Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2011 and ending 09-30-2012
BCheck if applicable:
CName of organization
COUNCIL ON AGING OF VOLUSIA COUNTY
INC
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
PO BOX 671
 
Room/suite
City or town, state or country, and ZIP + 4
DAYTONA BEACH, FL321150671
D Employer identification number

59-1160221
E Telephone number

G Gross receipts $ 5,109,434
F Name and address of principal officer:
DR RICHARD D TUCKER
5510 S ATLANTIC AVE
NEW SMYRNA BEACH,FL321694602
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
DAYTONASENIORSERVICES.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1967
M State of legal domicile: FL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE COUNCIL ON AGING OF VOLUSIA COUNTY, IN PARTNERSHIP WITH THE COMMUNITY PROMOTES HEALTHY, INDEPENDENT LIVING THROUGH CARING, COMPETENT AND COMPASSIONATE SERVICES. PROVIDES GRANT SERVICES TO SENIORS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 30
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 30
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 266
6 Total number of volunteers (estimate if necessary) .... 6 593
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b  
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 3,761,352 3,780,703
9 Program service revenue (Part VIII, line 2g) ......... 1,280,734 1,500,784
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....   -136,492
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,262 -41,353
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 5,043,348 5,103,642
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 3,103,937 3,167,233
16a Professional fundraising fees (Part IX, column (A), line 11e).....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet175,248    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 2,219,768 2,474,959
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 5,323,705 5,642,192
19 Revenue less expenses. Subtract line 18 from line 12....... -280,357 -538,550
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,799,288 1,953,698
21 Total liabilities (Part X, line 26)............. 1,593,426 2,286,386
22 Net assets or fund balances. Subtract line 21 from line 20..... 205,862 -332,688
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid preparer use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III .........
1
Briefly describe the organization’s mission: THE COUNCIL ON AGING OF VOLUSIA COUNTY, IN PARTNERSHIP WITH THE COMMUNITY PROMOTES HEALTHY, INDEPENDENT LIVING THROUGH CARING, COMPETENT AND COMPASSIONATE SERVICES. PROVIDES GRANT SERVICES TO SENIORS.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 4,545,796 including grants of $   ) (Revenue $   )
OLDER AMERICANS ACT - UNDER OLDER AMERICANS ACT LEGISLATION, US RESIDENTS OVER 60 YEARS OF AGE ARE ELIGIBLE FOR SERVICES WITH PRIORITY GIVEN TO THE PEOPLE WITH THE MOST ECONOMIC AND SOCIAL NEED. THESE SERVICES INCLUDE CONGREGATE AND HOME DELIVERED MEALS, NUTRITION EDUCATION, HOMEMAKER, PERSONAL CARE, MATERIAL AID, TRANSPORTATION, IN-HOME AND IN-FACILITY RESPITE, CARE GIVER TRAINING AND SUPPORT, INFORMATION, REFERRAL, OUTREACH, EDUCATION AND COUNSELING. COMMUNITY CARE FOR THE ELDERLY - THE STATE OF FLORIDA GENERAL REVENUE PROGRAM PROVIDES IN-HOME SERVICES FOR CLIENTS 60 AND OVER WHO HAVE BEEN ASSESSED FUNCTIONALLY IMPAIRED BY TRAINED CASE MANAGERS. THIS PROGRAM INCLUDES FOLLOW-UP VISITS AND PROVIDES LINKS TO OTHER COMMUNITY SERVICES. THE SERVICES INCLUDE CASE MANAGEMENT,HOMEMAKER, PERSONAL CARE, RESPITE, ADULT DAY CARE, MEALS, EMERGENCY ALERT RESPONSE, MEDICAL TRANSPORTATION, MATERIAL AID AND PEST CONTROL. MEDICARE WAIVER PROJECT - THIS STATE FUNDED PROGRAM ASSISTS THE MOST FRAIL AND FINANCIALLY CHALLENGED ELDERS OVER THE AGE OF 65. TRANSFERRING APPROPRIATE CLIENTS TO THIS PROGRAM OPENS SLOTS IN THE OTHER GRANTS, MAXIMIZING SERVICES AVAILABLE TO THE ELDERS IN VOLUSIA COUNTY. SERVICES INCLUDE CASE MANAGEMENT, HOMEMAKER, PERSONAL CARE, RESPITE, ADULT DAY CARE, MEALS, EMERGENCY ALERT RESPONSE, MATERIAL AID, PEST CONTROL AND MEDICAL TRANSPORTATION. ALZHEIMER'S DISEASE INITIATIVE - THE STATE FUNDED PROGRAM PROVIDES RESPITE CARE SERVICES, INCLUDING IN-HOME SERVICES, FOR THE VICTIMS OF ALZHEIMER'S DISEASE AND PROVIDES TRAINING FOR CARE GIVERS OF THESE VICTIMS. HOME CARE FOR THE ELDERLY - THE GOAL OF THE HCE PROGRAM IS TO ENCOURAGE THE PROVISION OF CARE FOR ELDERS IN FAMILY-TYPE LIVING ARRANGEMENTS IN PRIVATE HOMES AS AN ALTERNATIVE TO INSTITUTIONAL CARE. THE PROGRAM ENCOURAGES CARE GIVERS TO PROVIDE, ON A NOT-FOR-PROFIT BASIS, BASIC SUPPORT AND MAINTENANCE AS WELL AS ASSISTANCE IN ARRANGING SPECIALIZED SERVICES FOR ELDERLY RELATIVES OR NON-RELATIVES. CASE MANAGEMENT AND SUBSIDY PAYMENTS ARE AVAILABLE TO QUALIFIED CARE GIVERS AND/OR VENDORS ON BEHALF OF ELIGIBLE CLIENTS. COMMUNITY CARE FOR DISABLED ADULTS - THIS STATE OF FLORIDA PROGRAM, ADMINISTERED BY THE DEPARTMENT OF CHILDREN AND FAMILIES, PROVIDES HOME-DELIVERED MEALS AND IN HOME SERVICES TO CLIENTS AGED 18-59 WITH PHYSICAL, MENTAL, OR OTHER DISABILITIES. EMERGENCY HOME ENERGY ASSISTANCE PROGRAM - THIS FEDERALLY FUNDED PROGRAM PROVIDES ASSISTANCE FOR LOW INCOME ELDERLY PERSONS WHO ARE IN DANGER OF HAVING THEIR UTILITIES TURNED OFF DUE TO NONPAYMENT. FAN PURCHASES AND AIRCONDITIONER REPAIR ARE PART OF THE SUMMER PROGRAM AND BLANKET AND SPACE HEATER PURCHASES ARE PART OF THE WINTER PROGRAM.
4b (Code:   ) (Expenses $ 127,844 including grants of $   ) (Revenue $   )
PUBLIC GUARDIANSHIP PROGRAM - THE COUNCIL ON AGING IS THE PUBLIC GUARDIAN FOR VOLUSIA COUNTY CARING FOR THE MOST INDIGENT INDIVIDUALS AS DETERMINED BY THE COURT TO BE UNABLE TO MANAGE THEIR OWN AFFAIRS. GUARDIANSHIP MAY BE FOR THE PERSON, OR THEIR PROPERTY, OR BOTH. THE COUNCIL ALSO ACTS AS A PROFESSIONAL GUARDIAN EXPANDING THE PROGRAM TO THOSE THAT DO NOT QUALIFY UNDER THE PUBLIC PROGRAM.
4c (Code:   ) (Expenses $ 168,686 including grants of $   ) (Revenue $   )
THE COUNCIL ALSO ACTS AS A PROFESSIONAL GUARDIAN EXPANDING THE PROGRAM TO THOSE THAT DO NOT QUALIFY UNDER THE PUBLIC GUARDIANSHIP PROGRAM DESCRIBE ABOVE.
(Code:   ) (Expenses $ 423,723 including grants of $   ) (Revenue $   )
OTHER COMMUNITY PROGRAMS FOR THE ELDERLY AND NEEDY: CAREGIVER RESPITE - IN THE YEAR 2003 THE COUNCIL DEVELOPED A CAREGIVER RESPITE PROGRAM, WITH INITIAL FUNDING PROVIDED BY HOSPICE OF VOLUSIA/FLAGLER. THE PROGRAM HAS GROWN TO TEN CENTERS AROUND THE COUNTY, UTILIZING LOCAL CHURCH FACILITIES AND VOLUNTEERS ALONG WITH COUNCIL STAFF. EACH CENTER OPERATES ONE DAY PER WEEK, AND PROVIDES ELIGIBLE "CAREES" WITH A SECURE AND STIMULATING ENVIRONMENT WHILE THEIR CAREGIVERS ARE GIVEN TIME FOR WELL DESERVED RELIEF. CAREGIVERS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN VARIOUS EDUCATIONAL AND COUNSELING PROGRAMS TO HELP THEM BETTER COPE WITH THE DEMANDS OF TWENTY-FOUR HOUR SEVEN DAY CARE. PRIVATE PAY PROGRAMS - THIS PROGRAM PROVIDES FOR HOME-DELIVERED MEALS AND IN-HOME SERVICES TO CLIENTS THAT DO NOT QUALIFY FOR PROGRAMS ADMINISTERED THROUGH A STATE OR FEDERAL PROGRAM. SENIOR CENTERS - THE COUNCIL OPERATES AND MAINTAINS FIVE FULL-TIME SENIOR CENTERS THROUHOUT VOLUSIA COUNTY. PROGRAMS ARE FOCUSED ON THE AREAS OF HEALTH, EDUCATION, AND RECREATION. ALLOTMENTS FROM VOLUSIA COUNTY CITIES, CONTRIBUTIONS FROM THE PUBLIC AND PARTICIPANTS, MEMBERSHIP DUES AND PROGRAM FEES OFFSET THE COSTS OF OPERATING THE CENTERS.
4d Other program services (Describe in Schedule O.)
(Expenses $ 423,723 including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 5,266,049
Form 990 (2011)
Form 990 (2011)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment....................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................
23
 
No
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III.........
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1.....................
34
 
No
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2...........
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2011)
Form 990 (2011)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V .........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
13
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
266
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
Form 990 (2011)
Form 990 (2011)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI .........
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
30
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
30
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ..........
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes," to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
FL
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
FINANCE DIRECTOR
160 N BEACH STREET
DAYTONA BEACH,FL32115
(386) 253-4700
Form 990 (2011)
Form 990 (2011)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII .........
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JAMES O'SHAUGHNESSY
B. MEMBER
 1.00 X           0 0 0
(2) RICHARD D TUCKER
PRESIDENT
 1.00 X   X       0 0 0
(3) STEVE R MESSINGER
B. MEMBER
 1.00 X           0 0 0
(4) JANICE ALLEN-KELSEY
B. MEMBER
 1.00 X           0 0 0
(5) REV JOHN CAMPBELL
B. MEMBER
 1.00 X           0 0 0
(6) HARRY HEILMAN
B. MEMBER
 1.00 X           0 0 0
(7) RENNIE HENRY
B. MEMBER
 1.00 X           0 0 0
(8) PETER GAMBLE
B. MEMBER
 1.00 X           0 0 0
(9) GAIL HINTON
B. MEMBER
 1.00 X           0 0 0
(10) ROBERT HOLLAND
B. MEMBER
 1.00 X           0 0 0
(11) PATRICIA LAGONI
B. MEMBER
 1.00 X           0 0 0
(12) TONY GRIPPA
B. MEMBER
 1.00 X           0 0 0
(13) FRANK MERCER
B. MEMBER
 1.00 X           0 0 0
(14) DAVE LYNN
VICE PRESIDE
 1.00 X   X       0 0 0
(15) BUD J MURPHY
B. MEMBER
 1.00 X           0 0 0
(16) DR RICHARD LEMMON
B. MEMBER
 1.00 X           0 0 0
(17) R J DAILEY
B. MEMBER
 1.00 X           0 0 0
Form 990 (2011)
Form 990 (2011)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) JOSEPH PEREZ
B. MEMBER
 1.00 X           0 0 0
(19) DEAN P KURTZ
B. MEMBER
 1.00 X           0 0 0
(20) GEORGEANNE TIPTON
B. MEMBER
 1.00 X           0 0 0
(21) DR SUZANNE M DEMMING MD
B. MEMBER
 1.00 X           0 0 0
(22) SHARON SODHI
B. MEMBER
 1.00 X           0 0 0
(23) WILLIAM WELSHEIMER
B. MEMBER
 1.00 X           0 0 0
(24) EUGENE MILLER
B. MEMBER
 1.00 X           0 0 0
(25) SHARON MOCK
TREASURER
 1.00 X   X       0 0 0
(26) JOSEPH P PINELLO
B. MEMBER
 1.00 X           0 0 0
(27) AIMEE B GURTIS
SECRETARY
 1.00 X   X       0 0 0
(28) TERI KOENKE
B. MEMBER
 1.00 X           0 0 0
(29) CINDY TUCKER
B. MEMBER
 1.00 X           0 0 0
(30) ROMAN YURKIEWICZ
B. MEMBER
 1.00 X           0 0 0
(31) DR DOUGLAS BEACH
EXECUTIVE DI
 40.00     X       137,285 0 12,179
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 137,285   12,179
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet1
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
 
No
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
GA FOOD SERVICE
12200 32ND COURT N
ST PETERSBURG,FL33716 		MEAL SERVICE 829,978
FLORIDA HEALTH CARE
PO BOX 9910
DAYTONA BEACH,FL32120 		EMPLOYEE BENEFI 449,765
BURGOYNE PROPERTIES LTD
1010 EAST ADAMS STREET
JACKSONVILLE,FL32202 		BUILDING RENT 107,062
STAY FOR A DAY
100 TOWN CENTER DRIVE
ORANGE CITY,FL32763 		ADULT DAY CARE 103,858
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a 63,832
b Membership dues....1b  
c Fundraising events....1c 49,348
d Related organizations...1d  
e Government grants (contributions)1e 3,528,592
f All other contributions, gifts, grants, and
similar amounts not included above1f 		138,931
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 3,780,703
Program Service Revenue Business Code
2a MEDICAID WAVIER SERVICES   905,084 905,084    
b PRIVATE PAY HOME HEALTH CARE   261,430 261,430    
c PRIVATE PAY GUARDIANSHIP   145,002 145,002    
d COMMUNITY CARE FOR ELDERLY   114,818 114,818    
e SENIOR CENTER SUPPORT   66,460 66,460    
f All other program service revenue . 7,990 7,990    
g Total. Add lines 2a–2f........MediumBullet 1,500,784
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet -136,492 -136,492    
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$ 49,348
of contributions reported on line 1c). See Part IV, line 18 ...
a 5,792
b Less: direct expenses ...b 5,792
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a RENT REIMBURSEMENT   13,948 13,948    
b WORKER COMP REIMBURSEMENT   8,601 8,601    
c MISCELLANEOUS   3,888 3,888    
d All other revenue .... -67,790 -67,790    
e Total. Add lines 11a–11d ......MediumBullet -41,353
12 Total revenue. See Instructions....MediumBullet 5,103,642 1,322,939    
Form 990 (2011)
Form 990 (2011)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Check if Schedule O contains a response to any question in this Part IX. .........
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21    
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 137,285   137,285  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 2,243,587 1,898,195 294,646 50,746
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 21,861 15,703 6,017 141
9 Other employee benefits ....... 536,780 437,526 88,581 10,673
10 Payroll taxes ........... 227,720 183,141 39,674 4,905
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 69,753 6,322 63,423 8
c Accounting ........... 40,287   40,287  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 177,732 50,782 95,360 31,590
12 Advertising and promotion .... 52,560 5,457 10,134 36,969
13 Office expenses ....... 145,876 111,028 23,053 11,795
14 Information technology ...... 16,151 10,450 4,378 1,323
15 Royalties ..        
16 Occupancy ........... 162,831 18,052 144,779  
17 Travel ............ 210,035 199,735 8,956 1,344
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 7,714 79 7,585 50
20 Interest ........... 19,791   19,791  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 16,200 1,200 15,000  
23 Insurance .............. 28,104 22,221 5,671 212
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a FOOD SUBCONTRACTORS 800,605 800,605    
b IN-FACILITY CARE SUBCONTR 382,453 382,453    
c MISCELLANEOUS 287,845 214,308 71,952 1,585
d IN-HOME CARE SUBCONTRACTO 246,850 246,850    
e
f All other expenses -189,828 661,942 -875,677 23,907
25 Total functional expenses. Add lines 1 through 24f 5,642,192 5,266,049 200,895 175,248
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 172,756 1 148,137
2 Savings and temporary cash investments ....... 52,369 2 43,744
3 Pledges and grants receivable, net ......... 803,909 3 758,579
4 Accounts receivable, net ......... 168,350 4 365,572
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use ..............   8  
9 Prepaid expenses and deferred charges ............ 30,792 9 40,376
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 397,859
b Less: accumulated depreciation. ..... 10b 330,405 70,280 10c 67,454
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 500,832 15 529,836
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,799,288 16 1,953,698
Liabilities 17 Accounts payable and accrued expenses . 535,502 17 813,718
18 Grants payable ..........   18  
19 Deferred revenue .......... 557,924 19 344,048
20 Tax-exempt bond liabilities ..........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .... 500,000 24 462,300
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.....   25 666,320
26 Total liabilities. Add lines 17 through 25..... 1,593,426 26 2,286,386
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 205,862 27 -332,688
28 Temporarily restricted net assets .....   28  
29 Permanently restricted net assets .....   29  
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 205,862 33 -332,688
34 Total liabilities and net assets/fund balances ..... 1,799,288 34 1,953,698
Form 990 (2011)
Form 990 (2011)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI .........
1
Total revenue (must equal Part VIII, column (A), line 12) ...
1
5,103,642
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
5,642,192
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
-538,550
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
205,862
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
 
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) ....
6
-332,688
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII .........
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?....
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant? If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O. ...........................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2011)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COUNCIL ON AGING OF VOLUSIA COUNTY
INC
Employer identification number

59-1160221
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(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?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
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.") .... 3,806,965 3,873,396 4,459,048 3,761,352 3,786,495 19,687,256
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.. 3,806,965 3,873,396 4,459,048 3,761,352 3,786,495 19,687,256
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.           19,687,256
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
7 Amounts from line 4.. 3,806,965 3,873,396 4,459,048 3,761,352 3,786,495 19,687,256
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. 16,254 5,809       22,063
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.. 8,163 4,480 3,276 1,262 26,954 44,135
11 Total support (Add lines 7 through 10).           19,753,454
12
12
1,328,731
13
Section C. Computation of Public Support Percentage
14
14
99.660 %
15
15
99.720 %
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
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 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......            
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.            
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.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
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.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2011

Additional Data


Software ID:  
Software Version:  
SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COUNCIL ON AGING OF VOLUSIA COUNTY
INC
Employer identification number

59-1160221
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958), relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....        
b Contributions ........        
c Net investment earnings, gains, and losses ...        
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		       
f Administrative expenses ....        
g End of year balance ......        
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
No
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   38,320 21,862 16,458
d Equipment ................   338,539 301,881 36,658
e Other .................   21,000 6,662 14,338
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 67,454
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) 50% EQUITY INVESTMENT IN DASS, INC. 418,192
(2) GOODWILL 111,644
(3) WORKING CAPITAL LOAN - DASS, INC.  






Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 529,836
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes  
DUE TO RELATED PARTY - LGF 666,320








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 666,320
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 5,103,642
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 5,642,192
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 -538,550
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8  
9 Total adjustments (net). Add lines 4 through 8 ......................... 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 -538,550
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 5,526,564
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b 417,130
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV.) ............ 2d 5,792
e Add lines 2a through 2d ..................... 2e 422,922
3 Subtract line 2e from line 1..................... 3 5,103,642
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 5,103,642
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 6,065,114
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a 417,130
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV.) ............ 2d 5,792
e Add lines 2a through 2d...................... 2e 422,922
3 Subtract line 2e from line 1..................... 3 5,642,192
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 5,642,192
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
RECONCILIATION OF CHANGES - OTHER SCHEDULE D, PAGE 4, PART XI, LINE 8 FUNDRAISING COST REFUNDING 5,792 FUNDRAISING COST -5,792
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XII, LINE 2D FUNDRAISING COST REFUNDING 5,792
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHER SCHEDULE D, PAGE 4, PART XIII, LINE 2D FUNDRAISING COST 5,792
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,or if the organization entered more than $15,000 on Form 990-EZ, line 6a.right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
COUNCIL ON AGING OF VOLUSIA COUNTY
INC
Employer identification number

59-1160221
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
FL
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

MOW WALKATON
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

  
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 55,140     55,140
2 Less: Charitable
contributions . . . 		49,348     49,348
3 Gross income (line 1
minus line 2) . . . 		5,792     5,792
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages . .        
8 Entertainment . . .        
9 Other direct expenses . 5,792     5,792
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 5,792
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow  
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
Schedule G (Form 990 or 990-EZ) 2011
Schedule G (Form 990 or 990-EZ) 2011
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2011
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
COUNCIL ON AGING OF VOLUSIA COUNTY
INC
Employer identification number

59-1160221
Identifier Return Reference Explanation
FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A CLIENTS 60 AND OVER WHO HAVE BEEN ASSESSED FUNCTIONALLY IMPAIRED BY TRAINED CASE MANAGERS. THIS PROGRAM INCLUDES FOLLOW-UP VISITS AND PROVIDES LINKS TO OTHER COMMUNITY SERVICES. THE SERVICES INCLUDE CASE MANAGEMENT,HOMEMAKER, PERSONAL CARE, RESPITE, ADULT DAY CARE, MEALS, EMERGENCY ALERT RESPONSE, MEDICAL TRANSPORTATION, MATERIAL AID AND PEST CONTROL. MEDICARE WAIVER PROJECT - THIS STATE FUNDED PROGRAM ASSISTS THE MOST FRAIL AND FINANCIALLY CHALLENGED ELDERS OVER THE AGE OF 65. TRANSFERRING APPROPRIATE CLIENTS TO THIS PROGRAM OPENS SLOTS IN THE OTHER GRANTS, MAXIMIZING SERVICES AVAILABLE TO THE ELDERS IN VOLUSIA COUNTY. SERVICES INCLUDE CASE MANAGEMENT, HOMEMAKER, PERSONAL CARE, RESPITE, ADULT DAY CARE, MEALS, EMERGENCY ALERT RESPONSE, MATERIAL AID, PEST CONTROL AND MEDICAL TRANSPORTATION. ALZHEIMER'S DISEASE INITIATIVE - THE STATE FUNDED PROGRAM PROVIDES RESPITE CARE SERVICES, INCLUDING IN-HOME SERVICES, FOR THE VICTIMS OF ALZHEIMER'S DISEASE AND PROVIDES TRAINING FOR CARE GIVERS OF THESE VICTIMS. HOME CARE FOR THE ELDERLY - THE GOAL OF THE HCE PROGRAM IS TO ENCOURAGE THE PROVISION OF CARE FOR ELDERS IN FAMILY-TYPE LIVING ARRANGEMENTS IN PRIVATE HOMES AS AN ALTERNATIVE TO INSTITUTIONAL CARE. THE PROGRAM ENCOURAGES CARE GIVERS TO PROVIDE, ON A NOT-FOR-PROFIT BASIS, BASIC SUPPORT AND MAINTENANCE AS WELL AS ASSISTANCE IN ARRANGING SPECIALIZED SERVICES FOR ELDERLY RELATIVES OR NON-RELATIVES. CASE MANAGEMENT AND SUBSIDY PAYMENTS ARE AVAILABLE TO QUALIFIED CARE GIVERS AND/OR VENDORS ON BEHALF OF ELIGIBLE CLIENTS. COMMUNITY CARE FOR DISABLED ADULTS - THIS STATE OF FLORIDA PROGRAM, ADMINISTERED BY THE DEPARTMENT OF CHILDREN AND FAMILIES, PROVIDES HOME-DELIVERED MEALS AND IN HOME SERVICES TO CLIENTS AGED 18-59 WITH PHYSICAL, MENTAL, OR OTHER DISABILITIES. EMERGENCY HOME ENERGY ASSISTANCE PROGRAM - THIS FEDERALLY FUNDED PROGRAM PROVIDES ASSISTANCE FOR LOW INCOME ELDERLY PERSONS WHO ARE IN DANGER OF HAVING THEIR UTILITIES TURNED OFF DUE TO NONPAYMENT. FAN PURCHASES AND AIRCONDITIONER REPAIR ARE PART OF THE SUMMER PROGRAM AND BLANKET AND SPACE HEATER PURCHASES ARE PART OF THE WINTER PROGRAM.
ALL OTHER ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4D OTHER COMMUNITY PROGRAMS FOR THE ELDERLY AND NEEDY: CAREGIVER RESPITE - IN THE YEAR 2003 THE COUNCIL DEVELOPED A CAREGIVER RESPITE PROGRAM, WITH INITIAL FUNDING PROVIDED BY HOSPICE OF VOLUSIA/FLAGLER. THE PROGRAM HAS GROWN TO TEN CENTERS AROUND THE COUNTY, UTILIZING LOCAL CHURCH FACILITIES AND VOLUNTEERS ALONG WITH COUNCIL STAFF. EACH CENTER OPERATES ONE DAY PER WEEK, AND PROVIDES ELIGIBLE "CAREES" WITH A SECURE AND STIMULATING ENVIRONMENT WHILE THEIR CAREGIVERS ARE GIVEN TIME FOR WELL DESERVED RELIEF. CAREGIVERS ALSO HAVE THE OPPORTUNITY TO PARTICIPATE IN VARIOUS EDUCATIONAL AND COUNSELING PROGRAMS TO HELP THEM BETTER COPE WITH THE DEMANDS OF TWENTY-FOUR HOUR SEVEN DAY CARE. PRIVATE PAY PROGRAMS - THIS PROGRAM PROVIDES FOR HOME-DELIVERED MEALS AND IN-HOME SERVICES TO CLIENTS THAT DO NOT QUALIFY FOR PROGRAMS ADMINISTERED THROUGH A STATE OR FEDERAL PROGRAM. SENIOR CENTERS - THE COUNCIL OPERATES AND MAINTAINS FIVE FULL-TIME SENIOR CENTERS THROUHOUT VOLUSIA COUNTY. PROGRAMS ARE FOCUSED ON THE AREAS OF HEALTH, EDUCATION, AND RECREATION. ALLOTMENTS FROM VOLUSIA COUNTY CITIES, CONTRIBUTIONS FROM THE PUBLIC AND PARTICIPANTS, MEMBERSHIP DUES AND PROGRAM FEES OFFSET THE COSTS OF OPERATING THE CENTERS.
POLICIES AND PROCEDURES GOVERNING CHAPTERS FORM 990, PAGE 6, PART VI, LINE 10B THE COUNCIL GOVERNS THE ACTIVITIES OF TWO RELATED ENTITIES. THE RELATED ENTITIES ARE DAYTONA AREA SENIOR SERVIES, INC. AND LIVING GIFTS FOUNDATION OF THE COUNCIL ON AGING OF VOLUSIA COUNTY, INC. THE TWO RELATED ENTITIES ARE BOTH 501(C)(3) ORGANIZATIONS, OPERATING EXCLUSIVELY FOR THE BENEFIT OF THE COUNCIL. THE TWO RELATED ENTITIES HAVE SEPARATE BOARDS WHICH ARE SELECTED BY THE COUNCIL'S BOARD. ALL POLICIES AND PROCEDURES GOVERNING THE ACTIVITIES OF THE COUNCIL ARE SUBJECTED TO THE TWO RELATED ENTITIES. FOR FINANCIAL STATEMENT REPORTING PURPOSES, THE TWO RELATED ENTITIES ARE COMBINED WITH THE COUNCIL.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B FORM 990 IS REVIEW BY MANAGEMENT, AND SUBSEQUENTLY APPROVED BY THE FINANCE COMMITTEE BEFORE FILING AND RELEASE TO OTHER INTERESTED PARTIES.
ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C AT THE END OF EACH FISCAL YEAR, ALL BOARD OF DIRECTORS, ALL KEY EMPLOYEES AND DEPARTMENT MANAGERS, ARE REQUIRED TO COMPLETE AND RESPOND TO ANY RELATED PARTY ACTIVITIES ENGAGED IN DURING THE FISCAL YEAR OPERATING CYCLE. ANY DISCOVERY IS DISCUSSED AND ACTED UPON BY THE BOARD OF DIRECTORS AND MANAGEMENT. THE INQUIRY IS CONDUCTED USING POSITIVE CONFIRMATION QUESTIONAIRS, AND ARE REQUIRED TO BE RETURNED, EVEN WHEN NO RELATED PARTY ACTIVITIES OCCURED. SUBSEQUENT TO THE CURRENT YEAR END, THE BOARD OF DIRECTORS WERE REVISING THE CURRENT CONFLICT OF INTEREST POLICY TO COVER ADDITIONAL COMPLIANCE ISSUES NOT PREVIOUSLY ADDRESSED.
COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE EXECUTIVE DIRECTOR'S COMPENSATION AGREEMENT IS REVIEWED ANNUALLY THROUGH AN ADVISORY COMMITTEE SELECTED BY THE BOARD OF DIRECTORS. THE PROCESS AND RECOMMENDATION CONCLUDED BY THE ADVISORY COMMITTEE ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS.
COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B ALL EMPLOYEE COMPENSATION AGREEMENTS, INCLUDING KEY EMPLOYEES (DEPARTMENT MANAGERS), ARE REVIEWED ANNUALLY BY DEPARTMENT MANAGERS AND OR THE EXECUTIVE DIRECTOR THROUGH WRITTEN EVALUATION REPORTS. A WRITTEN EVALUATION REPORT CONSISTS OF VALUATION OF JOB PERFORMANCE, DUTIES, AND OTHER OPERATIONAL FUNCTIONS CONDUCTED BY EACH RESPECTIVE EMPLOYEE. RECOMMENDATIONS ARE GIVEN BY THE DEPARTMENT MANAGERS DISCLOSED IN THE WRITTEN EVALUATION REPORTS REGARDING SALARY AND WAGE STRUCTURE FOR EACH EVALUATED EMPLOYEE. THE FINAL DETERMINATION IS MADE BY THE EXECUTIVE DIRECTOR, AFTER DISCUSSIONS AND APPROVAL FROM BOARD OF DIRECTOR COMMITTEES, USUALLY THE FINANCE COMMITTEE. THE COUNCIL ACTS AS A COMMON PAYMASTER AGENT WITH DAYTONA AREA SENIOR SERVICES, INC. (DASS) AND VOLUSIA COUNTY COUNCIL ON AGING LIVING GIFTS FOUNDATION, INC. (FOUNDATION) RELATIVE TO PAYROLL REPORTING AND REQUIRED PAYROLL INFORMATION TAX RETURNS. SALARY AND WAGE EXPENSES AND ALL RELATED PAYROLL COSTS ARE ALLOCATED TO DASS AND FOUNDATION BASED ON THE DIRECT PERSONNEL COSTS ASSOCIATED WITH THOSE TWO ENTITIES. HOWEVER, ALL EMPLOYEES OF THE COUNCIL, DASS AND FOUNDATION ARE INCLUDED IN THE COUNCIL'S PAYROLL INFORMATION RETURNS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

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