Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (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 VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| SCHEDULE E, LINE 3 | ADMISSION FORMS HAVE THE NONDISCRIMINATORY STATEMENT ON THEM. ALL STUDENTS ARE REFERRED BY STATE OF NEW MEXICO AND NAVAJO TRIBE DIVISION OF SOCIAL SERVICES. |
| SCHEDULE E, LINE 4 | THE CENTER HAS NOT PUBLISHED ITS NONDISCRIMINATORY POLICY IN A NEWSPAPER NOR HAS IT BROADCAST THIS POLICY. THE CENTER DOES NOT SOLICIT CLIENTS AND IT DOES NOT HAVE A REGISTRATION PERIOD. CLIENTS CAN ENROLL IN THE CENTER'S PROGRAMS AT ANY TIME DURING THE YEAR IF THE FACILITIES CAN SUPPORT AN ADDITIONAL PERSON. ALL CLIENTS AT THE CENTER ARE REFERRED BY THE STATE OF NEW MEXICO AND THE NAVAJO TRIBE DIVISION OF SOCIAL SERVICES. BROCHURES GIVEN TO POTENTIAL CLIENTS AND THEIR FAMILIES DO DESCRIBE THE NONDISCRIMINATORY POLICIES OF THE CENTER. THE CENTER IS PHYSICALLY LOCATED ON THE NAVAJO RESERVATION. CURRENTLY, ALL CLIENTS SERVED BY THE CENTER ARE MEMBERS OF THE NAVAJO NATION. THE CENTER DOES NOT PROVIDE SCHOLARSHIPS OR OTHER FINANCIAL ASSISTANCE TO ITS CLIENTS. THE CENTER DOES NOT SOLICIT CONTRIBUTIONS. |
| SCHEDULE E, LINE 6 | CCRC, INC. PROVIDES CARE AND EDUCATIONAL PROGRAMS FOR DEVELOPMENTALLY DISABLED PERSONS. THE CENTER RECEIVES FUNDS FROM THE DEPARTMENT OF SOCIAL SERVICE THAT ARE USED FOR HOUSING AND CARE OF THE CENTER'S RESIDENTS. THE CENTER ALSO RECEIVES FUNDS FROM THE DEPARTMENT OF EDUCATION THAT HELP FUND THE VOCATIONAL TRAINING PROGRAMS. |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | PROVIDE SUPPORT AND ASSISTANCE TO ADULTS WITH DEVELOPMENTAL DISABILITIES THAT ENABLES INDIVIDUALS TO EXERCISE THEIR RIGHTS AND FREEDOM OF CHOICE. BE A LEADING PERSON PROGRAM THAT MAXIMIZES CULTURAL, SOCIAL, FINANCIAL, AND PERSONAL INDEPENDENCE. |
| FORM 990 | FORM 990 SCHEDULE R PART II LINE 1 PART B - PRIMARY ACTIVITY PROVIDE RESIDENTIAL HOUSING FOR DEVELOPMENTALLY DISABLED ADULTS. |
| FORM 990, PART III | FORM 990 PART III - EXEMPT FUNCTION REVENUES THE MAJORITY OF REVENUE RELATED TO THE EXEMPT PURPOSES OF THE CENTER IS FOR GENERAL PURPOSES OF THE ORGANIZATION, NOT ALLOCATED TO A SPECIFIC PROGRAM. THE ONLY REVENUES SPECIFICALLY RELATED TO A PROGRAM ARE THE REVENUES RECEIVED FROM THE VOCATIONAL PROGRAM ACTIVITIES LISTED ON FORM 990 PART VIII LINE 10A. |
| FORM 990, PART V | FORM 990 PART V LINES 7G & 7H - CONTRIBUTIONS RECEIVED THE CENTER DID NOT RECEIVE ANY CONTRIBUTION OF INTELLECTUAL PROPERTY OR ANY TYPE OF VEHICLE. |
| FORM 990, PAGE 6, PART VI, LINE 8B | THERE ARE NO COMMITTESS WITH AUTHORITY TO ACT FOR THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 11B | COPIES OF THE AUDITED FINANCIAL STATEMENTS AND THE FORM 990 ARE PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING THE 990. A CPA FROM THE INDEPENDENT AUDITOR ATTENDS A BOARD MEETING TO PRESENT AN OVERVIEW OF THE DOCUMENTS TO THE BOARD AND TO ANSWER ANY QUESTIONS RELATED TO THEM. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY APPLIES TO THE BOARD AND KEY EMPLOYEES. EACH BOARD MEMBER/KEY EMPLOYEE COMPLETES A CONFLICT OF INTEREST DISCLOSURE STATEMENT AT THE END OF THE YEAR TO CERTIFY THEY HAD NO CONFLICTS OR LIST ANY CONFLICTS OF INTEREST DURING THE YEAR. THE POLICY REQUIRES BOARD/KEY EMPLOYEES TO NOTIFY THE EXECUTIVE DIRECTOR IMMEDITELY IF THEY SUSPECT THEY MAY HAVE A CONFLICT. THE EXECUTIVE DIRECTOR DECIDES WHETHER THERE IS A CONFLICT OF INTEREST AND, IF SO, REJECTS THE TRANSACTION OR TAKES OTHER STEPS TO PROTECT CCRC'S INTERESTS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD REVIEWS THE EXECUTIVE DIRECTOR'S COMPENSATION AND DETERMINES WHETHER IT SHOULD BE INCREASED. THE EVALUATION IS BASED ON PERFORMANCE AND DOES NOT CONSIDER ANY COMPARABILITY DATA. THE BOARD MAY ALSO DECIDE TO GRANT A COST OF LIVING INCREASE BASED ON A RATE SET BY THE NAVAJO NATION. THE EXECUTIVE DIRECTOR DID NOT RECEIVE A PERFORMANCE BASED INCREASE OR A COST OF LIVING INCREASE DURING THE FISCAL YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD REVIEWS KEY EMPLOYEES COMPENSATION AND DETERMINES WHETHER IT SHOULD BE INCREASED. THE EVALUATION IS BASED ON PERFORMANCE AND DOES NOT CONSIDER ANY COMPARABILITY DATA. THE BOARD MAY ALSO DECIDE TO GRANT A COST OF LIVING INCREASE BASED ON A RATE SET BY THE NAVAJO NATION. KEY EMPLOYEES DID NOT RECEIVE A PERFORMANCE BASED INCREASE OR A COST OF LIVING INCREASE DURING THE FISCAL YEAR. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC ON REQUEST. |
| FORM 990, PART VII | HOURS PER WEEK FOR RELATED ORGANIZATION JEFFERSON KEE SPENDS APPROXIMATELY 10 HOURS/WEEK AND THE BOARD MEMBERS EACH SPEND APPROXIMATELY 5 HOURS/WEEK ON TSE' KO' O' HOUSING CORPORATION A RELATED ENTITY TO THE CENTER. |
| FORM 990, PART XI | FORM 990 PART XI LINE 9 - NET ASSETS THE NET ASSETS OF COYOTE CANYON REHABILITATION CENTER, INC. DO NOT MATCH THE NET ASSETS PER THE FINANCIAL STATEMENT BECAUSE THE FINANCIAL STATEMENTS ARE CONSOLIDATED WITH AN AFFILIATED ENTITY, TSE' KO' O' HOUSING CORP. |
| FORM 990, PART XII | FORM 990 PART XII LINE 2C - AUDIT OVERSIGHT THERE WAS NO CHANGE TO THE MANNER BY WHICH THE INDEPENDENT ACCOUNTANT TO PERFORM THE AUDIT WAS SELECTED OR TO THE OVERSIGHT PROCESS FOR THE AUDIT. THE BOARD SELECTS THE INDEPENDENT AUDITOR AND OVERSEES THE AUDIT. THE EXECUTIVE DIRECTOR AND FINANCE DIRECTOR PROVIDE DAY-TO-DAY OVERSIGHT OF THE AUDIT. |
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