OPERATION SAMAHAN INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- OPERATION SAMAHAN INC (EIN 95-3008798)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-08
- IRS object ID
- 202531289349303343
- Schema version
- 2023v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-08T18:15:37-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953008798 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPERATION SAMAHAN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OPER | BusinessNameControlTxt |
| Phone | 8442002426 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1428 HIGHLAND AVENUE | AddressLine1Txt |
| City | NATIONAL CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91950 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ARCHIE BELLA MD MBA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8442002426 | PhoneNum |
| Signature | 2025-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL LUMSDEN | PreparerPersonNm |
| PTIN | P01262236 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Preparation | 2025-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OPSAM HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ARCHIE BELLA MD MBA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1428 HIGHLAND AVENUE | AddressLine1Txt |
| City | NATIONAL CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91950 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,656,202 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OPERATIONSAMAHAN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1974 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | OPERATING A COMMUNITY HEALTH CLINIC TO BUILD HEALTHIER, HAPPIER COMMUNITIES TOGETHER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 207 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,611,700 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,728,749 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,371,379 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,902,893 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,062 | PYInvestmentIncomeAmt |
| CY Investment Income | $24,560 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,390 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $22,000,531 | PYTotalRevenueAmt |
| CY Total Revenue | $25,656,202 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,754,454 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,793,057 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,357,441 | PYOtherExpensesAmt |
| CY Other Expenses | $9,961,207 | CYOtherExpensesAmt |
| PY Total Expenses | $18,111,895 | PYTotalExpensesAmt |
| CY Total Expenses | $20,756,264 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,888,636 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,899,938 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,171,694 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,749,649 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,066,759 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,744,776 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,104,935 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,004,873 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE EXIST TO PROVIDE QUALITY AND PATIENT-CENTERED HEALTHCARE TO EVERY MEMBER OF THE COMMUNITIES WE SERVE, REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,844,067 | ExpenseAmt |
| Grant | $2,000 | GrantAmt |
| Revenue | $20,902,893 | RevenueAmt |
| Desc | OPERATION SAMAHAN PROVIDES INDIGENT, LOW-INCOME, UNINSURED, AND UNDERSERVED INDIVIDUALS AND FAMILIES HIGH-QUALITY, AFFORDABLE, AND CULTURALLY ACCESSIBLE PRIMARY HEALTH CARE, DENTAL CARE, BEHAVIORAL HEALTH COUNSELING, HOLISTIC HEALTH PROMOTION AND EDUCATION, AND MULTI-FACETED SOCIAL SERVICES. OPERATION SAMAHAN HAD APPROXIMATELY 65,804 PATIENT VISITS DURING THE YEAR. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | N/A | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,844,067 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 102 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 207 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELIZABETH DAVID | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6194774451 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1428 HIGHLAND AVENUE | AddressLine1Txt |
| City | NATIONAL CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91950 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ALEX CAROLINO | |||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| OSCAR CAMPOS | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARINEL BRUAL | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SILVESTER KNOX | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARCELO MANGALINDAN MD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSE RODRIGUEZ | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY TORRES | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PEARL TRINIDAD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOEL TUBAO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ARCHIE BELLA MD MBA | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $252,046 | $0 | $12,032 | ||
| ELIZABETH DAVID | |||||||
| FINANCE DIRECTOR | 40.00 | Yes (X) | $155,503 | $0 | $67 | ||
| JOSIE NUQUI MD | |||||||
| FAMILY MEDICINE DOCTOR | 40.00 | $212,147 | $0 | $11,048 | Yes (X) | ||
| BEATRICE BAEZ MD | |||||||
| FAMILY MEDICINE DOCTOR | 40.00 | $202,599 | $0 | $9,411 | Yes (X) | ||
| KRYSTAL VALDEZ MD | |||||||
| ENDOCRINOLOGIST | 40.00 | $208,343 | $0 | $7,816 | Yes (X) | ||
| KANKA KARMAKAR MD | |||||||
| PEDIATRICIAN | 40.00 | $156,472 | $0 | $5,576 | Yes (X) | ||
| IMELDA LIM FNP | |||||||
| NURSE PRACTITIONER | 40.00 | $153,600 | $0 | $3,420 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,340,710 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $49,370 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMUNITY MEDICAL SPECIALISTS INC | |||||
| 457 KNOLL CREST DR 120 | REDDING | CA | 96002 | BEHAVIORAL THERAPIST SERVICES | $877,783 |
| MEDUSIND INC | |||||
| 1035 GRAND NATIONAL DR SUITE 100 | ORLANDO | FL | 32819 | BILLING SERVICES | $628,101 |
| MEDICUS | |||||
| 100 NORTH POINT CENTER EAST | ALPHARETTA | GA | 30022 | IT SERVICES | $371,524 |
| ECLINICAL WORKS (ECW) | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | PATIENT MANGEMENT / IT SERVICES | $363,992 |
| FIRESTONE BUILDERS | |||||
| 751 RANCHEROS DR SUITE 9 | SAN MARCOS | CA | 92069 | CONSTRUCTION SERVICES | $323,675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,335,347 | GovernmentGrantsAmt |
| All Other Contributions | $393,402 | AllOtherContributionsAmt |
| Noncash Contributions | $252,713 | NoncashContributionsAmt |
| Total Contributions | $4,728,749 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $20,902,893 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,902,893 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,902,893 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,560 | TotalRevenueColumnAmt |
| Exclusion | $24,560 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,656,202 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,902,893 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $24,560 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Program Services | $2,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $419,648 | TotalAmt |
| Program Services | $264,078 | ProgramServicesAmt |
| Management And General | $155,570 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,861,225 | TotalAmt |
| Program Services | $6,050,762 | ProgramServicesAmt |
| Management And General | $2,810,463 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,514 | TotalAmt |
| Program Services | $114,460 | ProgramServicesAmt |
| Management And General | $90,054 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,727 | TotalAmt |
| Program Services | $305,960 | ProgramServicesAmt |
| Management And General | $233,767 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $767,943 | TotalAmt |
| Program Services | $439,087 | ProgramServicesAmt |
| Management And General | $328,856 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,447 | TotalAmt |
| Management And General | $122,447 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,371 | TotalAmt |
| Management And General | $132,371 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,671,387 | TotalAmt |
| Program Services | $2,390,449 | ProgramServicesAmt |
| Management And General | $2,280,938 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,922 | TotalAmt |
| Program Services | $7,986 | ProgramServicesAmt |
| Management And General | $15,936 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,303 | TotalAmt |
| Program Services | $28,755 | ProgramServicesAmt |
| Management And General | $110,548 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,080,557 | TotalAmt |
| Program Services | $201,049 | ProgramServicesAmt |
| Management And General | $879,508 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,199,915 | TotalAmt |
| Program Services | $764,297 | ProgramServicesAmt |
| Management And General | $435,618 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,614 | TotalAmt |
| Program Services | $10,554 | ProgramServicesAmt |
| Management And General | $21,060 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,214 | TotalAmt |
| Program Services | $25,443 | ProgramServicesAmt |
| Management And General | $50,771 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,507 | TotalAmt |
| Program Services | $22 | ProgramServicesAmt |
| Management And General | $183,485 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,110 | TotalAmt |
| Management And General | $414,110 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,195 | TotalAmt |
| Management And General | $79,195 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $896,701 | $896,701 | |
| REPAIRS & MAINTENANCE | $220,936 | $113,768 | $107,168 |
| DUES AND SUBSCRIPTIONS | $159,396 | $53,213 | $106,183 |
| LICENSES & FEES | $28,909 | $9,651 | $19,258 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500,723 | TotalAmt |
| Program Services | $165,832 | ProgramServicesAmt |
| Management And General | $334,891 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,756,264 | TotalAmt |
| Program Services | $11,844,067 | ProgramServicesAmt |
| Management And General | $8,912,197 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,501,771 | BOYAmt |
| EOY | $9,273,299 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,003,172 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,112 | BOYAmt |
| EOY | $227,037 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,231,066 | BOYAmt |
| EOY | $2,017,517 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,711 | BOYAmt |
| EOY | $34,623 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,580,411 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,651,200 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,026,411 | BOYAmt |
| EOY | $3,929,211 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,023,973 | BOYAmt |
| EOY | $2,053,667 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,108,478 | BOYAmt |
| EOY | $1,214,295 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,171,694 | BOYAmt |
| EOY | $18,749,649 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,647,825 | BOYAmt |
| EOY | $1,559,407 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,944,270 | BOYAmt |
| EOY | $1,627,511 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,474,664 | BOYAmt |
| EOY | $6,557,858 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,066,759 | BOYAmt |
| EOY | $9,744,776 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,104,935 | BOYAmt |
| EOY | $9,004,873 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,104,935 | BOYAmt |
| EOY | $9,004,873 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,171,694 | BOYAmt |
| EOY | $18,749,649 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,899,938 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,884,401 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,886,076 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,602,754 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,611,700 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,728,749 | CurrentTaxYearAmt |
| Total | $25,713,680 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,884,401 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,886,076 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,602,754 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,611,700 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,728,749 | CurrentTaxYearAmt |
| Total | $25,713,680 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $25,713,680 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $97 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $103,873 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $319 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,241 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,560 | CurrentTaxYearAmt |
| Total | $132,090 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $60 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,414 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,390 | CurrentTaxYearMinus1YearAmt |
| Total | $9,864 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $25,855,634 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $68,175,594 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99450 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99500 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 6,969. 2022 AMOUNT: $ 2,390. 2023 AMOUNT: $ 0. MEDICAL RECORDS - 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 60. 2021 AMOUNT: $ 445. 2022 AMOUNT: $ 0. 2023 AMOUNT: $ 0. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,125 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,125 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA PRIMARY CARE ASSOCIATION; A PORTION OF THESE DUES WERE INDICATED AS UTILIZED FOR LOBBYING PURPOSES PERTAINING TO HEALTHCARE RELATED INITIATIVES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $779,797 | OtherCostOrOtherBasisAmt |
| Book Value | $779,797 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,548,269 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,015,943 | DepreciationAmt |
| Book Value | $1,532,326 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,307,721 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,443,971 | DepreciationAmt |
| Book Value | $863,750 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,904,072 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,191,286 | DepreciationAmt |
| Book Value | $712,786 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $40,552 | OtherCostOrOtherBasisAmt |
| Book Value | $40,552 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,929,211 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT-OF-USE ASSETS, NET | Desc |
| Book Value | $1,214,295 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,214,295 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS, NET | $5,343,346 |
| OPERATING LEASE LIABILITIES | $1,093,097 |
| FINANCE LEASE LIABILITIES | $121,415 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,557,858 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $25,656,202 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,656,202 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,656,202 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,756,264 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,756,264 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,756,264 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ARCHIE BELLA MD MBA | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $252,046 | $0 | $0 | $0 | $0 | $0 | $5,779 | $0 | $6,253 | $0 | $264,078 | $0 | $0 | $0 |
| JOSIE NUQUI MD | ||||||||||||||
| FAMILY MEDICINE DOCTOR | $212,147 | $0 | $0 | $0 | $0 | $0 | $4,184 | $0 | $6,864 | $0 | $223,195 | $0 | $0 | $0 |
| KRYSTAL VALDEZ MD | ||||||||||||||
| ENDOCRINOLOGIST | $208,343 | $0 | $0 | $0 | $0 | $0 | $3,365 | $0 | $4,451 | $0 | $216,159 | $0 | $0 | $0 |
| BEATRICE BAEZ MD | ||||||||||||||
| FAMILY MEDICINE DOCTOR | $202,599 | $0 | $0 | $0 | $0 | $0 | $3,692 | $0 | $5,719 | $0 | $212,010 | $0 | $0 | $0 |
| KANKA KARMAKAR MD | ||||||||||||||
| PEDIATRICIAN | $156,472 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,576 | $0 | $162,048 | $0 | $0 | $0 |
| IMELDA LIM FNP | ||||||||||||||
| NURSE PRACTITIONER | $153,600 | $0 | $0 | $0 | $0 | $0 | $3,420 | $0 | $0 | $0 | $157,020 | $0 | $0 | $0 |
| ELIZABETH DAVID | ||||||||||||||
| FINANCE DIRECTOR | $155,503 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $67 | $0 | $155,570 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1807 | ContributionCnt |
| Noncash Contributions Rpt F990 | $252,713 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS CONTRIBUTED IN SCHEDULE M, PART I, COLUMN (B). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT IN CONJUNCTION WITH THE ORGANIZATION'S ACCOUNTING AND FINANCE DEPARTMENT. A DRAFT FORM 990 IS REVIEWED BY THE CEO AND FINANCE DIRECTOR; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS THEN MADE AVAILABLE TO ALL MEMBERS OF THE GOVERNING BODY PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH COVERS ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. UNDER THE CONFLICT OF INTEREST POLICY, CONFLICTED INDIVIDUALS ARE REQUIRED TO CONTINUOUSLY DISCLOSE TO MANAGEMENT (IN THE CASE OF EMPLOYEES) OR TO THE BOARD OF DIRECTORS (IN THE CASE OF THE CEO OR OTHER MEMBERS OF THE BOARD OF DIRECTORS) POTENTIAL OR APPARENT CONFLICTS. CONFLICTED INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF ANY CONTRACT OR OTHER AGREEMENT SUPPORTED BY FEDERAL GRANT FUNDS FOR THE FURNISHING OF SERVICES OR SUPPLIES TO THE ORGANIZATION IF A REAL OR APPARENT CONFLICT OF INTEREST WOULD ARISE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S BOARD OF DIRECTORS ESTABLISHES COMPENSATION FOR THE CEO AND OTHER OFFICERS AND KEY EMPLOYEES BASED-OFF INFORMATION FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION'S COMPENSATION AND BENEFITS STATEWIDE SURVEY REPORT, UTILIZING INFORMATION FROM SIMILARLY SITUATED ORGANIZATIONS IN SIMILAR GEOGRAPHIC REGIONS. THE DELIBERATION AND DECISION IS CONTEMPORANEOUSLY SUBSTANTIATED WITHIN THE MEETING MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,330,815. MANAGEMENT AND GENERAL EXPENSES 1,278,422. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,609,237. CARES ACT ERC PREPARER FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 883,522. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 883,522. JANITORIAL / SECURITY SERVICES: PROGRAM SERVICE EXPENSES 59,634. MANAGEMENT AND GENERAL EXPENSES 118,994. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 178,628. |
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