2018-05-15T15:57:16-05:00 2017-06-30 910189318 Moss Adams LLP 975 Oak Street Suite 500 Eugene OR 97401 990 2016-07-01 473334579 The Primary School - East Palo Alto PRIM 6508047100 314 Lytton Avenue Suite 200 Palo Alto CA 94301 Tom Van Loben Sels Treasurer/Secretary 6508047100 2018-05-14 1 Wendy Campos P00448102 5416861040 2018-05-13 2016 2022-09-23 18:48:47Z Dr Priscilla Chan MD 314 Lytton Avenue Suite 200 Palo Alto CA 94301 8978286 0 X www.theprimaryschool.org X 2015 CA integrated health and education model serving children and families from birth through high school 3 3 28 5 0 0 7204240 8305280 0 0 706 670688 0 2318 7204946 8978286 0 0 0 0 748278 1983216 0 0 0 559559 1697656 1307837 3680872 5897109 5297414 6126643 12698531 229534 1504008 5897109 11194523 X To foster each child's wellbeing as a foundation for academic and life success by drawing on the strengths of the child's entire community including family, educators, and medical and mental health providers. 0 0 2969935 See Schedule OTHE PRIMARY SCHOOL - EAST PALO ALTO (TPS-EPA) IS DEDICATED TO DRAMATICALLY IMPROVING HEALTH AND EDUCATIONAL OUTCOMES FOR CHILDREN. FUELED BY THE BELIEF THAT THE CURRENT MODEL OF SCHOOL IS TOO LIMITED TO CLOSE THE ACHIEVEMENT GAP FOR OUR NATION'S MOST AT RISK CHILDREN, TPS-EPA IS DESIGNING A NEW MODEL OF PRIMARY EDUCATION AND PRIMARY CARE WHICH BRAIDS TOGETHER EDUCATION, HEALTH, AND FAMILY SUPPORT SERVICES STARTING AT BIRTH. WE PAIR HIGH EXPECTATIONS AND JOY, IN A POWERFUL COMMUNITY OF SUPPORTS, TO CARE FOR THE WHOLE CHILD. WE PARTNER WITH A PROGRESSIVE HEALTH CENTER THAT AIMS TO REDEFINE THE BOUNDARIES OF PRIMARY HEALTH CARE. WITH THIS INNOVATIVE NEW MODEL, WE AIM TO EXPAND THE TRADITIONAL DEFINITION OF "SCHOOL" IN ORDER TO PREPARE ALL CHILDREN TO SUCCEED IN COLLEGE, CAREER, AND LIFE. OUR APPROACH HAS THREE DEFINING CHARACTERISTICS: -PROVIDE INTEGRATED AND COMPREHENSIVE SERVICES: WE PARTNER WITH AN EXISTING HEALTH CARE ORGANIZATION TO ADDRESS THE NEEDS OF THE WHOLE CHILD. EDUCATORS, PARENT COACHES, AND HEALTHCARE PROFESSIONALS COME TOGETHER AS A TEAM TO PROVIDE INTEGRATED ACADEMIC AND HEALTH (PHYSICAL, MENTAL, AND SOCIO-EMOTIONAL) SERVICES TO STUDENTS AND FAMILIES.-START EARLY: WE ADMIT STUDENTS AT OR BEFORE BIRTH, AND PROVIDE PARENT-DRIVEN, EARLY CHILDHOOD SUPPORTS ALONGSIDE MEDICAL CARE DURING THE CRITICAL YEARS OF CHILD DEVELOPMENT, ENSURING THAT STUDENTS ARE READY FOR SCHOOL AT AGE 3. OUR INFANT-TODDLER PROGRAM CONSISTS OF REGULAR PARENT-CHILD PLAYGROUPS TO SUPPORT THE GOALS OF ATTACHMENT, LANGUAGE DEVELOPMENT, AND RESILIENCE.-OFFER TWO-GENERATION SUPPORTS: WE PUT FAMILIES AT THE CENTER OF THIS WORK AND FOCUS ON BUILDING PARENT CAPACITY TO SUPPORT THE HEALTH AND EDUCATION OF THEIR CHILDREN. FAMILIES RECEIVE SERVICES, INCLUDING PRIMARY CARE, PARENTING COACHING, AND CONNECTION TO OTHER SOCIAL SERVICES TO HELP THEM BETTER SUPPORT THEIR CHILDREN AND BECOME HEALTHIER THEMSELVES.IN 2016-2017, TPS-EPA COMPLETED ITS FIRST FULL YEAR OF PROGRAMMING FOR FAMILIES AND CHILDREN IN EAST PALO ALTO.IN ADDITION TO OUR CORE FOCUS ON DIRECTLY SERVING CHILDREN AND FAMILIES, TPS-EPA IS COMMITTED TO DESIGNING A MODEL THAT IS REPLICABLE IN OTHER COMMUNITIES AND REDEFINES WHAT IS POSSIBLE FOR OUR HIGHEST NEED CHILDREN AND FAMILIES. WE ARE INVESTING IN DESIGN, RESEARCH, EVALUATION, AND DISSEMINATION THAT WILL ALLOW US TO REPLICATE OUR MODEL AND TRANSFER OUR LEARNINGS TO OTHERS. IN FEBRUARY 2017, A SEPARATE ENTITY was created TO CARRY ON THIS WORK. 2969935 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 47 0 1 28 1 0 0 0 0 0 0 0 0 0 0 X 3 3 1 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Apercen Partners LLC 6508047100 314 Lytton Avenue Suite 200 Palo Alto CA 94301 X Dr Priscilla Chan CEO, Chair 4.00 4.00 X X 0 0 0 Naomi Gleit Director 0.50 0.50 X 0 0 0 Diane Tavenner Director 0.50 0.50 X 0 0 0 Meg Campbell Director 0.50 X 0 0 0 Jessica Lessin Director 0.50 X 0 0 0 Meredith Liu President, COO 40.00 40.00 X 168755 0 8148 Tom van Loben Sels Treasurer/Secretary 0.50 0.50 X 0 0 0 Sunita Mohanty Director of Early Child/Parent Systems 40.00 X 150571 0 7163 Andrew Elliott-Chandler Principal 40.00 X 114856 0 11900 Lindsey Luebchow Director of Special Projects 40.00 X 106712 0 6889 540894 0 34100 4 0 1 0 GREEN VALLEY CORPORATION 777 N 1st ST SAN JOSE CA 95112 CONSTRUCTION 600000 JENNIFER VON DER AHE 18130 CONSTITUTION AVE LOS GATOS CA 95030 CONSULTING 228693 STUDIO BONDY ArCHITECTURE 110 LINDEN ST OAKLAND CA 94607 CONSTRUCTION 207519 VANCE BROWN INC 3197 PARK BLVD PALO ALTO CA 94306 Construction 147371 4 179168 8126112 8305280 13150 13150 657538 0 657538 657538 657538 Other Income 900099 2318 2318 2318 8978286 0 0 673006 109736 109736 1580540 1349068 231472 146968 124057 22911 145972 120152 25820 26484 1425 25059 59844 59844 251507 211018 40489 13876 12832 1044 317202 247815 69387 72728 38202 34526 738330 722458 15872 12510 7294 5216 34595 31951 2644 68103 28376 39727 17903 17903 Meals & Entertainment 65417 65417 Recruiting 19157 9870 9287 3680872 2969935 710937 0 372730 643448 304543 2548805 0 55371 0 1394 36902 241651 8021147 68103 5412468 7953044 0 1254818 6126643 12698531 229534 1504008 229534 1504008 X 5897109 11194523 5897109 11194523 6126643 12698531 5297414 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3805000 3805000 245170 68103 177067 3970977 3970977 7953044 Due from related party 1254818 1254818 X Part X, Line 2: THE ORGANIZATION, A CALIFORNIA NOT-FOR-PROFIT CORPORATION, IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE. THE LLC'S ARE DISREGARDED ENTITIES FOR INCOME TAX PURPOSES. THE ORGANIZATION HAD NO UNRECOGNIZED TAX BENEFITS OR LIABILITIES AS OF JUNE 30, 2017 or 2016. 1 1 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 Schedule E, Part I, Line 3 The school draws its students from the local community and more than 95% of our students are under-represented minorities (African-American, Latino, or Pacific Islander), which represents the demographics of the community. Schedule E, Part I, Line 4 The school does not charge tuition or solicit contributions. Schedule E, Part I, Line 6 The organization received funding from the following governmental agencies: California Department of Education - California State Preschool Program United States Department of Agriculture - Child and Adult Care Food Program X X 0 0 0 0 0 0 0 0 0 Meredith Liu President, COO 168755 0 0 0 0 0 0 0 8148 0 176903 0 0 0 Sunita Mohanty Director of Early Child/Parent Syste 130571 0 20000 0 0 0 0 0 7163 0 157734 0 0 0 Form 990, Part VI, Section A, line 2 The following persons reported in Part VII, Section A have a business relationship: Priscilla Chan and Tom van Loben Sels, Naomi Gleit and Tom van Loben Sels. Form 990, Part VI, Section A, line 7a Priscilla Chan, as Designator as defined in the organization's bylaws, has the sole power to appoint board members, subject to the power of the Board to fix the number of directors as provided in the bylaws. Form 990, Part VI, Section A, line 7b The governance decisions of the Board to remove board members and amend the bylaws require consent from Priscilla Chan, as Designator as defined in the organization's bylaws. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the audit committee and then distributed to the Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c The organization's conflict of interest policy covers 1) current directors, officers, key employees, and committee members, 2) spouses or domestic partners of anyone listed in 1), and 3) former officers, directors or key employees who served in such capacity within the last five years. Covered persons are required under the policy to disclose all known or potential conflicts to the Board, Committee or Board's Designee upon appointment and at any time a potential conflict arises, and all covered persons must sign a statement annually affirming understanding and compliance with the policy. When a potential conflict arises, the Board, Committee or Board's Designee determines if a conflict exists by concluding whether the covered person has an actual financial interest in and will benefit from a proposed transaction or arrangement. If it is determined that a covered person has a financial interest, the chairperson of the board or a majority of the disinterested directors shall appoint, if necessary to protect the interests of the corporation, a disinterested person or committee to investigate alternatives to the proposed transaction and determine whether the organization could obtain a more advantageous transaction with a non-covered person. The Board or committee shall then determine by a majority vote of the disinterested members whether to enter into the proposed transaction or arrangement. If the Chairperson of the Board or a majority of the disinterested directors determine that it is not necessary to investigate alternatives to the proposed transaction or arrangement to protect the interests of the corporation, the Board or committee shall determine the extent to which the covered person shall recuse himself or herself from further involvement in the proposed transaction or arrangement. Form 990, Part VI, Section B, line 15 The Board of Directors or a committee thereof shall review any compensation packages (including benefits) of the Chief Executive Officer, President, Treasurer and Chief Financial Officer, regardless of job title, and shall approve such compensation only after determining that the compensation is just and reasonable. This review and approval shall occur when such officer is hired, when the term of employment of such officer is renewed or extended, and when the compensation of such officer is modified, unless the modification applies to substantially all of the employees of this Corporation. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request when legally required. Form 990, Part VII, Section A, Line 1a, Column B, Average hours per week: The organization's President was an employee of The Primary School - East Palo Alto through January 2017 and an employee of a related organization, The Primary School, beginning in February 2017. The average hours per week reported reflect the hours dedicated to each entity while employed by each entity. 2014 #3 LLC 314 Lytton Avenue Suite 200 Palo Alto CA 94301 371767104 Holding Company DE 0 6227399 The Primary School - East Palo Alto Ravenswood 2015 LLC 314 Lytton Avenue Suite 200 Palo Alto CA 94301 364807788 Holding Company DE 0 0 The Primary School - East Palo Alto The Primary School - East Palo Alto LLC 314 Lytton Avenue Suite 200 Palo Alto CA 94301 812403435 Holding Company DE 0 0 The Primary School - East Palo Alto The Primary School 314 Lytton Avenue Suite 200 Palo Alto CA 94301 364858582 Health and education CA 501(c)(4) N/A 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 The Primary School G 657538 Fair Market Value The Primary School N 268604 Cost The Primary School O 328676 Cost