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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
THE COMMUNITY FOUNDATION
OF MENDOCINO COUNTY
Employer identification number
68-0330462
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) Action Network
PO Box 1163
Gualala,CA95445
45-0479312 501(c)(3) 5,176 0     Programs
(2) Adventist Health Ukiah Valley
275 Hospital Drive
Ukiah,CA95482
94-1639901 501(c)(3) 32,897 0     Equipment, health screening
(3) Albion-Little River Fire Dist
PO Box 634
Albion,CA95410
26-1583790 501(c)(1) 10,929 0     General operating support
(4) Anderson Valley Community Ser
PO Box 398
Boonville,CA95415
94-2533616 501(c)(3) 10,000 0     Anderson Valley Teen Center trips
(5) Anderson Valley Elderhome
PO Box 455
Boonville,CA95415
68-0419055 501(c)(3) 10,000 0     ADA-compliant bathroom
(6) Anderson Valley Fire Departme
PO Box 398
Boonville,CA95415
94-2533616 501(c)(3) 6,900 0     General support
(7) Anderson Valley High School
PO Box 130
Boonville,CA95415
94-6002711 501(c)(1) 12,500 0     Summer school and history programs
(8) Anderson Valley Land Trust
PO Box 141
Boonville,CA95415
94-3142400 501(c)(3) 6,500 0     General Support
(9) Arts Council of Mendocino
309 East Perkins
Ukiah,CA95482
68-0455596 501(c)(3) 35,824 0     GASP astist program and grants
(10) BONES Pet Rescue
PO Box 1009
Covelo,CA95428
74-3055225 501(c)(3) 7,100 0     Spay and neutering , equipment
(11) Boys & Girls Central Sonoma
1400 N Dutton Ave Suite 14
Santa Rosa,CA95401
68-0309534 501(c)(3) 20,000 0     Summer camps for victims of fires
(12) Boys and Girls Club of Ukiah
PO Box 67
Ukiah,CA95482
68-0340783 501(c)(3) 6,750 0     Canopies and picnic tables
(13) Cancer Resource Center
PO Box 50
Mendocino,CA95460
68-0357416 501(c)(3) 21,937 0     Programs
(14) CASA of Seventh Judicial Dist
PO Box 1708
Montrose,CO81402
68-0357416 501(c)(3) 25,000 0     General support
(15) Coastal Seniors
PO Box 437
Point Arena,CA95468
94-2902833 501(c)(3) 11,000 0   Meals and food cost assistance  
(16) Community Care Management Cor
301 South State Street
Ukiah,CA95482
68-0046074 501(c)(3) 5,499 0     Programs and general support
(17) Comptche Volunteer Fire Depar
PO Box 164
Comptche,CA95427
94-3020003 501(c)(3) 10,000 0     Generator for emergency shelter
(18) Covelo Fire Protection Distri
PO Box 36
Covelo,CA95428
94-2289703 501(c)(1) 7,000 0     Pagers for volunteer responders
(19) Eagle Peak Middle School
8601 West Rd
Redwood Valley,CA95470
46-1344445 501(c)(1) 8,500 0     Programs for fire survivors
(20) Earle Baum Center of the Blin
4539 Occidental Road
Santa Rosa,CA94501
91-1840275 501(c)(3) 10,000 0     Impacted by fires youth assistance
(21) Earthjustice
50 California Street
San Francisco,CA94111
94-1730465 501(c)(3) 10,000 0     General operating support
(22) Family Medicine Education
PO Box 595
Ukiah,CA95482
47-4314677 501(c)(3) 6,000 0     Data sharing licenses and training
(23) Forget Me Not Farm Childrens
5345 Highway 12 West
Santa Rosa,CA95407
26-3464770 501(c)(3) 20,000 0     Summer camp for fire survivors
(24) Fort Bragg Unified School Dis
312 South Lincoln
Fort Bragg,CA95437
94-6002711 501(c)(1) 11,500 0     Kitchen hot holding cabinet, music
(25) Friends of ArtQuest
PO Box 5693
Santa Rosa,CA95402
68-0446082 501(c)(3) 30,000 0     ArtQuest program
(26) Friends of Hospice
PO Box 754
Fort Bragg,CA95437
68-0202517 501(c)(3) 6,959 0     General operating support
(27) Habitat for Humanity
PO Box 770
Fort Bragg,CA95437
68-0245947 501(c)(3) 5,970 0     General operating support
(28) Hospice of Ukiah
620 South Dora Street Ste 1
Ukiah,CA95482
68-0248383 501(c)(3) 8,737 0     General operating support
(29) Humane Society Sonoma County
5345 Highway 12 West
Santa Rosa,CA95407
94-6001315 501(c)(3) 10,000 0     Vet car for pets of fire victims
(30) Humane Society Inland Mendo
9700 Uva Dr
Redwood Valley,CA95470
94-2674977 501(c)(3) 7,550 0     General and emergency support
(31) Kelley House Museum
PO Box 922
Mendocino,CA95460
94-2277534 501(c)(3) 7,929 0     General operating support
(32) Lomi Psychotherapy Clinic
534 B Street
Santa Rosa,CA95401
94-2495238 501(c)(3) 12,000 0     Counseling for youth fire victims
(33) Long Valley Health Center
PO Box 870
Laytonville,CA95454
94-2536128 501(c)(3) 10,000 0     Vehicle for patients transportation
(34) Mendocino Area Parks Associat
PO Box 1387
Mendocino,CA95460
68-0049014 501(c)(3) 15,250 0     Standish Hickey recreation area
(35) Mendocino Art Center
PO Box 765
Mendocino,CA95460
94-6050398 501(c)(3) 7,959 0     Board training, operating support
(36) Mendocino Coast Audubon Socie
PO Box 2297
Fort Bragg,CA95437
31-1578005 501(c)(3) 7,898 0     General support
(37) Mendocino Coast Botanical Grd
18220 N Highway 1
Fort Bragg,CA95437
94-2800886 501(c)(3) 7,789 0     General operating support
(38) Mendocino Coast Childrens Fu
PO Box 1616
Mendocino,CA95460
68-0367383 501(c)(3) 21,000 0     Immediate relief for fire survivors
(39) Mendocino Coast Hospital Foun
775 River Drive
Fort Bragg,CA95437
68-0041554 501(c)(3) 5,970 0     General operating support
(40) Mendocino Coast Hospitality
PO Box 2168
Fort Bragg,CA95437
94-3016840 501(c)(3) 18,000 0     Equipment, general support
(41) Mendocino Music Festival
PO Box 1808
Mendocino,CA95460
94-3047133 501(c)(3) 7,789 0     General operating support
(42) Mendocino Performing Arts
PO Box 800
Mendocino,CA95460
94-2599308 501(c)(3) 7,500 0     Supporting the 2018 Season
(43) Mendocino Presbyterian Church
PO Box 105
Mendocino,CA95460
94-2202684 501(c)(3) 39,204 0     General operating support
(44) Mendocino Rotary Foundation
PO Box 1910
Mendocino,CA95460
46-2212022 501(c)(3) 6,959 0     Support a park construction
(45) Mendocino Study Club
PO Box 48
Mendocino,CA95460
94-6091466 501(c)(3) 6,959 0     General operating support
(46) Mendocino Unified School Dist
PO Box 1154
Mendocino,CA95460
94-6002711 501(c)(1) 9,000 0     Training Mental Health First Aid
(47) Mendocino Volunteer Fire Dept
44700 Little Lake Road
Mendocino,CA95460
68-0295787 501(c)(3) 17,929 0     General operating, program support
(48) Navarro-by-the-Sea Center
PO Box 1710
Mendocino,CA95460
91-2024571 501(c)(3) 6,500 0     General support
(49) North Coast Opportunities
413 N State St
Ukiah,CA95482
94-1671958 501(c)(3) 828,575 0     Fire relief and program support
(50) Piercy Fire Protection Distri
PO Box 206
Piercy,CA95587
20-5475212 501(c)(1) 7,500 0     Center entry handicap access
(51) Potter Valley Community Servi
PO Box 46
Potter Valley,CA95469
501(c)(1) 25,000 0     Support from PG&E gift
(52) Potter Valley Youth Center
PO Box 273
Potter Valley,CA95469
91-1818721 501(c)(3) 36,041 0     Relief for fire disaster victims
(53) Puma Athletic Boosters
6975 Montecito Boosters
Santa Rosa,CA95409
46-2828377 501(c)(3) 7,000 0     Athletic Program at Maria Carrillo
(54) Raise & Shine
166 E Gobbi St Ste A
Ukiah,CA95482
47-3718451 501(c)(3) 152,701 0     Medical and education programs
(55) Redwood Coast Seniors
484 N Harold St
Fort Bragg,CA95437
23-7286987 501(c)(3) 20,166 0     Meals on Wheels, medical support
(56) Redwood Community Services
PO Box 2077
Ukiah,CA95482
68-0367894 501(c)(3) 15,050 0     Camp program, performances
(57) Redwood Valley Calpella Fire
PO Box 385
Redwood Valley,CA95470
94-1622618 501(c)(1) 20,000 0     Support from PG&E gift
(58) Redwood Valley Pomo Indians
3250 Road I
Redwood Valley,CA95470
68-0042928   10,000 0     Native plant garden restoration.
(59) Ridgewood TRAIL Riders Associ
16200 N Highway 101
Willits,CA95490
61-1487079 501(c)(3) 5,500 0     Handicap accessible restroom
(60) SAFE Passage
208 Dana Street
Fort Bragg,CA95437
68-0430046 501(c)(3) 5,873 0     Programs
(61) SAFER
9825 Mill Station Rd
Sebastopol,CA95472
26-3593812 501(c)(3) 20,000 0     Evacuation and care of animals
(62) Santa Rosa High School Agricu
1235 Mendocino Ave
Santa Rosa,CA95401
68-0180139 501(c)(3) 20,000 0     Rebuilding farm facility
(63) Sherwood Oaks Auxiliary
130 Dana St
Fort Bragg,CA95437
94-2816374 501(c)(3) 10,000 0     Programs for seniors
(64) Social Advocates for Youth
2447 Summerfield Road
Santa Rosa,CA95405
94-1711490 501(c)(3) 20,000 0     Mental health services
(65) South Ukiah Rotary Foundation
PO Box 1740
Ukiah,CA95482
37-1787088 501(c)(3) 10,000 0     Trees for reforestation
(66) SPACE-School of PerformingArt
508 W Perkins
Ukiah,CA95482
68-0379044 501(c)(3) 28,250 0     General operating support
(67) Ukiah Foundation for Commerce
200 S School St
Ukiah,CA95482
94-3235558 501(c)(3) 7,000 0     Mendocino Construction Corps
(68) Ukiah Senior Center
499 Leslie St
Ukiah,CA95482
23-7258082 501(c)(3) 33,899 0     General operating support
(69) Ukiah Valley Christmas Effort
PO Box 801
Ukiah,CA95482
33-1101697 501(c)(3) 5,250 0     General support
(70) Vintage House Senior Center
264 First Street East
Sonoma,CA95476
94-2745586 501(c)(3) 20,000 0     PTSD/stress reduction curriculum
(71) West Company
760 Stewart St Ste B
Fort Bragg,CA95437
68-0264466 501(c)(3) 14,500 0     Programs and operating support
(72) Willits Seniors
1501 Baechtel Road
Willits,CA95490
94-2250908 501(c)(3) 5,381 0     Meals on Wheels and transportation
(73) Willits Unified School Distri
1277 Blosser Lane
Willits,CA95490
94-6002711 501(c)(1) 10,000 0     Constructing a safe walking path
(74) Youth Garden Project
530 South 400 East
Moab,UT84532
87-0568051 501(c)(3) 7,000 0     Programs and summer camp
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
73
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2017
Page 2

Schedule I (Form 990) 2017
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
noncash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of noncash assistance
(1) Scholarship grants 71 102,875   N/A N/A
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Additional Supplemental Information Grants for scholarships listed in Part III are made directly to educational institutions and not directly to a scholarship recipient. Individual scholarships amounts do not exceed $5,000 per student.
Grantmaker's Description of How Grants are Used The Board of Directors must approve all grants and grant agreements must be completed and signed by all parties before funds are released. After release of funds, recipients must supply report(s) on the actual use made of the grant funds and how that use complies with the terms of the grant.
Schedule I (Form 990) 2017



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Software ID: 17005038
Software Version: 2017v2.2