SAMUEL DIXON FAMILY HEALTH CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
SAMUEL DIXON FAMILY HEALTH CENTER INC (EIN 95-4278726)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-04-10
IRS object ID
202331009349301728
Schema version
2021v4.1
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)
Return2023-04-10T17:17:05-07:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN954401626PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Vasin Heyn & CompanyBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15000 N Parkway Calabasas 201AddressLine1Txt
CityCalabasasCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91302ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN954278726EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Samuel Dixon Family Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAMUBusinessNameControlTxt
Phone6612572339PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line125115 W Avenue Stanford A-104AddressLine1Txt
CityValenciaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91355ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPhilip SolomonPersonNm
Person TitleCEOPersonTitleTxt
Signature2023-04-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstPhilipPersonFirstNm
Person LastSolomonPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRolland VasinPreparerPersonNm
PTINP00644882PTIN
Phone8182223500PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPhilip Solomon MPAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line125115 W Avenue Stanford A-104AddressLine1Txt
CityValenciaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91355ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,605,300GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1990FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionA community health center offering medical, dental, and mental health services to uninsured and under insured persons based on a sliding fee scale which is based on federal poverty guidelines. See Schedule O for further details.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee59TotalEmployeeCnt
Total Volunteers15TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,192,157PYContributionsGrantsAmt
CY Contributions Grants$4,412,494CYContributionsGrantsAmt
PY Program Service Revenue$204,001PYProgramServiceRevenueAmt
CY Program Service Revenue$163,482CYProgramServiceRevenueAmt
PY Investment Income$1,614PYInvestmentIncomeAmt
CY Investment Income$1,563CYInvestmentIncomeAmt
PY Other Revenue$78,115PYOtherRevenueAmt
CY Other Revenue$15,525CYOtherRevenueAmt
PY Total Revenue$4,475,887PYTotalRevenueAmt
CY Total Revenue$4,593,064CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,986,294PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,053,384CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$357,985CYTotalFundraisingExpenseAmt
PY Other Expenses$1,173,563PYOtherExpensesAmt
CY Other Expenses$1,182,487CYOtherExpensesAmt
PY Total Expenses$4,159,857PYTotalExpensesAmt
CY Total Expenses$4,235,871CYTotalExpensesAmt
PY Revenues Less Expenses$316,030PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$357,193CYRevenuesLessExpensesAmt
Total Assets BOY$2,570,708TotalAssetsBOYAmt
Total Assets EOY$2,939,942TotalAssetsEOYAmt
Total Liabilities BOY$203,218TotalLiabilitiesBOYAmt
Total Liabilities EOY$201,097TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,367,490NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,738,845NetAssetsOrFundBalancesEOYAmt
MissionA community health center offering medical, dental, and mental health services to uninsured and under insured persons based on a sliding fee scale which is based on federal poverty guidelines. See Schedule O for further details.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,986,485ExpenseAmt
Revenue$163,482RevenueAmt
DescSamuel Dixon Family Health Center, Inc.s goal is to enhance wellness by providing quality outpatient health care services, dental services, mental health services and other programs including; outreach and enrollment, health education, community resources, and referrals. Ensuring that all our friends and neighbors have access to affordable quality primary care while making a special effort to serve the uninsured and under-insured residents of Santa Clarita Valley.Desc
Total Program Service Expenses$2,986,485TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee59EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTom ChristensenPersonNm
Phone6612572339PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line125115 W Avenue Stanford Suite A-104AddressLine1Txt
CityValenciaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91355ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Samuel P Dixon
Chief Medical Offi40.000.00$234,881$0$10,124
Philip Solomon MPA
CEO40.000.00$153,328$0$5,347Yes (X)
Ruben Esparza
Physicians Asst.40.000.00$137,200$0$3,956
Mary Overlander
Nurse Practitioner40.000.00$124,387$0$5,198
Fariba Mason
Nurse Practitioner40.000.00$113,294$0$9,011
Thomas Christensen
CFO40.000.00$115,909$0$5,317
Gloria Mercado-Fortine
Chairperson0.500.00$0$0$0Yes (X)Yes (X)
Michael Fisher
Vice Chairman0.500.00$0$0$0Yes (X)Yes (X)
Carolina Orozco Hernandez
Treasurer0.500.00$0$0$0Yes (X)Yes (X)
Dr David Goldberg DDS
Secretary0.500.00$0$0$0Yes (X)Yes (X)
Anthony McKinnies
Director0.500.00$0$0$0Yes (X)
Nickie DeTolve
Director0.500.00$0$0$0Yes (X)
Paul Lowe
Director0.500.00$0$0$0Yes (X)
Mike Thomas
Director0.500.00$0$0$0Yes (X)
Chris Hermosura
Director0.500.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$878,999TotalReportableCompFromOrgAmt
Total Other Compensation$38,953TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$4,189,024GovernmentGrantsAmt
All Other Contributions$223,470AllOtherContributionsAmt
Noncash Contributions$12,813NoncashContributionsAmt
Total Contributions$4,412,494TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Incentives900099$90,179$90,179
Program Service Fees624100$73,303$73,303
FieldValueIRS element (for citing)
Total Program Service Revenue$163,482TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,563TotalRevenueColumnAmt
Exclusion$1,563ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$8,269FundraisingGrossIncomeAmt
Fundraising Direct Expenses$12,236FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,967TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOther IncomeDesc
Business900099BusinessCd
Total Revenue Column$19,492TotalRevenueColumnAmt
Related Or Exempt Func Income$19,492RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$19,492OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,593,064TotalRevenueColumnAmt
Related Or Exempt Func Income$182,974RelatedOrExemptFuncIncomeAmt
Exclusion$1,563ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$170,595TotalAmt
Management And General$170,595ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,555,730TotalAmt
Program Services$1,938,911ProgramServicesAmt
Management And General$304,388ManagementAndGeneralAmt
Fundraising$312,431FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$124,369TotalAmt
Program Services$92,800ProgramServicesAmt
Management And General$16,407ManagementAndGeneralAmt
Fundraising$15,162FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$202,690TotalAmt
Program Services$143,910ProgramServicesAmt
Management And General$35,268ManagementAndGeneralAmt
Fundraising$23,512FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,885TotalAmt
Management And General$1,885ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$15,225TotalAmt
Management And General$15,225ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$83,145TotalAmt
Program Services$46,741ProgramServicesAmt
Management And General$36,404ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$73,249TotalAmt
Management And General$73,176ManagementAndGeneralAmt
Fundraising$73FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$60,443TotalAmt
Program Services$40,071ProgramServicesAmt
Management And General$19,977ManagementAndGeneralAmt
Fundraising$395FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,765TotalAmt
Program Services$6,678ProgramServicesAmt
Management And General$932ManagementAndGeneralAmt
Fundraising$155FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$304,216TotalAmt
Program Services$212,951ProgramServicesAmt
Management And General$91,265ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$19,180TotalAmt
Program Services$384ProgramServicesAmt
Management And General$18,796ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$105,525TotalAmt
Program Services$93,917ProgramServicesAmt
Management And General$11,608ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$81,634TotalAmt
Program Services$62,365ProgramServicesAmt
Management And General$13,433ManagementAndGeneralAmt
Fundraising$5,836FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies - Medical$111,258$111,258
Outside Services$67,212$3,003$64,209
Repairs and Maintenance$65,986$65,986
Provision for Bad Debt$60,162$60,162

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$125,602TotalAmt
Program Services$107,348ProgramServicesAmt
Management And General$17,833ManagementAndGeneralAmt
Fundraising$421FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$4,235,871TotalAmt
Program Services$2,986,485ProgramServicesAmt
Management And General$891,401ManagementAndGeneralAmt
Fundraising$357,985FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$551,267BOYAmt
EOY$548,671EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$997,046BOYAmt
EOY$1,072,886EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$267,021BOYAmt
EOY$372,591EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,130BOYAmt
EOY$24,801EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,910BOYAmt
EOY$24,721EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,549,376LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,653,104LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$721,334BOYAmt
EOY$896,272EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,570,708BOYAmt
EOY$2,939,942EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$21,529BOYAmt
EOY$10,284EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$181,689BOYAmt
EOY$190,813EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$203,218BOYAmt
EOY$201,097EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,367,490BOYAmt
EOY$2,733,845EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$5,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,367,490BOYAmt
EOY$2,738,845EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,570,708BOYAmt
EOY$2,939,942EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$357,193ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$14,162OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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$3,274,804CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,295,786CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,482,008CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,065,044CurrentTaxYearMinus1YearAmt
Current Tax Year$4,399,681CurrentTaxYearAmt
Total$18,517,323TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,274,804CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,295,786CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,482,008CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,065,044CurrentTaxYearMinus1YearAmt
Current Tax Year$4,399,681CurrentTaxYearAmt
Total$18,517,323TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$18,517,323PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,059CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,514CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,660CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,614CurrentTaxYearMinus1YearAmt
Current Tax Year$1,563CurrentTaxYearAmt
Total$12,410TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,038CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,864CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$183,831CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$78,115CurrentTaxYearMinus1YearAmt
Current Tax Year$19,492CurrentTaxYearAmt
Total$288,340TotalAmt
FieldValueIRS element (for citing)
Total Support$18,818,073TotalSupportAmt
Public Support CY1700.98400PublicSupportCY170Pct
Public Support PY1700.98320PublicSupportPY170Pct
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

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$70,978InvestmentCostOrOtherBasisAmt
Book Value$70,978BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$483,737InvestmentCostOrOtherBasisAmt
Depreciation$325,240DepreciationAmt
Book Value$158,497BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$765,830InvestmentCostOrOtherBasisAmt
Depreciation$316,731DepreciationAmt
Book Value$449,099BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,228,831InvestmentCostOrOtherBasisAmt
Depreciation$1,011,133DepreciationAmt
Book Value$217,698BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$896,272TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Accrued Payroll and Rel Liabilities$155,359
Contracts payable$6,443
Government Funded Assets$29,011
FieldValueIRS element (for citing)
Total Liability$190,813TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,619,462TotalRevEtcAuditedFinclStmtAmt
Other Revenue$26,398OtherRevenueAmt
Revenue Not Reported$26,398RevenueNotReportedAmt
Revenue Subtotal$4,593,064RevenueSubtotalAmt
Total Revenue Per Form990$4,593,064TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,248,107TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$12,236OtherExpensesIncludedAmt
Expenses Not Reported$12,236ExpensesNotReportedAmt
Expenses Subtotal$4,235,871ExpensesSubtotalAmt
Total Expenses Per Form990$4,235,871TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X : FIN48 FootnoteSamuel Dixon Family Health Center, Inc. follows the Financial Accounting Standards Board Accounting Standards Codification (ASC)Section 740-10, which clarifies the accounting for uncertainty in income taxes. ASC Section 740-10 prescribes 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. ASC Section 740-10 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, 2022, Samuel Dixon Family Health Center, Inc. had no material unrecognized tax benefits, tax penalties or interest.Samuel Dixon Family Health Center, Inc.'s Forms 990, Return of Organization Exempt from Income Tax, for each of the tax years ended June 30, 2021, 2020, and 2019, are subject to examination by the IRS, generally for 3 years after they were filed.Samuel Dixon Family Health Center, Inc.'s Forms 199, California Exempt Organization Return, for each of the tax years ended June 30, 2021, 2020, 2019, and 2018, are subject to examination by the Franchise Tax Board, generally for 4 years after they were filed.
Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990Accountability for Gov't Funded Assets $23152 Net Assets Reinstatement $-8990 Fundraising expenses $12236
Part XII, Line 2d: Other expenses and losses per audited F/SFundraising expenses $12236

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
Philip Solomon MPA
CEO$153,328$5,347$158,675
Samuel P Dixon
Chief Medical Offi$234,881$10,124$245,005

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe Chief Executive Officer and Chief Financial Officer review the 990 before finalizing and filing. There is no Board review nor will one be conducted.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsConflicts presented to the Executive Committee for resolution are monitored by the Executive Director.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementReviewed and established by the Board of Directors.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesReviewed and established by Executive Director.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableUpon Request
Other Changes In Net Assets Or Fund Balances - Other IncreasesAccountability for Gov't Funded Assets = $23152
Other Changes In Net Assets Or Fund Balances - Other DecreasesNet Assets Reinstatement = -$8990
Organization's MissionA community health center offering medical, dental, and mental health services to uninsured and under insured persons based on a sliding fee scale which is based on federal poverty guidelines. Families for whom medical, dental, mental health, and health education services would otherwise not be available due to financial hardship or disadvantage are welcomed and cared for at Samuel Dixon Family Health Center, Inc.

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