2018-05-15T11:13:53-05:00 2017-06-30 946214841 Armanino LLP 12657 Alcosta Blvd Ste 500 San Ramon CA 945834600 990 2016-07-01 237118361 Tiburcio Vasquez Health Center Inc TIBU 5104715880 22331 Mission Blvd Hayward CA 945413911 David B Vliet CEO 5104715880 2018-05-14 1 Katy Brown P00650274 9257902600 2018-05-14 73.15.165.122 2018-05-14 18:11:47 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 32CDE991C152F389A30DE5702E9B7F379660D813 2016 2021-01-29 14:40:06Z David B Vliet 22331 Mission Blvd Hayward CA 945413911 31061503 0 X www.tvhc.org X 1971 CA Tiburcio Vasquez Health Center, Inc. is a private nonprofit organization formed to sponsor, promote, and provide comprehensive community health services that appropriately meet the physical, mental, and social needs of Southern Alameda county. 10 10 358 15 0 0 10452791 12158494 17059907 18343633 71145 70726 426638 488650 28010481 31061503 750 1000 0 0 18345722 20911022 0 0 0 7938698 8119217 26285170 29031239 1725311 2030264 17761719 18037104 10406808 8651929 7354911 9385175 Provide Comprehensive community health services to Southern Alameda county. 0 0 3222832 1000 3221832 Healthpac: provides medically necessary services to low-income uninsured individuals enrolled in the county medically indigent services plan. 2283286 2360649 Primary Care Outpatient: The medical clinic provides basic health care for the people of all ages family medicine, internal medicine, pediatrics and obstetrics-gynocology. The dental department offers a variety of dental care for children and adults, including dental exams, fillings, crowns, root canals, extractions, space maintainers, and emergency services. 1777617 1777612 EPSDT: provides mental health services, case management, crisis intervention, and medication support services to teen parents, adult parents and their children. 16904905 11451739 16904905 11451739 24188640 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 50 0 1 358 1 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X Brent Copen 5104715880 22331 Mission Blvd Hayward CA 945413911 Nancy Soto President 3.00 X X 0 0 0 Minyon Corcuchia-Garde Vice President 1.50 X X 0 0 0 Jaime Patino TREASURER 1.50 X X 0 0 0 Jesse Robles board Member 1.50 X 0 0 0 Josue A Hernandez Secretary 1.50 X X 0 0 0 Ahmad Asir Board Member 1.50 X 0 0 0 Carla Ramirez Board Member 1.50 X 0 0 0 Maria Sabado Board Member 1.50 X 0 0 0 Christian Stockwell Board Member 1.50 X 0 0 0 Jennie Reyes Board Member 1.50 X 0 0 0 David B Vliet Chief Executive Officer 40.00 X 254269 0 17492 BRENT COPEN CHIEF FINANCIAL OFFICER 40.00 X 194774 0 18163 CALEB J SANDFORD CHIEF OPERATIONS OFFICER 40.00 X 44248 0 380 ANITHA L MULLANGI CHIEF MEDICAL OFFICER 40.00 X 246775 0 10867 SRIDEVI PONNALA CHIEF DENTAL OFFICER 40.00 X 204404 0 2374 JAMES H KRAVETZ PHYSICIAN 40.00 X 196098 0 1113 MICHAEL MILLER PHYSICIAN 40.00 X 188577 0 5451 PARVEEN KAUR PHYSICIAN 40.00 X 179108 0 6544 ANKITA SHRIVASTAVA PHYSICIAN 40.00 X 175808 0 2288 OLGA KASHLINSKAYA PHYSICIAN 40.00 X 169659 0 7200 1853720 0 71872 24 0 1 0 Priority Management Group 700 School Street Pawtucket RI 02860 Billing 661762 BAY CHILDREN'S PHYSICIANS 6475 CHRISTIE AVENUE SUITE 300 EMERYVILLE CA 94608 PHYSICIAN SERVICES 523364 QUEST DIAGNOSTICS PO Box 50368 LOS ANGELES CA 900740368 Laboratory Services 474612 OAKLAND PHARMACY INC 333 9TH STREET OAKLAND CA 94607 PHARMACY SERVICES 265597 13 10988451 1170043 12158494 Patient & Third Party 621300 15380278 15380278 Capitation Revenue 621300 2722387 2722387 Other Program Revenue 621300 240968 240968 18343633 70726 70726 5500 0 5500 5500 5500 Property Tax Refund 900099 468199 468199 Other Income 900099 14951 14951 483150 31061503 18811832 0 91177 X 1000 1000 1231396 407604 823792 15746599 13823787 1922812 313084 287340 25744 2301302 1944970 356332 1318641 1104952 213689 114058 114058 102664 19200 83464 2454720 2190088 264632 77408 36576 40832 477638 234621 243017 211142 173313 37829 1482493 1295037 187456 162849 114646 48203 267949 240693 27256 265831 126816 139015 151579 151579 Program Supplies 1017181 1017181 Equipment & Maintenance 597425 548559 48866 PHARMACY 424363 424363 Miscellaneous Expenses 240362 188423 51939 71555 9471 62084 29031239 24188640 4842599 0 4047713 3968756 9872 12186 2352599 2395152 983193 1706250 148153 150880 9084660 7046146 1966063 2038514 7003000 7003000 1251126 762366 17761719 18037104 2611917 2859681 776837 142823 6546980 5395650 471074 253775 10406808 8651929 X 7273995 9326729 80916 58446 7354911 9385175 17761719 18037104 2030264 0 X X 0 1 X 1 1 1 X 12873729 11461538 10576830 10452791 12158494 57523382 12873729 11461538 10576830 10452791 12158494 57523382 57523382 756 28005 77526 76145 76226 258658 318225 369885 498113 455546 14951 1656720 59438760 69529634 0.96780 0.86930 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20317 20317 3545966 2283764 1262202 5518377 4762382 755995 2038514 Investment in NMTC TVHC Fund 7003000 F 7003000 PPS Settlements 253775 253775 X Part X, Line 2: TVHC is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and from state income tax under Section 23701(d) of the Revenue and Taxation Code of the state of California. Accordingly, contributions to TVHC are qualified charitable contribution deductions. TVHC has evaluated its current tax positions and has concluded that as of June 30, 2017, it does not have any uncertain tax positions for which a reserve would be necessary. TVHC files U.S. federal and state returns, and is generally no longer subject to tax examinations for years prior to 2013 and 2012, respectively. TVHC Facilities, Inc. and TVHC Facilities II, Inc. are qualified as tax exempt organizations. X 0 1 0 0 0 0 0 0 0 David B Vliet Chief Executive Officer 234269 0 20000 0 0 0 5840 0 11652 0 271761 0 0 0 BRENT COPEN CHIEF FINANCIAL OFFICER 187004 0 7770 0 0 0 0 0 18163 0 212937 0 0 0 ANITHA L MULLANGI CHIEF MEDICAL OFFICER 246775 0 0 0 0 0 1040 0 9827 0 257642 0 0 0 SRIDEVI PONNALA CHIEF DENTAL OFFICER 204404 0 0 0 0 0 1040 0 1334 0 206778 0 0 0 JAMES H KRAVETZ PHYSICIAN 196098 0 0 0 0 0 176 0 937 0 197211 0 0 0 MICHAEL MILLER PHYSICIAN 188577 0 0 0 0 0 975 0 4476 0 194028 0 0 0 PARVEEN KAUR PHYSICIAN 176358 0 2750 0 0 0 1430 0 5114 0 185652 0 0 0 ANKITA SHRIVASTAVA PHYSICIAN 173808 0 2000 0 0 0 1690 0 598 0 178096 0 0 0 OLGA KASHLINSKAYA PHYSICIAN 168409 0 1250 0 0 0 1690 0 5510 0 176859 0 0 0 Part I, Line 4b During FYE 06/30/17, David B. Vliet participated in and contributed $4,800 to a 457(b) contribution plan. Form 990, Part VI, Section A, line 2 Nancy Soto and Jesse Robles have a Family Relationship. Form 990, Part VI, Section B, line 11b The tax return is reviewed by the Finance Committee and made available to the board before filing. Form 990, Part VI, Section B, line 12c All employees sign a form that signifies receipt and understanding of the conflict of interest policy upon hire. The HR department makes sure that new consultants, vendors, & future employees are not related to any of the employees that have a direct business relationship/transaction with any relative of an officer, board member or employee in a management position that will have a direct benefit from the transaction. The conflict of interest policy monitored by a combination of management, supervisors, and the Human Resources Department. If any interested person has a conflict of interest, it is the duty of the interested person to report it. If the interested person is not able to mitigate the conflict of interest, management will determine the appropriate course of action in either mitigating the conflict of interest or dismissing the interested person. Form 990, Part VI, Section B, line 15 The HR officer compares the compensations of TVHC's top management officials, directors, and staff to the state primary care association to make sure TVHC's compensations are close to market. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and financial statements are available to the public upon request. Form 990, Part IX, line 11g Other Professional Fees: Program service expenses 2,190,088. Management and general expenses 264,632. Fundraising expenses 0. Total expenses 2,454,720. Form 990, Part XII, Line 2c: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR TVHC Facilities Inc 22331 Mission Blvd Hayward CA 945413911 270250766 Support TVHC's Direct Charitable & Educational Activities CA 509(A)(3) Line 12b, II Tiburcio Vasquez Health Center Inc 1 TVHC Facilities II Inc 22331 Mission Blvd Hayward CA 945413911 463821919 Support TVHC's Direct Charitable & Educational Activities CA 509(A)(3) Line 12b, II Tiburcio Vasquez Health Center Inc 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0