2024-11-15T16:22:22-06:00 2024-06-30 770549163 SOREN MCADAM LLP 2068 ORANGE TREE LANE SUITE 100 REDLANDS CA 92374 990 2023-07-01 952116809 SALEM CHRISTIAN HOMES INC SALE 9096140575 6921 EDISON AVENUE CHINO CA 91710 ROD BOLLINS CEO 9096140575 2024-11-15 1 0 KATHERINE VANDER VEEN P01250381 9097982222 2024-11-15 2023 2024-10-15 13:58:12Z ROD BOLLINS 6921 EDISON AVENUE CHINO CA 91710 15626101 0 X HTTPS://WWW.SALEMCHRISTIANHOMES.ORG X 1961 CA BOARD, CARE, AND TRAINING OF PHYSICALLY AND MENTALLY HANDICAPPED ADULTS. 9 9 224 0 0 0 1903155 2936632 11088983 11091456 31538 -35620 -1786 -73780 13021890 13918688 0 0 0 0 8923880 10317165 78652 37880 145963 3692371 4493792 12694903 14848837 326987 -930149 9080285 8745955 1476116 2068440 7604169 6677515 BOARD, CARE AND TRAINING OF PHYSICALLY AND MENTALLY HANDICAPPED ADULTS. 0 0 11862611 11091456 SALEM CHRISTIAN HOMES OFFERS RESIDENTIAL CARE AND TRAINING FOR ADULTS WHO HAVE DEVELOPMENTAL DISABILITIES. WE PROVIDE CARE IN BOTH INTERMEDIATE CARE FACILITIES AND COMMUNITY CARE FACILITIES. OUR ICF HOMES ARE ALL HABILITATIVE LEVEL. OUR COMMUNITY CARE FACILITIES ARE LEVELS 2 THROUGH 4. DURING THE YEAR WE SERVED APPROXIMATELY 104 RESIDENTS IN OUR FACILITIES. BELIEVING EACH PERSON IS CREATED IN GOD'S IMAGE, WE STRIVE TO ENHANCE THE QUALITY OF LIFE FOR THOSE WE SERVE BY SUPPORTING AND ENCOURAGING EACH RESIDENT TOWARDS GREATER INDEPENDENCE. 11862611 1 1 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 21 0 1 224 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 1 0 0 CA X X ROD BOLLINS 9096140582 6921 EDISON AVENUE CHINO CA 91710 DAVE MCNICHOLS PRESIDENT 1.00 1.00 X X 0 0 0 TED ROBINSON VICE PRESIDENT 1.00 X X 0 0 0 HENRY WIND SECRETARY 1.00 X 0 0 0 BOB DE JONG DIRECTOR 1.00 X 0 0 0 JOSEPH FREENO DIRECTOR 1.00 X 0 0 0 LORETTA SCHEENSTRA DIRECTOR 1.00 X 0 0 0 ELSA STOUT DIRECTOR 1.00 X 0 0 0 JIM WEST DIRECTOR 1.00 X 0 0 0 SCOTT KUETHEN DIRECTOR 1.00 X 0 0 0 REGINA BEKENDAM DIRECTOR 1.00 X 0 0 0 TIM SCHRADER DIRECTOR 1.00 X 0 0 0 ROD BOLLINS CEO 40.00 1.00 X 229891 0 23856 ITIOLA ADESIGBIN RESIDENT CARE MANAGER 40.00 X 106427 0 8865 TIMOTHY FELDE HUMAN RESOURCES DIRECTOR 40.00 X 104768 0 17829 SUSAN HOWERZYL REGISTERED NURSE 40.00 X 106840 0 6871 ANAT LYON REGISTERED NURSE 40.00 X 102073 0 6507 SHELLY DAWSON QUALITY ASSURANCE DIRECTOR 40.00 X 105567 0 6472 755566 0 70400 6 0 1 0 0 446085 812082 1678465 741153 2936632 CLIENT CARE SERVICES 623990 11091456 11091456 11091456 5577 5577 14901 0 14901 14901 14901 827173 743912 823555 788727 3618 -44815 -41197 -41197 6450 446085 95131 -88681 -88681 13918688 11091456 0 -109400 266466 266466 9010746 7668331 1292388 50027 174844 124322 49096 1426 176562 70595 102634 3333 688547 574062 110895 3590 82455 82455 40245 40245 37880 37880 249552 133225 98887 17440 543 543 207941 101890 92873 13178 325350 290028 35322 31266 5108 25333 825 1811 1811 425919 355917 70002 675595 463934 205489 6172 SETTLEMENTS 595199 595199 WORKER'S COMPENSATION 522275 415077 106779 419 CLIENT SERVICE 350871 350007 864 REPAIRS AND MAINTENANCE 308970 255093 53641 236 675800 459823 204540 11437 14848837 11862611 2840263 145963 1012733 939938 5269 969220 824979 285300 647452 10955457 4656963 6178482 6298494 530904 29823 103646 9080285 8745955 1439155 1910712 18706 8828 18255 15631 0 133269 1476116 2068440 X 7365464 6464469 238705 213046 7604169 6677515 9080285 8745955 -930149 3495 0 X 0 1 X 1 0 X 1194396 1666741 1758730 1481451 2548016 8649334 7459370 7693375 9765479 11088983 11091456 47098663 22964 22842 23228 23622 14901 107557 8676730 9382958 11547437 12594056 13654373 55855554 277500 680422 850117 1808039 253897 90435 953 345285 531397 770857 851070 2153324 53702230 22204 72569 35117 7533 9195 146618 22204 72569 35117 7533 9195 146618 178217 120475 240114 394957 241119 1174882 8877151 9576002 11822668 12996546 13904687 57177054 0.93920 0.94690 0.00260 0.00290 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: GROSS INCOME FROM FUNDRAISING ACTIVITIES - 2019 AMOUNT: $ 178,217. 2020 AMOUNT: $ 120,475. 2021 AMOUNT: $ 240,114. 2022 AMOUNT: $ 394,957. 2023 AMOUNT: $ 241,119. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1488464 1488464 7509242 3662502 3846740 126400 63570 62830 1767851 930891 836960 63500 63500 6298494 13772725 0 13772725 145963 145963 13918688 14702874 0 14702874 145963 145963 14848837 PART IV, LINE 2B: SOME RESIDENTS RECEIVE SMALL STIPENDS THROUGH THE RESIDENTIAL PROGRAM FOR PERSONAL AND INCIDENTAL EXPENSE. SEPARATE CHECKING ACCOUNTS WERE ESTABLISHED FOR THE FUNDS AND AMOUNTS ARE DISBURSED TO THE RESIDENT AS NEEDED. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE RECLASS FROM GROSS INCOME 145,963. PART XII, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSE RECLASS FROM GROSS INCOME 145,963. 1 LIND & ASSOCIATES LLC 19501 RANCH LN 108 HUNTINGTON BEACH CA 92648 ASSIST IN FUND RAISING FOR THE STRATEGIC PLAN 0 0 37880 -37880 37880 -37880 CA GALA 437500 431050 6450 78920 -4559 CHRISTMAS WISHLIST 15035 15035 8731 -2110 2 0 0 14149 452535 446085 6450 87651 7480 95131 -88681 SCHEDULE G, PART I, LINE 2B, COLUMN (V) PAYMENTS PROVIDED ON AN AS-NEEDED BASIS REGARDING DONOR DEVELOPMENT, COACHING, AND STRATEGY FOR THE ORGANIZATION'S STRATEGIC PLAN RELATING TO DEVELOPMENT OF A MEMORY CARE FACILITY. X X 0 0 0 0 0 0 0 0 0 ROD BOLLINS CEO 189891 0 40000 0 0 0 9535 0 14321 0 253747 0 0 0 X 1 11153 77 SHARES AMAZON STOCK X 1 730000 ARMS-LENGTH SALE AMOUNT 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE COMPLETED DRAFT 990 (INCLUDING REQUIRED SCHEDULES) IS PROVIDED TO THE CEO AND AUDIT COMMITEE IN EITHER ELECTRONIC OR PAPER FORM FOR REVIEW AND APPROVAL. ANY QUESTIONS OR CONCERNS WILL BE NOTED AND ADDRESSED AND MANAGEMENT STAFF WILL ENSURE THAT CHANGES ARE INCORPORATED INTO THE FORM 990 AS APPROPRIATE. COPIES OF THE DRAFT FORM 990 WILL THEN BE DISTRIBUTED TO THE BOARD OF DIRECTORS IN EITHER ELECTRONIC OR PAPER FORM FOR REVIEW AND APPROVAL ANY QUESTIONS OR CONCERNS WILL BE NOTED AND ADDRESSED AND MANAGEMENT STAFF WILL ENSURE THAT CHANGES ARE INCORPORATED INTO THE FORM 990 AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 12C IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, THE INTERESTED PERSON SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. EACH PERSON COVERED BY THE POLICY SHALL,AS APPROPRIATE EITHER (1) PRIOR TO THE EFFECTIVE DATE OF BECOMING A PERSON COVERED BY THIS POLICY, OR (2) WITHIN 30 DAYS AFTER BECOMING A PERSON COVERED BY THE POLICY, SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER, AND THEREAFTER AT LEAST 30 DAYS PRIOR TO THE ANNUAL MEETING OF THE CORPORATION, A CONFLICT OF INTEREST DISCLOSURE STATEMENT WHICH AFFIRMS SUCH PERSON: 1. HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY, 2. HAS READ AND UNDERSTANDS THE POLICY. 3. HAS AGREED TO COMPLY WITH THE POLICY, AND 4. UNDERSTANDS THE CORPORATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. FORM 990, PART VI, SECTION B, LINE 15A THE CEO COMPENSATION IS DETERMINED AND APPROVED BY THE BOARD USING COMPARABLE DATA OF SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS NOT AVAILABLE TO THE PUBLIC. SALEM FOUNDATION 6921 EDISON AVE BLDG 1 CHINO CA 91710 953425829 RAISE FUNDS FOR SALEM CHRISTIAN HOMES, INC CA 501(C)(3) LINE 12D, III-O 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SALEM FOUNDATION C 812082 CASH SALEM FOUNDATION D 133269 CASH