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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 1,110,019 | 1,319,600 | 1,608,053 | 1,864,728 | 2,202,861 | 8,105,261 |
| 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 | 1,110,019 | 1,319,600 | 1,608,053 | 1,864,728 | 2,202,861 | 8,105,261 |
| 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. | 8,105,261 | |||||
Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,110,019 | 1,319,600 | 1,608,053 | 1,864,728 | 2,202,861 | 8,105,261 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | -36 | 12 | 63 | 417 | 456 | |
| 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.).. | 5,426 | 5,426 | 30,000 | 41,348 | 82,200 | |
| 11 | Total support. Add lines 7 through 10 | 8,187,917 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 2022 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-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | SNACK-BAR AND KITCHEN - 2019 AMOUNT: $ 5,426. 2020 AMOUNT: $ 5,426. 2022 AMOUNT: $ 11,348. RENT - 2021 AMOUNT: $ 30,000. 2022 AMOUNT: $ 30,000. |
| 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 - ORGANIZATION'S MISSION | MISSION: TO CHAMPION BEHAVIORAL HEALTH RECOVERY BY FACILITATING CLUBHOUSE EXPANSION THROUGHOUT THE PUGET SOUND REGION. VISION: WE ENVISION A WORLD WHERE PEOPLE LIVING WITH SERIOUS MENTAL ILLNESS THRIVE IN COMMUNITIES OF HOPE AND OPPORTUNITY. |
| FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT | CLUBHOUSE PHILOSOPHY IS BASED ON THE WORK-ORDERED DAY, FUNCTIONING AS A BUSINESS WHERE MEMBERS ARE ENCOURAGED TO DEVELOP AND STRENGTHEN THEIR TALENTS AND ABILITIES WHILE ACCOMPLISHING THE CLUBHOUSE WORK. NO CLUBHOUSE COULD FUNCTION WITHOUT THE HOSPITALITY UNIT (FOOD SERVICE UNIT). IN THE MORNING THE MAIN FOCUS IS ON PREPARING NUTRITIOUS MEALS FOR EVERYONE IN THE CLUBHOUSE. AT LUNCHTIME THERE ARE OPPORTUNITIES FOR MEMBERS TO GET INVOLVED IN SERVING THE FOOD AND IN CLEANING UP. THE HOSPITALITY UNIT ALSO INCLUDES OPERATION/MAMANGEMENT OF THE SNACK BAR, BANK, EMPLOYMENT AND SOCIAL PROGRAM. THE FOLLOWING TASKS ARE PART OF THIS UNIT: COOKING/BAKING, MENU PLANNING, GROCERY SHOPPING, PREPARING MEALS, TAKING ORDERS FOR LUNCH AND WAITING ON TABLES, CLEANING/DISHWASHING, ORGANIZING/RESTOCKING THE SNACKBAR, KEEPING TRACK OF INVENTORY, DEPOSITING REVENUE, OPERATING THE CASH REGISTER, AND PRIMARY EVENT COORDINATION FOR SPECIAL EVENTS. THE HOSPITALITY UNIT ALSO OPERATED THE SNACK BAR AND THE MEMBER BANK. THE FOOD SERVICE UNIT IS IN CHARGE OF THE "DINE WITH A HERO" PROGRAM. IN THIS PROGRAM, WE INVITE KEY COMMUNITY LEADERS, SUPPORTERS, AND STAKEHOLDERS TO OUR CLUBHOUSE FOR A TOUR, A MEAL, AND SHORT PRESENTATION. THE BUSINESS UNIT IN A CLUBHOUSE IS ALWAYS VERY BUSY AND IS RESPONSIBLE FOR ALL THE GENERAL ADMINISTRATIVE AND CLERICAL TASKS OF THE CLUBHOUSE. TASKS INCLUDE: 1. STATISTICS FOR WASHINGTON STATE CLUBHOUSE COALITION AND MEDICAID 2. BASIC COMPUTING INCLUDING DATABASE INPUT, SPREADHSHEETS 3. MANAGES THE IT NEEDS OF THE CLUBHOUSE INCLUDING: E-MIAL ACCESS, SERVER, PRINTER, COPIER, ETC. 4. ENROLLMENT OF NEW MEMBERS 5. PRODUCTION OF HERO HOUSE HERALD NEWSLETTER 6. RECEPTION 7. CREATING AND MAINTAINING NEW DOCUMENT 8. COPYING, FILING AND COLLATING 9. MAINTENANCE OF THE UNIT (INCLUDING LIBRARY, MEDIA CENTER, BUSINESS UNIT AND BATHROOMS) 10. MANAGES EVENT ANNOUNCEMENTS, WEEKLY CARDS, BIRTHDAY AND CELEBRATION CARDS AND CLUBHOUSE MAILINGS VISISTS IN THE WORK-ORDERED DAY PROGRAM TOTALED 7,072 VISITS. |
| FORM 990, PART III, LINE 4B - SECOND ACCOMPLISHMENT | EMPLOYMENT & EDUCATIONAL PROGRAM: THE HERO HOUSE CAREER DEVELOPMENT CENTER IS COMMITTED TO SUPPORTING OUR MEMBERS' EDUCATIONAL AND EMPLOYMENT GOALS, FROM LEARNING TO READ TO FINDING EMPLOYMENT. WITH TODAY'S JOBS REQUIRING SPECIALIZED TRAINING AND SKILLS, THE CONNECTION BETWEEN HAVING A SOLID EDUCATION AND CAREER DEVELOPMENT HAS BECOME INCREASINGLY CRUCIAL. HERO HOUSE HAS A GOOD TRACK RECORD OF INITIATING AND DEVELOPING TRANSITIONAL EMPLOYMENT (TE). WE HAVE WORKED WITH LOCAL COMPANIES TO PLACE MEMBERS ON TRANSITIONAL EMPLOYMENT JOBS AT THEIR PLACE OF BUSINESS SINCE 2005. THROUGH THE TE PROGRAM, MANAGED BY MEMBERS AND STAFF TOGETHER, MEMBERS ARE PLACED IN PAID, ENTRY-LEVEL POSITIONS IN TWO SENSES: THEY LET MEMBERS EASE INTO THE WORLD OF WORK WITH A DIRECT CONNECTION TO THE JOB, AS WELL AS ON THE JOB TRAINING AND JOB SITE VISITS FROM HERO HOUSE PLACEMENT MANAGERS. TYPICALLY, EACH PLACEMENT LASTS BETWEEN SIX AND NINE MONTHS. THE MEMBER MAY THEN MOVE ON TO OTHER PLACEMENTS UNTIL THEY ARE READY FOR A LESS SUPPORTED JOB. SUPPORTED EMPLOYMENT (SE) COMBINES ASPECTS OF BOTH TRANSITIONAL EMPLOYMENT AND INDEPENDENT EMPLOYMENT. IT IS DESIGNED TO EASE MEBER'S INTEGRATION INTO LONG-TERM JOBS. WHILE PROVIDING A DIRECT REFERRAL FROM THE CLUBHOUSE TO THE EMPLOYER, AS WELL AS SOME INITIAL ON-JOB-TRAINING AND ASSISTANCE WHERE IT MAY BE NEEDED, SE IS DESIGNED TO OFFER ONGOING HERO HOUSE SUPPORT TO MEMBERS WHO ARE SEEKING OR HAVE MOVED INTO MORE PERMANENT EMPLOYMENT. THIS INCLUDES A FULL JOB SEARCH, ASSISTANCE WITH APPLICATION FORMS, RESUMES, COVER LETTERS, MOCK INTERVIEWS, AS WELL AS ACCESSING ITEMS NEEDED FOR INTERVIEWS, SUCH AS CLOTHING. ONCE COMFORTABLY ON THE JOB , MEMBERS ARE KEPT IN TOUCH WITH THROUGH EMPLOYMENT PHONE REACH OUT, MONTHLY DINNERS AND OTHER SUPPORTS AS NEEDED. IT ALSO PROVIDES SUPPORT TO THE COMPANY THAT MAY INITIALLY BE UNSURE ABOUT HIRING A MEMBER FOR A REGULAR JOB. MEMBERS WITH PRIOR WORK EXPERIENCE, AND/OR JOB RELATED EDUCATION, SKILLS AND ABILITIES AS WELL AS THOSE WHO THROUGH TE COMPLETE A NUMBER OF PLACEMENTS ARE ENCOURAGED TO SEEK THEIR OWN JOB. HERO HOUSE'S EMPLOYMENT SUPPORT HELPS THEM PREPARE RESUMES, COACHES THEM IN JOB SEARCH AND INTERVIEW TECHNIQUES. UNLIKE TE AND SE, MEMBERS GO ON COMPETITIVE INTERVIEWS TO GET JOBS GAINING INDEPENDENT EMPLOYMENT (IE). WHILE MEMBERS ARE WORKING, THEY CAN CONTINUE TO CALL ON HERO HOUSE FOR SUPPORT BY PHONE AND THROUGH A UNIT AVAILABLE TO WORKING MEMBERS WEEKDAY EVENINGS AND SUNDAY AFTERNOONS. JOB CLUB IS HELD EACH WEEK TO ASSIST MEMBERS WITH BECOMING JOB READY. IN JOB CLUB MEMBERS TAKE AN ACTIVE ROLE TOWARD MOVING BACK INTO THE WORKING COMMUNITY. JOB CLUB HELPS MEMBERS WITH WRITING RESUME'S, PREPARING COVER LETTERS, SEARCHING FOR JOBS, INTERVIEW PREPARATION, AND OVERALL JOB READINESS. HERO HOUSE SUPPORTS MEMBERS WITH BASIC COURSES, GEARED TOWARD SUPPORTING GED ACHIEVEMENT, IN READING, WRITING, MATH, AND COMPUTERS TAUGHT BY HERO HOUSE MEMBERS WITH SUBJECT MATTER EXPERTISE. |
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S PROCESS TO REVIEW FORM 990 COPIES OF THE FORM 990 ARE REVIEWED BY THE EXECUTIVE DIRECTOR AND THE FINANCE COMMITTEE, INCLUDING THE PRESIDENT OF THE BOARD, PRIOR TO FILING THE DOCUMENT WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE EXECUTIVE DIRECTOR ASSISTS THE BOARD WITH REGULARLY AND CONSISTENTLY MONITORING AND ENFORCING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC USING GUIDESTAR WHO RECEIVES THE 990 FROM THE IRS. THE HERO HOUSE MAKES GOVERNING DOCUMENTS AVAILABLE UPON REQUEST. BOARD MEMBERS REVIEW FINANCIAL STATEMENTS ON A MONTHLY BASIS. AFTER THE AUDIT PROCESS, THE AUDITOR GOES OVER THE FINANCIALS WITH THE BOARD. THE AUDITED FINANCIAL STATEMENTS ARE ROUTINELY SHARED WITH POTENTIAL GRANTORS AND A SUMMARIZED VERSION OF THE FINANCIAL DATA IS SHARED WITH DONORS, ETC. IN AN ANNUAL REPORT. |
| Software ID: | |
| Software Version: |