2019-05-14T01:36:01-05:00 2018-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-07-01 680149424 OLE HEALTH FOUNDATION OLEH 7076037100 1100 TRANCAS STREET NO 300 NAPA CA 94558 BILL DEANE CFO 7076037100 2019-05-13 1 RICHARD CROGHAN P00089862 4159561500 2019-05-09 12.129.7.100 2019-05-13 14:46:14 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32BFBF1104AA8EEBC72962A0CCB0C2C16BC479E3 2017 2019-02-21 02:37:17Z JESSICA THOMASON 1100 TRANCAS STREET NO 300 NAPA CA 94558 8122914 0 X WWW.OLEHEALTH.ORG X 1987 CA FUNDRAISING AND OTHER SERVICES TO SUPPORT OLE HEALTH. 10 10 4 20 0 0 12688294 1100097 0 0 121206 20032 13275 122927 12822775 1243056 10567785 148095 0 0 0 503089 0 0 584169 69909 201292 10637694 852476 2185081 390580 8686927 8297037 2645228 1867528 6041699 6429509 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 148095 148095 FUNDRAISING SERVICES IN SUPPORT OF OLE HEALTH, A HEALTH CENTER FOR LOW INCOME INDIVIDUALS AND OTHERS WITHOUT HEALTH INSURANCE. 148095 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 10 0 1 4 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 0 1 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X BILL DEANE 7072541770 1100 TRANCAS STREET SUITE 300 NAPA CA 94558 PETER MCCREA CHAIR THROUGH 1/2018 / DIRECTOR 2.00 0.00 X X 0 0 0 TODD ZAPOLSKI CHAIR EFFECTIVE 1/2018 2.00 0.00 X X 0 0 0 BLAKESLEY CHAPPELLET VICE CHAIR EFFECTIVE 1/2018 2.00 0.00 X X 0 0 0 RACHEL CUSICK SECR./CHIEF DEV OFF THROUGH 11/2017 40.00 0.00 X X 0 124671 16677 SUZANNE BESU TRUCHARD SECRETARY EFFECTIVE 1/2018 2.00 0.00 X X 0 0 0 DAN LYNCH TREASURER 2.00 0.00 X X 0 0 0 JANNETTE BROOKS DIRECTOR 2.00 0.00 X 0 0 0 NAOKO DALLA VALLE DIRECTOR 2.00 0.00 X 0 0 0 RICK JONES DIRECTOR 2.00 3.00 X 0 0 0 DARIOUSH KHALEDI DIRECTOR 2.00 0.00 X 0 0 0 JOHN R SHAFER DIRECTOR 2.00 0.00 X 0 0 0 TANIR AMI CHIEF EXECUTIVE OFFICER 40.00 1.00 X 0 264866 22949 MOLLY NELSON CFO THROUGH 11/2017 8.00 33.00 X 0 186026 13518 EMMA MAYER INTERIM CFO 11/2017 - 2/2018 8.00 32.00 X 0 14300 0 BILL DEANE INTERIM CFO EFFECTIVE 2/2018 8.00 32.00 X 0 1237 0 0 591100 53144 0 0 1 0 0 291252 808845 84896 1100097 20109 20109 6711133 6711210 -77 -77 -77 266425 291252 168648 97777 97777 25150 0 25150 25150 1243056 0 0 142959 148095 148095 377178 377178 1120 1120 121756 121756 3035 3035 4630 4630 22545 22545 26331 26331 15404 15404 10129 10129 85 85 23 23 90497 90497 2540 2540 IN-KIND EXPENSES 20000 20000 STORAGE 3910 3910 DONOR RECOGNITION 3484 3484 ALL OTHER EXPENSES 1714 1714 852476 148095 120212 584169 1715170 2874446 6385861 3788878 340 0 585556 1619117 0 14596 8686927 8297037 2430526 1629595 214702 237933 2645228 1867528 X 6041699 5929509 500000 6041699 6429509 8686927 8297037 390580 -2770 0 X 0 1 X 1 1 1 X X X 1 OLE HEALTH 237221695 3 1 148095 0 1 148095 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 DUE TO RELATED ORGANIZATIONS 237933 237933 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, 2018 AND 2017, 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. GALA 557677 291252 266425 17629 28479 2755 119785 557677 291252 266425 17629 28479 2755 119785 168648 97777 25150 1 0.90000 25150 25150 CA 1 0 1 0 1.00000 BILL DEANE 1100 TRANCAS STREET SUITE 300 NAPA CA 94558 0 TANIR AMI 0 OVERSIGHT OF RAFFLE X 1 22635 1 OLE HEALTH 1100 TRANCAS STREET SUITE 300 NAPA CA 94558 237221695 501(C)(3) 148095 GENERAL SUPPORT 1 0 PART I, LINE 1: THE ORGANIZATION PROVIDES GRANTS SOLELY TO OLE HEALTH, ITS SUPPORTED ORGANIZATION. BOTH ORGANIZATIONS MAINTAIN AN OVERLAP OF OFFICERS, WHO GRANT FUNDS FROM OLE HEALTH FOUNDATION TO OLE HEALTH IN ACCOMPLISHMENT OF ITS EXEMPT PURPOSE. 0 0 0 0 0 0 0 0 0 TANIR AMI CHIEF EXECUTIVE OFFICER 0 264386 0 0 0 480 0 7229 0 15720 0 287815 0 0 MOLLY NELSON CFO THROUGH 11/2017 0 148702 0 0 0 37324 0 7441 0 6077 0 199544 0 0 PART I, LINE 3 COMPENSATION FOR THE ORGANIZATION'S CEO IS ESTABLISHED BY OLE HEALTH, A RELATED ORGANIZATION. OLE HEALTH UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF OLE HEALTH FOUNDATION'S CEO: COMPENSATION SURVEY AND APPROVAL BY THE BOARD OF DIRECTORS. X 5000 FAIR MARKET VALUE X 23500 FAIR MARKET VALUE X 3 40159 FAIR MARKET VALUE X 14 16327 FAIR MARKET VALUE 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 3 FROM NOVEMBER 2017 - FEBRUARY 2017, THE ORGANIZATION CONTRACTED WITH EMMA MAYER, AN INDEPENDENT CONSULTANT, TO FULFILL THE ROLE OF INTERIM CFO. THEREAFTER, THE ORGANIZATION CONTRACTED WITH BILL DEANE, AN INDEPENDENT CONSULTANT, TO FULFILL THE ROLE OF INTERIM CFO UNTIL AUGUST 2018, WHEN THE INTERIM TITLE WAS REMOVED AND HE WAS ELEVATED TO A FULL-TIME EMPLOYEE. BOTH INDIVIDUALS WERE COMPENSATED BY OLE HEALTH, A RELATED ORGANIZATION. 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 1100 TRANCAS STREET SUITE 300 NAPA CA 94558 237221695 PROVIDES HEALTH CARE TO LOW INCOME AND UNINSURED RESIDENTS CA 501(C)(3) LINE 3 N/A 0 OLE HEALTH NMTC 1100 TRANCAS STREET SUITE 300 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 0 1 1 0 0 0 0 0 0 1 1 1 1 1 0 0 0