2021-04-22T15:43:58-05:00 2020-06-30 953001179 WINDES INC PO BOX 87 LONG BEACH CA 908010087 990 2019-07-01 954536824 COMMUNITY HEALTH ALLIANCE OF PASADENA COMM 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 MARGARET B MARTINEZ CEO 6263986300 2021-03-30 1 DONITA M JOSEPH P00286656 5624351191 2021-03-27 2019 2022-09-23 18:48:47Z CHAPCARE MARGARET B MARTINEZ 455 WEST MONTANA STREET PASADENA CA 91103 21887051 0 X WWW.CHAPCARE.ORG X 1995 CA PROVIDE MEDICAL, DENTAL, BEHAVORIAL HEALTH, AND OPTOMETRY SERVICES TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 14 14 551 14 0 0 10110128 8820620 12864107 13038391 138 320 24320 27720 22998693 21887051 0 0 0 0 11753230 11658373 0 0 195583 9653618 9236395 21406848 20894768 1591845 992283 16646336 17756043 11308451 11425875 5337885 6330168 TO PROVIDE EXCELLENT, COMPREHENSIVE, INNOVATIVE HEALTH CARE THAT IS ACCESSIBLE TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 0 0 13647883 11585431 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 47,000 MEDICAL VISITS TO OVER 14,000 UNDUPLICATED PATIENTS DURING THE FISCAL YEAR, JUNE 30, 2020. 2027379 1345942 CHAPCARE OFFERS DENTAL SERVICES FOR CHILDREN AND ADULTS. SERVICES INCLUDE ROUTINE CLEANING, EXAMINATION AND RESTORATIVE WORK. IN THE REPORTING YEAR, OVER 8,000 DENTAL VISITS WERE PROVIDED TO OVER 3,500 UNDUPLICATED PATIENTS. 784275 107018 CHAPCARE PROVIDES WELLNESS SERVICES AVAILABLE TO ALL THROUGH EXPERT PROFESSIONALS IN THE AREA OF DIABETES, WEIGHT MANAGEMENT, NUTRITION COUNSELING, SALSA COURSES, AS WELL AS PHARMACY CONSULTATION OUTREACH FOR DIRECT MEDICAL SERVICES AT SPECIFIC LOCATIONS FOR HOMELESS SERVICES AS WELL AS SCREENING AT HEALTH FAIRS. 16459537 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 20 0 1 551 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X FRANCISCO BENAVIDES 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 SARAH SPYKSMA CHAIR 1.00 X X 0 0 0 DEBORAH VILLAR VICE CHAIR 1.00 X X 0 0 0 MIKE HERNANDEZ TREASURER 1.00 X X 0 0 0 MAURICETTE MONTREDON SECRETARY 1.00 X X 0 0 0 PORFIRIO FRAUSTO MEMBER 1.00 X X 0 0 0 DAVID LEE MEMBER 1.00 X X 0 0 0 THOMAS THORMAN MEMBER 1.00 X X 0 0 0 HAKIM BAXTER MEMBER 1.00 X X 0 0 0 JESSICAL RUIZ MEMBER 1.00 X X 0 0 0 MICHAEL OLIVARES MEMBER 1.00 X X 0 0 0 BETH SY HO MEMBER 1.00 X X 0 0 0 PAM WALD MEMBER 1.00 X X 0 0 0 CONNIE CASILLAS MEMBER 1.00 X X 0 0 0 JAY LEE MEMBER 1.00 X X 0 0 0 ARMANDO LUNA MEMBER 1.00 X X 0 0 0 MARGARET B MARTINEZ CHIEF EXECUTIVE OFFICER 40.00 X 225000 0 27755 SERGIO BAUTISTA CHIEF DEPUTY DIRECTOR 40.00 X 217720 0 26857 VICTOR SUNGA MD CHIEF CARE OFFICER 40.00 X 156124 0 19259 SCOTT YUNG KIM CHIEF CARE OFFICER 40.00 X 35712 0 4405 FRANCISCO BENAVIDES CHIEF FINANCIAL OFFICER 40.00 X 163534 0 20173 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 40.00 X 163441 0 20161 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFIC 40.00 X 163534 0 20173 IRIS MARQUEZ PAISO DENTAL DIRECTOR 40.00 X 182773 0 22546 KENNETH EDWARD ROTHSTEIN PHARMACY MANAGING DIRECTOR 40.00 X 163524 0 20171 ENRIQUE HUGO VALLOTA PHYSICIAN 40.00 X 202078 0 24927 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 40.00 X 192808 0 23784 ONNIG JOHN PANOSIAN PHYSICIAN 32.00 X 164782 0 20327 REX SAYO LAURENTE DENTIST 40.00 X 135188 0 16676 CHARLES EVERETT BRADSHAW PHARMACIST 40.00 X 129150 0 15931 2295368 0 283145 21 0 1 0 AMERISOURCEBERGEN CHAP PO BOX 100565 PASADENA CA 91189 PHARMACEUTICALS 1027867 KAISER FOUNDATION HEALTH PLAN INC FILE 5915 LOS ANGELES CA 90074 MEDICAL HEALTH PLAN 896844 CSI ELECTRICAL CONTRACTOR SERVICES INC 4195 CHINO HILLS PARKWAY 544 CHINO HILLS CA 91709 GENERAL CONTRACTOR 693732 OCHIN 1881 SW NAITO PARKWAY PORTLAND CA 97201 ELECTRONIC HEALTH RECORD PROVIDER 441332 7 LAYER IT SOLUTIONS INC 8921 FULLBRIGHT AVE CHATSWORTH CA 91311 IT MANAGED SERVICE PROVIDER 389673 20 6533766 2286854 8820620 PATIENT FEES 624100 8417820 8417820 PHARMACY 624100 3920941 3920941 PROGRAM PARTICIPANT INCENTIVES 624100 360465 360465 OTHER PROGRAM INCOME 624100 339165 339165 13038391 320 320 27720 0 27720 27720 27720 21887051 13038391 0 28040 1670781 1342199 313792 14790 8233896 6530666 1629671 73559 1015686 805585 201027 9074 738010 586499 144927 6584 628011 254946 370225 2840 818791 445337 373454 127129 114813 7937 4379 77881 37089 40488 304 363844 289148 71450 3246 844554 840347 4207 46612 39404 7208 420441 225771 194670 1281738 1054043 215795 11900 138974 23195 115779 SUPPLIES - PHARMACY 1070644 1070644 UTILITIES 903983 784168 119815 SUPPLIES - CLINICAL 577349 577349 ELECTRONIC HEALTH RECOR 459931 459931 1476513 978403 429203 68907 20894768 16459537 4239648 195583 342712 1159230 367397 398035 175532 65946 1687473 2032578 408781 410161 56841 49671 18436537 8953402 10418637 9483135 3188963 4157287 16646336 17756043 3398086 2399094 7910365 9026781 11308451 11425875 X 4819718 5769284 518167 560884 5337885 6330168 16646336 17756043 992283 0 X 0 1 X 1 1 1 X 7707375 7774080 7663187 10110128 8820620 42075390 392487 536887 617935 630483 587902 2765694 8099862 8310967 8281122 10740611 9408522 44841084 44841084 27423 23221 23246 24458 28040 126388 44967472 58527662 0.99720 0.96520 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1268878 1268878 5252199 3674961 1577238 5040312 1521655 3518657 6875148 3756786 3118362 9483135 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS 4018340 DEPOSITS 138947 4157287 X 22474953 587902 587902 21887051 0 21887051 21482670 587902 587902 20894768 0 20894768 PART X, LINE 2: 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, 2020, 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 1 0 0 0 0 0 0 0 0 MARGARET B MARTINEZ CHIEF EXECUTIVE OFFICER 225000 0 0 0 0 0 0 0 27755 0 252755 0 0 0 SERGIO BAUTISTA CHIEF DEPUTY DIRECTOR 217720 0 0 0 0 0 0 0 26857 0 244577 0 0 0 VICTOR SUNGA MD CHIEF CARE OFFICER 156124 0 0 0 0 0 0 0 19259 0 175383 0 0 0 FRANCISCO BENAVIDES CHIEF FINANCIAL OFFICER 163534 0 0 0 0 0 0 0 20173 0 183707 0 0 0 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 163441 0 0 0 0 0 0 0 20161 0 183602 0 0 0 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFIC 163534 0 0 0 0 0 0 0 20173 0 183707 0 0 0 IRIS MARQUEZ PAISO DENTAL DIRECTOR 182773 0 0 0 0 0 0 0 22546 0 205319 0 0 0 KENNETH EDWARD ROTHSTEIN PHARMACY MANAGING DIRECTOR 163524 0 0 0 0 0 0 0 20171 0 183695 0 0 0 ENRIQUE HUGO VALLOTA PHYSICIAN 202078 0 0 0 0 0 0 0 24927 0 227005 0 0 0 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 192808 0 0 0 0 0 0 0 23784 0 216592 0 0 0 ONNIG JOHN PANOSIAN PHYSICIAN 164782 0 0 0 0 0 0 0 20327 0 185109 0 0 0 REX SAYO LAURENTE DENTIST 135188 0 0 0 0 0 0 0 16676 0 151864 0 0 0 PART I, LINE 4A SERGIO BAUTISTA RECEIVED ONE MONTH SEVERANCE OF MEDICAL INSURANCE OF $571.32 FOR THE MONTH OF JUNE 2020. FORM 990, PART VI, SECTION B, LINE 11B 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 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 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. FORM 990, PART VI, SECTION C, LINE 19 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.