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.
Attach to Form 990 or Form 990-EZ. See separate instructions. Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Shelter House Inc
Employer identification number
52-1217106
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II, or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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 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
Provide the following information about the supported organization(s).
(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 monetary support
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2,939,127
3,585,977
3,577,144
3,681,726
3,994,276
17,778,250
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
0
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
662,613
736,496
887,247
913,864
975,626
4,175,846
4
Total. Add lines 1 through 3
3,601,740
4,322,473
4,464,391
4,595,590
4,969,902
21,954,096
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)..
0
6
Public support. Subtract line 5 from line 4.
21,954,096
Section B. Total Support
Calendar year
(or fiscal year beginning in)
(a) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(f) Total
7
Amounts from line 4..
3,601,740
4,322,473
4,464,391
4,595,590
4,969,902
21,954,096
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
25,085
18,139
31,119
41,910
47,491
163,744
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
0
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
0
11
Total support (Add lines 7 through 10).
22,117,840
12
Gross receipts from related activities, etc. (see instructions)
..................
12
306,707
13
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.................................................
Section C. Computation of Public Support Percentage
14
Public support percentage for 2013 (line 6, column (f) divided by line 11, column (f))
.........
14
99.260 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.279 %
16a
33 1/3% support test—2013.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
.......................
b
33 1/3% support test—2012.
If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2013.
If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization
.....................................................
b
10%-facts-and-circumstances test—2012.
If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization
................................................
18
Private foundation.
If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions
.....................................................
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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) 2009
(b) 2010
(c) 2011
(d) 2012
(e) 2013
(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
First five years.
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public support percentage for 2013 (line 8, column (f) divided by line 13, column (f))
.........
15
16
Public support percentage from 2012 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2013 (line 10c, column (f) divided by line 13, column (f))
......
17
18
Investment income percentage from 2012 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2013.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
........
b
33 1/3% support tests—2012.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
.....
20
Private foundation.
If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information.
Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2013
Additional Data
Software ID:
Software Version:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Shelter House Inc
Employer identification number
52-1217106
Return Reference
Explanation
Statement of Program Service Accomplishments
(continued from Form 990, Part III, line 4a) A. PATRICK HENRY FAMILY SHELTER (PHFS) IS DESIGNATED AS A LARGE FAMILY SHELTER (FIVE OR MORE FAMILY MEMBERS) AND HAS A CAPACITY OF SEVEN FAMILIES WITH TWO ADDITIONAL UNITS USED FOR OVERFLOW SPACE. ADULTS CAN BENEFIT FROM PROGRAMS SUCH AS HEALTH EDUCATION CLASSES, ORGANIZATION WORKSHOPS, RESUME WRITING AND INTERVIEW SKILLS WORKSHOPS, HOUSING LOCATION SERVICES, ETC. AT THE SAME TIME, THE CHILDREN CAN BENEFIT FROM PROGRAMS AS WELL. THESE INCLUDE: AFTER-SCHOOL TUTORING, BIRTHDAY PARTIES, HOLIDAY PARTIES, KIDS' NIGHT, SCHOOL SHOPPING, ETC. WE SERVED 44 FAMILIES (234 INDIVDIUALS) IN FY2014 THROUGH THIS SHELTER. B. KATHERINE HANLEY FAMILY SHELTER (KHFS) HAS NO FAMILY SIZE LIMIT, BUT CAN ACCOMMODATE UP TO 20 FAMILIES AT A TIME. IT WAS THE FIRST SHELTER IN FAIRFAX COUNTY TO OPERATE ON THE "HOUSING FIRST/RAPID REHOUSING" MODEL, EMPHASIZING MOVING FAMILIES INTO PERMANENT HOUSING AS QUICKLY AS POSSIBLE AND CONTINUING TO WORK WITH FAMILIES ONCE THEY ARE IN PERMANENT HOUSING. ONCE THE FAMILY ENTERS THE SHELTER, THEY ARE IMMEDIATELY ASSESSED FOR MAJOR HOUSING BARRIERS. THE KHFS STAFF ASSISTS THE FAMILIES IN OVERCOMING THOSE BARRIERS. THE FAMILIES ARE THEN MOVED INTO PERMANENT HOUSING AS QUICKLY AS POSSIBLE. SOME OF THE PROGRAMS OFFERED AT KHFS INCLUDE: HOUSING LOCATION SERVICES, EMPLOYMENT COACHING, AFTER-SCHOOL TUTORING, ETC. WE SERVED 134 FAMILIES (417 INDIVIDUALS) THROUGH THIS SHELTER IN FY2014. C. ARTEMIS HOUSE BECAME A PART OF SHELTER HOUSE IN 2010. THIS PROGRAM IS SPECIFICALLY FOR FAMILIES AND INDIVIDUALS FLEEING DOMESTIC AND SEXUAL VIOLENCE AND HUMAN TRAFFICKING. THESE CLIENTS INCLUDE INDIVIDUAL SURVIVORS, PARENTS WHO HAVE BEEN ABUSED, AND THEIR CHILDREN WHO HAVE WITNESSED AND POSSIBLY EVEN EXPERIENCED ABUSE THEMSELVES. ARTEMIS HOUSE STAFF STRIVES TO PROVIDE A SAFE AND STABLE HOME-LIKE ENVIRONMENT WHERE MUTUAL RESPECT AND CONSTRUCTIVE PROBLEM-SOLVING SKILLS ARE MODELED. THREE PRIMARY OBJECTIVES FOR ARTEMIS HOUSE CLIENTS ARE SAFETY, EMPOWERMENT, AND SECURITY. TO ACHIEVE THESE GOALS, CRITICAL ELEMENTS OF OUR DOMESTIC VIOLENCE PROGRAM INCLUDE CRISIS INTERVENTION, TEMPORARY HOUSING, SAFETY PLANNING, IMMEDIATE BASIC NEEDS ASSISTANCE, COMPREHENSIVE SERVICE PLANNING AND CASE MANAGEMENT TO PREPARE FOR A TRANSITION TO MORE PERMANENT, SAFE AND STABLE HOUSING. WE SERVED 130 HOUSEHOLDS (259 INDIVIDUALS) IN THIS SHELTER IN FY2014. D. SHELTER HOUSE ALSO SUPPORTS FAMILIES WHO ARE LIVING IN TRANSITIONAL OR PERMANENT SUPPORTIVE HOUSING THROUGH SEVERAL DIFFERENT PROGRAMS: 1. OFFSITE HOUSING & IVES HOUSE: THE OFFSITE PROGRAM CONSISTS OF FOUR APARTMENT UNITS IN FAIRFAX COUNTY, EACH OF WHICH IS OWNED BY SHELTER HOUSE AND IVES HOUSE IS A THREE YEAR SHARED HOUSE. BOTH PROGRAMS ARE NON-TIME LIMITED AND SERVES FAMILIES THAT HAVE HIGH BARRIERS TO HOUSING DUE TO LARGE DEBT AND OR POOR CREDIT. FAMILIES PARTNER WITH A CASE MANAGER AND TOGETEHR THEY WORK ON DECREASING OR ELIMINATING THESE BARRIERS TO HELP THEM MOVE TO PERMANENT HOUSING. WE SERVED 7 FAMILIES (28 INDIVIDUALS) IN OFFSITE IN FY2014 AND 5 FAMILIES (10 INDIVIDUALS) IN IVES HOUSE IN FY2014. 2. RISE & KATE'S PLACE: RISE (REACHING INDEPENDENCE THROUGH STABILITY AND EMPOWERMENT) & KATE'S PLACE ARE PERMANENT SUPPORTIVE HOUSING PROGRAMS DESIGNED TO PROVIDE A STABLE, SUPPORTIVE ENVIRONMENT TO HOMELESS FAMILIES WHO HAVE HIGH RISK FACTORS FOR BOTH DISINTEGRATION AND RECIDIVISM INTO HOMELESS SERVICES. THE RISE UNITS ARE MANAGED THROUGH AN EFFECTIVE PARTNERSHIP BETWEEN FAIRFAX COUNTY DEPARTMENT OF FAMILY SERVICES, SHELTER HOUSE, AND NEW HOPE HOUSING. SHELTER HOUSE MANAGES 14 UNITS IN THE RISE PROGRAM AND AS OF FEBRUARAY 2015, KATE'S PLACE WAS OPENED TO INCLUDE AN ADDITIONAL 6 AVAILABLE UNITS. THESE PROGRAMS PROVIDE HOUSEHOLD MEMBERS WITH ACCESS TO A FLEXIBLE AND COMPREHENSIVE ARRAY OF SERVICES. FAMILIES ARE ALLOWED TO CONTINUE IN THE PROGRAMS UNTIL THEIR YOUNGEST CHILD TURNS 18 YEARS OF AGE, GIVING THEM A CONTINUED, SUPPORTIVE ENVIRONMENT. CASE MANAGERS HAVE MORE TIME TO ENGAGE THE FAMILIES AND BREAK TRUST BOUNDARIES THAT CAN LEAD TO A RELAPSE OF HOMELESSNESS. SHELTER HOUSE SERVED 15 FAMILIES (48 INDIVIDUALS) IN RISE IN FY2014. 3. NOVACO & CHRP TRANSITIONAL HOUSING PROGRAMS BECAME A PART OF SHELTER HOUSE IN DECEMBER 2013, PARTWAY THROUGH FY2014. THESE PROGRAMS COMPRISE SHELTER HOUSE'S DOMESTIC VIOLENCE SUPPORTIVE HOUSING DEPARTMENT (DVSH) AND ARE DESIGNED TO SERVE VICTIMS OF DOMESTIC VIOLENCE THROUGH 24 SCATTERED SITE UNITS. PARTICIPATING FAMILIES RECEIVE SUPPORTIVE SERVICES FOR UP TO TWO YEARS. SERVICES ARE TAILORED TO THE UNIQUE INDIVIDUAL NEEDS OF EACH HOUSEHOLD. SAFETY PLANNING IS CONDUCTED WITH ALL CLIENTS AND AS IMMEDIATE BASIC NEEDS ARE MET, CASE MANAGERS ASSIST THE FAMILIES SERVED IN DEVELOPING THEIR HOUSING PLAN SO THEY CAN SUCCESSFULLY EXIT TO PERMANENT, SAFE, AND STABLE HOUSING.
Form 990, Part VI, Section B, Line 11
Process for 990 review before IRS filing The draft of the form 990 is provided to all members of the Board of Directors. A briefing is provided at meeting of the Board of Directors and members of the Board are given time to submit questions and comments. Any significant changes will be resent to the Board for future consideration. A copy of the final form 990 is provided electronically to all Board Members.
Form 990, Part VI, Section B, Line 12c
procedure for annual monitoring of conflict of interest policy the organization asks for conflict of interest disclosure statements from all new board members. We also get a written confirmation from existing board members on an annual basis. Board members should disclose any possible conflicts before the event occurs. Possible conflicts are discussed with the appropriate board members.
Form 990, Part VI, Section B, line 15a
process for determining ceo compensation The current executive director has held her position for over 10 years. The salary at that time was set at the prevailing rate for similar non-profits. An annual evaluation is done by the executive committee of the board. Any raises given are in line with raises given to the organization as a whole.
Form 990, part vi. section c. line 19
certain documents open to public disclosure the governing documents, conflict of interest policy and financial statements are available to the public upon request.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.