2021-05-17T11:46:24-05:00 2020-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2019-07-01 680149424 OLE HEALTH FOUNDATION OLEH 7076037100 1141 PEAR TREE LANE NO 100 NAPA CA 94558 ROSE MACISAAC CHIEF FIN AND ADMIN OFFICER 7076037100 2021-05-14 1 MICHAEL LUMSDEN P01262236 4159561500 2021-05-14 2019 2022-09-23 18:48:47Z ALICIA HARDY 1141 PEAR TREE LANE NO 100 NAPA CA 94558 2468843 0 X WWW.OLEHEALTH.ORG X 1987 CA FUNDRAISING AND OTHER SERVICES TO SUPPORT OLE HEALTH. 10 9 3 10 0 0 1486471 2399559 0 0 83366 67339 -172848 0 1396989 2466898 130244 1753304 0 0 303742 0 0 0 963856 139562 998434 573548 2751738 823441 -284840 7709512 7030677 449962 47291 7259550 6983386 OUR MISSION IS TO INSPIRE PHILANTHROPIC CONTRIBUTIONS TO ENSURE THAT OLE HEALTH IS ALWAYS HERE TO CARE FOR EVERYONE IN OUR BEAUTIFUL AND DIVERSE COMMUNITY. 0 0 1753304 1753304 0 FUNDRAISING SERVICES IN SUPPORT OF OLE HEALTH, A HEALTH CENTER FOR LOW INCOME INDIVIDUALS AND OTHERS WITHOUT HEALTH INSURANCE. DURING THE YEAR, OLE HEALTH FOUNDATION GAVE A $1,753,304 GRANT TO OLE HEALTH TO SUPPORT OLE HEALTH'S ONGOING OPERATIONS AND SPECIAL PROJECTS TO CREATE LASTING RESERVE FUNDS, ASSURING THAT OLE HEALTH CAN CONTINUE TO PROVIDE HIGH QUALITY PRIMARY HEALTH CARE TO OUR ENTIRE COMMUNITY. 1753304 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 14 0 1 3 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X ROSE MACISAAC 7072541774 1141 PEAR TREE LANE SUITE 200 NAPA CA 94558 ALICIA HARDY BOARD MEMBER / CEO OF OLE HEALTH 1.00 39.00 X 0 300985 23645 JESSICA THOMASON EXECUTIVE DIRECTOR THROUGH 9/2019 40.00 0.00 X 0 46126 1623 ROSE MACISAAC CHIEF FIN. & ADMINISTRATIVE OFFICER 8.00 32.00 X 0 39060 753 TODD ZAPOLSKI CHAIR THROUGH 12/2019 / BOARD MEMBER 1.00 0.00 X X 0 0 0 PETE RICHMOND CHAIR START 12/2019 1.00 0.00 X X 0 0 0 BLAKESLEY CHAPPELLET VICE CHAIR THROUGH 12/2019 / SECR 1.00 0.00 X X 0 0 0 DARIOUSH KHALEDI VICE CHAIR START 12/2019 1.00 0.00 X X 0 0 0 SUZANNE BESU TRUCHARD SECR THROUGH 12/2019 / BOARD MEMBER 1.00 0.00 X X 0 0 0 DAN LYNCH TREAS THROUGH 12/2019 / BOARD MEMBER 1.00 0.00 X X 0 0 0 RICK JONES TREASURER START 12/2019 1.00 2.00 X X 0 0 0 JANETTE BROOKS BOARD MEMBER THROUGH 12/2019 1.00 0.00 X 0 0 0 NAOKO DALLA VALLE BOARD MEMBER 1.00 0.00 X 0 0 0 PETER MCCREA BOARD MEMBER 1.00 0.00 X 0 0 0 0 386171 26021 0 0 1 0 0 925000 1474559 29120 2399559 69284 69284 1945 -1945 -1945 -1945 2466898 0 0 67339 1753304 1753304 356 356 24000 21500 2500 5011 5011 7846 6291 1555 5 5 44 44 DONOR RECOGNITION 18037 18037 STAFF APPRECIATION 14151 14151 STORAGE 1955 1955 LICNESES & PERMITS 256 256 926773 4215 922558 2751738 1753304 34578 963856 1743576 1450347 853890 276008 5100370 5199245 11676 105077 7709512 7030677 425415 624 24547 46667 449962 47291 X 7259550 6125849 857537 7259550 6983386 7709512 7030677 -284840 8676 0 X 0 1 X 1 0 X X 1 OLE HEALTH 237221695 3 1 1753304 0 1 1753304 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED ORGANIZATION 46667 46667 X PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2020 AND 2019, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 501(C)(3) 1753304 GENERAL SUPPORT 1 0 PART I, LINE 2: DURING THE JUNE 30, 2020 TAX YEAR, THE ORGANIZATION PROVIDED GRANTS SOLELY TO OLE HEALTH, A RELATED ORGANIZATION. BOTH ORGANIZATIONS MAINTAIN AN OVERLAP OF OFFICERS, WHO MONITOR PROPER USE OF THE GRANT FUNDS. 0 0 0 0 0 0 0 0 0 ALICIA HARDY BOARD MEMBER / CEO OF OLE HEALTH 0 288639 0 1000 0 11346 0 11033 0 12612 0 324630 0 0 PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S EXECUTIVE DIRECTOR IS ESTABLISHED BY OLE HEALTH, A RELATED ORGANIZATION. OLE HEALTH UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF OLE HEALTH FOUNDATION'S EXECUTIVE DIRECTOR: COMPENSATION SURVEY AND APPROVAL BY THE BOARD OF DIRECTORS. X 1 5041 FMV X MEALS FOR OLE STAFF 1 14022 FMV X WINE 12 6789 FMV X GARDEN SUPPLIES 1 3268 FMV 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS, RATHER THAN THE NUMBER OF ITEMS CONTRIBUTED, IN SCHEDULE M, PART I, COLUMN (B). FORM 990, PART VI, SECTION A, LINE 6 OLE HEALTH FOUNDATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO, PURSUANT TO A PROVISION OF THE ORGANIZATION'S GOVERNING DOCUMENTS, HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE (INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY). ACCORDINGLY, OLE HEALTH FOUNDATION HAS ONE SOLE MEMBER: OLE HEALTH. FORM 990, PART VI, SECTION A, LINE 7A OLE HEALTH (OLE HEALTH FOUNDATION'S SUPPORTED ORGANIZATION) HAS THE POWER TO APPOINT EACH OF THE DIRECTORS OF OLE HEALTH FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION UTILIZED A PROFESSIONAL ACCOUNTING FIRM TO PREPARE THE FORM 990, WHO WORKED WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM TO GATHER THE REQUIRED INFORMATION. UPON REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT TEAM, A COPY OF THE FORM 990 AND ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING IN ORDER TO ALLOW SUFFICIENT TIME FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS OF OLE HEALTH FOUNDATION HAVE A RESPONSIBILITY TO MAKE FULL DISCLOSURE OF INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN SATISFYING THEIR FIDUCIARY OBLIGATIONS TO OLE HEALTH FOUNDATION. IN THAT REGARD, IT IS THE POLICY OF OLE HEALTH FOUNDATION TO REFRAIN FROM CONSUMMATING ANY TRANSACTION INVOLVING A POTENTIAL CONFLICT OF INTEREST UNTIL ALL RELEVANT AND PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT HAVE BEEN DISCLOSED AND CONSIDERED, DURING WHICH THE INTERESTED PARTY WOULD REFRAIN FROM DELIBERATIONS. DIRECTORS AND OFFICERS ARE REQUIRED TO REVIEW AND SIGN THE "STATEMENT PERTAINING TO CONFLICT OF INTEREST AND CONFIDENTIALITY" UPON APPOINTMENT, ELECTION AND HIRE, AND THEN ANNUALLY THEREAFTER. ACTIVITIES THAT MAY CAUSE A CONFLICT OF INTEREST ARE REPORTED TO AND MONITORED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT DIRECTLY COMPENSATE ANY INDIVIDUALS; ALL EMPLOYEES PERFORMING WORK FOR OLE HEALTH FOUNDATION ARE COMPENSATED BY OLE HEALTH CLINIC, A REALTED ORGANIZATION. AS SUCH, PART VI, SECTION B, LINES 15A AND 15B HAVE BEEN ANSWERED "NO" AS MANDATED BY THE FORM 990 INSTRUCTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE ALL AVAILABLE UPON REQUEST. OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 HEALTH CARE TO LOW INCOME AND UNINSURED RESIDENTS CA 501(C)(3) LINE 7 N/A 0 OLE HEALTH NMTC 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 815395044 SUPPORT THE CHARITABLE PURPOSES OF OLE HEALTH AND OLE HEALTH FOUNDATION CA 501(C)(3) LINE 12A, I OLE HEALTH 0 0 1 1 1 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0