE AUDIT COMMITTEE FOR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION MAINTAINS A CONFLICT OF INTERESTS POLICY FOR BOARD MEMBERS, OFFICERS, AND EMPLOYEES. IN CONNECTION WITH ANY ACTUAL OR POTENTIAL CONFLICT OF INTERESTS, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE AND NATURE OF ANY OUTSIDE INTEREST, OUTSIDE ACTIVITY, AND FINANCIAL INTEREST TO THE BOARD OF DIRECTORS, OR THE BOARD COMMITTEE DELEGATED THE AUTHORITY TO RECEIVE SUCH DISCLOSURES. MONITORING IS DONE REGULARLY BY THE OFFICERS TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AS ISSUES ARISE. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, ANY INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE TRUSTEES. AFTER DISCLOSURE AND DISCUSSION, THE TRUSTEES WILL DETERMINE IF A CONFLICT OF INTEREST EXISTS, AND IF SO, DETERMINE THE PROPER COURSE OF ACTION. FORM 990, PART VI, SECTION B, LINE 15 BOARD OF TRUSTEES DETERMINES COMPENSATION FOR ALL OFFICERS AND KEY EMPLOYEES, BASED ON COMPARABLE SALARIES IN THE LOCAL AREA. THE PROCESS DESCRIBED HERE WAS LAST COMPLETED IN 2025. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL AND CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,720,732. MANAGEMENT AND GENERAL EXPENSES 371,735. FUNDRAISING EXPENSES 15,568. TOTAL EXPENSES 2,108,035. REPAIRS AND MAINTENANCE CONTRACTOR: PROGRAM SERVICE EXPENSES 38,637. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,637. PROGRAM ACTIVITIES CONTRACTOR: PROGRAM SERVICE EXPENSES 109,344. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,344. OTHER CONTRACTOR FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 644,998. MANAGEMENT AND GENERAL EXPENSES 625,998. FUNDRAISING EXPENSES 584. TOTAL EXPENSES 1,271,580. FORM 990, PART XI, LINE 9: CHANGE IN PENSION LIABILITY 63,614. FORM 990, PART XII, LINE 2C THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE YEAR.