CALIFORNIA COVERAGE AND HEALTH INITIATIVES: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CALIFORNIA COVERAGE AND HEALTH INITIATIVES (EIN 47-4034471)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-09-16
- IRS object ID
- 202122599349301607
- Schema version
- 2020v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-09-16T15:42:00-07:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 200276349 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MANN URRUTIA NELSON CPAs & ASSOC LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2901 Douglas Blvd Suite 290 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 474034471 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | California Coverage & Health Initiatives | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CALI | BusinessNameControlTxt |
| Phone | 9164049442 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Ninth Street Suite 601 | AddressLine1Txt |
| City | Sacramento | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95814 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Diel | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2021-09-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Mark | PersonFirstNm |
| Person Last | Diel | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Justin J Williams CPA | PreparerPersonNm |
| PTIN | P00851793 | PTIN |
| Phone | 9167744208 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Ninth Street Suite 601 | AddressLine1Txt |
| City | Sacramento | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,396,779 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cchi4families.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | CCHIs mission is to improve the health and well-being of California children and families by supporting its members in meeting the needs of their communities. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,150,634 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,396,779 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | -$533 | CYOtherRevenueAmt |
| PY Total Revenue | $1,150,634 | PYTotalRevenueAmt |
| CY Total Revenue | $3,396,246 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $234,624 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,991,374 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $529,216 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $725,371 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,967 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $429,794 | PYOtherExpensesAmt |
| CY Other Expenses | $524,136 | CYOtherExpensesAmt |
| PY Total Expenses | $1,193,634 | PYTotalExpensesAmt |
| CY Total Expenses | $3,240,881 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$43,000 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $155,365 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $403,334 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,158,502 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $728,737 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,328,540 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$325,403 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$170,038 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CCHIs mission is to improve the health and well-being of California children and families by supporting its members in meeting the needs of their communities. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,058,498 | ExpenseAmt |
| Grant | $1,991,374 | GrantAmt |
| Desc | CCHI was able to secure about $4,200,000 in public and private contracts for CCHI and its member organizations to provide health insurance outreach and enrollment services for the next two years. CCHI expanded its Salesforce CRM system to six additional agencies and building modifications, including reference manual, to improve back-end system for our contracts and Medi-Medi program. CCHI recieved funding to provide educational outreach and application assistance for Cencus resulting to outreaching to 49,032 individuals in five counties with 3,155 Census applications completed. CCHI was able to transition to work remotely in response to the COVID-19 pandemic successfully. During this time, CCHI also successfully converted its in-person Health Access Assister training program to an online training to meet the changing needs of its members. CCHI established California Coverage and Health Insurance Services (CCHIS), a health and life insurance agency subsidiary of CCHI, to help provide services and support to its member organizations who are providing Medi Medi services to the community. CCHI continues to provide technical assistance to its members to build new business lines, advocate for state funding, and develop new funding streams to meet the health access needs in the communities its members serve. | Desc |
| Total Program Service Expenses | $3,058,498 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | Yes (true) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Yaomee Xiong | PersonNm |
| Phone | 9164049442 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 Ninth Street Suite 601 | AddressLine1Txt |
| City | Sacramento | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95814 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Mark Diel | |||||||
| CEO | 40.00 | 0.00 | Yes (X) | $224,227 | $0 | $39,200 | |
| Maria Romero-Mora | |||||||
| Dir. of Programs | 40.00 | 0.00 | $107,249 | $0 | $32,544 | ||
| Elba Gonzalez-Mares | |||||||
| Board Chair | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Alan Fernandes | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Georgina Maldonado | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Katie Villegas | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Bradford Onorato | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| James Rolfe | |||||||
| Board member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Victor Manuel Perez | |||||||
| Board member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Kathleen King | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Georgene Lowe | |||||||
| Board member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Maria Lemus | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $331,476 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $71,744 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Health Initiatives CHI | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2140 Fefferson St STE D | AddressLine1Txt |
| City | Napa | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94559 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Medical Consultant Servic | ServicesDesc |
| Compensation | $122,935 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $13,000 | MembershipDuesAmt |
| Fundraising | $30,000 | FundraisingAmt |
| Government Grants | $2,435,243 | GovernmentGrantsAmt |
| All Other Contributions | $918,536 | AllOtherContributionsAmt |
| Total Contributions | $3,396,779 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $30,000 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $533 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$533 | TotalRevenueColumnAmt |
| Exclusion | -$533 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,396,246 | TotalRevenueColumnAmt |
| Exclusion | -$533 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,991,374 | TotalAmt |
| Program Services | $1,991,374 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,428 | TotalAmt |
| Program Services | $243,489 | ProgramServicesAmt |
| Management And General | $19,939 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $315,923 | TotalAmt |
| Program Services | $305,314 | ProgramServicesAmt |
| Management And General | $10,609 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,219 | TotalAmt |
| Program Services | $10,848 | ProgramServicesAmt |
| Management And General | $3,371 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,997 | TotalAmt |
| Program Services | $75,874 | ProgramServicesAmt |
| Management And General | $18,123 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,804 | TotalAmt |
| Program Services | $1,939 | ProgramServicesAmt |
| Management And General | $35,865 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,739 | TotalAmt |
| Program Services | $16,848 | ProgramServicesAmt |
| Management And General | $10,891 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,695 | TotalAmt |
| Program Services | $188,308 | ProgramServicesAmt |
| Management And General | $123,387 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,781 | TotalAmt |
| Program Services | $27,244 | ProgramServicesAmt |
| Management And General | $9,537 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,969 | TotalAmt |
| Program Services | $57,507 | ProgramServicesAmt |
| Management And General | $462 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,284 | TotalAmt |
| Program Services | $15,829 | ProgramServicesAmt |
| Management And General | $455 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,606 | TotalAmt |
| Program Services | $37,598 | ProgramServicesAmt |
| Management And General | $41 | ManagementAndGeneralAmt |
| Fundraising | $1,967 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,050 | TotalAmt |
| Management And General | $2,050 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,787 | TotalAmt |
| Program Services | $6,087 | ProgramServicesAmt |
| Management And General | $700 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES & SUBSCRIPTIONS | $15,076 | $2,689 | $12,387 |
| MISCELLANEOUS | $10,149 | $5,000 | $5,149 |
| Indirect Grant Cost | $0 | $72,550 | -$72,550 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,240,881 | TotalAmt |
| Program Services | $3,058,498 | ProgramServicesAmt |
| Management And General | $180,416 | ManagementAndGeneralAmt |
| Fundraising | $1,967 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $252,758 | BOYAmt |
| EOY | $166,285 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,713 | BOYAmt |
| EOY | $104,110 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,029 | BOYAmt |
| EOY | $860,460 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,834 | BOYAmt |
| EOY | $17,308 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,198 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,050 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,148 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,191 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $403,334 | BOYAmt |
| EOY | $1,158,502 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,270 | BOYAmt |
| EOY | $708,846 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $619,713 | BOYAmt |
| EOY | $356,200 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $216,441 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,754 | BOYAmt |
| EOY | $47,053 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $728,737 | BOYAmt |
| EOY | $1,328,540 | 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 | -$325,403 | BOYAmt |
| EOY | -$234,269 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $64,231 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$325,403 | BOYAmt |
| EOY | -$170,038 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $403,334 | BOYAmt |
| EOY | $1,158,502 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $155,365 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
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 | $2,401,257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,804,905 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,059,919 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,150,634 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,295,350 | CurrentTaxYearAmt |
| Total | $9,712,065 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,401,257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,804,905 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,059,919 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,150,634 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,295,350 | CurrentTaxYearAmt |
| Total | $9,712,065 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $9,712,065 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $5,022 | CurrentTaxYearAmt |
| Total | $5,022 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,717,087 | TotalSupportAmt |
| Public Support CY170 | 0.99950 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (true) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $75,000 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Total Lobbying Expenditures | $75,000 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | $75,000 paid to Campbell for lobby works. Activities provided include lobbied the Legislature on the state budget, related to funding for programs to increase health care coverage for low income seniors and the Navigator Program; Lobbied the Legislature and Governor in support of the Medi-Medi Navigator Program. | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,198 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,050 | DepreciationAmt |
| Book Value | $6,148 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,148 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYROLL LIABILITY | Desc |
| Amt | $47,053 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $47,053 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $3,396,779 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $533 | OtherRevenueAmt |
| Revenue Not Reported | $533 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,396,246 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $3,396,246 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,241,414 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $533 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $533 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,240,881 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $3,240,881 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Direct Fundraising Expenses $533 |
| Part XII, Line 2d: Other expenses and losses per audited F/S | Direct Fundraising Expenses $533 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CHAMPS Event | Event1Nm |
| Gross Receipts Event1 | $30,000 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $30,000 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $533 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $30,000 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $30,000 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $533 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $533 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$533 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (17 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Ampla Health | |||||||
| 935 Market Street | Yuba City | CA | 95991 | 942210447 | $59,500 | $0 | Outreach/Enrollment |
| Children and Family Resource | |||||||
| PO Box 6307 | Santa Barbara | CA | 93160 | 824121880 | $273,921 | $0 | Outreach/Enrollment |
| Community Health Initiative o | |||||||
| 1505 E 17th Street Ste 121 | Santa Ana | CA | 92705 | 472671013 | $58,500 | $0 | Outreach/Enrollment |
| Community Health Initiatives | |||||||
| 2140 Jefferson Street Suite | Napa | CA | 94559 | 251924934 | $71,000 | $0 | Outreach/Enrollment |
| Community Health Partnership | |||||||
| 408 N Capital Ave | San Jose | CA | 95133 | 770352645 | $590,546 | $0 | Outreach/Enrollment |
| First 5 Santa Cruz County | |||||||
| Po Box 1457 | Capitola | CA | 95010 | 941422471 | $22,000 | $0 | Outreach/Enrollment |
| Give for a Smile | |||||||
| 1811 W Katella Ave Suite 11 | Anaheim | CA | 92804 | 452454983 | $14,633 | $0 | Outreach/Enrollment |
| Healthier Kids Foundation | |||||||
| 4040 Moorpark Ave Suite 100 | San Jose | CA | 95117 | 770545774 | $201,372 | $0 | Outreach/Enrollment |
| Healthways Inc | |||||||
| 901 Campus Drive Suite 209 | Daly City | CA | 94015 | 260659810 | $10,491 | $0 | Outreach/Enrollment |
| High Desert Community Foundat | |||||||
| PO Box 2028 | Apply Valley | CA | 92307 | 841179212 | $26,733 | $0 | Outreach/Enrollment |
| Mercy Foundation - Bakersfiel | |||||||
| PO Box 119 | Bakersfield | CA | 93302 | 770201321 | $78,751 | $0 | Outreach/Enrollment |
| San Diegans for Healthcare Co | |||||||
| 814 Morena Blvd Suite 309 | San Diego | CA | 92110 | 470846723 | $35,000 | $0 | Outreach/Enrollment |
| Santa Cruz Community Health C | |||||||
| PO Box 542 | Santa Cruz | CA | 95061 | 237428303 | $36,500 | $0 | Outreach/Enrollment |
| United Way of Northern Califo | |||||||
| 2280 Benton Dr Bldg B | Redding | CA | 96003 | 941251675 | $39,427 | $0 | Outreach/Enrollment |
| Ventura County Public Health | |||||||
| 2220 E Gonzales Road Suite | Oxnard | CA | 93036 | 956000944 | $45,307 | $0 | Outreach/Enrollment |
| Vision y Compromiso | |||||||
| PO Box 708 | San Lorenzo | CA | 94580 | 320071651 | $401,776 | $0 | Outreach/Enrollment |
| Yolo County Childrens Allian | |||||||
| 600 A Street Suite Y | Davis | CA | 95616 | 680526185 | $25,917 | $0 | Outreach/Enrollment |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 17 | Total501c3OrgCnt |
| Total Other Org | 17 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Grantmaker's Description of How Grants are Used | FormAndLineReferenceDesc |
| Explanation | Site visits are performed and annual financial reports are provided bygrantees indicating use of funds. Additionally, for the grants involvingenrollment, enrollment and retention numbers are verified with CoveredCalifornia. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mark Diel | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $224,227 | BaseCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $11,211 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $27,989 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $263,427 | TotalCompensationFilingOrgAmt |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp (7 entries)
| Relationship With OrgRelationshipWithOrgTxt | Cash GrantCashGrantAmt | Type Of AssistanceTypeOfAssistanceTxt | Assistance PurposeAssistancePurposeTxt |
|---|---|---|---|
| Elba Gonzalez-Mares | |||
| ED of Community Health In | $111,035 | SubGrant | Outreach/Enrollment |
| Georgina Maldonado | |||
| ED of CHI OC Organization | $58,500 | SubGrant | Outreach/Enrollment |
| Katie Villegas | |||
| ED of Yolo County Childre | $25,917 | SubGrant | Outreach/Enrollment |
| James Rolfe | |||
| ED of Covered Community O | $2,103 | SubGrant | Outreach/Enrollment |
| Kathleen King | |||
| CEO of Healthier Kids Fou | $201,372 | SubGrant | Outreach/Enrollment |
| Georgene Lowe | |||
| ED of Affiliate Children | $273,921 | SubGrant | Outreach/Enrollment |
| Maria Lemus | |||
| ED of Vision Y Compromiso | $401,776 | Subgrant | Outreach/Enrollment |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 9: Officer, Director, Trustee, Key Employee Mailing Address | Elba Gonzalez-MaresAlan FernandesGeorgina Maldonado Katie VillegasBradford Onorato |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The review process involves a detailed meeting with the CPA firm and the Executive Director. After discussion, the Executive Director and management review independently and analyze for accuracy. Once approved, the Executive Director will sign the returns and disburse to the Board for its review and approval. This approval will follow with actual filing of the returns with the appropriate authorites. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The Board of Directors review the terms and have established an employment agreement relating to compensation and benefits of the Executive Director. The Executive Director is responsible for the management of the organization, its volunteers and securiting is funding. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents are made available to the public upon written request. |
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