TY 2013 Form 990 Schedule O

efile Public Visual Render ObjectId: 201510379349301181 - Submission: 2015-02-06 TIN: 85-0222934

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.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

COYOTE CANYON REHABILITATION
CENTER INC

Employer identification number

85-0222934

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 COMMITTEES WITH THE 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 MACDONALD AVERY SPENDS APPROXIMATELY 4 HOURS/WEEK AND THE BOARD MEMBERS EACH SPEND APPROXIMATELY .77 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 XI, LINE 9	AFFILIATED ORGANIZATION INCOME REMOVED IN CONSOLIDATION -48,258 AFFILIATED ORGANIZATION REPORTED SEPARATELY 112,373 COST OF GOODS SOLD 131,468 EXPENSES OF AFFILIATED ORGANIZATION REPORTED SEPARATELY -90,495 COST OF GOODS SOLD REPORTED ON LINE 10B -131,468 RENT PAID TO AFFILIATED ORG ELIMINATED IN CONSOLIDATION 25,178 SUPPORT TO AFFILIATED ORG ELIMINATED IN CONSOLIDATION 23,080 BOOK / TAX DEPRECIATION DIFFERENCE -1
FORM 990, PART XI, LINE 9	NET ADJUSTMENTS FOR AFFILIATE, NOT IN RETURN -21,877
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.

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 COMMITTEES WITH THE 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 MACDONALD AVERY SPENDS APPROXIMATELY 4 HOURS/WEEK AND THE BOARD MEMBERS EACH SPEND APPROXIMATELY .77 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 XI, LINE 9

AFFILIATED ORGANIZATION INCOME REMOVED IN CONSOLIDATION -48,258 AFFILIATED ORGANIZATION REPORTED SEPARATELY 112,373 COST OF GOODS SOLD 131,468 EXPENSES OF AFFILIATED ORGANIZATION REPORTED SEPARATELY -90,495 COST OF GOODS SOLD REPORTED ON LINE 10B -131,468 RENT PAID TO AFFILIATED ORG ELIMINATED IN CONSOLIDATION 25,178 SUPPORT TO AFFILIATED ORG ELIMINATED IN CONSOLIDATION 23,080 BOOK / TAX DEPRECIATION DIFFERENCE -1

FORM 990, PART XI, LINE 9

NET ADJUSTMENTS FOR AFFILIATE, NOT IN RETURN -21,877

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.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

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