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
NORTH BAY DEVELOPMENTAL DISABILITIES SERVICES INC
Employer identification number
94-1719894
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.") ....
145,353,758
148,042,305
140,376,070
149,235,554
157,024,998
740,032,685
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
145,353,758
148,042,305
140,376,070
149,235,554
157,024,998
740,032,685
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.
740,032,685
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..
145,353,758
148,042,305
140,376,070
149,235,554
157,024,998
740,032,685
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
180,184
129,819
63,193
53,190
46,520
472,906
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.)..
6,938
63,479
120,139
130,540
112,458
433,554
11
Total support (Add lines 7 through 10).
740,939,145
12
Gross receipts from related activities, etc. (see instructions)
..................
12
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
99.880 %
15
Public support percentage for 2012 Schedule A, Part II, line 14
...............
15
99.850 %
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
NORTH BAY DEVELOPMENTAL DISABILITIES SERVICES INC
Employer identification number
94-1719894
Return Reference
Explanation
FORM 990, PART I, LINE 16B
THE CENTER RECEIVES FUNDING ON AN ANNUAL BASIS FROM THE STATE OF CALIFORNIA. THE CENTER CONTRACTS WITH THE DEPARTMENT OF DEVELOPMENTAL SERVICES TO PROVIDE OR COORDINATE SERVICES AND SUPPORT FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES. THERE IS NO MONEY SPENT BY THE CENTER FOR FUNDRAISING FROM PRIVATE DONORS.
FORM 990, PART IV, LINE 28A
THE CENTER WAS ORGAINZED IN ACCORDANCE WITH THE PROVISIONS OF THE LANTERMAN DEVELOPMENTAL DISABILITIES SERVICES ACT (THE ACT) OF THE WELFARE AND INSTITUTIONS CODE OF THE STATE OF CALIFORNIA. THE ACT INCLUDES GOVERNANCE PROVISIONS REGARDING THE COMPOSITION OF THE CENTER'S BOARD OF DIRECTORS (THE BOARD). THE ACT STATES THAT THE BOARD SHALL BE COMPRISED OF INDIVIDUALS WITH DEMONSTRATED INTEREST IN, OR KNOWLEDGE OF, DEVELOPMENTAL DISABILITIES, AND OTHER RELEVANT CHARACTERISTICS, AND REQUIRES THAT A MINIMUM OF 50 PERCENT OF THE GOVERNING BOARD BE PERSONS WITH DEVELOPMENTAL DISABILITIES OR THEIR PARENTS OR LEGAL GUARDIANS; AND THAT NO LESS THAN 25 PERCENT OF THE MEMBERS OF THE GOVERNING BOARD SHALL BE PERSONS WITH DEVELOPMENTAL DISABILITIES. IN ADDITION, A MEMBER OF A REQUIRED ADVISORY COMMITTEE COMPOSED OF PERSONS REPRESENTING THE VARIOUS CATEGORIES OF PROVIDERS FROM WHICH THE CENTER PURCHASES CLIENT SERVICES, SHALL SERVE AS A MEMBER OF THE CENTER'S BOARD. THE CENTER'S BOARD INCLUDES PERSONS WITH DEVELOPMENTAL DISABILITIES, OR THEIR PARENTS OR LEGAL GUARDIANS, WHO RECEIVE SERVICES FROM THE CENTER, AND A CLIENT SERVICE PROVIDER OF THE CENTER.
FORM 990, PART VI, SECTION A, LINE 5
DURING THE YEAR ENDED JUNE 30, 2014, MANAGEMENT DISCOVERED AN EMBEZZLEMENT INVOLVING A FORMER CASE WORKER WHICH TRANSPIRED DURING THE TIME PERIOD OF 2006 THROUGH 2012 THAT IS ESTIMATED AT $385,000. THE EMBEZZLEMENT INVOLVES CLIENT TRUST FUNDS FOR WHICH THE CENTER HAS A FIDUCIARY DUTY TO OVERSEE. ACCORDINGLY, IT IS MANAGEMENT'S INTENT TO FINANCIALLY RESTORE THE IMPACTED CLIENTS. ONCE THE EMBEZZLEMENT WAS DISCOVERED, MANAGEMENT REPORTED THIS INCIDENT TO VARIOUS AUTHORITIES INCLUDING, BUT NOT LIMITED TO, THOSE CHARGED WITH GOVERNANCE, ADULT PROTECTION SERVICES, DDS, AND THE SANTA ROSA POLICE DEPARTMENT (SRPD). ON THE ADVICE FROM THE SRPD, MANAGEMENT UNDERTOOK AN INTERNAL INVESTIGATION TO PRODUCE EVIDENCE AND TO QUANTIFY THE LOSS BY REVIEWING ALL AVAILABLE SUPPORTING DOCUMENTS. BECAUSE OF THE UNAVAILABILITY OF CERTAIN RECORDS, LOSSES PRIOR TO 2006 MAY EXIST BUT ARE NOT QUANTIFIABLE. IN MANAGEMENT'S OPINION, THE ESTIMATED LOSS IS REASONABLE AND THE EMBEZZLEMENT IS AN ISOLATED CASE. THE FORMER EMPLOYEE SUSPECTED OF THE EMBEZZLEMENT WAS ARRESTED AND HAS PLEADED NO CONTEST. THE CENTER WILL SEEK RESTITUTION THROUGH A COMBINATION OF ACTIONS INCLUDING, BUT NOT LIMITED TO, RESTITUTION FROM THE FORMER EMPLOYEE AND CLAIMS AGAINST FINANCIAL INSTITUTIONS AND THE CENTER'S INSURANCE CARRIER COVERING EMPLOYEE DISHONESTY COVERAGE. AT JUNE 30, 2014 AND 2013, THE OPERATING FUND INCLUDES THE ACCRUAL FOR THE LOSS OF $385,000 AND A PAYABLE TO THE CLIENT TRUST FUND. WHEN THE CENTER RECEIVES RESTITUTION, IT WILL RECOGNIZE INCOME AND WILL THEN USE THE PROCEEDS TO REIMBURSE THE IMPACTED CLIENTS BY TRANSFERRING THE FUNDS TO THE CLIENT TRUST FUND. BECAUSE OF THE LIMITATIONS ON RECOGNIZING GAIN CONTINGENCIES, THE OPERATING FUND WILL RECOGNIZE RESTITUTION AS IT IS RECEIVED. AS A RESULT, THERE IS AN UNRESTRICTED ACCUMULATED DEFICIT AS OF JUNE 30, 2014 AND 2013. SUBSEQUENT TO JUNE 30, 2014, THE CENTER HAS RECEIVED $200,000 FROM ITS INSURANCE CARRIER.
FORM 990, PART VI, SECTION B, LINE 11
A DRAFT OF THE FORM 990 IS REVIEWED AND APPROVED BY THE MANAGEMENT TEAM. BEFORE FILING, THE FORM 990 IS APPROVED AND FORWARDED TO THE ENTIRE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C
THE BOARD MEMBERS ARE REQUIRED TO SIGN A CONFLICT OF INTEREST FORM ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15
THE EXECUTIVE DIRECTOR IS EVALUATED BY KEY STAFF MEMBERS AND BY THE BOARD OF DIRECTORS. HIS PERFORMANCE AND COMPENSATION IS REVIEWED ANNUALLY. THE COMPENSATION PACKAGE IS NEGOTIATED BETWEEN THE COMMITTEE AND THE EXECUTIVE DIRECTOR AND IS THEN PRESENTED TO THE FULL BOARD FOR APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19
AVAILABLE UPON REQUEST.
FORM 990, PART X, LINE 10
PURSUANT TO THE TERMS OF THE DDS CONTRACT, EQUIPMENT PURCHASES BECOME THE PROPERTY OF THE STATE OF CALIFORNIA AND, ACCORDINGLY, ARE CHARGED AS EXPENSES WHEN INCURRED. THE CENTER IS REQUIRED TO TRACK ACQUISITIONS OF FURNITURE AND EQUIPMENT WITH A COST OR VALUE IN EXCESS OF $5,000 AND WITH AN ESTIMATED LIFE BEYOND ONE YEAR. FOR THE YEARS ENDED JUNE 30, 2014 AND 2013, EQUIPMENT PURCHASES TOTALED $0 AND $34,526, RESPECTIVELY. THE AGGREGATE CAPITALIZED EQUIPMENT COSTS AT JUNE 30, 2014 AND 2013, TOTALED $299,439 AND $337,656, RESPECTIVELY.
PART XII, LINE 2C
THERE HAVE BEEN NO CHANGES TO THE PROCESS FROM THE PRIOR YEAR.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.