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
PATCH (PEOPLE ATTENTIVE TO CHILDREN)
Employer identification number
99-0167464
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.") ....
2,867,200
2,925,406
3,024,240
3,028,553
3,164,470
15,009,869
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
2,867,200
2,925,406
3,024,240
3,028,553
3,164,470
15,009,869
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.
15,009,869
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..
2,867,200
2,925,406
3,024,240
3,028,553
3,164,470
15,009,869
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
8,520
9,028
6,373
620
224
24,765
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..
1,618
2,370
15,930
10,070
28,686
58,674
11
Total support (Add lines 7 through 10).
15,093,308
12
Gross receipts from related activities, etc. (see instructions)
..................
12
915,221
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
99.450 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.450 %
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
PATCH (PEOPLE ATTENTIVE TO CHILDREN)
Employer identification number
99-0167464
Return Reference
Explanation
FORM 990, PART VI, SECTION A, LINE 6
WE HAVE A GENERAL MEMBERSHIP FOR INDIVIDUALS ($25/YEAR) OR ORGANIZATIONS ($100/YEAR) WHO HAVE THE RIGHT TO VOTE FOR MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7A
RIGHTS OF MEMBERS: ALL MEMBERS SHALL HAVE COEQUAL RIGHTS AND OBLIGATIONS WITH RESPECT TO VOTING, DISSOLUTION, REDEMPTION AND TRANSFER. EACH MEMBER SHALL BE ENTITLED TO ONE (1) VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11
THE DRAFT FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR FOR ACCURACY. IT IS THEN FORWARDED TO A BOARD OFFICER FOR REVIEW AND SIGNATURE.
FORM 990, PART VI, SECTION B, LINE 12C
NEW DIRECTORS, OFFICERS AND EMPLOYEES SHALL BE REQUIRED TO REVIEW A COPY OF THE CONFLICT OF INTEREST POLICY AND TO ACKNOWLEDGE IN WRITING THAT HE OR SHE HAS DONE SO. A DISCLOSURE FORM IS REQUIRED TO BE COMPLETED ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15A
BECAUSE THE EXECUTIVE DIRECTOR IS SO CENTRAL TO THE SUCCESS OR FAILURE OF THE AGENCY, EVALUATION OF THE EXECUTIVE DIRECTOR BY THE BOARD IS AN IMPORTANT COMPONENT OF THE BOARD'S RESPONSIBILITIES. AN ANNUAL, WRITTEN EVALUATION BOTH DOCUMENTS THE EXECUTIVE DIRECTOR'S ACHIEVEMENTS AND SHORTCOMINGS, AND HELPS THE EXECUTIVE DIRECTOR UNDERSTAND AREAS FOR IMPROVEMENT OR WHERE THE BOARD IS INSUFFICIENTLY INFORMED. TYPICALLY, THE EXECUTIVE COMMITTEE OF THE BOARD LEADS THE EVALUATION PROCESS, REPORTS ON THE EVALUATION TO THE ENTIRE BOARD, AND RECOMMENDS THE SALARY AMOUNT FOR THE NEXT YEAR. BECAUSE THE EXECUTIVE DIRECTOR ACTS BOTH DIRECTLY AND INDIRECTLY THROUGH OTHERS TO MANAGE THE ORGANIZATION, EVALUATING THE EXECUTIVE DIRECTOR'S PERFORMANCE IS INEVITABLY LINKED TO EVALUATING THE AGENCY'S PERFORMANCE AS A WHOLE. AS A RESULT, EVALUATION OF THE EXECUTIVE DIRECTOR IS INCORPORATED INTO THE ANNUAL REVIEW OF ORGANIZATIONAL PERFORMANCE AND GOAL-SETTING FOR THE COMING YEAR. THE EXECUTIVE COMMITTEE CAN INVOLVE OTHER BOARD MEMBERS IN THE EVALUATION PROCESS. THEY CAN ALSO CHOOSE TO UTILIZE FEEDBACK FROM THE STAFF OF THE EXECUTIVE DIRECTOR AS WELL. THEY CAN ALSO GO OUTSIDE THE AGENCY TO GATHER INFORMATION REGARDING THE PERFORMANCE OF BOTH THE AGENCY AND THE EXECUTIVE DIRECTOR, FOR EXAMPLE, TO FUNDERS, COLLABORATING AGENCIES, VOLUNTEERS, AND CLIENTS. THE EXECUTIVE DIRECTOR NEEDS FEEDBACK ALL YEAR ROUND. LIKE ANY EMPLOYEE, EXECUTIVE DIRECTORS NEED PRAISE AND ACKNOWLEDGMENT FOR WORK WELL DONE, AND IMMEDIATE FEEDBACK WHEN PROBLEMS ARISE. IN THE BEST SITUATIONS, THE BOARD PRESIDENT AND OFFICERS HAVE ESTABLISHED GOOD WORKING RELATIONSHIPS WITH THE EXECUTIVE DIRECTOR WHERE CONSTANT FEEDBACK FLOWS IN BOTH DIRECTIONS. THE ANNUAL FORMAL EVALUATION IS AN IMPORTANT COMPONENT OF, NOT A SUBSTITUTE FOR, THAT RELATIONSHIP. IN GENERAL, THE BOARD OF DIRECTORS EXPECTS THE EXECUTIVE DIRECTOR TO: - SERVE AS THE CHIEF OF OPERATIONS FOR THE ORGANIZATION - BE AN ADVISOR TO THE BOARD - RECOMMEND APPROPRIATE POLICIES FOR BOARD CONSIDERATION - IMPLEMENT EFFECTIVELY ALL POLICIES ADOPTED BY THE BOARD - INFORM THE BOARD FULLY AND ACCURATELY REGARDING OPERATIONS AND PROGRAMS - INTERPRET THE NEEDS OF THE PROGRAM AND PRESENT PROFESSIONAL RECOMMENDATIONS ON ALL PROBLEMS AND ISSUES CONSIDERED BY THE BOARD - DEVELOP A BUDGET, IN CONJUNCTION WITH THE FINANCE COMMITTEE, AND KEEP THE BOARD UP-TO-DATE ON BUDGET PROBLEMS - RECRUIT THE BEST PERSONNEL; DEVELOP AND SUPERVISE A COMPETENT STAFF - ASSIST THE BOARD IN BUILDING CONNECTIONS IN THE COMMUNITY - COMPLETE ASSIGNMENTS AS DIRECTED BY THE BOARD IN GENERAL, THE EXECUTIVE DIRECTOR EXPECTS THE BOARD OF DIRECTORS TO: - COUNSEL AND ADVISE- GIVE THE BENEFIT OF BOARD MEMBER JUDGMENT, EXPERTISE AND KNOWLEDGE - CONSULT WITH THE EXECUTIVE DIRECTOR ON ALL MATTERS THE BOARD IS CONSIDERING - DELEGATE RESPONSIBILITY FOR ALL EXECUTIVE FUNCTIONS - REFRAIN FROM HANDLING ADMINISTRATIVE DETAILS - ASSIGN STAFF MANAGEMENT TO THE EXECUTIVE DIRECTOR - SHARE ALL COMMUNICATIONS WITH THE EXECUTIVE DIRECTOR - PROVIDE SUPPORT TO THE EXECUTIVE DIRECTOR AND STAFF IN CARRYING OUT THEIR PROFESSIONAL DUTIES - SUPPORT THE EXECUTIVE DIRECTOR IN ALL DECISIONS AND ACTIONS CONSISTENT WITH POLICIES OF THE BOARD AND THE STANDARDS OF THE ORGANIZATION - HOLD THE EXECUTIVE DIRECTOR ACCOUNTABLE FOR THE SUPERVISION OF THE ORGANIZATION - EVALUATE THE WORK OF THE EXECUTIVE DIRECTOR - ASSIST IN FUNDRAISING FOR THE SUPPORT OF THE AGENCY AND PROGRAMS ANNUALLY, THE EXECUTIVE COMMITTEE WILL EVALUATE THE EXECUTIVE DIRECTOR. THE EXECUTIVE COMMITTEE ESTABLISHES PERFORMANCE CRITERIA. THE EXECUTIVE COMMITTEE DETERMINES THE EVALUATION CATEGORIES BASED ON THE PRIORITIES DURING THE EVALUATION PERIOD AND ASSIGNS SPECIFIC WEIGHTING FACTORS FOR EACH CATEGORY. THE COMBINED CATEGORY WEIGHTINGS MUST TOTAL 100%. THE EXECUTIVE COMMITTEE COLLABORATES TO COMPLETE THE EVALUATION. THE COMMITTEE PROVIDES THE EVALUATION REPORT TO THE EXECUTIVE DIRECTOR. THE COMMITTEE WILL ENSURE THAT PLANS ARE MADE TO ADDRESS ANY BELOW AVERAGE RATINGS. THE HUMAN RESOURCES COMMITTEE ANNUALLY REVIEWS THE NONPROFIT SALARY SURVEYS PUT OUT BY THE UNITED WAY AND THE HAWAII EMPLOYERS' COUNCIL. ALL DOCUMENTATION RELATED TO THE EXECUTIVE DIRECTOR'S EVALUATION WILL BE FILED IN HIS OR HER PERSONNEL FILE. THIS PROCESS WAS LAST UNDERTAKEN IN 2014.
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE ANNUAL REPORT IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.
FORM 990, PART IX, LINE 7, OTHER SALARIES AND WAGES DESCRIPTION:
THE AMOUNTS INCLUDE WAGES, EMPLOYEE BENEFITS AND PAYROLL TAXES.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.