2024-11-06T16:15:08-06:00 2023-12-31 912011386 JACOBSON JARVIS & CO PLLC 200 1ST AVE W SUITE 200 SEATTLE WA 98119 990 2023-01-01 911154902 POLACK ADULT DAY CENTER POLA 2067258800 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 JEFFREY COHEN CEO 2067258800 2024-10-23 1 0 JACOB J DEHNE CPA P02534988 2066288990 2024-10-23 2023 2024-10-15 13:58:12Z JEFFREY COHEN 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 42402 0 X WWW.KLINEGALLAND.ORG X 1981 WA PROVIDES DAY CARE FACILITIES, MEALS, HEALTH MONITORING, RECREATIONAL AND SOCIAL ACTIVITIES FOR SENIOR ADULTS. 25 25 0 25 0 0 40700 29607 12486 12795 0 0 0 0 53186 42402 0 0 0 0 3731 717 0 0 0 49726 41418 53457 42135 -271 267 61515 61782 0 0 61515 61782 POLACK ADULT DAY CENTER PROVIDES DAY CARE FACILITIES, MEALS, HEALTH MONITORING, RECREATIONAL AND SOCIAL ACTIVITIES FOR SENIOR ADULTS. 0 0 39384 12795 MEALS ON WHEELS PROVIDED 2,470 MEALS TO SENIORS. 39384 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 25 25 0 0 1 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X TRACEY GROSCOST 2067258800 7500 SEWARD PARK AVENUE SOUTH SEATTLE WA 98118 IRENE FISHER CHAIR 0.50 3.00 X X 0 0 0 ROBERT SIMON VICE CHAIR 0.50 3.00 X X 0 0 0 BARBARA SULMAN SECRETARY 0.50 3.00 X X 0 0 0 JAY RIFFKIN TREASURER 0.50 3.00 X X 0 0 0 JEANIE ALHADEFF DIRECTOR 0.25 1.75 X 0 0 0 JACK ALMO DIRECTOR 0.50 3.00 X 0 0 0 DAVID BENOLIEL DIRECTOR 0.25 1.75 X 0 0 0 MARC BRIDGE DIRECTOR 0.25 1.75 X 0 0 0 MICHAEL COHEN DIRECTOR 0.25 1.75 X 0 0 0 LYNN DUBEY DIRECTOR 0.25 1.75 X 0 0 0 DAVID FAIN DIRECTOR 0.25 1.75 X 0 0 0 MARK KANE DIRECTOR 0.25 1.75 X 0 0 0 THOMAS LEAVITT DIRECTOR 0.25 1.75 X 0 0 0 ALVIN MARTIN DIRECTOR 0.25 1.75 X 0 0 0 RABBI JAMES MIREL DIRECTOR 0.25 1.75 X 0 0 0 MICHAEL MORGAN DIRECTOR 0.25 1.75 X 0 0 0 JEFF PIHA DIRECTOR 0.25 1.75 X 0 0 0 BRIAN QUINT DIRECTOR 0.25 1.75 X 0 0 0 ARI ROBICSEK DIRECTOR 0.25 1.75 X 0 0 0 DOUGLAS ROSEN DIRECTOR 0.25 1.75 X 0 0 0 STEVEN SCHWARTZ DIRECTOR 0.25 1.75 X 0 0 0 DAVID SHAPIRO DIRECTOR 0.25 1.75 X 0 0 0 ALLAN STEINMAN DIRECTOR 0.25 1.75 X 0 0 0 DOUG WIVIOTT DIRECTOR 0.25 1.75 X 0 0 0 ELANA ZANA DIRECTOR 0.25 1.75 X 0 0 0 JEFF COHEN CHIEF EXECUTIVE OFFICER 0.40 39.60 X 0 795342 63010 TRACEY GROSCOST CHIEF FINANCIAL OFFICER 0.40 39.60 X 0 327439 10075 ERIN SHERIDAN CHIEF COMPLIANCE OFFICER AND GENERAL COUNSEL 0.40 39.60 X 0 182638 10167 0 1305419 83252 0 0 1 0 0 24000 5607 29607 MEALS ON WHEELS 624100 12795 12795 12795 42402 12795 0 0 603 603 30 30 41 41 43 43 41 41 1753 1753 476 388 88 3002 3000 2 125 125 7 7 4 4 14697 14697 7609 7609 13614 13614 OTHER EXPENSES 90 76 14 42135 39384 2751 0 2622 4137 1554 3403 2590 92883 75597 24895 17286 30595 36215 61515 61782 0 0 X 61515 61782 61515 61782 61515 61782 267 0 X 0 1 X 1 0 X 233283 106122 55198 40700 29607 464910 29549 10541 10522 12486 12795 75893 262832 116663 65720 53186 42402 540803 0 0 0 540803 262832 116663 65720 53186 42402 540803 1.00000 1.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 92883 75597 17286 17286 DUE FROM AFFILIATES 36215 36215 0 0 0 0 0 0 0 0 0 JEFF COHEN CHIEF EXECUTIVE OFFICER 0 743128 0 43552 0 8662 0 39000 0 24010 0 858352 0 0 TRACEY GROSCOST CHIEF FINANCIAL OFFICER 0 324810 0 2629 0 0 0 9744 0 331 0 337514 0 0 ERIN SHERIDAN CHIEF COMPLIANCE OFFICER AND GENERAL 0 181166 0 1472 0 0 0 3015 0 7152 0 192805 0 0 FORM 990, PART VII, SECTION A, LINE 4: THE COMPENSATION AMOUNTS REPORTED IN PART VII WERE PAID BY KLINE GALLAND PAYROLL COMPANY LLC, WHICH SERVES AS THE MASTER PAYROLL COMPANY FOR THIS ENTITY AND THOSE RELATED ENTITIES LISTED IN SCHEDULE R PART II. FORM 990, PART VI, SECTION A, LINE 4 FILED ARTICLES OF AMENDMENT AND RESTATED ARTICLES OF INCORPORATION. FORM 990, PART VI, SECTION A, LINE 6 THE KLINE GALLAND CENTER IS THE SOLE CORPORATE MEMBER OF THIS ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED FIRST BY THE CFO, AND THEN THE CEO AND ALL MEMBERS OF THE BOARD RECEIVE A DRAFT PRIOR TO THE FILING OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C DESIGNATED COMPLIANCE OFFICER REPORTS TO THE BOARD AND CEO THAT OVERSEES COMPLIANCE AND ADHERENCE TO APPLICABLE LAWS, RULES, AND REGULATIONS. FORM 990, PART VI, SECTION B, LINE 15 A COMMITTEE OF THE BOARD DETERMINES THE CEO'S COMPENSATION BY CONSULTING A NATIONAL SALARY SURVEY. COMPENSATION OF THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED VIA LOCAL SALARY SURVEYS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC BY REQUEST. KLINE GALLAND CENTER (KGC) 7500 SEWARD PARK AVE S SEATTLE WA 98118 911154904 SUPPORT WA 501(C)(3) LINE 12A, I 0 CAROLINE KLINE GALLAND HOME 7500 SEWARD PARK AVE S SEATTLE WA 98118 910950710 NURSING CARE WA 501(C)(3) LINE 10 KGC 0 THE SUMMIT AT FIRST HILL 7500 SEWARD PARK AVE S SEATTLE WA 98118 911973348 INDEPENDENT AND ASSISTED LIVING WA 501(C)(3) LINE 10 KGC 0 POLACK FAMILY SUPPORTING FOUNDATION 7500 SEWARD PARK AVE S SEATTLE WA 98118 911289467 SUPPORT WA 501(C)(3) LINE 12A, I KGC 0 CAROLINE KLINE GALLAND TESTAMENTARY TRUST 7500 SEWARD PARK AVE S SEATTLE WA 98118 910567729 SUPPORT WA 501(C)(3) LINE 12A, I KGC 0 KLINE GALLAND CENTER FOUNDATION 7500 SEWARD PARK AVE S SEATTLE WA 98118 911973347 SUPPORT WA 501(C)(3) LINE 12A, I KGC 0 KLINE GALLAND PAYROLL COMPANY LLC 7500 SEWARD PARK AVE S SEATTLE WA 98118 912087012 COMMON PAYMASTER WA KGC C 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0