Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | ||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 187,691 | 195,298 | 195,805 | 218,603 | 215,260 | 1,012,657 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 187,691 | 195,298 | 195,805 | 218,603 | 215,260 | 1,012,657 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | 1,012,657 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 187,691 | 195,298 | 195,805 | 218,603 | 215,260 | 1,012,657 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 6,730 | 4,181 | 1,178 | 519 | 235 | 12,843 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 6,730 | 4,181 | 1,178 | 519 | 235 | 12,843 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | 0 | 0 | 0 | ||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 194,421 | 199,479 | 196,983 | 219,122 | 215,495 | 1,025,500 |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000129 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| F990_P05_S00_L01a | Form 990, Part V, Line 1a | All payments to vendors and/or independent contractors are made thru the parent organization, Wesley Woods Senior Living, Inc. (WWSL), which functions as a paymaster/central treasury for all subsidiary organizations. Therefore, the number of forms reported on the form 1096 is zero for this organization. All forms are filed by and reported on the returns of WWSL. |
| F990_P05_S00_L02b | Form 990, Part V, Line 2b | All staff is employed by Wesley Woods Center of Emory University, Inc. (WWCEU), a related organization. The employees are leased to Wesley Woods Senior Living, Inc. (related, controlling organization) and Affiliates (990 reporting organization). All employment tax returns are filed by the related organization (WWCEU) for wages earned at Wesley Woods, Inc. The number reported on this line represents the number of employees leased to this organization. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | Draft copies of the Form 990 are supplied to members of the Audit Committee of Wesley Woods Senior Living, Inc. and senior management approximately one week prior to a scheduled audit committee meeting. At that meeting, each section of the Form 990 and accompanying schedules are reviewed by the group and discussed thoroughly with senior management and external auditors, if necessary. Any additions, deletions and/or modifications agreed upon by the committee are incorporated into the return and re-distributed to members for review prior to final submission. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | A conflict of interest questionnaire is required to be completed annually by board members, officers and key employees. In addition, each person is sworn to bring to the attention of management or the board any conflict of interest that should arise during the year. All conflict of interest issues are reviewed and approved or disapproved by the executive committee or board of directors, if necessary. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Compensation studies from executive search firms and/or similar studies conducted internally by the human resources division of the company's management agent (Wesley Woods Center of Emory University, Inc. are used in determining the salary of officers and key management personnel. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The organization's governing documents, conflict of interest policy and financial statements are not available through any type of publicly available print media or website. However, any person requesting such documents in person or in writing will be provided a copy of these documents. A printed copy of the Form 990 will be provided to any person requesting such document(s). |
| F990_P07_S0A_L01a | Form 990, Part VII, Section A, Line 1a | Hours per week worked at related organizations by officers and/or director: Kenneth Weber: Wesley Woods of Athens, Inc., 10; Wesley Woods of Newnan-Peachtree City, Inc., 10; Foundation of Wesley Woods, Inc., 5; Wesley Woods Senior Living, Inc., 10; Wesley Homes, Inc., 10. Walter K Gadd: Wesley Woods of Athens, Inc., 5; Wesley Woods of Newnan-Peachtree City, Inc., 8; Foundation of Wesley Woods, Inc., 10; Wesley Woods Senior Living, Inc., 10; Wesley Homes, Inc., 10. Terry Barcroft: Wesley Woods of Athens, Inc., 10; Wesley Woods of Newnan-Peachtree City, Inc., 5; Wesley Woods Senior Living, Inc., 10; Wesley Homes, Inc., 15. |
| F990_P10_S00_L26 | Form 990, Part X, Line 26 | There are no uncertain liabilities reported on the audited financial statements under FIN 48 (ASC740-10). |
| Software ID: | 11000129 |
| Software Version: | v1.00 |