2018-11-12T15:13:04-06:00 2018-06-30 262350873 CALIBER AUDIT & ATTEST LLP 805 AEROVISTA PLACE SUITE 103 SAN LUIS OBISPO CA 93401 990 2017-07-01 770346861 TOLOSA CHILDREN'S DENTAL CENTER TOLO 8052385334 717 WALNUT DRIVE PASO ROBLES CA 93446 JON HOLLISTER PRESIDENT 8052385334 2018-11-12 1 KIMBERLYN SPILLER CPA P01491937 8058880200 76.221.137.249 2018-11-12 08:30:30 PS P D5071A6AD33905CD2544596186E4D5A01D3BD946 D5071A6AD33905CD2544596186E4D5A01D3BD946 2017 2019-02-21 02:37:17Z JON HOLLISTER 717 WALNUT DRIVE PASO ROBLES CA 93446 2176122 0 X TOLOSACHILDRENSDENTAL.ORG X 1993 CA TO PROVIDE DENTAL SERVICES FOR UNDERPRIVILEGED CHILDREN IN SAN LUIS OBISPO COUNTY 10 10 28 6 0 0 342672 179747 1209790 1981377 1039 1833 847 5035 1554348 2167992 0 0 0 0 1066146 1427814 0 0 76100 339379 456950 1405525 1884764 148823 283228 1098101 1365508 94153 78332 1003948 1287176 TO PROVIDE DENTAL SERVICES FOR UNDERPRIVILEGED CHILDREN IN SAN LUIS OBISPO COUNTY. 0 0 1644321 1981377 TO PROVIDE DENTAL SERVICES TO UNDERPRIVILEDGED CHILDREN IN SAN LUIS OBISPO COUNTY. PRODUCTION PROGRAM REVENUE IS DERIVED MAINLY FROM DENTI-CAL REIMBURSEMENTS AND IS REPORTED NET OF CLAIMS ADJUSTMENTS OF $2,590,492. 1644321 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 14 0 1 28 1 0 0 0 0 0 1 1 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 CA X SUZANNE RUSSELL 8052385334 717 WALNUT DRIVE PASO ROBLES CA 93446 JON HOLLISTER DDS PRESIDENT 3.00 X X 0 0 0 JAMES TEDFORD MD VICE PRESIDENT 1.00 X X 0 0 0 CHUCK BRAUN TREASURER/SECRETARY 2.00 X X 0 0 0 MARTY CRAVEN MD DDS DIRECTOR 0.50 X 0 0 0 JENNI DUVAL DIRECTOR 0.50 X 0 0 0 DIANELA JOHNSON BSDH RDH DIRECTOR 0.50 X 0 0 0 SCOTT MILSTEAD DIRECTOR 0.50 X 0 0 0 ROBYN FLORES DMD DIRECTOR 0.50 X 0 0 0 LAURIE TORGERSON DIRECTOR 0.50 X 0 0 0 SUZANNE RUSSELL EXECUTIVE DIRECTOR 45.00 X 75659 0 8283 ALEXANDRA CHAMBERLAIN DIRECTOR OF DEVELOPMENT 40.00 X 10000 0 0 MARTIN DUNNE DDS EMPLOYEE-DENTIST 32.00 X 142620 0 5009 ANDREA N LIVINGOOD DDS EMPLOYEE-DENTIST - FORMER 40.00 X 192220 0 8024 420499 0 21316 2 1 1 0 0 22830 69933 86984 8570 179747 PRODUCTION PROGRAM REV 621300 1766923 1766923 DTI INCENTIVES 621300 214454 214454 1981377 1888 1888 60 115 -55 -55 -55 13050 22830 8015 5035 5035 2167992 1981377 0 6868 124738 88138 36600 1123877 1123877 27052 23265 2164 1623 55386 48173 4122 3091 96761 83214 7741 5806 7623 215 6356 1052 534 534 22356 22356 75750 75750 17313 17313 8601 1837 6764 20496 10248 10248 12300 12300 30149 24119 5873 157 23183 19322 2470 1391 DENTAL SUPPLIES 150636 150636 REPAIRS 27075 27075 DUES 13811 13811 OUTSIDE SERVICE 9929 9929 37194 20550 7577 9067 1884764 1644321 164343 76100 18177 79587 569601 888627 185422 17297 75280 120710 1850 4370 601204 346287 247771 254917 1098101 1365508 59653 78332 34500 94153 78332 X 1003948 1277176 10000 1003948 1287176 1098101 1365508 283228 0 X 0 1 X 0 0 X 156990 147042 152122 198208 182202 836564 156990 147042 152122 198208 182202 836564 836564 1304 947 755 1852 1888 6746 843310 0.99200 0.99040 X 10921 324 11245 292269 201950 90319 308935 144337 164598 254917 X 2392041 224049 224049 2167992 0 2167992 1957315 72551 72551 1884764 0 1884764 PART V, LINE 4: EXPLANATION: THE ENDOWMENT FUND WAS HELD AND ADMINISTERED BY THE SAN LUIS OBISPO COUNTY COMMUNITY FOUNDATION. THE PRIMARY PURPOSE OF THE FUND WAS TO PROVIDE SUPPORT TO THE PARTNERSHIP FOR THE CHILDREN TO CARRY OUT ITS ROLE, MISSION AND CHARITABLE WORK AS DESCRIBED BY ITS GOVERNING DOCUMENTS. THE FUND WAS CLOSED DURING 2014. PART X, LINE 2: THE ORGANIZATION'S ACTIVITIES ARE GENERALLY EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA FRANCHISE TAX CODE. SINCE THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE INCOME TAX LIABILITY, NO PROVISION IS MADE FOR CURRENT OR DEFERRED INCOME TAX EXPENSE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION. MANAGEMENT IS NOT AWARE OF ANY TRANSACTIONS THAT WOULD IMPACT THE ORGANIZATION'S TAX-EXEMPT STATUS. FOR THE YEAR ENDED JUNE 30, 2018, MANAGEMENT OF THE ORGANIZATION IS NOT AWARE OF ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE ACCOUNTED FOR IN THE FINANCIAL STATEMENTS UNDER THE PRINCIPLES OF THE INCOME TAXES TOPIC OF THE FASB (ASC). THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST EXPENSE. ALL TAX EXEMPT ENTITIES ARE SUBJECT TO REVIEW AND AUDIT BY FEDERAL, STATE AND OTHER APPLICABLE AGENCIES. SUCH AGENCIES MAY REVIEW THE TAXABILITY OF UNRELATED BUSINESS INCOME, OR THE QUALIFICATION OF THE TAX-EXEMPT ENTITY UNDER THE INTERNAL REVENUE CODE AND APPLICABLE STATE STATUTES. SIP FOR SMILES 19840 9365 10475 2455 895 887 2065 ANNUAL APPEAL 13465 13465 742 1 2575 2575 971 35880 22830 13050 2455 895 887 3778 8015 5035 0 0 0 0 0 0 0 0 0 SUZANNE RUSSELL EXECUTIVE DIRECTOR 75659 0 0 0 0 0 2601 0 5682 0 83942 0 0 0 ALEXANDRA CHAMBERLAIN DIRECTOR OF DEVELOPMENT 10000 0 0 0 0 0 0 0 0 0 10000 0 0 0 MARTIN DUNNE DDS EMPLOYEE-DENTIST 142620 0 0 0 0 0 4296 0 713 0 147629 0 0 0 ANDREA N LIVINGOOD DDS EMPLOYEE-DENTIST - FORMER 192220 0 0 0 0 0 4583 0 3441 0 200244 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B KEY OFFICERS OF THE ORGANIZATION REVIEW THE TAX RETURN BEFORE SIGNING AND FILING FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS MONITORED ANNUALLY AND INTERESTED PARTIES WOULD REPORT ANY POTENTIAL CONFLICTS AS THEY SHOULD ARISE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL: THE EXECUTIVE COMMITTEE PERFORMS AN ANNUAL REVIEW AND SALARY REVIEW FOR THE ORGANIZATION'S CLINIC DIRECTOR AND EXECUTIVE DIRECTOR. FORM 990, PART VI, SECTION C, LINE 18 DOCUMENTS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR PUBLIC INSPECTION VIA MONTHLY PUBLIC BOARD MEETINGS AND UPON REQUEST.