LAGUNA BEACH COMMUNITY CLINIC INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
LAGUNA BEACH COMMUNITY CLINIC INC (EIN 95-2637633)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-02-06
IRS object ID
202420379349301862
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-02-06T18:42:42-06:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN953001179PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WINDES INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 87AddressLine1Txt
CityLONG BEACHCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90801ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN952637633EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LAGUNA BEACH COMMUNITY CLINICBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLAGUBusinessNameControlTxt
Phone9494940761PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1362 3RD STREETAddressLine1Txt
CityLAGUNA BEACHCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92651ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJORGE RUBAL MDPersonNm
Person TitleCEOPersonTitleTxt
Phone9494940761PhoneNum
Signature2024-01-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJORGEPersonFirstNm
Person LastRUBAL MDPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONITA JOSEPHPreparerPersonNm
PTINP00286656PTIN
Phone5624351191PhoneNum
Preparation2024-01-29PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJORGE RUBAL MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1362 3RD STREETAddressLine1Txt
CityLAGUNA BEACHCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92651ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,971,955GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LBCLINIC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1970FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE PRIMARY MEDICAL AND OTHER SERVICE PROGRAMS TO INDIVIDUALS AND FAMILIES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee21TotalEmployeeCnt
Total Volunteers19TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,741,479PYContributionsGrantsAmt
CY Contributions Grants$1,945,895CYContributionsGrantsAmt
PY Program Service Revenue$2,249,537PYProgramServiceRevenueAmt
CY Program Service Revenue$2,274,165CYProgramServiceRevenueAmt
PY Investment Income$80,032PYInvestmentIncomeAmt
CY Investment Income$176,334CYInvestmentIncomeAmt
PY Other Revenue$155,172PYOtherRevenueAmt
CY Other Revenue$239,802CYOtherRevenueAmt
PY Total Revenue$4,226,220PYTotalRevenueAmt
CY Total Revenue$4,636,196CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,066,627PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,430,777CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$163,080CYTotalFundraisingExpenseAmt
PY Other Expenses$1,800,261PYOtherExpensesAmt
CY Other Expenses$1,706,635CYOtherExpensesAmt
PY Total Expenses$3,866,888PYTotalExpensesAmt
CY Total Expenses$4,137,412CYTotalExpensesAmt
PY Revenues Less Expenses$359,332PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$498,784CYRevenuesLessExpensesAmt
Total Assets BOY$4,591,137TotalAssetsBOYAmt
Total Assets EOY$5,111,417TotalAssetsEOYAmt
Total Liabilities BOY$220,863TotalLiabilitiesBOYAmt
Total Liabilities EOY$299,174TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,370,274NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,812,243NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE MISSION OF LAGUNA BEACH COMMUNITY CLINIC (LBCC) IS TO PROVIDE EXCELLENT MEDICAL CARE REGARDLESS OF THE PATIENT'S ABILITY TO PAY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,589,508ExpenseAmt
Revenue$2,274,165RevenueAmt
DescAS A HEALTH SERVICES ORGANIZATION WITH A TARGET POPULATION OF ECONOMICALLY DISADVANTAGED, LOW-INCOME, AND UNDERSERVED INDIVIDUALS AND FAMILIES, LBCC IS A SAFETY NET ORGANIZATION. 88% OF LBCC PATIENTS ARE LIVING BELOW 200% FEDERAL POVERTY LEVEL; APPROXIMATELY 67% LIVE IN SEVERE POVERTY (2022 OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT UTILIZATION REPORT). 38% OF PATIENTS ARE HISPANIC, MANY OF WHOM SPEAK ONLY SPANISH. PATIENTS ARE LOCAL SHOP STAFF, HOTEL AND RESTAURANT EMPLOYEES, ARTISTS, HOUSEHOLD WORKERS, GARDENERS, DAY LABORERS, AND NANNIES. THE PATIENTS WE SERVE ARE AT RISK OF FOREGOING EARLY MEDICAL CARE OF CONDITIONS, WHICH WOULD NEGATIVELY AFFECT THEIR MORBIDITY RATES, AND ALSO BURDEN THE HEALTHCARE SYSTEM IN THE LONG RUN. THEIR NEEDS TO ACCESS HEALTHCARE INCLUDE FINDING:- A REGISTERED MEDI-CAL PROVIDER.- A PROVIDER WHICH ACCEPTS UNINSURED PATIENTS AND OFFERS LOW-COST SERVICE: MANY WILL NEVER QUALIFY FOR GOVERNMENT SUBSIDIZED INSURANCE THROUGH MEDI-CAL OR WILL OPT-OUT, AND WILL REMAIN UNINSURED. THESE PATIENTS RISK FALLING THROUGH THE GAPS IN THE SAFETY-NET.- CARE THAT IS ACCESSIBLE BOTH LINGUISTICALLY AND GEOGRAPHICALLY.- HIGH QUALITY CARE.A SAFETY-NET PROVIDER, LAGUNA BEACH COMMUNITY CLINIC (LBCC) SERVES DISADVANTAGED, LOW-INCOME, AND UNDERSERVED PATIENTS. LBCC IS AN INDEPENDENT, NON-PROFIT, PRIMARY CARE HEALTH FACILITY THAT PROVIDES FAMILY-CENTERED MEDICAL AND DENTAL CARE. THE CLINIC OFFERS NON-EMERGENCY CURATIVE AND PREVENTIVE CARE, AS WELL AS EDUCATIONAL SERVICES FOR INDIVIDUALS AND FAMILIES IN ORANGE COUNTY AND SERVES AS A TRAINING SITE FOR HEALTH CARE PROFESSIONALS. THE AGENCY'S MISSION IS TO PROVIDE EXCELLENT MEDICAL CARE TO INDIVIDUALS IN ORANGE COUNTY, REGARDLESS OF THEIR ABILITY TO PAY. THE CLINIC WAS FOUNDED IN 1970 WHEN A GROUP OF CONCERNED PHYSICIANS AND COMMUNITY LEADERS ESTABLISHED A FREE CLINIC TO MEET THE NEEDS OF LOW-INCOME AND MEDICALLY UNINSURED PEOPLE OF SOUTH ORANGE COUNTY. IN 1985, LBCC BECAME A LICENSED COMMUNITY CLINIC DEDICATED TO MEETING THE COMPREHENSIVE MEDICAL NEEDS OF THE DISADVANTAGED. THE CLINIC BECAME A PATIENT CENTERED MEDICAL HOME (PCMH) IN 2015 AND RECEIVED DESIGNATION AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) LOOK-ALIKE IN LATE 2018. THE DESIGNATION AIDS IN FUTURE FINANCIAL SUSTAINABILITY AND IS INDICATIVE OF HIGHER PATIENT CARE STANDARDS, LOWER PATIENT COSTS, EXPANDED SERVICES TO INCLUDE MEDICAL AND DENTAL, HIGHER GOVERNANCE STANDARDS, AND COMMITMENT TO PROVIDING ACCESS FOR UNDERSERVED PATIENTS. NO LONGER A FREE CLINIC, TODAY SERVICES ARE DELIVERED WITH RESPECT FOR CLIENT DIGNITY, AND PATIENT PAYMENTS ARE BASED ON A SLIDING FEE SCALE. THE CLINIC IS A REGISTERED MEDI-CAL PROVIDER WITH COVERED CALIFORNIA CERTIFIED ENROLLMENT COUNSELORS ON-SITE, AND ADDITIONALLY WELCOMES PATIENTS WITHOUT HEALTH INSURANCE. THE CLINIC OFFERS CARE IN THE AREAS OF: PRIMARY CARE; DIAGNOSTIC AND RADIOLOGY SCREENINGS; FAMILY PLANNING, OBSTETRICAL AND GYNECOLOGICAL CARE; SPECIALTY SERVICES OF ENDOCRINOLOGY, UROLOGY, NEPHROLOGY, AND NEUROLOGY; PREVENTIVE DENTAL; SUBSTANCE ABUSE SERVICES; IMMUNIZATIONS; WELL-CHILD SERVICES; HEALTH EDUCATION; MENTAL HEALTH; PHARMACEUTICAL; NUTRITION; REFERRAL TO OPTOMETRY AND ADDITIONAL DENTAL; AND INSURANCE ELIGIBILITY ASSISTANCE. LBCC DELIVERS THE FULL SCOPE OF PRIMARY CARE SERVICES, INCLUDING OFFERING WALK-IN URGENT CARE HOURS SIX DAYS PER WEEK.Desc
Total Program Service Expenses$3,589,508TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee21EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJORGE RUBAL MDPersonNm
Phone9494940761PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1362 3RD STREETAddressLine1Txt
CityLAGUNA BEACHCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92651ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ROYA COLE
DIRECTOR1.00Yes (X)$0$0$0
DANIEL HASPERT
TREASURER1.00Yes (X)$0$0$0Yes (X)
MONICA SILVA MCCUSKER
SECRETARY1.00Yes (X)$0$0$0Yes (X)
SUSAN NEELY
DIRECTOR1.00Yes (X)$0$0$0
JANET CHANCE
DIRECTOR1.00Yes (X)$0$0$0
MARION JACOBS
DIRECTOR1.00Yes (X)$0$0$0
EDWARD LUCERO
DIRECTOR1.00Yes (X)$0$0$0
LIDIA MANDALA
DIRECTOR1.00Yes (X)$0$0$0
JOHN LINK JR
PRESIDENT1.00Yes (X)$0$0$0Yes (X)
CHRISTIE CORNWALL
DIRECTOR1.00Yes (X)$0$0$0
ZACH MARTIN
DIRECTOR1.00Yes (X)$0$0$0
DR JORGE RUBAL MD
CEO/CMO50.00$472,830$0$10,260Yes (X)
ADRIANA NIETO-SAYEGH RN
COO50.00$145,398$0$15,371Yes (X)
PATRICK WOOD
CFO16.00$161,200$0$7,068Yes (X)
DR CHAU NGO MD
INTERNAL MEDICINE30.00$167,679$0$13,301Yes (X)
DR FARANGIS JALALI MD
FAMILY MEDICINE40.00$165,540$0$9,795Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,112,647TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$55,795TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$963,694GovernmentGrantsAmt
All Other Contributions$982,201AllOtherContributionsAmt
Total Contributions$1,945,895TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT FEESDesc
Business900099BusinessCd
Total Revenue Column$2,274,165TotalRevenueColumnAmt
Related Or Exempt Func Income$2,274,165RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,274,165TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$48,895TotalRevenueColumnAmt
Exclusion$48,895ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$26,709RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$26,709RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,709TotalRevenueColumnAmt
Exclusion$26,709ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,463,198SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,335,759SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$127,439SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$127,439TotalRevenueColumnAmt
Exclusion$127,439ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEDICAL INCENTIVE INCOME900099$121,157$121,157
INCENTIVE PAYMENT ASSIGNMENT900099$91,000$91,000
AMERICAN EXPRESS CASH BACK/MISC I900099$936$936
FieldValueIRS element (for citing)
Other Revenue Total$213,093OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,636,196TotalRevenueColumnAmt
Related Or Exempt Func Income$2,274,165RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$416,136ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$943,723TotalAmt
Program Services$674,651ProgramServicesAmt
Management And General$269,072ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,214,912TotalAmt
Program Services$1,214,912ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$56,382TotalAmt
Program Services$49,641ProgramServicesAmt
Management And General$6,741ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$91,788TotalAmt
Program Services$91,788ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$123,972TotalAmt
Program Services$109,149ProgramServicesAmt
Management And General$14,823ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$68,062TotalAmt
Program Services$38,280ProgramServicesAmt
Management And General$29,782ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$17,217TotalAmt
Management And General$17,217ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$181,026TotalAmt
Program Services$17,946ProgramServicesAmt
Fundraising$163,080FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$150,678TotalAmt
Program Services$132,661ProgramServicesAmt
Management And General$18,017ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$98,562TotalAmt
Program Services$86,778ProgramServicesAmt
Management And General$11,784ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$557TotalAmt
Management And General$557ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$51,038TotalAmt
Program Services$44,936ProgramServicesAmt
Management And General$6,102ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$56,625TotalAmt
Program Services$49,855ProgramServicesAmt
Management And General$6,770ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PHARMACEUTICALS$753,501$753,501
COMPUTER$132,360$132,360
OPERATION SUPPLIES$129,949$129,949
LAB FEES$33,948$33,948

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$33,112TotalAmt
Program Services$29,153ProgramServicesAmt
Management And General$3,959ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,137,412TotalAmt
Program Services$3,589,508ProgramServicesAmt
Management And General$384,824ManagementAndGeneralAmt
Fundraising$163,080FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,268,594BOYAmt
EOY$686,456EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$324,948BOYAmt
EOY$263,686EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,012BOYAmt
EOY$36,203EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$102,501BOYAmt
EOY$123,360EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$866BOYAmt
EOY$902EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,823,604LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$759,834LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,651,739BOYAmt
EOY$2,063,770EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,228,477BOYAmt
EOY$1,937,040EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,591,137BOYAmt
EOY$5,111,417EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$212,196BOYAmt
EOY$296,908EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,667BOYAmt
EOY$2,266EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$220,863BOYAmt
EOY$299,174EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,322,939BOYAmt
EOY$3,662,606EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,047,335BOYAmt
EOY$1,149,637EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,370,274BOYAmt
EOY$4,812,243EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,591,137BOYAmt
EOY$5,111,417EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$498,784ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$56,815NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,583,384CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,032,311CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,707,590CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,741,479CurrentTaxYearMinus1YearAmt
Current Tax Year$1,945,895CurrentTaxYearAmt
Total$10,010,659TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,583,384CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,032,311CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,707,590CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,741,479CurrentTaxYearMinus1YearAmt
Current Tax Year$1,945,895CurrentTaxYearAmt
Total$10,010,659TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$857,488SubstantialContributorsTotAmt
Public Support Total170$9,153,171PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$66,020CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$70,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$48,196CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$69,972CurrentTaxYearMinus1YearAmt
Current Tax Year$75,604CurrentTaxYearAmt
Total$330,186TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$50CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,895CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,300CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$122,700CurrentTaxYearMinus1YearAmt
Current Tax Year$213,093CurrentTaxYearAmt
Total$424,038TotalAmt
FieldValueIRS element (for citing)
Total Support$10,764,883TotalSupportAmt
Gross Receipts Rltd Activities$11,044,473GrossReceiptsRltdActivitiesAmt
Public Support CY1700.85030PublicSupportCY170Pct
Public Support PY1700.85980PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,047,335BeginningYearBalanceAmt
Investment Earnings Or Losses$102,302InvestmentEarningsOrLossesAmt
End Year Balance$1,149,637EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,175,440BeginningYearBalanceAmt
Investment Earnings Or Losses-$69,196InvestmentEarningsOrLossesAmt
Other Expenditures$58,909OtherExpendituresAmt
End Year Balance$1,047,335EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,040,568BeginningYearBalanceAmt
Investment Earnings Or Losses$187,066InvestmentEarningsOrLossesAmt
Other Expenditures$52,194OtherExpendituresAmt
End Year Balance$1,175,440EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,077,802BeginningYearBalanceAmt
Investment Earnings Or Losses$16,609InvestmentEarningsOrLossesAmt
Other Expenditures$53,843OtherExpendituresAmt
End Year Balance$1,040,568EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,046,621BeginningYearBalanceAmt
Investment Earnings Or Losses$83,390InvestmentEarningsOrLossesAmt
Other Expenditures$52,209OtherExpendituresAmt
End Year Balance$1,077,802EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$345,000OtherCostOrOtherBasisAmt
Book Value$345,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,559,434OtherCostOrOtherBasisAmt
Depreciation$403,171DepreciationAmt
Book Value$1,156,263BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$496,725OtherCostOrOtherBasisAmt
Depreciation$27,099DepreciationAmt
Book Value$469,626BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$422,445OtherCostOrOtherBasisAmt
Depreciation$329,564DepreciationAmt
Book Value$92,881BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,063,770TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLEASE PAYABLEDesc
Amt$2,266Amt
FieldValueIRS element (for citing)
Total Liability$2,266TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,575,254TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$56,815NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$13,090DonatedServicesAndUseFcltsAmt
Revenue Not Reported-$43,725RevenueNotReportedAmt
Revenue Subtotal$4,618,979RevenueSubtotalAmt
Investment Expenses Not Incld$17,217InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$17,217RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$4,636,196TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,133,285TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$13,090DonatedServicesUseFcltsAmt
Expenses Not Reported$13,090ExpensesNotReportedAmt
Expenses Subtotal$4,120,195ExpensesSubtotalAmt
Investment Expenses Not Incld2$17,217InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$17,217ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$4,137,412TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE TO BE APPLIED TOWARD THE GREATEST COMMUNITY HEALTH NEEDS AS DETERMINED BY THE CLINIC.
PART X, LINE 2:THE CLINIC HAS BEEN DESIGNATED AS TAX-EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), IS ALSO EXEMPT FROM STATE FRANCHISE TAXES UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, AND IS NOT GENERALLY SUBJECT TO FEDERAL OR STATE INCOME TAXES. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IT REQUIRES THAT AN ORGANIZATION RECOGNIZE IN THE FINANCIAL STATEMENTS THE IMPACT OF THE TAX POSITION IF THAT POSITION WILL MORE LIKELY THAN NOT BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF AND FOR THE YEAR ENDED JUNE 30, 2023, THE CLINIC HAD NO UNRECOGNIZED TAX BENEFITS, TAX PENALTIES, OR INTEREST. THE CLINIC IS SUBJECT TO POTENTIAL INCOME TAX AUDITS ON OPEN TAX YEARS BY ANY TAXING JURISDICTION IN WHICH IT OPERATES. THE STATUTE OF LIMITATIONS FOR FEDERAL PURPOSES IS THREE YEARS AND FOR CALIFORNIA IS FOUR YEARS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR JORGE RUBAL MD
CEO/CMO$472,830$0$0$0$0$0$0$0$10,260$0$483,090$0$0$0
DR CHAU NGO MD
INTERNAL MEDICINE$167,679$0$0$0$0$0$0$0$13,301$0$180,980$0$0$0
DR FARANGIS JALALI MD
FAMILY MEDICINE$165,540$0$0$0$0$0$0$0$9,795$0$175,335$0$0$0
PATRICK WOOD
CFO$161,200$0$0$0$0$0$0$0$7,068$0$168,268$0$0$0
ADRIANA NIETO-SAYEGH RN
COO$145,398$0$0$0$0$0$0$0$15,371$0$160,769$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BDESCRIBE THE PROCESS THE ORGANIZATION USES TO REVIEW FORM 990. THE DRAFT 990 IS PROVIDED TO THE FINANCE COMMITTEE FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12DESCRIBE HOW THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. STAFF WHO ATTEND BOARD MEETINGS MONITOR BOARD BEHAVIOR THAT MAY FALL WITHIN UNACCEPTABLE PARAMETERS OF THE POLICY. ANNUAL AUDIT REVIEW OF BOARD MEETING MINUTES MAY ALSO REVEAL POTENTIAL CONFLICT. MANAGEMENT MONITORS STAFF ADHERENCE DURING VENDOR REVIEW. ADHERENCE TO CONFLICT OF INTEREST POLICY IS NOT MONITORED ANNUALLY, BUT PER TERM OF OFFICE FOR THE BOARD AND HIRE DATE OF THE EMPLOYEE.
FORM 990, PART VI, SECTION B, LINE 15DESCRIBE THE PROCESS THE ORGANIZATION USES TO DETERMINE COMPENSATION OF ITS OFFICERS, DIRECTORS, AND OTHER EMPLOYEES. A BOARD MEMBER PERFORMED A COMPENSATION ANALYSIS FOR DR. RUBAL'S INCREASE IN COMPENSATION. THE BOARD MEMBER REVIEWED IT WITH THE BOARD OF DIRECTORS AND THE BOARD PRESIDENT CONFIRMED THE INCREASE IN COMPENSATION.
FORM 990, PART VI, SECTION C, LINE 19DESCRIBE HOW THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 1023 AND 990 ARE AVAILABLE TO THE PUBLIC BY REQUEST.

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