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  5. JOHN CLARKE RETIREMENT CENTER

JOHN CLARKE RETIREMENT CENTER

Company Details

Name: JOHN CLARKE RETIREMENT CENTER
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 12 Mar 1979 (46 years ago)
Identification Number: 000029448
ZIP code: 02842
County: Newport County
Principal Address: 600 VALLEY ROAD, MIDDLETOWN, RI, 02842, USA
Purpose: LONG TERM NURSING CARE
Fictitious names: John Clarke Senior Living (trading name, 2021-05-14 - )
Historical names: THE JOHN CLARKE RETIREMENT CENTER

Industry & Business Activity

NAICS

624120 Services for the Elderly and Persons with Disabilities

This industry comprises establishments primarily engaged in providing nonresidential social assistance services to improve the quality of life for the elderly, persons diagnosed with intellectual and developmental disabilities, or persons with disabilities. These establishments provide for the welfare of these individuals in such areas as day care, non-medical home care or homemaker services, social activities, group support, and companionship. Learn more at the U.S. Census Bureau

Companies doing Services for the elderly and persons with disabilities

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1144338476 2006-08-27 2023-06-01 600 VALLEY RD, MIDDLETOWN, RI, 028427014, US 600 VALLEY RD, MIDDLETOWN, RI, 028427014, US

Contacts
Phone +1 401-846-0743
Fax 4018485890

Authorized person
Name JOAN M. WOODS
Role CHIEF EXECUTIVE OFFICER
Phone 4013245424

Taxonomy
Taxonomy Code 314000000X - Skilled Nursing Facility
License Number LTC00634
State RI
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 4105076
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2023 050382511 2024-03-21 THE JOHN CLARKE RETIREMENT CENTER 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2022 050382511 2023-04-05 THE JOHN CLARKE RETIREMENT CENTER 98
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2021 050382511 2022-03-01 THE JOHN CLARKE RETIREMENT CENTER 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2020 050382511 2021-05-11 THE JOHN CLARKE RETIREMENT CENTER 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2019 050382511 2020-07-29 THE JOHN CLARKE RETIREMENT CENTER 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2020-07-29
Name of individual signing JOAN WOODS
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2018 050382511 2019-07-18 THE JOHN CLARKE RETIREMENT CENTER 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing KRISTEN TAVARES
Valid signature Filed with authorized/valid electronic signature
403 B THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2017 050382511 2018-08-31 THE JOHN CLARKE RETIREMENT CENTER 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 028427014

Signature of
Role Plan administrator
Date 2018-08-31
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2016 050382511 2017-04-07 THE JOHN CLARKE RETIREMENT CENTER 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2017-04-07
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2015 050382511 2016-07-14 THE JOHN CLARKE RETIREMENT CENTER 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing JOE SOUSA
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF THE JOHN CLARKE RETIREMENT CENTER 2014 050382511 2016-07-13 THE JOHN CLARKE RETIREMENT CENTER 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/13/20160713090423P040031430167001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712100028P030024351469001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712111129P030030503095001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/07/12/20160712100040P030024352061001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLET RD, MIDDLETOWN, RI, 02842

Signature of
Role Plan administrator
Date 2016-07-12
Name of individual signing JOSEPH SOUSA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/07/20101007111235P070014501249001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-01-01
Business code 623000
Sponsor’s telephone number 4018460743
Plan sponsor’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842

Plan administrator’s name and address
Administrator’s EIN 050382511
Plan administrator’s name THE JOHN CLARKE RETIREMENT CENTER
Plan administrator’s address 600 VALLEY RD, MIDDLETOWN, RI, 02842
Administrator’s telephone number 4018460743

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing NANCY E. CICOGNA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-07
Name of individual signing NANCY E. CICOGNA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHERI L. PIZZI Agent ONE FINANCIAL PLAZA 18TH FLOOR C/O BARTON GILMAN LLP, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
JOHN THORPE PRESIDENT 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

TREASURER

Name Role Address
HUGH HALL TREASURER 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

SECRETARY

Name Role Address
DAVID MAINE SECRETARY 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

DIRECTOR

Name Role Address
JOSEPH MARION DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JENNIFER FAIRBANK DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JOHN SWEENEY DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
CHRISTINE MCGUIRE DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
JOHN BAGWILL DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
DIANE MEDEROS DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA
REGINA DUBLIN DIRECTOR 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

VICE PRESIDENT

Name Role Address
PETER CHATELLIER VICE PRESIDENT 600 VALLEY ROAD MIDDLETOWN, RI 02842 USA

Events

Type Date Old Value New Value
Name Change 2021-05-14 THE JOHN CLARKE RETIREMENT CENTER JOHN CLARKE RETIREMENT CENTER

Filings

Number Name File Date
202445323980 Annual Report 2024-02-02
202326418060 Annual Report 2023-01-23
202211286550 Annual Report 2022-02-17
202196603700 Fictitious Business Name Statement 2021-05-14
202196603340 Articles of Amendment 2021-05-14
202196562890 Annual Report 2021-05-12
202042311740 Annual Report 2020-06-16
202040705280 Statement of Change of Registered/Resident Agent 2020-05-22
202032576340 Statement of Change of Registered/Resident Agent 2020-01-17
201927687200 Annual Report 2019-11-19

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
312347180 0112300 2010-08-13 600 VALLEY ROAD, MIDDLETOWN, RI, 02842
Inspection Type Planned
Scope Complete
Safety/Health Health
Close Conference 2010-08-17
Emphasis N: NURSING, N: SSTARG09, S: ELECTRICAL
Case Closed 2011-02-11

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100332 B01
Issuance Date 2011-01-18
Abatement Due Date 2011-02-11
Current Penalty 625.0
Initial Penalty 1250.0
Nr Instances 1
Nr Exposed 2
Gravity 05
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100335 A01 I
Issuance Date 2011-01-18
Abatement Due Date 2011-01-21
Nr Instances 1
Nr Exposed 2
Gravity 05
Citation ID 01002
Citaton Type Serious
Standard Cited 19101030 D04 IIIA2
Issuance Date 2011-01-18
Abatement Due Date 2011-02-11
Current Penalty 375.0
Initial Penalty 750.0
Nr Instances 1
Nr Exposed 3
Gravity 01
Citation ID 02001
Citaton Type Other
Standard Cited 19040007 B03
Issuance Date 2011-01-18
Abatement Due Date 2011-02-11
Current Penalty 250.0
Initial Penalty 500.0
Nr Instances 1
Nr Exposed 1
Gravity 00
Citation ID 02002
Citaton Type Other
Standard Cited 19040029 B02
Issuance Date 2011-01-18
Abatement Due Date 2011-01-21
Current Penalty 250.0
Initial Penalty 500.0
Nr Instances 1
Nr Exposed 4
Gravity 00
Citation ID 02003
Citaton Type Other
Standard Cited 19040032 B03
Issuance Date 2011-01-18
Abatement Due Date 2011-01-21
Current Penalty 250.0
Initial Penalty 500.0
Nr Instances 2
Nr Exposed 10
Gravity 00
Citation ID 02004
Citaton Type Other
Standard Cited 19101030 G01 IH
Issuance Date 2011-01-18
Abatement Due Date 2011-02-11
Current Penalty 250.0
Initial Penalty 500.0
Nr Instances 1
Nr Exposed 6
Gravity 03

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
05-0382511 Corporation Unconditional Exemption 600 VALLEY RD, MIDDLETOWN, RI, 02842-7029 1979-07
In Care of Name % JOAN WOODS
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that normally receives no more than one-third of its support from gross investment income and unrelated business income and at the same time more than one-third of its support from contributions, fees, and gross receipts related to exempt purposes 509(a)(2)
Tax Period 2023-12
Asset 5,000,000 to 9,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 7433185
Income Amount 8544697
Form 990 Revenue Amount 8096712
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name JOHN CLARKE RETIREMENT CENTER
EIN 05-0382511
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5701597307 2020-04-30 0165 PPP 600 Valley Rd, Middletown, RI, 02842
Loan Status Date 2021-01-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 563900
Loan Approval Amount (current) 563900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 434162
Servicing Lender Name Citizens Bank, National Association
Servicing Lender Address 1 Citizens Plaza, PROVIDENCE, RI, 02903-1344
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Middletown, NEWPORT, RI, 02842-0001
Project Congressional District RI-01
Number of Employees 74
NAICS code 446199
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 434162
Originating Lender Name Citizens Bank, National Association
Originating Lender Address PROVIDENCE, RI
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 567607.84
Forgiveness Paid Date 2020-12-31

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Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State

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