2024-05-15T10:57:30-05:00 2023-06-30 951777440 GREEN HASSON & JANKS LLP 700 S FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2022-07-01 273484548 VENICE FAMILY CLINIC FOUNDATION VENI 3103928630 604 ROSE AVENUE VENICE CA 90291 MITESH POPAT CEO 3103928630 2024-03-21 1 MITESH POPAT 999009999 1 LIZBETH G NEVAREZ P01399868 3108731600 2024-03-21 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MITESH POPAT 604 ROSE AVENUE VENICE CA 90291 4190003 0 X HTTP://WWW.VENICEFAMILYCLINIC.ORG/ X 2010 CA TO SUPPORT THE MISSION OF THE VENICE FAMILY CLINIC, TO PROVIDE QUALITY PRIMARY HEALTHCARE TO PEOPLE IN NEED. 34 34 0 35 0 0 4269648 3516452 0 0 3803 212345 193435 72710 4466886 3801507 3000000 0 0 0 0 0 0 0 355563 73684 366551 3073684 366551 1393202 3434956 10283231 13755252 20376 12284 10262855 13742968 THE FOUNDATION'S SPECIFIC PURPOSE IS TO SUPPORT THE MISSION OF THE VENICE FAMILY CLINIC, TO PROVIDE QUALITY PRIMARY HEALTHCARE TO PEOPLE IN NEED. 0 0 SUPPORTING THE EFFORTS OF THE VENICE FAMILY CLINIC. 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 34 34 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 CA X X ANDREA BLACKBIRD 3106647941 604 ROSE AVENUE VENICE CA 90291 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER (LEFT 12/22) 1.00 40.00 X 0 318948 94572 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 254161 76788 MITESH POPAT CHIEF EXECUTIVE OFFICER (AS OF 12/22) 1.00 40.00 X 0 1724 554 JOAN E HERMAN CHAIR 2.00 2.00 X X 0 0 0 MARK GAVENS CHAIR ELECT 2.00 2.00 X X 0 0 0 FRANK MATRICARDI DR PH TREASURER 2.00 0.00 X X 0 0 0 FERN SEIZER SECRETARY 2.00 0.00 X X 0 0 0 CAROL L ARCHIE MD BOARD MEMBER 2.00 0.00 X 0 0 0 JOANNE BOURNE BOARD MEMBER 2.00 2.00 X 0 0 0 LOWELL C BROWN ESQ BOARD MEMBER 2.00 0.00 X 0 0 0 SCOTT F BURNS BOARD MEMBER 2.00 0.00 X 0 0 0 MAYER B DAVIDSON MD BOARD MEMBER 2.00 2.00 X 0 0 0 SUSAN FLEISCHMAN MD BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM FLUMENBAUM BOARD MEMBER 2.00 0.00 X 0 0 0 MARK R GAVENS BOARD MEMBER 2.00 0.00 X 0 0 0 JOHN R GERESI BOARD MEMBER 2.00 2.00 X 0 0 0 CHESTER F GRIFFITHS MD BOARD MEMBER 2.00 0.00 X 0 0 0 ALLAN GORDON BOARD MEMBER 2.00 2.00 X 0 0 0 ELLEN GORDON BOARD MEMBER 2.00 0.00 X 0 0 0 JIMMY H HARA MD BOARD MEMBER 2.00 0.00 X 0 0 0 JOY O HIGA BOARD MEMBER 2.00 0.00 X 0 0 0 HENRY A HORTON BOARD MEMBER 2.00 0.00 X 0 0 0 BARSAM KASRAVI MD MBA MPH BOARD MEMBER 2.00 0.00 X 0 0 0 DEBORAH LAUB BOARD MEMBER 2.00 0.00 X 0 0 0 BRYAN LEWITT BOARD MEMBER 2.00 0.00 X 0 0 0 HARLEY LIKER MD MBA BOARD MEMBER 2.00 0.00 X 0 0 0 TRACEY LOEB BOARD MEMBER (LEFT 6/23) 2.00 0.00 X 0 0 0 VIREN MEHTA BOARD MEMBER 2.00 0.00 X 0 0 0 WENDY SMITH MEYER PHD LCSW BOARD MEMBER 2.00 0.00 X 0 0 0 ETAN CHAIM MILGROM MD MS BOARD MEMBER 2.00 0.00 X 0 0 0 WILLIAM D PARENTE BOARD MEMBER 2.00 0.00 X 0 0 0 NEIL H PARKER MD BOARD MEMBER 2.00 2.00 X 0 0 0 JEFFREY E SINAIKO BOARD MEMBER 2.00 2.00 X 0 0 0 JOHNESE SPISSO MPA BOARD MEMBER 2.00 0.00 X 0 0 0 SUSAN TICK BOARD MEMBER 2.00 0.00 X 0 0 0 ERIC STERN BOARD MEMBER 2.00 0.00 X 0 0 0 RUSSEL TYNER AIA BOARD MEMBER 2.00 0.00 X 0 0 0 MICHAEL S WILKES MD PHD BOARD MEMBER 2.00 0.00 X 0 0 0 0 574833 171914 0 0 1 0 0 104318 3412134 39799 3516452 212345 212345 461206 104318 388496 72710 72710 3801507 0 0 285055 X 3500 3500 88711 2875 85836 69019 385 68634 2253 2253 879 879 SPECIAL EVENTS 174962 3149 171813 LICENSES, FEES, AND DUE 26862 200 26662 EQUIPMENT LEASES & RENT 365 365 366551 0 10988 355563 1040501 298875 8085686 13259979 2500 0 45895 74719 879 0 1107770 121679 10283231 13755252 20376 12284 20376 12284 X 10262855 13742968 10262855 13742968 10283231 13755252 3434956 45157 0 X X 0 1 X 1 0 X 3322937 5693715 6197868 4269648 3516452 23000620 3322937 5693715 6197868 4269648 3516452 23000620 2757277 20243343 8460 33742 5263 3320 212345 263130 40710 191437 193435 72710 498292 23762042 0.85190 0.85010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: THE VENICE FAMILY CLINIC FOUNDATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED JUNE 30, 2023, THE VENICE FAMILY CLINIC FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT IDENTIFY ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. ART WALK 565524 104318 461206 26261 26435 2425 333375 565524 104318 461206 26261 26435 2425 333375 388496 72710 0 0 0 0 0 0 0 0 0 ELIZABETH B FORER CHIEF EXECUTIVE OFFICER (LEFT 12/22) 0 318948 0 0 0 0 0 49743 0 44829 0 413520 0 0 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 0 254161 0 0 0 0 0 40389 0 36399 0 330949 0 0 SCHEDULE J, PART II OFFICERS ELIZABETH B. FORER, ANDREA B. BLACKBIRD, AND MITESH POPAT ARE COMPENSATED BY THE RELATED ENTITY VENICE FAMILY CLINIC (VFC). THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. X 5 39799 FMV 0 1 0 PART I, COLUMN (B): NONCASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONOR CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 8B THIS QUESTION IS NOT APPLICABLE AS THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO BOARD MEMBERS TO DISCLOSE ANY CONFLICTS. IF A CONFLICT IS DISCLOSED IN THE ANNUAL QUESTIONNAIRE, THE INDIVIDUAL WILL BE ASKED TO RECUSE THEMSELVES FROM ANY CONVERSATIONS PERTAINING TO THIS CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS ELIZABETH B. FORER ,ANDREA B. BLACKBIRD, AND MITESH POPAT ARE COMPENSATED BY THE RELATED ENTITY VENICE FAMILY CLINIC (VFC). THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY, WITH THE CEO'S PARTICIPATION. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,875. FUNDRAISING EXPENSES 85,836. TOTAL EXPENSES 88,711. FORM 990, PART XII, LINE 2C: NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. VENICE FAMILY CLINIC 604 ROSE AVENUE VENICE CA 90291 952769432 HEALTH CARE CA 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0