2023-07-18T18:10:45-05:00 2022-06-30 953001179 WINDES INC PO BOX 87 LONG BEACH CA 908010087 990 2021-07-01 954536824 COMMUNITY HEALTH ALLIANCE OF PASADENA COMM 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 DEYNER ZAPATA CEO 6263986300 2023-07-17 1 DEYNER ZAPATA 999009999 DONITA JOSEPH P00286656 5624351191 2023-07-14 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z CHAPCARE DEYNER ZAPATA 455 WEST MONTANA STREET PASADENA CA 91103 28284131 0 X WWW.CHAPCARE.ORG X 1995 CA PROVIDE MEDICAL, DENTAL, BEHAVORIAL HEALTH, AND OPTOMETRY SERVICES TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 12 12 236 12 0 0 10191350 10389474 14724045 17862184 2080 1321 30316 31152 24947791 28284131 0 0 0 0 11341078 14475887 0 0 184110 10272624 11530442 21613702 26006329 3334089 2277802 18827487 21216461 9163230 9274402 9664257 11942059 TO PROVIDE EXCELLENT, COMPREHENSIVE, INNOVATIVE HEALTH CARE THAT IS ACCESSIBLE TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 0 0 17205774 15904055 CHAPCARE OFFERS A FULL RANGE OF PRIMARY MEDICAL CARE SERVICES, PHYSICAL EXAMINATIONS FOR PEOPLE OF ALL AGES, CHOLESTEROL CHECKS, CANCER SCREENING, COMMUNICABLE DISEASE SCREENING, VISION AND HEARING TESTING, FAMILY PLANNING, BLOOD PRESSURE SCREENING, LAB AND RADIOLOGY, MEDICATIONS, PRESCRIPTIONS, AND CASE MANAGEMENT SERVICES. CHAPCARE PROVIDED OVER 59,000 MEDICAL VISITS TO OVER 14,000 UNDUPLICATED PATIENTS DURING THE FISCAL YEAR, JUNE 30, 2022. 2200782 1958129 CHAPCARE OFFERS DENTAL SERVICES FOR CHILDREN AND ADULTS. SERVICES INCLUDE ROUTINE CLEANING, EXAMINATION AND RESTORATIVE WORK. IN THE REPORTING YEAR, OVER 6,500 DENTAL VISITS WERE PROVIDED TO OVER 2,500 UNDUPLICATED PATIENTS. 19406556 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 21 0 1 236 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X SAM ORTIZ 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 DR PAMELA WALD CHAIR 1.00 X X 0 0 0 JAY LEE CO-CHAIR/TREASURER 1.00 X X 0 0 0 MAURICETTE MONTREDON SECRETARY 1.00 X X 0 0 0 HAKIM BAXTER MEMBER 1.00 X X 0 0 0 THOMAS THORMAN MEMBER 1.00 X X 0 0 0 PORFIRIO FRAUSTO MEMBER 1.00 X X 0 0 0 MICHAEL OLIVARES MEMBER 1.00 X X 0 0 0 BERNABETH HO MEMBER 1.00 X X 0 0 0 ARMANDO LUNA MEMBER 1.00 X X 0 0 0 SARAH SPYKSMA MEMBER 1.00 X X 0 0 0 DR CONSUELO CASILLAS MEMBER 1.00 X X 0 0 0 DEBORAH VILLAR MEMBER 1.00 X X 0 0 0 DR ERIC TAM MEMBER 1.00 X X 0 0 0 SCOTT YUNG KIM CHIEF CARE OFFICER 40.00 X 351736 0 49243 MARGARET B MARTINEZ CEO 40.00 X 274478 0 38427 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 40.00 X 224278 0 31399 FRANCISCO JAVIER BENAVIDES CHIEF FINANCE OFFICER 40.00 X 210009 0 29401 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFICER 40.00 X 203868 0 28542 IRIS MARQUEZ PAISO CHIEF CARE OFFICER/DENTAL 40.00 X 201428 0 28200 GILMER JOHN YOUN PHYSICIAN 40.00 X 247575 0 34661 EMMELINE CHAN PHYSICIAN 40.00 X 240955 0 33734 ENRIQUE HUGO VALLOTA MEDICAL DIRECTOR/PHYSICIAN 40.00 X 240955 0 33734 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 40.00 X 239874 0 33582 ONNIG JOHN PANOSIAN PHYSICIAN 32.00 X 195495 0 27369 2630651 0 368292 29 0 1 0 AMERISOURCEBERGEN CHAP PO BOX 100565 PASADENA CA 91189 PHARMACEUTICALS 1580414 KAISER FOUNDATION HEALTH PLAN INC FILE 5915 LOS ANGELES CA 90074 MEDICAL HEALTH PLAN 1070118 OCHIN 1881 SW NAITO PARKWAY PORTLAND CA 97201 ELECTRONIC HEALTH RECORD PROVIDER 685345 CITY OF PASADENA PO BOX 7115 PASADENA CA 91109 PROPERTY LEASE 563209 GLOBAL IT COMMUNICATIONS 6720 BRIGHT AVENUE WHITTIER CA 90601 NETWORK & IT SERVICES 554985 29 8637406 1752068 10389474 PATIENT FEES 624100 13468440 13468440 PHARMACY 624100 4071814 4071814 OTHER PROGRAM INCOME 624100 306109 306109 PROGRAM PARTICIPANT INCENTIVES 624100 15821 15821 17862184 1321 1321 31152 0 31152 31152 31152 28284131 17862184 0 32473 1671008 565500 1105508 10921940 8834096 2012170 75674 992458 832608 152533 7317 890481 670689 214352 5440 590409 279894 308389 2126 2073598 1054363 1016185 3050 184700 159785 24915 185236 87474 96385 1377 1151307 1064104 87203 11961 6880 5081 384529 192966 191563 1191455 905915 274316 11224 186566 78786 107780 SUPPLIES - PHARMACY 1394592 1394592 0 0 SUPPLIES - CLINICAL 709222 709222 0 0 UTILITIES 668950 601559 67391 0 ELECTRONIC HEALTH RECOR 581775 581775 0 0 2216142 1386348 751892 77902 26006329 19406556 6415663 184110 4678542 5032323 118312 1619585 86812 17674 1898003 2508200 444504 448665 124420 262531 19819645 11383259 8705056 8436386 2771838 2891097 18827487 21216461 2069576 1795432 7093654 7478970 9163230 9274402 X 9433007 11918811 231250 23248 9664257 11942059 18827487 21216461 2277802 0 X 0 1 X 1 1 1 X 7663187 10110128 8820620 10191350 10389474 47174759 617935 630483 587902 0 0 1836320 8281122 10740611 9408522 10191350 10389474 49011079 49011079 23246 24458 28040 32396 32473 140613 49151692 70786820 0.99710 0.99710 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1268878 1268878 5539126 4672307 866819 5078623 1934616 3144007 7645260 4776336 2868924 287758 287758 8436386 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS 2822909 DEPOSITS 68188 2891097 X 28284131 0 28284131 0 28284131 26006329 0 26006329 0 26006329 PART X, LINE 2: FIN 48: THE ORGANIZATION 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, 2021, THE ORGANIZATION HAD NO UNRECOGNIZED TAX BENEFITS, TAX PENALTIES, OR INTEREST. THE ORGANIZATION 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. 1 X X X X 0 0 0 0 0 0 0 0 0 SCOTT YUNG KIM CHIEF CARE OFFICER 351736 0 0 0 0 0 0 0 49243 0 400979 0 0 0 MARGARET B MARTINEZ CEO 274478 0 0 0 0 0 0 0 38427 0 312905 0 0 0 GILMER JOHN YOUN PHYSICIAN 247575 0 0 0 0 0 0 0 34661 0 282236 0 0 0 EMMELINE CHAN PHYSICIAN 240955 0 0 0 0 0 0 0 33734 0 274689 0 0 0 ENRIQUE HUGO VALLOTA MEDICAL DIRECTOR/PHYSICIAN 240955 0 0 0 0 0 0 0 33734 0 274689 0 0 0 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 239874 0 0 0 0 0 0 0 33582 0 273456 0 0 0 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 224278 0 0 0 0 0 0 0 31399 0 255677 0 0 0 FRANCISCO JAVIER BENAVIDES CHIEF FINANCE OFFICER 210009 0 0 0 0 0 0 0 29401 0 239410 0 0 0 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFICER 203868 0 0 0 0 0 0 0 28542 0 232410 0 0 0 IRIS MARQUEZ PAISO CHIEF CARE OFFICER/DENTAL 201428 0 0 0 0 0 0 0 28200 0 229628 0 0 0 ONNIG JOHN PANOSIAN PHYSICIAN 195495 0 0 0 0 0 0 0 27369 0 222864 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE THE PROCESS THE ORGANIZATION USES TO REVIEW FORM 990. IT IS THE RESPONSIBILITY OF THE FINANCE COMMITTEE TO ACCEPT AND MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. THE APPROVED 990 IS SIGNED BY THE CEO AND MAILED TO THE APPROPRIATE TAX AGENCY. FORM 990, PART VI, SECTION B, LINE 12C DESCRIBE THE PROCESS THE ORGANIZATION USES TO MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. REVIEW OF POLICY IS PERFORMED BY THE BOARD OF DIRECTORS AND ANY POTENTIAL CONFLICTS ARE IDENTIFIED. EACH BOARD MEMBER SIGNS AN ETHICS AND CONFLICT OF INTEREST FORM ANNUALLY. FORM 990, PART VI, SECTION B, LINE 15 DESCRIBE THE PROCESS USED TO DETERMINE COMPENSATION OF THE OFFICERS AND EMPLOYEES OF THE ORGANIZATION. THE BOARD USES A CPCA REPORT AND A LOCAL CLINIC SURVEY TO DETERMINE THE COMPENSATION PACKAGE FOR THE CEO. THE BOARD APPROVES THE COMPENSATION PACKAGE, WHICH IS DOCUMENTED IN THE MINUTES. THE FINANCE COMMITTEE PRESENTS TO THE BOARD A COMPREHENSIVE BUDGET, WHICH INCLUDES THE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES. MANAGEMENT USES A CPCA REPORT AND A LOCAL CLINIC SURVEY TO DETERMINE THE COMPENSATION PACKAGE FOR THE OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE CEO APPROVES THE COMPENSATION PACKAGE, WHICH IS DOCUMENTED IN THE MLNUTES OF THE GOVERNANCE COMMITTEE. THE FINANCE COMMITTEE PRESENTS TO THE BOARD A COMPREHENSIVE BUDGET, WHICH INCLUDES THE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 DESCRIBE HOW THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ALL ITEMS ARE AVAILABLE UPON REQUEST. THE ITEMS SHOULD BE REQUESTED, IN WRITING, TO THE ATTENTION OF MARGARET B MARTINEZ, CEO. FORM 990 IS ALSO AVAILABLE ON WWW.GUIDESTAR.COM.