SONOMA VALLEY COMMUNITY HEALTH CENTER: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SONOMA VALLEY COMMUNITY HEALTH CENTER (EIN 68-0286382)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-10
- IRS object ID
- 201733149349303023
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-10T14:16:51-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 680456752 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dillwood Burkel & Millar LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 Concourse Blvd Ste A | AddressLine1Txt |
| City | Santa Rosa | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680286382 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sonoma Valley Community Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SONO | BusinessNameControlTxt |
| Phone | 7079396070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 Sonoma Highway | AddressLine1Txt |
| City | Sonoma | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Cheryl Johnson | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7079396070 | PhoneNum |
| Signature | 2017-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Penny Millar | PreparerPersonNm |
| PTIN | P00140274 | PTIN |
| Phone | 7075778806 | PhoneNum |
| Preparation | 2017-11-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 184.23.232.130 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-08 | IPDt |
| IP Tm | 12:07:23 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B0FBFEAAE675D2E52F13D0C13783599EDD6214F3 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B0FBFEAAE675D2E52F13D0C13783599EDD6214F3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Cheryl Johnson | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 Sonoma Highway | AddressLine1Txt |
| City | Sonoma | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,413,546 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | svchc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Providing accessible quality health care services, especially to the underserved, regardless of ability to pay. Sonoma Valley Community Health Center is a California nonprofit public benefit corporation organized to provide high quality health care access to those in need, regardless of ability to pay. Services provided include routine health assessments and treatment, physical examinations, preventative services, behavioral health and dentistry. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 104 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,948,656 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,985,930 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,303,210 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,423,434 | CYProgramServiceRevenueAmt |
| PY Investment Income | $275 | PYInvestmentIncomeAmt |
| CY Investment Income | -$10,218 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $3,600 | CYOtherRevenueAmt |
| PY Total Revenue | $8,252,141 | PYTotalRevenueAmt |
| CY Total Revenue | $9,402,746 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,354,970 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,403,478 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $28,831 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,767,606 | PYOtherExpensesAmt |
| CY Other Expenses | $4,351,215 | CYOtherExpensesAmt |
| PY Total Expenses | $8,151,407 | PYTotalExpensesAmt |
| CY Total Expenses | $9,754,693 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $100,734 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$351,947 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,811,760 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,399,923 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,876,471 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,816,579 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,935,289 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,583,344 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Providing accessible quality health care services, especially to the underserved, regardless of ability to pay. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,600,542 | ExpenseAmt |
| Revenue | $3,980,736 | RevenueAmt |
| Desc | FAMILY PRACTICE SERVICES: The Health Center provides medical care services for infants through adults, with extended day and evening hours and is open 6 days per week. Services include routine examinations, immunizations, physicals, urgent care and diagnosis, and treatment of acute and chronic illness. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $272,074 | ExpenseAmt |
| Revenue | $547,314 | RevenueAmt |
| Desc | COMPREHENSIVE PERINATAL SERVICES: The Health Center provides pre- and post-natal OB services and education to pregnant women. Nurse educators and nutritionists are available full time to support patients. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $632,307 | ExpenseAmt |
| Revenue | $760,667 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH SERVICES: The Health Center provides behavioral health services utilizing a psychiatrist, psychologists, licensed clinical social workers, and behavioral health candidates. The Health Center also has a substance abuse counseling program staffed by part time certified substance abuse counselors provided through a contract with the Drug Abuse Alternative Center. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|
| $1,302,987 | $1,427,045 | DENTAL SERVICES: The Health Center dentists and registered dental hygienists provide full service dentistry five days per week.OTHER PROGRAM SERVICES: include quality shared savings, incentives, and other revenue. |
| $700,472 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,302,987 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $2,127,517 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $6,807,910 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 104 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Susan Torres | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7079396070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 Sonoma Highway | AddressLine1Txt |
| City | Sonoma | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Richard Gantenbein | |||||||
| Chair | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Michael Mainardi | |||||||
| Vice Chair | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Pamela Stephens | |||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Stanley Pawlak | |||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Linda McTaggart | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Michelle Alba | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| James Rosen | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Patricia Coleman | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Audrey Chapman | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Martha Evans | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Victoria Hall | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Karen Brady | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Cheryl Johnson | |||||||
| CEO | 40.00 | Yes (X) | $138,182 | $0 | $35,872 | ||
| Susan Torres | |||||||
| Controller | 40.00 | Yes (X) | $101,713 | $0 | $17,980 | ||
| Carol Ahern | |||||||
| Medical Director | 30.00 | Yes (X) | $118,499 | $0 | $26,511 | ||
| Frances X Perez | |||||||
| MD | 40.00 | $145,125 | $0 | $11,935 | Yes (X) | ||
| Yen-Trang Vo | |||||||
| MD | 40.00 | $205,581 | $0 | $18,710 | Yes (X) | ||
| Erin Akar | |||||||
| MD | 40.00 | $169,160 | $0 | $23,264 | Yes (X) | ||
| Monica Haimowitz | |||||||
| LCSW | 40.00 | $101,896 | $0 | $17,988 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $980,156 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $152,260 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MD Placement | |||||
| 6101 Long Prairie Rd Ste 744 PMB 2 | Flower Mound | TX | 75028 | Contracted Providers: Locums | $281,998 |
| HITCare LLC | |||||
| 775 Baywood Dr Ste 314 | Petaluma | CA | 94954 | Contracted IT: Hardware systms | $183,835 |
| Michael Thompson | |||||
| 5600 Benhenry Ct | Rocklin | CA | 95677 | Contracted IT: Consulting | $151,141 |
| Julie M Vlasis Consulting | |||||
| 5172 E Woodward Ave | Fresno | CA | 83727 | Operations/Compliance | $137,950 |
| Dr Paul Amara | |||||
| 181 Andrieux St Ste 108 | Sonoma | CA | 95476 | Contracted Provider | $129,135 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,285,480 | GovernmentGrantsAmt |
| All Other Contributions | $700,450 | AllOtherContributionsAmt |
| Noncash Contributions | $219,165 | NoncashContributionsAmt |
| Total Contributions | $1,985,930 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenu | 624100 | $6,254,079 | $6,254,079 |
| Other program service | 624100 | $1,169,355 | $1,169,355 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,423,434 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $582 | TotalRevenueColumnAmt |
| Exclusion | $582 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,600 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,600 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,600 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,600 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $10,800 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$10,800 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$10,800 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,402,746 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,416,234 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $582 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,757 | TotalAmt |
| Program Services | $328,651 | ProgramServicesAmt |
| Management And General | $110,106 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,162,712 | TotalAmt |
| Program Services | $3,006,747 | ProgramServicesAmt |
| Management And General | $1,155,965 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $456,102 | TotalAmt |
| Program Services | $330,131 | ProgramServicesAmt |
| Management And General | $125,971 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,907 | TotalAmt |
| Program Services | $256,850 | ProgramServicesAmt |
| Management And General | $89,057 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,910 | TotalAmt |
| Management And General | $157,910 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,740 | TotalAmt |
| Management And General | $8,740 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,522 | TotalAmt |
| Management And General | $139,522 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,426,147 | TotalAmt |
| Program Services | $888,952 | ProgramServicesAmt |
| Management And General | $537,195 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,792 | TotalAmt |
| Program Services | $111,381 | ProgramServicesAmt |
| Management And General | $12,411 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,939 | TotalAmt |
| Program Services | $32,276 | ProgramServicesAmt |
| Management And General | $104,663 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,681 | TotalAmt |
| Program Services | $170,806 | ProgramServicesAmt |
| Management And General | $78,875 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $496,215 | TotalAmt |
| Program Services | $395,549 | ProgramServicesAmt |
| Management And General | $100,666 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,489 | TotalAmt |
| Program Services | $4,734 | ProgramServicesAmt |
| Management And General | $1,755 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,841 | TotalAmt |
| Program Services | $19,238 | ProgramServicesAmt |
| Management And General | $19,603 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69 | TotalAmt |
| Management And General | $69 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $777,066 | TotalAmt |
| Program Services | $478,469 | ProgramServicesAmt |
| Management And General | $298,597 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,021 | TotalAmt |
| Program Services | $32,021 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $649,170 | $649,170 | |
| Bad debt | $74,302 | $74,302 | |
| Dues & subscriptions | $34,311 | $28,633 | $5,678 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,754,693 | TotalAmt |
| Program Services | $6,807,910 | ProgramServicesAmt |
| Management And General | $2,946,783 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $855,579 | BOYAmt |
| EOY | $590,213 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,480 | BOYAmt |
| EOY | $1,003,585 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,314 | BOYAmt |
| EOY | $241,801 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $451,977 | BOYAmt |
| EOY | $551,185 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,482 | BOYAmt |
| EOY | $59,536 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,282,232 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,328,769 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,659,788 | BOYAmt |
| EOY | $9,953,463 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | $140 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,811,760 | BOYAmt |
| EOY | $12,399,923 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $834,001 | BOYAmt |
| EOY | $1,046,906 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,042,470 | BOYAmt |
| EOY | $4,769,673 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,876,471 | BOYAmt |
| EOY | $5,816,579 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,663,286 | BOYAmt |
| EOY | $6,541,942 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,003 | BOYAmt |
| EOY | $41,402 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,935,289 | BOYAmt |
| EOY | $6,583,344 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,811,760 | BOYAmt |
| EOY | $12,399,923 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$351,947 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $2 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,159,618 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,811,969 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,935,251 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,948,656 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,985,930 | CurrentTaxYearAmt |
| Total | $8,841,424 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,159,618 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,811,969 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,935,251 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,948,656 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,985,930 | CurrentTaxYearAmt |
| Total | $8,841,424 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $8,841,424 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $559 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $475 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $313 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $275 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $582 | CurrentTaxYearAmt |
| Total | $2,204 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,843,628 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $24,321,693 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99980 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99950 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,538,780 | OtherCostOrOtherBasisAmt |
| Book Value | $1,538,780 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,821,641 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,141,737 | DepreciationAmt |
| Book Value | $7,679,904 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,745,616 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,144,072 | DepreciationAmt |
| Book Value | $601,544 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $176,195 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,960 | DepreciationAmt |
| Book Value | $133,235 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,953,463 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,413,546 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,413,546 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$10,800 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$10,800 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,402,746 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,765,493 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $10,800 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $10,800 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,754,693 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,754,693 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Organization determines whether its tax positions are "more-likely-than-not" to be sustained upon examination by the applicable taxing authority based on the technical merits of the positions. As of December 31, 2016 and 2015, the Organization has reviewed its tax positions and has concluded no reserve for uncertain tax positions is required. The Organization's exempt organization information returns are subject to review through three years after the date of filing for Federal and four years after the date of filing for State. |
| Part XI, Line 4b - Other Adjustments: | Loss on disposal of assets -10,800. |
| Part XII, Line 2d - Other Adjustments: | Loss on disposal of assets 10,800. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cheryl Johnson | ||||||||||||||
| CEO | $138,182 | $0 | $0 | $0 | $0 | $0 | $23,999 | $0 | $11,873 | $0 | $174,054 | $0 | $0 | $0 |
| Frances X Perez | ||||||||||||||
| MD | $145,125 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,935 | $0 | $157,060 | $0 | $0 | $0 |
| Yen-Trang Vo | ||||||||||||||
| MD | $205,581 | $0 | $0 | $0 | $0 | $0 | $12,000 | $0 | $6,710 | $0 | $224,291 | $0 | $0 | $0 |
| Erin Akar | ||||||||||||||
| MD | $169,160 | $0 | $0 | $0 | $0 | $0 | $18,000 | $0 | $5,264 | $0 | $192,424 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Pamela Stephens | PersonNm |
| Relationship With Org | Board director/secretary | RelationshipWithOrgTxt |
| Cash Grant | $1,090 | CashGrantAmt |
| Type Of Assistance | Internet Services | TypeOfAssistanceTxt |
| Assistance Purpose | To allow access to board material, meeting agendas, etc. electronically. | AssistancePurposeTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 25 | ContributionCnt |
| Noncash Contributions Rpt F990 | $179,015 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Purchase orders/invoices | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Software | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $40,150 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Email from vendor wi | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part IV, Line 4: | The organization pays dues to the California Primary Care Association (CPCA). A portion of these dues may be used for lobbying. Also, board members and staff have on occasion had direct contact with legislators and/or their staff. Such contact was limited in duration and not part of a lobbying effort. |
| Form 990, Part VI, Section A, line 4 | SVCHC amended the portion of their by-laws pertaining to election and terms of office. See attached copy of articles & bylaws amended December 14, 2016. |
| Form 990, Part VI, Section B, line 11b | CEO and CFO/Controller do the initial review with the preparer. This Draft is then mailed and/or electronically sent to all board members for their review prior to the final draft. The draft is then finalized and filed. |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy relating to the board of directors and officers is included in the bylaws of the organization. Disclosure of any conflicts is required when a board member is elected to service on the Board. The Board is required to complete the conflict of interest statements annually. The CEO maintains the conflict of interest file. |
| Form 990, Part VI, Section B, line 15a | The organization utilizes written employment contracts, a compensation survey or study, and requires approval by the Board or a compensation committee to establish reasonable compensation of insiders. The Board has final authority over the hiring, dismissal, and annual evaluation of the CEO. The CEO evaluates the CFO and the medical director. The CEO reviews the California Primary Care Association (CPCA) annual state wide salary survey for community health centers to set salary ranges and wages each year. |
| Form 990, Part VI, Section C, line 19 | The organization makes its Form 990 and 1023, financial statements, conflict of interest policy, and governing documents available to the general public upon request. |
| Form 990, Part XII, Line 2c: | The Audit Committee, under the Board's supervision, is responsible for making recommendations to the Board on the hiring and firing of independent certified public accountants (CPAs). The Audit Committee can negotiate the independent CPA's compensation on behalf of the Board. The Audit Committee must: (1) Confer with the Auditor to satisfy committee members that the financial affairs of the Health Center are in order; (2) Review the audit and decide whether to accept it; and (3) Approve non audit services by the independent CPAs accounting firm, and ensure such services conform to appropriate government standards. |
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