2018-05-09T11:19:15-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 680149424 OLE Health Foundation OLEH 7076037100 1100 Trancas Street No 300 Napa CA 94558 Tanir Ami CEO 7076037100 2018-05-08 1 Richard Croghan P00089862 4159561500 2018-04-11 2016 2022-09-23 18:48:47Z Tanir Ami 1100 Trancas Street No 300 Napa CA 94558 43755122 0 X www.olehealth.org X 1987 CA Fundraising and other services to support OLE Health. 8 7 4 9 0 0 1614328 12688294 0 0 78076 121206 0 13275 1692404 12822775 894432 10567785 0 0 0 0 84200 0 38904 15856 69909 994488 10637694 697916 2185081 4442968 8686927 601991 2645228 3840977 6041699 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 10567785 10567785 0 FUNDRAISING SERVICES IN SUPPORT OF OLE HEALTH, A HEALTH CENTER FOR LOW INCOME INDIVIDUALS AND OTHERS WITHOUT HEALTH INSURANCE. 10567785 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 1 4 1 0 0 0 0 0 1 1 0 0 0 0 X 8 7 0 0 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 2.00 0.00 X X 0 0 0 Todd Zapolski Vice Chair 2.00 0.00 X X 0 0 0 Dan Lynch TREASURER 2.00 0.00 X X 0 0 0 Rachel Cusick Secretary and Chief Dev Officer 40.00 0.00 X X 0 122389 7386 John R Shafer Director 1.00 0.00 X 0 0 0 Suzanne Besu Truchard Director 1.00 0.00 X 0 0 0 Blakesley Chappellet Director 1.00 0.00 X 0 0 0 Rick Jones Director 1.00 8.00 X 0 0 0 Martha May Director through November 2016 1.00 0.00 X 0 0 0 Terry Hall Director through April 2017 1.00 0.00 X 0 0 0 Tanir Ami CHIEF EXECUTIVE OFFICER 1.00 44.00 X 0 213619 14508 0 336008 21894 0 0 1 0 0 205988 12482306 918340 12688294 91533 91533 30799546 30769873 29673 29673 29673 175749 205988 162474 13275 13275 12822775 0 0 134481 10567785 10567785 12753 12753 2396 2396 17687 17687 725 725 1968 1968 14177 14177 Storage 2710 2710 Staff Appreciation 1055 1055 Board/Staff Training 656 656 Recruitment 396 396 15386 15386 10637694 10567785 31005 38904 894943 2290288 303972 6385861 0 340 3244053 10438 4442968 8686927 601991 214702 2430526 601991 2645228 X 3840977 6041699 3840977 6041699 4442968 8686927 2185081 15641 0 X 0 1 X 1 0 X X X 1 Ole Health 237221695 3 1 10567785 0 1 10567785 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 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, 2017 and 2016, 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. April 2017 Gala 381737 205988 175749 143207 19267 381737 205988 175749 143207 19267 162474 13275 0 Ole Health 1100 TRANCAS STREET SUITE 300 Napa CA 94558 237221695 501(c)(3) 10567785 general support 1 0 Part I, Line 1: The organization provides grants solely to OLE Health, its supported organization. Separate records are not maintained to substantiate the amount of grants or assistance, the grantees' eligiblity for grants or assistance, and the selection criteria used to award the grants or assistance; rather, 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 184010 0 0 0 29609 0 7254 0 7254 0 228127 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 6 886261 Fair Market Value X Wine/Food/Prizes for Fundraising Event 29 32079 Cost 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 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 in conjunction 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. 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 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0