2020-07-14T13:40:26-05:00 2019-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2018-07-01 953222316 SHARE OUR SELVES CORPORATION SHAR 9492702100 1550 SUPERIOR AVENUE COSTA MESA CA 92627 CHRISTY WARD CHIEF EXECUTIVE OFFICER 9492702100 2020-06-30 1 LIZBETH G NEVAREZ P01399868 3108731600 108.233.72.19 2020-06-30 14:43:18 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1E5C2E37194314C3A47C760AEAFDC059525B6175 2018 2021-01-29 14:40:06Z CHRISTY WARD 1550 SUPERIOR AVENUE COSTA MESA CA 92627 18145801 0 X WWW.SHAREOURSELVES.ORG X 1970 CA WE ARE SERVANTS WHO PROVIDE CARE AND ASSISTANCE TO THOSE IN NEED AND ACT AS ADVOCATES FOR CHANGE. 12 12 211 1535 0 0 5303223 6281724 12895659 11127332 30631 52265 137536 102105 18367049 17563426 1452484 1437809 0 0 12426454 11948745 0 0 786719 4446404 4714479 18325342 18101033 41707 -537607 10259085 9233293 5061695 4665753 5197390 4567540 X SOS PROVIDES VULNERABLE AND LOW-INCOME FAMILIES AND INDIVIDUALS WITH DIRECT ACCESS TO HEALTH, FOOD AND SAFETY NET SERVICES THEY NEED TO IMPROVE THEIR LIVES. SOS IS THE LARGEST COMMUNITY HEALTH CENTER IN ORANGE COUNTY TO COMBINE WRAP-AROUND SOCIAL SERVICES WITH HEALTHCARE. 0 0 13698324 1313529 11070005 CLINICS: ANNUALLY SOS PROVIDES CARE TO APPROXIMATELY 15,000 UNDUPLICATED PATIENTS ACCOUNTING FOR OVER 58,792 PATIENT VISITS. SOS PROVIDES COMPREHENSIVE HEALTHCARE INCLUDING A FULL PROGRAM OF PRIMARY, SPECIALTY, SUB-SPECIALTY, DENTAL, INTEGRATED BEHAVIORAL HEALTH AND COMPLEMENTS ITS OUTPATIENT CARE WITH HOSPITALIST INPATIENT FOLLOW-UPS, TREATMENT ADHERENCE EDUCATION, CLINICAL CASE MANAGEMENT, DISEASE MANAGEMENT, COUNSELING, EDUCATION, AND TESTING. SOS OFFERS ONSITE LAB, NUTRITION AND DISPENSARY SERVICES COMPREHENSIVE QUALITY HEALTHCARE IS PROVIDED AT THREE CLINICAL SITES LOCATED IN COSTA MESA, SANTA ANA, AND LAKE FOREST. SOS IS DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). FQHCS ARE COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE COMPREHENSIVE PRIMARY CARE AND PREVENTIVE CARE, INCLUDING HEALTH, ORAL, AND MENTAL HEALTH SERVICES TO PERSONS OF ALL AGES, REGARDLESS OF THEIR ABILITY TO PAY OR HEALTH INSURANCE STATUS, IN A MEDICALLY UNDERSERVED AREA (MUA). 1273355 124280 57327 SOCIAL SERVICES: PROVIDES BOTH CLINICAL AND SOCIAL CASE MANAGEMENT, EMERGENCY FINANCIAL AID, FOOD, LEGAL AID, HOMELESS OUTREACH PROGRAMS, RESOURCE AND LINKAGE TO BENEFIT ENROLLMENT, AND SEASONAL SUPPORT PROGRAMS. PROGRAMS SERVE ALL OF ORANGE COUNTY WITH 75% IN SANTA ANA AND COSTA MESA. RESIDENTS SEEKING SERVICES INCLUDE THE CHRONICALLY DISADVANTAGED AND THOSE ACCESSING SUPPORTIVE SERVICES FOR THE FIRST TIME, CASUALTIES OF THE DEVASTATING RECESSION. S0S'S TARGET POPULATION IS ETHNICALLY DIVERSE AND LIVES AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL; THE HOMELESS, SENIORS ON FIXED INCOMES, THE DISABLED, AND THOSE WITH MENTAL ILLNESS ARE A SIGNIFICANT PORTION OF THE POPULATION SERVED. SOCIAL SERVICES ANNUALLY SERVES OVER 100,000 ORANGE COUNTY RESIDENTS. 14971679 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 129 0 1 211 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CHRISTY WARD CHIEF EXECUTIVE OFFICER 9492702100 20151 SW BIRCH STREET SUITE 250 NEWPORT BEACH CA 92660 DR GWYN P PARRY CHAIRMAN EMERITUS 2.00 0.00 X 0 0 0 WILL KLATTE III CHAIRMAN 2.00 0.00 X X 0 0 0 MARC HARPER VICE-CHAIR 2.00 0.00 X X 0 0 0 SUSAN BAERG-EPSTEIN SECRETARY 2.00 0.00 X X 0 0 0 JOHN YOO TREASURER 2.00 0.00 X X 0 0 0 SKI HARRISON MEMBER 2.00 0.00 X 0 0 0 LAWRENCE N KUGELMAN MEMBER 2.00 0.00 X 0 0 0 DAVID SNOW MEMBER 2.00 0.00 X 0 0 0 ROSARIO GALEAS MEMBER 2.00 0.00 X 0 0 0 MICHELLE CASTANEDA MEMBER 2.00 0.00 X 0 0 0 ALLYSON BROOKS MD MEMBER 2.00 0.00 X 0 0 0 MARTHA RIVERA MEMBER 2.00 0.00 X 0 0 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 40.00 0.00 X 247483 0 17694 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER (LEFT 9/18) 40.00 0.00 X 167178 0 7810 MARY ANN HUNTSMAN CHIEF QUALITY OFFICER 40.00 0.00 X 179229 0 16584 JILA NIKKHAH DENTAL DIRECTOR 40.00 0.00 X 194949 0 15200 TERESA FLORES ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 203625 0 12940 TERESA PRIETO ANGELINO ASSOCIATE MEDICAL DIRECTOR 40.00 0.00 X 175836 0 14209 DUC T VU DENTIST 40.00 0.00 X 167890 0 13337 DIANE BEYAOJU DENTIST 40.00 0.00 X 157635 0 19874 JOHN J DONOGHUE CHIEF DEVELOPMENT OFFICER 40.00 0.00 X 146303 0 707 1640128 0 118355 9 0 1 0 0 264778 2735642 3281304 1000547 6281724 CLINIC REVENUE 621400 10970678 10970678 PHARMACY 621400 99327 99327 SOCIAL SERVICES 900099 57327 57327 11127332 24419 24419 508808 22806 483759 20009 25049 2797 27846 27846 33460 264778 78607 -45147 -45147 MISCELLANEOUS INCOME 900099 147252 147252 147252 17563426 11127332 0 154370 1437809 1437809 798937 672730 94519 31688 9333942 7864399 1094555 374988 168265 140437 22365 5463 952746 795177 126634 30935 694855 579938 92356 22561 99170 99170 58016 58016 1540 1540 1136652 647210 305682 183760 8335 4988 3048 299 406981 304114 62191 40676 143644 101449 28049 14146 1139136 991073 89218 58845 30374 18222 12146 6 122540 56652 64555 1333 80403 48122 29398 2883 603954 551611 41552 10791 107942 57425 49255 1262 ANCILLARY MEDICAL 496619 496619 EHR MAINT./HOSTING 100752 100605 147 0 STAFF DEVELOPMENT 54877 25370 28910 597 EQUIPMENT REPAIR/MAINT. 33439 23801 6384 3254 90105 53928 32945 3232 18101033 14971679 2342635 786719 5798 6861 736769 466327 77099 544500 3303453 3007123 26611 8988 693253 605230 7936227 4167069 4298151 3769158 999351 665128 105000 0 13600 159978 10259085 9233293 2633266 2282200 1986283 1981063 442146 402490 5061695 4665753 X 4416450 3193248 329230 922582 451710 451710 5197390 4567540 10259085 9233293 X -537607 12757 -105000 X 0 1 X 1 1 1 X 7044567 8669610 8590276 5303223 6281724 35889400 7044567 8669610 8590276 5303223 6281724 35889400 269570 35619830 11718 21530 22758 21943 24419 102368 852 852 9228 64103 136938 171379 147252 528900 36521520 42838278 0.97530 0.97940 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 547797 30698 578495 538635 9162 547797 515586 5000 18049 538635 489646 5000 20940 515586 488674 2500 -1528 489646 0.00000 0.78080 0.21920 0 0 900000 900000 2624094 1778473 845621 1751452 753922 997530 2660681 1634674 1026007 3769158 DEFERRED RENT 402490 402490 PART V, LINE 4: SOS HAS ADOPTED AN ENDOWMENT INVESTMENT POLICY, APPROVED BY THE BOARD, FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THESE ENDOWMENT ASSETS OVER THE LONG TERM. THE INVESTMENT POLICY ESTABLISHES AN ACHIEVABLE RETURN OBJECTIVE THROUGH DIVERSIFICATION OF ASSET CLASSES. THE OBJECTIVE IS TO GROW THE AGGREGATE PORTFOLIO VALUE, NET OF SPENDING, AT THE RATE OF INFLATION OVER THE INVESTMENT HORIZON. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, SOS RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CAPITAL APPRECIATION (REALIZED AND UNREALIZED) AND CURRENT YIELD (INTEREST AND DIVIDENDS). SOS TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACES AN EMPHASIS ON EQUITY INVESTMENTS AND FIXED INCOME SECURITIES TO ACHIEVE ITS LONGTERM RATE OF RETURN OBJECTIVES WITHIN PRUDENT RISK PARAMETERS. CELEBRITY CHEF 206214 200384 5830 25669 1175 35521 TACO NIGHT 92024 64394 27630 472 200 15570 298238 264778 33460 25669 472 1375 51091 78607 -45147 1 RELIEF AND AID ASSISTANCE 1503 452369 FMV FOOD, RENT, UTILITIES, AND GIFT CARDS FOOD INVENTORY 52605 349440 FMV FOOD BACK TO SCHOOL TICKETS 7600 91200 FMV ORANGE COUNTY FAIR TICKETS ADOPT A FAMILY 1448 506800 FMV HOUSEHOLD GOODS SCHOOL SUPPLIES 4380 38000 FMV BAGS OF SCHOOL SUPPLIES PART I, LINE 2: INDIVIDUALS WHO REQUIRE FINANCIAL ASSISTANCE ARE REQUIRED TO GO THROUGH A FINANCIAL ASSISTANCE APPLICATION. THE INDIVIDUAL MUST PROVIDE SUPPORTING DOCUMENTS TO SHOW THE NEED FOR ASSISTANCE. THE ORGANIZATION PROVIDES GIFT CARDS AND OTHER HOUSING ASSISTANCE. X X 0 0 0 0 0 0 0 1 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 207483 0 40000 0 0 0 10922 0 6772 0 265177 0 0 0 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER (LEFT 9/18) 167178 0 0 0 0 0 7514 0 296 0 174988 0 0 0 MARY ANN HUNTSMAN CHIEF QUALITY OFFICER 179229 0 0 0 0 0 7455 0 9129 0 195813 0 0 0 JILA NIKKHAH DENTAL DIRECTOR 194949 0 0 0 0 0 8414 0 6786 0 210149 0 0 0 TERESA FLORES ASSOCIATE MEDICAL DIRECTOR 203625 0 0 0 0 0 6831 0 6109 0 216565 0 0 0 TERESA PRIETO ANGELINO ASSOCIATE MEDICAL DIRECTOR 175836 0 0 0 0 0 8101 0 6108 0 190045 0 0 0 DUC T VU DENTIST 167890 0 0 0 0 0 0 0 13337 0 181227 0 0 0 DIANE BEYAOJU DENTIST 157635 0 0 0 0 0 6671 0 13203 0 177509 0 0 0 PART I, LINE 7 BONUSES FOR THE CEO / EXECUTIVE TEAM ARE APPROVED BY THE BOARD AND ARE BASED ON PERFORMANCE REVIEWS AND MERIT. X 506800 FMV X 1 15107 FMV X 208000 349440 FMV X BACK TO SCHOOL TICKETS 1 91200 FMV X SCHOOL SUPPLIES 1 38000 FMV 0 1 0 PART I, COLUMN (B): NONCASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONOR CONTRIBUTORS. FOOD INVENTORY, LINE 19, IS LISTED BY TOTAL NUMBER OF POUNDS. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTE IS COMPRISED OF THE FOLLOWING BOARD MEMBERS: WILL KLATTE III, CHAIRMAN MARC HARPER, VICE-CHAIRMAN SUSAN BAERG EPSTEIN, SECRETARY JOHN YOO, TREASURER FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS FIRST REVIEWED BY MANAGEMENT. A COPY OF THE 990 IS THEN PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY TO DISCLOSE ANY CONFLICTS OF INTERESTS. QUESTIONNAIRES ARE THEN RETURNED TO THE EXECUTIVE DIRECTOR. ANY CONFLICTS THAT ARE DISCLOSED ARE REVIEWED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 BOARD MEMBERS DETERMINE THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES BY GATHERING DATA ON THE COMPENSATION FOR NON-PROFIT ORGANIZATIONS IN ORANGE COUNTY AND SOUTHERN CALIFORNIA. THE DATA IS UTILIZED IN CONJUNCTION WITH THE BOARD MEMBERS' EVALUATION TO PRODUCE A COMPENSATION RECOMMENDATION INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: IMPAIRMENT LOSS ON PHYSICIAN PRACTICE -105,000. THE SHARE OUR SELVES FOUNDATION 1550 SUPERIOR AVENUE COSTA MESA CA 92627 813076983 TO SUPPORT SHARE OUR SELVES CA 501(C)(3) LINE 12A, I SHARE OUR SELVES 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0