Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 7,872,089 | 5,123,891 | 5,063,122 | 8,624,044 | 11,790,868 | 38,474,014 |
| 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 | 7,872,089 | 5,123,891 | 5,063,122 | 8,624,044 | 11,790,868 | 38,474,014 |
| 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) .. | 922,594 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 37,551,420 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 7,872,089 | 5,123,891 | 5,063,122 | 8,624,044 | 11,790,868 | 38,474,014 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 28,484 | 2,966 | 56,634 | 110,308 | 15,700 | 214,092 |
| 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.).. | 2,490 | 656 | 239,104 | 167,095 | 22,830 | 432,175 |
| 11 | Total support. Add lines 7 through 10 | 39,120,281 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (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 on 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III, LINE 1 | THE MISSION OF COCOON HOUSE (THE AGENCY) IS TO EMPOWER YOUNG PEOPLE, FAMILIES AND THE COMMUNITY TO BREAK THE CYCLE OF HOMELESSNESS THROUGH OUTREACH, HOUSING AND PREVENTION. TO CARRY OUT THIS MISSION THE AGENCY HAS DEVELOPED A CONTINUUM OF SERVICES TO SERVE HOMELESS, AT-RISK AND HIGHLY DISCONNECTED YOUTH AND THEIR FAMILIES IN SNOHOMISH COUNTY, PROVIDING HOUSING, PREVENTION AND STREET OUTREACH SERVICES. |
| FORM 990, PART III, LINE 4A | HOUSING SERVICES: EMERGENCY SHELTER: THE AGENCY OPERATES TWO EMERGENCY SHELTERS FOR TEENS 12 TO 17 YEARS OLD. THE EAST SHELTER IN MONROE IS A LICENSED SHELTER FACILITY WITH 8 BEDS IN SERVICE. THIS FACILITY IS STAFFED 24/7 BY COCOON HOUSE. THE SECOND SHELTER IS A HOST HOME SHELTER MODEL, AND PROVIDES HOUSING FOR UP TO 8 TEENS WHO ARE PLACED IN VOLUNTEER SHORT TERM STAYS WITH TRAINED VOLUNTEER HOST FAMILIES. COCOON HOUSE STAFF PROVIDE DAILY CONTACT AND 24/7 SUPPORT AS NEEDED. 66 YOUTH RECEIVED EMERGENCY AND TRANSITIONAL HOUSING AT COCOON HOUSE. TRANSITIONAL HOUSING: THE AGENCY OPERATES A TRANSITIONAL HOUSING PROGRAM IN EVERETT, PROVIDING 20 BEDS TO TEEN 12-17. THERE IS A SECOND TRANSITIONAL HOUSING PROGRAM IN ARLINGTON, PROVIDING 5 BEDS TO TEEN MOTHERS 12-17 AND THEIR CHILDREN/INFANTS. YOUNG ADULT HOUSING: THE AGENCY OPERATES A SCATTERED SITE RAPID REHOUSING PROGRAM THAT SUPPORTS YOUNG ADULTS BETWEEN THE AGES OF 18 TO 24 IN LEASED APARTMENT UNITS. THE AGENCY ALSO MASTER LEASES UP TO 5 UNITS OF SCATTERED SITE APARTMENTS TO PROVIDE 18 TO 24 YEAR OLDS AN IMMEDIATE HOUSING OPTION UNTIL THEY CAN FIND AN APARTMENT TO RENT. THE AGENCY ALSO PROVIDES A SITE BASED PERMANENT HOUSING PROGRAM OF LEASED STUDIO UNITS TO 20 INDIVIDUALS BETWEEN THE AGES OF 18 TO 24. AVAILABLE SERVICES AT HOUSING PROGRAMS INCLUDE INTENSIVE CASE MANAGEMENT, DRUG/ALCOHOL ASSESSMENT/ COUNSELING/TREATMENT, MENTAL HEALTH COUNSELING, EDUCATION SUPPORT, JOB READINESS TRAINING, PARENTING SUPPORT AND EDUCATION (AS NEEDED FOR TEEN PARENTS) AND LIFE SKILLS TRAINING AS WELL AS HOUSING, FOOD, AND BASIC NEEDS FOR YOUTH WHO HAVE NO OTHER HOUSING OPTIONS. DURING THE YEAR 85 YOUTH PARTICIPATED IN ONGOING CASE MANAGEMENT AFTER EXITING EMERGENCY HOUSING, 26 YOUNG ADULTS RECEIVED PERMANENT HOUSING AND SUPPORT AT JOURNEYS, AND 49 YOUNG ADULTS RECEIVED TRANSITIONAL AND RAPID REHOUSING. |
| FORM 990, PART III, LINE 4B | STREET OUTREACH: STREET OUTREACH PROGRAM: THE STREET OUTREACH PROGRAM FEATURES MOBILE OUTREACH AND A DROP-IN CENTER TO ENGAGE AND ASSIST YOUTH AGES 12-24 IN SNOHOMISH COUNTY. STAFF CONDUCT STREET OUTREACH, STREET LEVEL CASE MANAGEMENT, ONGOING INTENSIVE CASE MANAGEMENT AND CONNECT YOUTH TO A MULTITUDE OF RESOURCES IN THE COMMUNITY INCLUDING ONSITE DRUG AND ALCOHOL TREATMENT AND CONNECTION WITH WORKSOURCE AT THE DROP-IN CENTER. DURING THE YEAR THE STREET OUTREACH PROGRAM SERVED: 165 YOUTH AND YOUNG ADULTS PARTICIPATED IN CASE MANAGEMENT SERVICES 573 YOUTH AND YOUNG ADULTS WERE CONTACTED AT LEAST ONCE AND RECEIVED SERVICES AND REFERRALS 494 YOUTH AND YOUNG ADULTS VISITED THE AGENCY'S DROP-IN CENTER, U-TURN 256 YOUNG ADULTS RECEIVED NAVIGATION AND HOUSING PLACEMENT SERVICES THROUGH COORDINATED ENTRY |
| FORM 990, PART III, LINE 4C | PREVENTION SERVICES FOR PARENTS AND TEENS: PARENT DROP IN: PARENTS OF 12 TO 18 YEAR OLDS ARE ABLE TO CALL IN OR STOP BY DURING SCHEDULED DROP IN HOURS TO RECEIVE SUPPORT AND RESOURCES FROM THE PREVENTION TEAM. PARENTING CLASSES: CLASSES ARE OFFERED TO PARENTS AND CAREGIVERS THAT WANT TO INCREASE THEIR KNOWLEDGE OF A VARIETY OF PARENTING TOPICS, INCLUDING; TEEENAGE BRAIN DEVELOPMENT, GRIEF AND LOSS AND THE EFFECT ON TEENS, COMMUNICATION STYLES, HEALTHY BOUNDARIES, AND A VARIETY OF OTHER TOPICS. 20 FAMILIES PARTICIPATED IN PARENTING EDUCATION SERVICES, INCLUDING PARENTING CLASSES. 18 FAMILIES PARTICIPATED IN ONGOING CASE MANAGEMENT THROUGH PREVENTION. WAYOUT: WAYOUT IS AN INTERACTIVE WORKSHOP FOR TEENS AND PARENTS OR GUARDIANS, DESIGNED SPECIFICALLY TO SERVE LOW-RISK YOUTH OFFENDERS REFERRED BY THE JUVENILE COURTS. TODAY THE PROGRAM RECEIVES REFERRALS FROM A WIDE VARIETY OF AGENCIES. DURING THE YEAR 20 FAMILIES PARTICIPATED IN WAYOUT SEMINARS. |
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS COMPRISED OF THE BOARD OF DIRECTORS AND THE IMMEDIATE PAST BOARD CHAIR AND THE CHAIR OF THE NOMINATING COMMITTEE AND GOVERNANCE COMMITTEE. THE SPECIFIC RESPONSIBILITIES OF THE EXECUTIVE COMMITTEE ARE DESCRIBED IN SECTION 4.2 OF THE BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE TAX RETURN IS PREPARED BY OUTSIDE CPAS WHICH IS SUBSEQUENTLY REVIEWED IN DETAIL BY THE CEO, CFO AND FINANCE COMMITTEE. A COPY OF THE TAX RETURN IS PROVIDED TO THE ENTIRE BOARD PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CH BOARD OF DIRECTORS SHALL TAKE APPROPRIATE DISCIPLINARY ACTION IN THE EVENT THAT ANY DIRECTOR, OFFICER OR COMMITTEE MEMBER FAILS TO DISCLOSE A FINANCIAL RELATIONSHIP THAT IS AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST OR OTHERWISE VIOLATES THE TERMS AND CONDITIONS OF THIS POLICY. THE BOARD'S DISCIPLINARY ACTION MAY INCLUDE SANCTION, PROBATION AND REMOVAL FROM THE BOARD OR THE COMMITTEE AS THE BOARD DEEMS APPROPRIATE UNDER THE CIRCUMSTANCES. THE ADOPTION AND ENFORCEMENT OF THIS POLICY BY THE CH BOARD OF DIRECTORS SUPPLEMENTS, RATHER THAN REPLACES, THE LAWS OF THE STATE OF WASHINGTON FOR CONFLICT OF INTEREST TRANSACTIONS BY OFFICERS AND DIRECTORS OF NON-PROFIT CORPORATIONS. |
| FORM 990, PART VI, SECTION B, LINE 15A | CEO WAGES ARE REVIEWED ANNUALLY BY THE BOARD AGAINST PERFORMANCE OUTCOMES AND SALARY SURVEY DATA FROM THE UNITED WAY AND LOCAL SALARY SURVEYS. STAFF WAGES ARE REVIEWED ANNUALLY BY THE CEO AGAINST PERFORMANCE OUTCOMES AND SALARY SURVEY DATA FROM THE UNITED WAY AND LOCAL SALARY SURVEYS. COMPENSATION WAS LAST REVIEWED IN 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | COCOON HOUSE MAKES AVAILABLE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. AUDITED FINANCIAL STATEMENTS AND IRS TAX FORM 990 ARE MADE AVAILABLE ONLINE. |
| FORM 990 PART XII, LINE 2C: | THE ORGANIZATION'S PROCESS FOR SELECTING AN INDEPENDENT AUDITOR AND FOR OVERSEEING THE FINANCIAL STATEMENT AUDIT DID NOT CHANGE DURING THE YEAR. |
| Software ID: | |
| Software Version: |