2024-04-22T14:27:32-05:00 2023-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-07-01 760730971 ELDER CARE ALLIANCE OF SAN RAFAEL ELDE 5107692700 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 BING ISENBERG CFO 5108582902 2024-04-16 1 BING ISENBERG 999009999 0 QI WEN LIANG P01270238 4159561500 2024-04-16 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALMAVIA OF SAN RAFAEL ADRIENE IVERSON 1301 MARINA VILLAGE PARKWAY 210 ALAMEDA CA 94501 13828086 0 X WWW.ELDERCAREALLIANCE.ORG X 2003 CA ALMAVIA OF SAN RAFAEL SERVES AND ENRICHES THE LIVES OF OLDER ADULTS BY PROVIDING HOUSING AND SERVICES AT ITS MEMORY CARE AND ASSISTED LIVING NEIGHBORHOODS. 4 3 103 13 0 0 256123 956866 10221138 12619364 -4360 -9937 19600 30199 10492501 13596492 0 0 0 0 4564303 4922076 0 0 0 5732318 6860232 10296621 11782308 195880 1814184 23945513 25029797 28786826 27881841 -4841313 -2852044 A NONPROFIT ORGANIZATION COMMITTED TO SERVING AND ENRICHING THE PHYSICAL, EMOTIONAL, AND SPIRITUAL WELL-BEING OF OLDER ADULTS THROUGH A PROFESSIONAL, FAITH-CENTERED CARE COMMUNITY AND SERVICES. 0 0 7265047 10237588 ALMAVIA OF SAN RAFAEL'S (AVSR) ASSISTED LIVING PROVIDES HOUSING AND SERVICES FOR UP TO 114 OLDER ADULT RESIDENTS THAT REQUIRE SOME ASSISTANCE WITH MEDICATION OR DAILY ACTIVITIES. THIS YEAR, AVSR PROVIDED ASSISTED LIVING HOUSING FOR 106.3 RESIDENTS EACH MONTH ON AVERAGE, EXCLUDING SECOND PERSONS IN EACH APARTMENT, FOR AN ANNUAL TOTAL OF 38,803 RESIDENT DAYS. THE ASSISTED LIVING RESIDENTS ARE OFFERED FIVE LEVELS OF CARE IN ADDITION TO THE BASE LEVEL OF CARE SO THAT THEIR INDIVIDUAL NEEDS CAN BE MET. THERE ARE MANY ACTIVITIES PROVIDED FOR ASSISTED LIVING RESIDENTS, INCLUDING SOME THAT REFLECT THE FAITH-CENTERED MISSION. 2053391 2381776 ALMAVIA OF SAN RAFAEL'S MEMORY CARE NEIGHBORHOOD PROVIDES HOUSING AND SERVICES FOR UP TO 22 OLDER ADULT RESIDENTS WHO HAVE DEMENTIA OR MEMORY LOSS. THIS YEAR, AVSR PROVIDED MEMORY CARE HOUSING FOR 21.2 RESIDENTS EACH MONTH ON AVERAGE FOR A TOTAL OF 7,726 RESIDENT DAYS. THE MEMORY CARE NEIGHBORHOOD HAS MANY DAILY ACTIVITIES DESIGNED FOR DEMENTIA OR MEMORY LOSS RESIDENTS. 9318438 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 22 0 1 103 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X BING ISENBERG 5107692758 1301 MARINA VILLAGE PARKWAY SUITE ALAMEDA CA 94501 ADRIENE IVERSON CEO 1.00 44.00 X X 0 390376 21128 JOY MOORE CHAIR 1.00 5.00 X X 0 0 0 GERALDINE MCGRATH VICE CHAIR 1.00 5.00 X X 0 0 0 JACKIE EJUWA SECRETARY 1.00 5.00 X X 0 0 0 ROBIN EVITTS CFO (THRU 4/23) 1.00 44.00 X 0 0 0 BING ISENBERG INTERIM CFO (AS OF 4/23) 1.00 44.00 X 0 0 0 ANGELA BOUCHER-TURIN EXECUTIVE DIRECTOR 40.00 1.00 X 161902 0 8932 ANDREA CLEMENTINO SALES AND MARKETING DIRECTOR 40.00 0.00 X 140847 0 8932 IGNACIO WILLIAMS CULINARY DIRECTOR 40.00 0.00 X 120612 0 8932 ROBERTA DUNHAM HEALTH CARE COORDINATOR 40.00 0.00 X 107675 0 13916 531036 390376 61840 4 0 1 0 FIRSTLIGHT HOME CARE 4340 REDWOOD HIGHWAY STE F-130 SAN RAFAEL CA 94903 TEMPORARY STAFFING 570977 ALLEN FLORES CONSULTING GROUP INC 1560 W BEEBE CAPPS EXPRESSWAY SEARCY AZ 72143 CONSULTING 215762 COBUILD CONSTRUCTION SERVICES 2560 CASTRO VALLEY BLVD CASTRO VALLEY CA 94546 CONSTRUCTION 143962 3 934228 22638 956866 RESIDENT SERVICES 623000 10586965 10586965 HEALTH SERVICE REVENUE 623000 2032399 2032399 12619364 20818 20818 14640 0 14640 14640 14640 200839 202105 29489 -1266 -29489 -30755 -30755 AFFILIATE CONSULTING 561000 15301 15301 MISCELLANEOUS REVENUE 561000 258 258 15559 13596492 12619364 0 20262 4062181 4062181 52457 52457 502013 502013 305425 305425 912413 29500 882913 90800 90800 40368 40368 916287 916287 149380 149380 324132 201518 122614 154563 154563 577000 577000 7246 7246 952336 952336 1041785 1041785 285669 140642 145027 ECA ALLOCATION EXPENSE 563955 334143 229812 FOOD 460318 460318 SUPPLIES 166365 166365 MEDICAL SUPPLIES 65409 65409 152206 152206 11782308 9318438 2463870 0 3169787 4780219 542474 191737 310672 474385 125593 120574 30366464 12925235 17646555 17441229 1505126 1699763 645306 321890 23945513 25029797 932186 1685573 26571198 25910226 969923 0 313519 286042 28786826 27881841 X -5236079 -3161198 394766 309154 -4841313 -2852044 23945513 25029797 1814184 175085 0 X 0 1 X 1 1 1 X 35062 34710 461086 256123 956866 1743847 11252073 10996628 10373468 10221138 12619364 55462671 11287135 11031338 10834554 10477261 13576230 57206518 0 77892 81103 107251 150146 416392 77892 81103 107251 150146 416392 56790126 44941 62376 96840 35100 35458 274715 44941 62376 96840 35100 35458 274715 4960 15559 20519 11332076 11093714 10931394 10517321 13627247 57501752 0.98760 0.98410 0.00480 0.00500 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2357136 2357136 23090319 10162207 12928112 2501766 2053546 448220 2417243 709482 1707761 17441229 DUE TO RELATED ORGANIZATIONS 275507 LEASE LIABILITY 10535 286042 13801066 175085 29489 204574 13596492 0 13596492 11811797 29489 29489 11782308 0 11782308 PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON ASSET DISPOSAL 29,489. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON ASSET DISPOSAL 29,489. 0 0 0 0 0 0 0 0 0 ADRIENE IVERSON CEO 0 388736 0 350 0 1290 0 12196 0 8932 0 411504 0 0 ANGELA BOUCHER-TURIN EXECUTIVE DIRECTOR 160949 0 263 0 690 0 0 0 8932 0 170834 0 0 0 PART I, LINE 3 THE MANAGEMENT COMPANY AND RELATED ORGANIZATION, ELDER CARE ALLIANCE (ECA), USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE TOP MANAGEMENT OFFICIAL: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 3 ALMAVIA OF SAN RAFAEL HAS A MANAGEMENT CONTRACT WITH ELDER CARE ALLIANCE, A NON-PROFIT PUBLIC BENEFIT CORPORATION THAT IS THE SOLE CORPORATE MEMBER OF ALMAVIA OF SAN RAFAEL, TO PROVIDE MANAGEMENT SERVICES INCLUDING, BUT NOT LIMITED TO, MARKETING, HUMAN RESOURCES, ACCOUNTING, INFORMATION TECHNOLOGY SERVICES, RISK MANAGEMENT, CLINICAL OVERSIGHT AND INSURANCE. ELDER CARE ALLIANCE HIRED ROBIN EVITTS AS CFO THROUGH REACH PARTNERS LLC, A MANAGEMENT CONSULTING FIRM. AS ELDER CARE ALLIANCE'S CFO, ROBIN REPORTS TO THE CEO AND BOARD OF DIRECTORS AND HER RESPONSIBILITIES INCLUDE: OVERSEEING ALL FINANCIAL AND ACCOUNTING FUNCTIONS INCLUDING FINANCIAL CLOSE, FINANCIAL PLANNING & ANALYSIS, CASH MANAGEMENT, FINANCING, TAX AND REGULATORY FINANCIAL COMPLIANCE, PAYROLL AND ACCOUNTS PAYABLE; LEADING THE INFORMATION TECHNOLOGY FUNCTION, RESPONSIBLE FOR STRATEGY AND DELIVERY, INCLUDING INFRASTRUCTURE AND APPLICATION SUPPORT OPERATIONS; MANAGING INSURANCE STRATEGY AND BROKER PARTNERS. THE PROFESSIONAL SERVICES EXPENSES TO REACH PARTNERS IS PAID BY ELDER CARE ALLIANCE DIRECTLY. ROBIN EVITTS LEFT THE ORGANIZATION ON 4/2023. BING ISENBERG WAS HIRED AS INTERIM CFO AT THE ORGANIZATION ON 4/2023. BING WAS COMPENSATED THROUGH KORN FERRY, A CONSULTING FIRM. AS ELDER CARE ALLIANCE'S INTERIM CFO, BING REPORTS TO THE CEO AND BOARD OF DIRECTORS AND HER RESPONSIBILITIES INCLUDE: OVERSEEING ALL FINANCIAL AND ACCOUNTING FUNCTIONS INCLUDING FINANCIAL CLOSE, FINANCIAL PLANNING & ANALYSIS, CASH MANAGEMENT, FINANCING, TAX AND REGULATORY FINANCIAL COMPLIANCE, PAYROLL AND ACCOUNTS PAYABLE; LEADING THE INFORMATION TECHNOLOGY FUNCTION, RESPONSIBLE FOR STRATEGY AND DELIVERY, INCLUDING INFRASTRUCTURE AND APPLICATION SUPPORT OPERATIONS; MANAGING INSURANCE STRATEGY AND BROKER PARTNERS. THE PROFESSIONAL SERVICES EXPENSE TO KORN FERRY IS PAID BY ELDER CARE ALLIANCE DIRECTLY. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION'S SOLE CORPORATE MEMBER IS ELDER CARE ALLIANCE. FORM 990, PART VI, SECTION A, LINE 7A ALL DIRECTORS SHALL BE APPOINTED BY THE BOARD OF DIRECTORS OF ELDER CARE ALLIANCE, EXCEPT FOR THE EX-OFFICIO DIRECTOR AND THE INITIAL DIRECTORS APPOINTED BY THE INCORPORATOR. THE PRESIDENT/CHIEF EXECUTIVE OFFICER (OR ACTING PRESIDENT/CHIEF EXECUTIVE OFFICER) OF ELDER CARE ALLIANCE SHALL SERVE ON THE BOARD AS AN EX-OFFICIO DIRECTOR WITH FULL VOTING RIGHTS FOR AS LONG AS HE OR SHE HOLDS THE OFFICE OF PRESIDENT/CHIEF EXECUTIVE OFFICER OF ELDER CARE ALLIANCE. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS OF ELDER CARE ALLIANCE OF SAN RAFAEL (THE CORPORATION) SHALL NOT BE IMPLEMENTED WITHOUT THE APPROVAL OF THE CORPORATE MEMBER: (A) ADOPTION OR AMENDMENT OF PHILOSOPHY AND MISSION OF THE CORPORATION; (B) APPROVAL OF STRATEGIC AND LONG RANGE PLANS OF THE CORPORATION; (C) REORGANIZATION, MERGER, CONSOLIDATION OR CHANGE OF CONTROL OF THE CORPORATION; (D) ANY CHANGE IN THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; (E) ADOPTION OF AND ANY CHANGE IN THE MISSION STATEMENT OR VALUES STATEMENT OF THE CORPORATION; (F) ADOPTION OF AND ANY CHANGE IN CHARITABLE CARE POLICIES OF THE CORPORATION; (G) SALE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; (H) DISSOLUTION OF THE CORPORATION; (I) ADOPTION OR APPROVAL OF OPERATING AND CAPITAL BUDGETS OF THE CORPORATION, AND ANY CAPITAL EXPENDITURES OR BORROWINGS IN EXCESS OF LIMITS ESTABLISHED BY ELDER CARE ALLIANCE POLICY; (J) CREATION OF A NEW CORPORATION, OR PARTICIPATION IN JOINT VENTURE REQUIRING CAPITAL COMMITMENTS IN EXCESS OF LIMITS ESTABLISHED BY ELDER CARE ALLIANCE POLICY; OR (K) ANY UNBUDGETED ACQUISITION OF ASSETS WITH A PURCHASE PRICE IN EXCESS OF LIMITS ESTABLISHED BY ELDER CARE ALLIANCE POLICY. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. BEFORE FILING, THE FORM 990 DRAFT RETURNS ARE REVIEWED BY THE CEO AND CFO, FOLLOWED BY THE AUDIT COMMITTEE OF THE BOARD. UPON THE AUDIT COMMITTEE'S RECOMMENDATION, THE FULL BOARD REVIEWS THE FORM 990'S TO PROVIDE THEIR APPROVAL, UPON WHICH THE TAX RETURNS ARE FILED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE SECRETARY OF ELDER CARE ALLIANCE CAUSES TO BE PREPARED UPDATED CONFLICT OF INTEREST DISCLOSURE FORMS FROM THE BOARD OF DIRECTORS, OFFICERS, KEY EMPLOYEES, AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED AUTHORITY. THE SECRETARY PREPARES A TABLE SUMMARIZING THE DISCLOSURES MADE AND PRESENTS THE TABLE TO THE BOARD OF DIRECTORS FOR THEIR INFORMATION. IF AN APPARENT CONFLICT OF INTEREST IS IDENTIFIED, THE MATTER IS REFERRED TO A COMMITTEE OF THE BOARD FOR REVIEW AND ACTION. IF DEEMED NECESSARY, THE BOARD OR COMMITTEE MAY TAKE ACTION SUCH AS REQUIRING AN INTERESTED DIRECTOR TO RECUSE HIMSELF FROM A VOTE ON THE MATTER OR TERMINATING A BUSINESS RELATIONSHIP ENTERED INTO IN VIOLATION OF THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 FORM 990, PART VI, SECTION B, LINES 15A AND 15B HAVE BOTH BEEN ANSWERED NO (AS MANDATED BY THE FORM 990 INSTRUCTIONS), AS THE CEO, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION ARE COMPENSATED BY A RELATED ORGANIZATION. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE ON WRITTEN REQUEST TO ELDER CARE ALLIANCE, ALMAVIA OF SAN RAFAELS'S MANAGEMENT COMPANY. DOCUMENTS WILL BE PROVIDED VIA EMAIL, US MAIL, OR BY FAX IF SO REQUESTED. ELDER CARE ALLIANCE 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943260975 MANAGEMENT CA 501(C)(3) LINE 12B, II N/A 0 MERCY RETIREMENT AND CARE CENTER 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 941156579 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF SAN FRANCISCO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943351615 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF UNION CITY 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943377985 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF SAN MATEO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 940831870 AGE-RESTRICTED APARTMENTS CA 501(C)(3) LINE 10 ECA 0 ELDER CARE ALLIANCE OF CAMARILLO 1301 MARINA VILLAGE PKWY SUITE 210 ALAMEDA CA 94501 943351613 SENIOR LIVING CA 501(C)(3) LINE 10 ECA 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0