401k Plan data: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN plan

PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 401k Plan overview

Plan Name	PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN
Plan identification number	002

PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN Benefits

401k Plan Type

Defined Contribution Pension

Plan Features/Benefits

Profit-sharing
ERISA section 404(c) Plan - This plan, or any part of it is intended to meet the conditions of 29 CFR 2550.404c-1.
Total participant-directed account plan - Participants have the opportunity to direct the investment of all the assets allocated to their individual accounts, regardless of whether 29 CFR 2550.404c-1 is intended to be met.
Code section 401(k) feature - A cash or deferred arrangement described in Code section 401(k) that is part of a qualified defined contribution plan that provides for an election by employees to defer part of their compensation or receive these amounts in cash.
Code section 401(m) arrangement - Employee contributions are allocated to separate accounts under the plan or employer contributions are based, in whole or in part, on employee deferrals or contribtions to the plan. Not applicable if plan is 401(k) plan with only QNECs and/or QMACs. Also not applicable if Code section 403(b)(1), 403(b)(7) or 408 arrangements/accounts/annuities.
Master plan - A pension plan that is made available by a sponsor for adoption by employers; that is the subject of a favorable opinion letter; and for which a single funding medium (for example, a trust or custodial account) is established for the joint use of all adopting employers.

401k Sponsoring company profile

PACIFIC LODGE YOUTH SERVICES, INC. has sponsored the creation of one or more 401k plans.

Company Name: PACIFIC LODGE YOUTH SERVICES, INC.

Employer identification number (EIN): 951691300

NAIC Classification: 623000
NAIC Description: Nursing and Residential Care Facilities

Form 5500 Filing Information

Submission information for form 5500 for 401k plan PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN

Plan id# Filing Submission Date Name of Administrator Date Administrator Signed Name of Company Sponsor Date Sponsor Signed
002 2017-01-01 DOUG BUTTRICK
002 2016-01-01 DOUG BUTTRICK
002 2015-01-01 DOUG BUTTRICK
002 2014-01-01 CHARLES M. BEST
002 2013-01-01 CHARLES M. BEST
002 2012-01-01 OLGA DIAZ 2013-09-23 OLGA DIAZ 2013-09-23
002 2011-01-01 NOEMI WATANABE 2012-06-14 NOEMI WATANABE 2012-06-14
002 2010-01-01 NOEMI WATANABE NOEMI WATANABE 2011-07-22

Plan id#	Filing Submission Date	Name of Administrator	Date Administrator Signed	Name of Company Sponsor	Date Sponsor Signed
002	2017-01-01	DOUG BUTTRICK
002	2016-01-01	DOUG BUTTRICK
002	2015-01-01	DOUG BUTTRICK
002	2014-01-01	CHARLES M. BEST
002	2013-01-01	CHARLES M. BEST
002	2012-01-01	OLGA DIAZ	2013-09-23	OLGA DIAZ	2013-09-23
002	2011-01-01	NOEMI WATANABE	2012-06-14	NOEMI WATANABE	2012-06-14
002	2010-01-01	NOEMI WATANABE		NOEMI WATANABE	2011-07-22

Plan Statistics for PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN

401k plan membership statisitcs for PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN

Measure Date Value
2017: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year 2017-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2017-01-01 0
Number of retired or separated participants receiving benefits 2017-01-01 0
Number of other retired or separated participants entitled to future benefits 2017-01-01 0
Total of all active and inactive participants 2017-01-01 0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2017-01-01 0
Total participants 2017-01-01 0
Number of participants with account balances 2017-01-01 0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2017-01-01 0
2016: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year 2016-01-01 204
Total number of active participants reported on line 7a of the Form 5500 2016-01-01 55
Number of retired or separated participants receiving benefits 2016-01-01 0
Number of other retired or separated participants entitled to future benefits 2016-01-01 118
Total of all active and inactive participants 2016-01-01 173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2016-01-01 0
Total participants 2016-01-01 173
Number of participants with account balances 2016-01-01 157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2016-01-01 19
2015: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year 2015-01-01 140
Total number of active participants reported on line 7a of the Form 5500 2015-01-01 102
Number of retired or separated participants receiving benefits 2015-01-01 0
Number of other retired or separated participants entitled to future benefits 2015-01-01 102
Total of all active and inactive participants 2015-01-01 204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2015-01-01 0
Total participants 2015-01-01 204
Number of participants with account balances 2015-01-01 169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2015-01-01 27
2014: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year 2014-01-01 202
Total number of active participants reported on line 7a of the Form 5500 2014-01-01 140
Number of retired or separated participants receiving benefits 2014-01-01 0
Number of other retired or separated participants entitled to future benefits 2014-01-01 75
Total of all active and inactive participants 2014-01-01 215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2014-01-01 0
Total participants 2014-01-01 215
Number of participants with account balances 2014-01-01 155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2014-01-01 17
2013: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year 2013-01-01 130
Total number of active participants reported on line 7a of the Form 5500 2013-01-01 122
Number of retired or separated participants receiving benefits 2013-01-01 0
Number of other retired or separated participants entitled to future benefits 2013-01-01 80
Total of all active and inactive participants 2013-01-01 202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2013-01-01 0
Total participants 2013-01-01 202
Number of participants with account balances 2013-01-01 131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2013-01-01 27
2010: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year 2010-01-01 108
Total number of active participants reported on line 7a of the Form 5500 2010-01-01 88
Number of retired or separated participants receiving benefits 2010-01-01 0
Number of other retired or separated participants entitled to future benefits 2010-01-01 10
Total of all active and inactive participants 2010-01-01 98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits 2010-01-01 0
Total participants 2010-01-01 98
Number of participants with account balances 2010-01-01 98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2010-01-01 1

Measure	Date	Value
2017: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k membership
Total participants, beginning-of-year	2017-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2017-01-01	0
Number of retired or separated participants receiving benefits	2017-01-01	0
Number of other retired or separated participants entitled to future benefits	2017-01-01	0
Total of all active and inactive participants	2017-01-01	0
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2017-01-01	0
Total participants	2017-01-01	0
Number of participants with account balances	2017-01-01	0
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2017-01-01	0
2016: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k membership
Total participants, beginning-of-year	2016-01-01	204
Total number of active participants reported on line 7a of the Form 5500	2016-01-01	55
Number of retired or separated participants receiving benefits	2016-01-01	0
Number of other retired or separated participants entitled to future benefits	2016-01-01	118
Total of all active and inactive participants	2016-01-01	173
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2016-01-01	0
Total participants	2016-01-01	173
Number of participants with account balances	2016-01-01	157
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2016-01-01	19
2015: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k membership
Total participants, beginning-of-year	2015-01-01	140
Total number of active participants reported on line 7a of the Form 5500	2015-01-01	102
Number of retired or separated participants receiving benefits	2015-01-01	0
Number of other retired or separated participants entitled to future benefits	2015-01-01	102
Total of all active and inactive participants	2015-01-01	204
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2015-01-01	0
Total participants	2015-01-01	204
Number of participants with account balances	2015-01-01	169
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2015-01-01	27
2014: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 401k membership
Total participants, beginning-of-year	2014-01-01	202
Total number of active participants reported on line 7a of the Form 5500	2014-01-01	140
Number of retired or separated participants receiving benefits	2014-01-01	0
Number of other retired or separated participants entitled to future benefits	2014-01-01	75
Total of all active and inactive participants	2014-01-01	215
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2014-01-01	0
Total participants	2014-01-01	215
Number of participants with account balances	2014-01-01	155
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2014-01-01	17
2013: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2013 401k membership
Total participants, beginning-of-year	2013-01-01	130
Total number of active participants reported on line 7a of the Form 5500	2013-01-01	122
Number of retired or separated participants receiving benefits	2013-01-01	0
Number of other retired or separated participants entitled to future benefits	2013-01-01	80
Total of all active and inactive participants	2013-01-01	202
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2013-01-01	0
Total participants	2013-01-01	202
Number of participants with account balances	2013-01-01	131
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2013-01-01	27
2010: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2010 401k membership
Total participants, beginning-of-year	2010-01-01	108
Total number of active participants reported on line 7a of the Form 5500	2010-01-01	88
Number of retired or separated participants receiving benefits	2010-01-01	0
Number of other retired or separated participants entitled to future benefits	2010-01-01	10
Total of all active and inactive participants	2010-01-01	98
Number of deceased participants whose beneficiaries are receiving or are entitled to receive benefits	2010-01-01	0
Total participants	2010-01-01	98
Number of participants with account balances	2010-01-01	98
Participants that terminated employment during the plan year with accrued benefits that were less than 100% vested	2010-01-01	1

Financial Data on PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN

Measure	Date	Value
2017 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 401k financial data
Total unrealized appreciation/depreciation of assets	2017-06-30	$0
Total transfer of assets from this plan	2017-06-30	$2,072,976
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2017-06-30	$0
Total income from all sources (including contributions)	2017-06-30	$181,915
Total loss/gain on sale of assets	2017-06-30	$0
Total of all expenses incurred	2017-06-30	$73,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2017-06-30	$73,414
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2017-06-30	$11,097
Value of total assets at end of year	2017-06-30	$0
Value of total assets at beginning of year	2017-06-30	$1,964,903
Total of administrative expenses incurred including professional, contract, advisory and management fees	2017-06-30	$428
Total interest from all sources	2017-06-30	$42
Total dividends received (eg from common stock, registered investment company shares)	2017-06-30	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2017-06-30	Yes
Value of any plan assets that reverted to the employer resulting from resoluton to terminate the plan	2017-06-30	$0
Assets. Real estate other than employer real property at end of year	2017-06-30	$0
Assets. Real estate other than employer real property at beginning of year	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2017-06-30	$0
Was this plan covered by a fidelity bond	2017-06-30	Yes
Value of fidelity bond cover	2017-06-30	$500,000
If this is an individual account plan, was there a blackout period	2017-06-30	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2017-06-30	$0
Were there any nonexempt tranactions with any party-in-interest	2017-06-30	No
Contributions received from participants	2017-06-30	$6,365
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$22,252
Participant contributions at end of year	2017-06-30	$0
Participant contributions at beginning of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at end of year	2017-06-30	$0
Assets. Other investments not covered elsewhere at beginning of year	2017-06-30	$0
Income. Received or receivable in cash from other sources (including rollovers)	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2017-06-30	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2017-06-30	$0
Assets. Loans (other than to participants) at end of year	2017-06-30	$0
Assets. Loans (other than to participants) at beginning of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2017-06-30	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2017-06-30	$0
Liabilities. Value of operating payables at end of year	2017-06-30	$0
Liabilities. Value of operating payables at beginning of year	2017-06-30	$0
Total non interest bearing cash at end of year	2017-06-30	$0
Total non interest bearing cash at beginning of year	2017-06-30	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Income. Non cash contributions	2017-06-30	$0
Value of net income/loss	2017-06-30	$108,073
Value of net assets at end of year (total assets less liabilities)	2017-06-30	$0
Value of net assets at beginning of year (total assets less liabilities)	2017-06-30	$1,964,903
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2017-06-30	No
Were any loans by the plan or fixed income obligations due to the plan in default	2017-06-30	No
Were any leases to which the plan was party in default or uncollectible	2017-06-30	No
Assets. partnership/joint venture interests at end of year	2017-06-30	$0
Assets. partnership/joint venture interests at beginning of year	2017-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2017-06-30	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2017-06-30	$0
Value of interest in pooled separate accounts at end of year	2017-06-30	$0
Value of interest in pooled separate accounts at beginning of year	2017-06-30	$1,942,651
Value of interest in master investment trust accounts at end of year	2017-06-30	$0
Value of interest in master investment trust accounts at beginning of year	2017-06-30	$0
Value of interest in common/collective trusts at end of year	2017-06-30	$0
Value of interest in common/collective trusts at beginning of year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2017-06-30	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2017-06-30	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2017-06-30	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2017-06-30	$42
Assets. Value of investments in 103.12 investment entities at end of year	2017-06-30	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2017-06-30	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2017-06-30	$0
Asset value of US Government securities at end of year	2017-06-30	$0
Asset value of US Government securities at beginning of year	2017-06-30	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2017-06-30	$170,776
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2017-06-30	No
Was there a failure to transmit to the plan any participant contributions	2017-06-30	No
Has the plan failed to provide any benefit when due under the plan	2017-06-30	No
Assets. Invements in employer securities at end of year	2017-06-30	$0
Assets. Invements in employer securities at beginning of year	2017-06-30	$0
Assets. Value of employer real property at end of year	2017-06-30	$0
Assets. Value of employer real property at beginning of year	2017-06-30	$0
Contributions received in cash from employer	2017-06-30	$4,732
Employer contributions (assets) at end of year	2017-06-30	$0
Employer contributions (assets) at beginning of year	2017-06-30	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2017-06-30	$73,414
Asset. Corporate debt instrument preferred debt at end of year	2017-06-30	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at end of year	2017-06-30	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2017-06-30	$0
Contract administrator fees	2017-06-30	$428
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2017-06-30	No
Assets. Corporate common stocks other than exployer securities at end of year	2017-06-30	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at end of year	2017-06-30	$0
Liabilities. Value of benefit claims payable at beginning of year	2017-06-30	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2017-06-30	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2017-06-30	$0
Did the plan have assets held for investment	2017-06-30	No
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2017-06-30	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2017-06-30	Yes
Liabilities. Value of acquisition indebtedness at end of year	2017-06-30	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2017-06-30	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2017-06-30	Yes
Opinion of an independent qualified public accountant for this plan	2017-06-30	Disclaimer
Accountancy firm name	2017-06-30	GROBSTEIN TEEPLE LLP
Accountancy firm EIN	2017-06-30	461955807
2016 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 401k financial data
Total unrealized appreciation/depreciation of assets	2016-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2016-12-31	$0
Total income from all sources (including contributions)	2016-12-31	$261,726
Total loss/gain on sale of assets	2016-12-31	$0
Total of all expenses incurred	2016-12-31	$161,286
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2016-12-31	$159,562
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2016-12-31	$123,608
Value of total assets at end of year	2016-12-31	$1,968,010
Value of total assets at beginning of year	2016-12-31	$1,867,570
Total of administrative expenses incurred including professional, contract, advisory and management fees	2016-12-31	$1,724
Total interest from all sources	2016-12-31	$960
Total dividends received (eg from common stock, registered investment company shares)	2016-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2016-12-31	No
Assets. Real estate other than employer real property at end of year	2016-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2016-12-31	$0
Was this plan covered by a fidelity bond	2016-12-31	Yes
Value of fidelity bond cover	2016-12-31	$500,000
If this is an individual account plan, was there a blackout period	2016-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2016-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2016-12-31	No
Contributions received from participants	2016-12-31	$70,085
Participant contributions at end of year	2016-12-31	$22,252
Participant contributions at beginning of year	2016-12-31	$28,035
Participant contributions at end of year	2016-12-31	$1,737
Participant contributions at beginning of year	2016-12-31	$4,234
Assets. Other investments not covered elsewhere at end of year	2016-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2016-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2016-12-31	$0
Assets. Loans (other than to participants) at end of year	2016-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2016-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2016-12-31	$0
Liabilities. Value of operating payables at end of year	2016-12-31	$0
Liabilities. Value of operating payables at beginning of year	2016-12-31	$0
Total non interest bearing cash at end of year	2016-12-31	$0
Total non interest bearing cash at beginning of year	2016-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Value of net income/loss	2016-12-31	$100,440
Value of net assets at end of year (total assets less liabilities)	2016-12-31	$1,968,010
Value of net assets at beginning of year (total assets less liabilities)	2016-12-31	$1,867,570
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2016-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2016-12-31	No
Were any leases to which the plan was party in default or uncollectible	2016-12-31	No
Assets. partnership/joint venture interests at end of year	2016-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2016-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2016-12-31	$0
Value of interest in pooled separate accounts at end of year	2016-12-31	$1,942,651
Value of interest in pooled separate accounts at beginning of year	2016-12-31	$1,832,463
Interest on participant loans	2016-12-31	$960
Value of interest in master investment trust accounts at end of year	2016-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2016-12-31	$0
Value of interest in common/collective trusts at end of year	2016-12-31	$0
Value of interest in common/collective trusts at beginning of year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2016-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2016-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2016-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2016-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2016-12-31	$0
Asset value of US Government securities at end of year	2016-12-31	$0
Asset value of US Government securities at beginning of year	2016-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2016-12-31	$137,158
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2016-12-31	No
Was there a failure to transmit to the plan any participant contributions	2016-12-31	No
Has the plan failed to provide any benefit when due under the plan	2016-12-31	No
Assets. Invements in employer securities at end of year	2016-12-31	$0
Assets. Invements in employer securities at beginning of year	2016-12-31	$0
Assets. Value of employer real property at end of year	2016-12-31	$0
Assets. Value of employer real property at beginning of year	2016-12-31	$0
Contributions received in cash from employer	2016-12-31	$53,523
Employer contributions (assets) at end of year	2016-12-31	$1,370
Employer contributions (assets) at beginning of year	2016-12-31	$2,838
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2016-12-31	$159,562
Asset. Corporate debt instrument preferred debt at end of year	2016-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2016-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2016-12-31	$0
Contract administrator fees	2016-12-31	$1,724
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2016-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2016-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2016-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2016-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2016-12-31	$0
Did the plan have assets held for investment	2016-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2016-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2016-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2016-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2016-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2016-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2016-12-31	Disclaimer
Accountancy firm name	2016-12-31	GROBSTEIN TEEPLE LLP
Accountancy firm EIN	2016-12-31	461955807
2015 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 401k financial data
Total unrealized appreciation/depreciation of assets	2015-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2015-12-31	$0
Total income from all sources (including contributions)	2015-12-31	$159,459
Total loss/gain on sale of assets	2015-12-31	$0
Total of all expenses incurred	2015-12-31	$146,005
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2015-12-31	$144,389
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2015-12-31	$202,479
Value of total assets at end of year	2015-12-31	$1,867,570
Value of total assets at beginning of year	2015-12-31	$1,854,116
Total of administrative expenses incurred including professional, contract, advisory and management fees	2015-12-31	$1,616
Total interest from all sources	2015-12-31	$1,410
Total dividends received (eg from common stock, registered investment company shares)	2015-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2015-12-31	No
Assets. Real estate other than employer real property at end of year	2015-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2015-12-31	$0
Was this plan covered by a fidelity bond	2015-12-31	Yes
Value of fidelity bond cover	2015-12-31	$500,000
If this is an individual account plan, was there a blackout period	2015-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2015-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2015-12-31	No
Contributions received from participants	2015-12-31	$135,672
Participant contributions at end of year	2015-12-31	$28,035
Participant contributions at beginning of year	2015-12-31	$41,361
Participant contributions at end of year	2015-12-31	$4,234
Participant contributions at beginning of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2015-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2015-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2015-12-31	$2,015
Value of other receiveables (less allowance for doubtful accounts) at end of year	2015-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2015-12-31	$0
Assets. Loans (other than to participants) at end of year	2015-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2015-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2015-12-31	$0
Liabilities. Value of operating payables at end of year	2015-12-31	$0
Liabilities. Value of operating payables at beginning of year	2015-12-31	$0
Total non interest bearing cash at end of year	2015-12-31	$0
Total non interest bearing cash at beginning of year	2015-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Value of net income/loss	2015-12-31	$13,454
Value of net assets at end of year (total assets less liabilities)	2015-12-31	$1,867,570
Value of net assets at beginning of year (total assets less liabilities)	2015-12-31	$1,854,116
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2015-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2015-12-31	No
Were any leases to which the plan was party in default or uncollectible	2015-12-31	No
Assets. partnership/joint venture interests at end of year	2015-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2015-12-31	$0
Investment advisory and management fees	2015-12-31	$1,616
Value of interest in registered invesment companies (eg mutual funds) at end of year	2015-12-31	$1,832,463
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2015-12-31	$1,812,755
Value of interest in pooled separate accounts at end of year	2015-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2015-12-31	$0
Interest on participant loans	2015-12-31	$1,410
Value of interest in master investment trust accounts at end of year	2015-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2015-12-31	$0
Value of interest in common/collective trusts at end of year	2015-12-31	$0
Value of interest in common/collective trusts at beginning of year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2015-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2015-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2015-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2015-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2015-12-31	$0
Asset value of US Government securities at end of year	2015-12-31	$0
Asset value of US Government securities at beginning of year	2015-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2015-12-31	$-44,430
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2015-12-31	No
Was there a failure to transmit to the plan any participant contributions	2015-12-31	No
Has the plan failed to provide any benefit when due under the plan	2015-12-31	No
Assets. Invements in employer securities at end of year	2015-12-31	$0
Assets. Invements in employer securities at beginning of year	2015-12-31	$0
Assets. Value of employer real property at end of year	2015-12-31	$0
Assets. Value of employer real property at beginning of year	2015-12-31	$0
Contributions received in cash from employer	2015-12-31	$64,792
Employer contributions (assets) at end of year	2015-12-31	$2,838
Employer contributions (assets) at beginning of year	2015-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2015-12-31	$144,389
Asset. Corporate debt instrument preferred debt at end of year	2015-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2015-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2015-12-31	$0
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2015-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2015-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2015-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2015-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2015-12-31	$0
Did the plan have assets held for investment	2015-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2015-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2015-12-31	No
Liabilities. Value of acquisition indebtedness at end of year	2015-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2015-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2015-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2015-12-31	Disclaimer
Accountancy firm name	2015-12-31	GROBSTEIN TEEPLE LLP
Accountancy firm EIN	2015-12-31	461955807
2014 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 401k financial data
Unrealized appreciation/depreciation of real estate assets	2014-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2014-12-31	$0
Total unrealized appreciation/depreciation of assets	2014-12-31	$0
Total transfer of assets to this plan	2014-12-31	$0
Total transfer of assets from this plan	2014-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2014-12-31	$0
Expenses. Interest paid	2014-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2014-12-31	$0
Total income from all sources (including contributions)	2014-12-31	$190,965
Total loss/gain on sale of assets	2014-12-31	$0
Total of all expenses incurred	2014-12-31	$216,770
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2014-12-31	$215,088
Expenses. Certain deemed distributions of participant loans	2014-12-31	$0
Value of total corrective distributions	2014-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2014-12-31	$188,118
Value of total assets at end of year	2014-12-31	$1,854,116
Value of total assets at beginning of year	2014-12-31	$1,879,921
Total of administrative expenses incurred including professional, contract, advisory and management fees	2014-12-31	$1,682
Total income from rents	2014-12-31	$0
Total interest from all sources	2014-12-31	$0
Total dividends received (eg from common stock, registered investment company shares)	2014-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2014-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2014-12-31	$0
Assets. Real estate other than employer real property at end of year	2014-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2014-12-31	$0
Administrative expenses professional fees incurred	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2014-12-31	$0
Was this plan covered by a fidelity bond	2014-12-31	Yes
Value of fidelity bond cover	2014-12-31	$500,000
If this is an individual account plan, was there a blackout period	2014-12-31	Yes
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2014-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2014-12-31	No
Contributions received from participants	2014-12-31	$96,200
Participant contributions at end of year	2014-12-31	$41,361
Participant contributions at beginning of year	2014-12-31	$41,945
Participant contributions at end of year	2014-12-31	$0
Participant contributions at beginning of year	2014-12-31	$2,615
Assets. Other investments not covered elsewhere at end of year	2014-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2014-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2014-12-31	$1,489
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2014-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2014-12-31	$217
Assets. Loans (other than to participants) at end of year	2014-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2014-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2014-12-31	$0
Other income not declared elsewhere	2014-12-31	$0
Administrative expenses (other) incurred	2014-12-31	$0
Liabilities. Value of operating payables at end of year	2014-12-31	$0
Liabilities. Value of operating payables at beginning of year	2014-12-31	$0
Total non interest bearing cash at end of year	2014-12-31	$0
Total non interest bearing cash at beginning of year	2014-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Income. Non cash contributions	2014-12-31	$0
Value of net income/loss	2014-12-31	$-25,805
Value of net assets at end of year (total assets less liabilities)	2014-12-31	$1,854,116
Value of net assets at beginning of year (total assets less liabilities)	2014-12-31	$1,879,921
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2014-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2014-12-31	No
Were any leases to which the plan was party in default or uncollectible	2014-12-31	No
Assets. partnership/joint venture interests at end of year	2014-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2014-12-31	$0
Investment advisory and management fees	2014-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2014-12-31	$1,812,755
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2014-12-31	$1,833,392
Value of interest in pooled separate accounts at end of year	2014-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2014-12-31	$0
Interest on participant loans	2014-12-31	$0
Income. Interest from loans (other than to participants)	2014-12-31	$0
Interest earned on other investments	2014-12-31	$0
Income. Interest from US Government securities	2014-12-31	$0
Income. Interest from corporate debt instruments	2014-12-31	$0
Value of interest in master investment trust accounts at end of year	2014-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2014-12-31	$0
Value of interest in common/collective trusts at end of year	2014-12-31	$0
Value of interest in common/collective trusts at beginning of year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2014-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2014-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2014-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2014-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at end of year	2014-12-31	$0
Value of funds held in insurance company general accounts (unallocated contracts) at beginning of year	2014-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2014-12-31	$0
Asset value of US Government securities at end of year	2014-12-31	$0
Asset value of US Government securities at beginning of year	2014-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2014-12-31	$2,847
Net investment gain/loss from pooled separate accounts	2014-12-31	$0
Net investment gain or loss from common/collective trusts	2014-12-31	$0
Net gain/loss from 103.12 investment entities	2014-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2014-12-31	No
Was there a failure to transmit to the plan any participant contributions	2014-12-31	No
Has the plan failed to provide any benefit when due under the plan	2014-12-31	No
Assets. Invements in employer securities at end of year	2014-12-31	$0
Assets. Invements in employer securities at beginning of year	2014-12-31	$0
Assets. Value of employer real property at end of year	2014-12-31	$0
Assets. Value of employer real property at beginning of year	2014-12-31	$0
Contributions received in cash from employer	2014-12-31	$90,429
Employer contributions (assets) at end of year	2014-12-31	$0
Employer contributions (assets) at beginning of year	2014-12-31	$1,752
Income. Dividends from preferred stock	2014-12-31	$0
Income. Dividends from common stock	2014-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2014-12-31	$215,088
Asset. Corporate debt instrument preferred debt at end of year	2014-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2014-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2014-12-31	$0
Contract administrator fees	2014-12-31	$1,682
Was the provided the required notice or one of the exceptions to providing the black out period notice applied under 29 CFR 2520.101-3	2014-12-31	Yes
Assets. Corporate common stocks other than exployer securities at end of year	2014-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at end of year	2014-12-31	$0
Liabilities. Value of benefit claims payable at beginning of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2014-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2014-12-31	$0
Did the plan have assets held for investment	2014-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2014-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2014-12-31	No
Aggregate proceeds on sale of assets	2014-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2014-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2014-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2014-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2014-12-31	Disclaimer
Accountancy firm name	2014-12-31	GROBSTEIN TEEPLE LLP
Accountancy firm EIN	2014-12-31	461955807
2013 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2013 401k financial data
Unrealized appreciation/depreciation of real estate assets	2013-12-31	$0
Unrealized appreciation/depreciation of other (non real estate) assets	2013-12-31	$0
Total unrealized appreciation/depreciation of assets	2013-12-31	$0
Total transfer of assets to this plan	2013-12-31	$0
Total transfer of assets from this plan	2013-12-31	$0
Total liabilities at end of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Total liabilities at beginning of year (benefit claims payable, operating payabales, acquisition indebtedness and other liabilities)	2013-12-31	$0
Expenses. Interest paid	2013-12-31	$0
Amount of participant contributions which was failed to transmit to the plan within the time period described in 29 CFR 251.3-102	2013-12-31	$0
Total income from all sources (including contributions)	2013-12-31	$495,605
Total loss/gain on sale of assets	2013-12-31	$0
Total of all expenses incurred	2013-12-31	$20,842
Benefit payments and payments to participlants,beneficiaries,insurance carriers and others	2013-12-31	$20,492
Expenses. Certain deemed distributions of participant loans	2013-12-31	$0
Value of total corrective distributions	2013-12-31	$0
Total contributions o plan (from employers,participants, others, non cash contrinutions)	2013-12-31	$157,600
Value of total assets at end of year	2013-12-31	$1,879,921
Value of total assets at beginning of year	2013-12-31	$1,405,158
Total of administrative expenses incurred including professional, contract, advisory and management fees	2013-12-31	$350
Total income from rents	2013-12-31	$0
Total interest from all sources	2013-12-31	$1,697
Total dividends received (eg from common stock, registered investment company shares)	2013-12-31	$0
Has a resolution to terminate the plan been adopted during the plan year or any prior plan year	2013-12-31	No
Total dividends received from registered investment company shares (eg mutual funds)	2013-12-31	$0
Assets. Real estate other than employer real property at end of year	2013-12-31	$0
Assets. Real estate other than employer real property at beginning of year	2013-12-31	$0
Administrative expenses professional fees incurred	2013-12-31	$350
Assets. Corporate prefeered stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate prefeered stocks other than exployer securities at beginning of year	2013-12-31	$0
Was this plan covered by a fidelity bond	2013-12-31	Yes
Value of fidelity bond cover	2013-12-31	$500,000
If this is an individual account plan, was there a blackout period	2013-12-31	No
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2013-12-31	$0
Were there any nonexempt tranactions with any party-in-interest	2013-12-31	No
Contributions received from participants	2013-12-31	$104,405
Participant contributions at end of year	2013-12-31	$41,945
Participant contributions at beginning of year	2013-12-31	$30,636
Participant contributions at end of year	2013-12-31	$2,615
Participant contributions at beginning of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at end of year	2013-12-31	$0
Assets. Other investments not covered elsewhere at beginning of year	2013-12-31	$0
Income. Received or receivable in cash from other sources (including rollovers)	2013-12-31	$0
Expenses. Other payments made (not to insurance carriers or or participants/beneficiaries)	2013-12-31	$0
Value of other receiveables (less allowance for doubtful accounts) at end of year	2013-12-31	$217
Value of other receiveables (less allowance for doubtful accounts) at beginning of year	2013-12-31	$0
Assets. Loans (other than to participants) at end of year	2013-12-31	$0
Assets. Loans (other than to participants) at beginning of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at end of year	2013-12-31	$0
Other liabilities (not benefit claims, operating payabales oe acquisition indebtedness) at beginning of year	2013-12-31	$0
Other income not declared elsewhere	2013-12-31	$0
Administrative expenses (other) incurred	2013-12-31	$0
Liabilities. Value of operating payables at end of year	2013-12-31	$0
Liabilities. Value of operating payables at beginning of year	2013-12-31	$0
Total non interest bearing cash at end of year	2013-12-31	$0
Total non interest bearing cash at beginning of year	2013-12-31	$0
Did the receive any noncash contributions whose value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Income. Non cash contributions	2013-12-31	$0
Value of net income/loss	2013-12-31	$474,763
Value of net assets at end of year (total assets less liabilities)	2013-12-31	$1,879,921
Value of net assets at beginning of year (total assets less liabilities)	2013-12-31	$1,405,158
Did the plan have a loss casued by fraud or dishonesty (regardless whether reimbursed by fidelity bond)	2013-12-31	No
Were any loans by the plan or fixed income obligations due to the plan in default	2013-12-31	No
Were any leases to which the plan was party in default or uncollectible	2013-12-31	No
Assets. partnership/joint venture interests at end of year	2013-12-31	$0
Assets. partnership/joint venture interests at beginning of year	2013-12-31	$0
Investment advisory and management fees	2013-12-31	$0
Value of interest in registered invesment companies (eg mutual funds) at end of year	2013-12-31	$1,833,392
Value of interest in registered invesment companies (eg mutual funds) at beginning of year	2013-12-31	$1,374,522
Value of interest in pooled separate accounts at end of year	2013-12-31	$0
Value of interest in pooled separate accounts at beginning of year	2013-12-31	$0
Interest on participant loans	2013-12-31	$1,480
Income. Interest from loans (other than to participants)	2013-12-31	$0
Interest earned on other investments	2013-12-31	$217
Income. Interest from US Government securities	2013-12-31	$0
Income. Interest from corporate debt instruments	2013-12-31	$0
Value of interest in master investment trust accounts at end of year	2013-12-31	$0
Value of interest in master investment trust accounts at beginning of year	2013-12-31	$0
Value of interest in common/collective trusts at end of year	2013-12-31	$0
Value of interest in common/collective trusts at beginning of year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at end of year	2013-12-31	$0
Interest-bearing cash (include money market accounts & certificates of deposit) at beginning of the Year	2013-12-31	$0
Value of interest bearing cash (including money market accounts and certificates of deposits) at beginning of year	2013-12-31	$0
Interest earned from interest bearing cash (including money market accounts and certificates of deposit)	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at end of year	2013-12-31	$0
Assets. Value of investments in 103.12 investment entities at beginning of year	2013-12-31	$0
Expenses. Payments to insurance carriers foe the provision of benefits	2013-12-31	$0
Asset value of US Government securities at end of year	2013-12-31	$0
Asset value of US Government securities at beginning of year	2013-12-31	$0
Net investment gain/loss from registered investment companies (e.g. mutual funds)	2013-12-31	$336,308
Net investment gain/loss from pooled separate accounts	2013-12-31	$0
Net investment gain or loss from common/collective trusts	2013-12-31	$0
Net gain/loss from 103.12 investment entities	2013-12-31	$0
Were any plan transactions or series of transactions in excess of 5% of the current value of the plan assets	2013-12-31	No
Was there a failure to transmit to the plan any participant contributions	2013-12-31	No
Has the plan failed to provide any benefit when due under the plan	2013-12-31	No
Assets. Invements in employer securities at end of year	2013-12-31	$0
Assets. Invements in employer securities at beginning of year	2013-12-31	$0
Assets. Value of employer real property at end of year	2013-12-31	$0
Assets. Value of employer real property at beginning of year	2013-12-31	$0
Contributions received in cash from employer	2013-12-31	$53,195
Employer contributions (assets) at end of year	2013-12-31	$1,752
Employer contributions (assets) at beginning of year	2013-12-31	$0
Income. Dividends from preferred stock	2013-12-31	$0
Income. Dividends from common stock	2013-12-31	$0
Benefit payments and payments to provide benefits directly to participlants or beneficiaries including direct rollovers	2013-12-31	$20,492
Asset. Corporate debt instrument preferred debt at end of year	2013-12-31	$0
Asset. Corporate debt instrument preferred debt at beginning of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at end of year	2013-12-31	$0
Asset. Corporate debt instrument debt (other) at beginning of year	2013-12-31	$0
Contract administrator fees	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at end of year	2013-12-31	$0
Assets. Corporate common stocks other than exployer securities at beginning of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at end of year	2013-12-31	$0
Assets. Value of buildings and other operty used in plan operation at beginning of year	2013-12-31	$0
Did the plan have assets held for investment	2013-12-31	Yes
Did the plan hold any assets whose current value was neither redily determinable on an established market nor set by an independent third party appraiser	2013-12-31	No
Were all the plan assets eitehr distributed to particpants/beneficiaries, transferred to another plan or brought under the control of the PBGC	2013-12-31	No
Aggregate proceeds on sale of assets	2013-12-31	$0
Aggregate carrying amount (costs) on sale of assets	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at end of year	2013-12-31	$0
Liabilities. Value of acquisition indebtedness at beginning of year	2013-12-31	$0
Accountant perfomed limited scope audit pursuant to 29 CFR 2520.103-8 and/or 103-12(d)	2013-12-31	Yes
Opinion of an independent qualified public accountant for this plan	2013-12-31	Disclaimer
Accountancy firm name	2013-12-31	GROBSTEIN TEEPLE LLP
Accountancy firm EIN	2013-12-31	461955807
2010 : PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2010 401k financial data
Total income from all sources	2010-12-31	$256,479
Expenses. Total of all expenses incurred	2010-12-31	$137,680
Benefits paid (including direct rollovers)	2010-12-31	$109,670
Total plan assets at end of year	2010-12-31	$1,146,932
Total plan assets at beginning of year	2010-12-31	$1,028,133
Value of fidelity bond covering the plan	2010-12-31	$200,000
Total contributions received or receivable from participants	2010-12-31	$58,438
Expenses. Other expenses not covered elsewhere	2010-12-31	$28,010
Other income received	2010-12-31	$168,039
Net income (gross income less expenses)	2010-12-31	$118,799
Net plan assets at end of year (total assets less liabilities)	2010-12-31	$1,146,932
Net plan assets at beginning of year (total assets less liabilities)	2010-12-31	$1,028,133
Assets. Value of participant loans	2010-12-31	$22,510
Total contributions received or receivable from employer(s)	2010-12-31	$30,002
Total value of distributions paid in property other than in cash, annuity contracts, or publicly traded employer securities	2010-12-31	$0

Form 5500 Responses for PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN

2017: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 form 5500 responses
2017-01-01	Type of plan entity	Single employer plan
2017-01-01	Submission has been amended	No
2017-01-01	This submission is the final filing	Yes
2017-01-01	This return/report is a short plan year return/report (less than 12 months)	Yes
2017-01-01	Plan is a collectively bargained plan	No
2017-01-01	Plan funding arrangement – Insurance	Yes
2017-01-01	Plan funding arrangement – Trust	Yes
2017-01-01	Plan benefit arrangement – Insurance	Yes
2017-01-01	Plan benefit arrangement - Trust	Yes
2016: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 form 5500 responses
2016-01-01	Type of plan entity	Single employer plan
2016-01-01	Submission has been amended	No
2016-01-01	This submission is the final filing	No
2016-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2016-01-01	Plan is a collectively bargained plan	No
2016-01-01	Plan funding arrangement – Insurance	Yes
2016-01-01	Plan funding arrangement – Trust	Yes
2016-01-01	Plan benefit arrangement – Insurance	Yes
2016-01-01	Plan benefit arrangement - Trust	Yes
2015: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 form 5500 responses
2015-01-01	Type of plan entity	Single employer plan
2015-01-01	Submission has been amended	No
2015-01-01	This submission is the final filing	No
2015-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2015-01-01	Plan is a collectively bargained plan	No
2015-01-01	Plan funding arrangement – Insurance	Yes
2015-01-01	Plan funding arrangement – Trust	Yes
2015-01-01	Plan benefit arrangement – Insurance	Yes
2015-01-01	Plan benefit arrangement - Trust	Yes
2014: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 form 5500 responses
2014-01-01	Type of plan entity	Single employer plan
2014-01-01	Submission has been amended	No
2014-01-01	This submission is the final filing	No
2014-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2014-01-01	Plan is a collectively bargained plan	No
2014-01-01	Plan funding arrangement – Insurance	Yes
2014-01-01	Plan funding arrangement – Trust	Yes
2014-01-01	Plan benefit arrangement – Insurance	Yes
2014-01-01	Plan benefit arrangement - Trust	Yes
2013: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2013 form 5500 responses
2013-01-01	Type of plan entity	Single employer plan
2013-01-01	Submission has been amended	No
2013-01-01	This submission is the final filing	No
2013-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2013-01-01	Plan is a collectively bargained plan	No
2013-01-01	Plan funding arrangement – Trust	Yes
2013-01-01	Plan benefit arrangement - Trust	Yes
2010: PACIFIC LODGE YOUTH SERVICES, INC. 401(K) PROFIT SHARING PLAN 2010 form 5500 responses
2010-01-01	Type of plan entity	Single employer plan
2010-01-01	Submission has been amended	No
2010-01-01	This submission is the final filing	No
2010-01-01	This return/report is a short plan year return/report (less than 12 months)	No
2010-01-01	Plan is a collectively bargained plan	No
2010-01-01	Plan funding arrangement – Insurance	Yes
2010-01-01	Plan funding arrangement – Trust	Yes
2010-01-01	Plan benefit arrangement – Insurance	Yes

Insurance Providers Used on plan

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300593

Policy instance

Insurance contract or identification number	300593
Number of Individuals Covered	157
Insurance policy start date	2017-01-01
Insurance policy end date	2017-06-30
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $680
Are there contracts with allocated funds for individual policies?	0
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	416
Additional information about fees paid to insurance broker	MARKETING ALLOWANCE AND/OR SERVICE FEES
Insurance broker organization code?	5
Insurance broker name	SWBC INVESTMENT ADVISORY SERVICES

THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA (National Association of Insurance Commissioners NAIC id number: 78778 )

Policy contract number

300593

Policy instance

Insurance contract or identification number	300593
Number of Individuals Covered	172
Insurance policy start date	2015-01-01
Insurance policy end date	2015-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $2,217
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Amount paid for insurance broker fees	2000
Additional information about fees paid to insurance broker	MARKETING ALLOWANCE AND/OR SERVICE FEES
Insurance broker organization code?	5
Insurance broker name	SWBC INVESTMENT ADVISORY SERVICES

JOHN HANCOCK LIFE INSURANCE COMPANY (U.S.A.) (National Association of Insurance Commissioners NAIC id number: 65838 )

Policy contract number

113233

Policy instance

Insurance contract or identification number	113233
Number of Individuals Covered	161
Insurance policy start date	2014-01-01
Insurance policy end date	2014-12-31
Total amount of commissions paid to insurance broker	USD $12,213
Total amount of fees paid to insurance company	USD $1,290
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $12,213
Amount paid for insurance broker fees	1290
Additional information about fees paid to insurance broker	FEES
Insurance broker organization code?	4
Insurance broker name	LIDEN, NESTLE SOLED & ASSOCIATES,IN

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

248061-J

Policy instance

Insurance contract or identification number	248061-J
Number of Individuals Covered	131
Insurance policy start date	2013-01-01
Insurance policy end date	2013-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $570
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	0
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	570
Additional information about fees paid to insurance broker	PORTION OF INCENTIVE COMP. PROGRAM
Insurance broker organization code?	3
Insurance broker name	LOS ANGELES REGIONAL OFFICE

MUTUAL OF AMERICA LIFE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 88668 )

Policy contract number

248061J

Policy instance

Insurance contract or identification number	248061J
Number of Individuals Covered	98
Insurance policy start date	2010-01-01
Insurance policy end date	2010-12-31
Total amount of commissions paid to insurance broker	USD $0
Total amount of fees paid to insurance company	USD $3,261
Are there contracts with allocated funds for individual policies?	No
Are there contracts with allocated funds for group deferred annuity?	No
Are there contracts with allocated funds for types other than group deferred annuity or individual?	No
Contract purchased, in whole or in part, to distribute benefits from a terminating plan	No
Contracts With Unallocated Funds Deposit Administration	1
Are there contracts with unallocated funds for contracts of type immediate participation guarantee?	No
Are there contracts with unallocated funds for contracts of type guaranteed investment?	No
Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment?	No
Health Insurance Welfare Benefit	No
Dental Insurance Welfare Benefit	No
Vision Insurance Welfare Benefit	No
Life Insurance Welfare Benefit	No
Temporary Disability Insurance Welfare Benefit	No
Long Term Disability Insurance Welfare Benefit	No
Unemployment Insurance Welfare Benefit	No
Were dividends or retroactive rate refunds paid in cash?	No
Were dividends or retroactive rate refunds paid as a credit?	No
Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500?	No
Commission paid to Insurance Broker	USD $0
Amount paid for insurance broker fees	1472
Additional information about fees paid to insurance broker	COMPENSATION
Insurance broker organization code?	3
Insurance broker name	TODD R. DIXON

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Company Name:	PACIFIC LODGE YOUTH SERVICES, INC.
Employer identification number (EIN):	951691300
NAIC Classification:	623000
NAIC Description:	Nursing and Residential Care Facilities