CLINICA MSR OSCAR A ROMERO: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CLINICA MSR OSCAR A ROMERO (EIN 95-3881333)
Tax period
2015-07-01 to 2016-06-30
Filed
2017-05-15
IRS object ID
201721359349311252
Schema version
2015v3.0
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

FieldValueIRS element (for citing)
Return2017-05-15T16:07:27-05:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line120 E THOMAS RD STE 2300AddressLine1Txt
CityPHOENIXCityNm
State AbbreviationAZStateAbbreviationCd
ZIP85012ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN953881333EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CLINICA MSR OSCAR A ROMEROBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCLINBusinessNameControlTxt
Phone3239871401PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1123 S ALVARADO STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90057ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSANDRA ROSSATOPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone3239871401PhoneNum
Signature2017-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNIONPreparerPersonNm
PTINP01469618PTIN
Phone6022662248PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSANDRA ROSSATOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1123 S ALVARADO STREETAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90057ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,417,916GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CLINICAROMERO.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionPROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE & OTHER SERVICES TO THE UNINSURED, INSURED & UNDERSERVED COMMUNITIES OF GREATER LOS ANGELES.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee148TotalEmployeeCnt
Total Volunteers172TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,619,153PYContributionsGrantsAmt
CY Contributions Grants$3,846,918CYContributionsGrantsAmt
PY Program Service Revenue$7,238,637PYProgramServiceRevenueAmt
CY Program Service Revenue$8,086,242CYProgramServiceRevenueAmt
PY Investment Income$773PYInvestmentIncomeAmt
CY Investment Income$783CYInvestmentIncomeAmt
PY Other Revenue$417,509PYOtherRevenueAmt
CY Other Revenue$463,952CYOtherRevenueAmt
PY Total Revenue$11,276,072PYTotalRevenueAmt
CY Total Revenue$12,397,895CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,850CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,757,170PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,900,751CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$112,924CYTotalFundraisingExpenseAmt
PY Other Expenses$3,406,438PYOtherExpensesAmt
CY Other Expenses$4,361,271CYOtherExpensesAmt
PY Total Expenses$11,163,608PYTotalExpensesAmt
CY Total Expenses$12,272,872CYTotalExpensesAmt
PY Revenues Less Expenses$112,464PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$125,023CYRevenuesLessExpensesAmt
Total Assets BOY$8,065,922TotalAssetsBOYAmt
Total Assets EOY$8,072,664TotalAssetsEOYAmt
Total Liabilities BOY$5,484,580TotalLiabilitiesBOYAmt
Total Liabilities EOY$5,366,299TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,581,342NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,706,365NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionOUR MISSION IS TO PROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE AND OTHER SERVICES TO THE UNINSURED, INSURED AND UNDERSERVED COMMUNITIES OF GREATER LOS ANGELES REGARDLESS OF THEIR ABILITY TO PAY BY UPHOLDING THE LEGACY AND TRADITION OF MONSENOR OSCAR ROMERO AND EDUCATING AND EMPOWERING SALVADORAN AND OTHER COMMUNITY MEMBERS THROUGH COMMUNITY ORGANIZING, HEALTH EDUCATION AND SOCIAL JUSTICE AND EXCHANGE PROGRAMS IN EL SALVADOR.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,166,708ExpenseAmt
Grant$10,850GrantAmt
Revenue$4,929,403RevenueAmt
DescCLINICA ROMERO PROVIDES LOW-COST COMPREHENSIVE PRIMARY CARE AND DISEASE PREVENTION SERVICES FOR MEN, WOMEN AND CHILDREN OF ALL AGES. OUR DOCTORS STRIVE TO PROVIDE THE BEST LEVEL OF CARE IN ORDER TO IMPROVE THE QUALITY OF LIFE OF ALL PATIENTS. SERVICES INCLUDE: EXAMS: COMPLETE MEDICAL EXAMINATIONS.CANCER SCREENINGS: LAB TESTS, ULTRASOUNDS.CHRONIC DISEASE MANAGEMENT: MEDICATIONS AND LIFESTYLE REGIMENS FOR AVOIDING COMPLICATIONS ASSOCIATED WITH ASTHMA, HEART DISEASE, HYPERTENSION, HIGH BLOOD PRESSURE AND DIABETES.FAMILY PLANNING: PROGRAMS TO ASSIST YOUNG AND BEGINNING FAMILIES.PRENATAL CARE: PRENATAL CLASSES AND NUTRITIONAL GUIDANCE.PEDIATRICS: WELL-CHILD VISITS FOR HEALTHY GROWTH AND DEVELOPMENT.VACCINATIONS: PEDIATRIC IMMUNIZATIONS AND ADULT VACCINES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,305,508ExpenseAmt
Grant$0GrantAmt
Revenue$1,499,223RevenueAmt
DescCLINICA ROMERO PROVIDES A LOW-COST DENTAL SERVICES FOR ADULTS AND CHILDREN IN A FRIENDLY ENVIRONMENT THAT PUTS OUR PATIENTS AT EASE. GOOD ORAL HEALTH REQUIRES REGULAR DENTAL EXAMINATION AND MAINTENANCE TO HELP PREVENT AND MANAGE DISEASE. OUR TEAM SPECIALIZES IN PREVENTATIVE CARE AND PROVIDES THE FOLLOWING SERVICES:SERVICES FOR ADULTS:COMPLETE ORAL EXAMINATIONS INCLUDING X-RAYS.PREVENTATIVE SERVICES AND PERIODIC PERIODONTAL MAINTENANCE TREATMENT:PROPHYLAXIS (CLEANINGS) AND NON-SURGICAL PERIODONTAL TREATMENT (SCALING AND ROOT PLANING), ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, CANAL TREATMENT LIMITED TO ANTERIOR TEETH, SIMPLE EXTRACTIONSSERVICES FOR CHILDREN:COMPLETE ORAL EXAMINATIONS AND X-RAYSPREVENTATIVE SERVICES:PROPHYLAXIS (CLEANINGS), FLUORIDE VARNISH APPLICATIONS, SEALANTS, ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, PULPOTOMIES, STAINLESS STEEL CROWNS, SPACE MAINTAINERS, SIMPLE EXTRACTIONSDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$365,640ExpenseAmt
Grant$0GrantAmt
Revenue$1,657,616RevenueAmt
DescCLINICA IS COMMITTED TO PROVIDING PRESCRIPTION MEDICATION THAT FITS WITHIN A PATIENT'S BUDGET. OUR PHARMACEUTICAL STAFF IS COMMITTED TO PROVIDING ACCURATE AND EASY TO UNDERSTAND INFORMATION REGARDING THE MEDICATION PRESCRIBED TO OUR PATIENTS. SERVICES INCLUDE:ON-SITE FILLING OF PRESCRIPTIONS.PRESCRIPTION REFILLS.MEDICATION MANAGEMENT IN COORDINATION WITH PRIMARY CARE PHYSICIAN.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$9,837,856TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document37IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee148EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local ChaptersYes (1)LocalChaptersInd
Policies Reference ChaptersYes (1)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SANDRA ROSSATOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2132012745PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1123 S ALVARADO STAddressLine1Txt
CityLOS ANGELESCityNm
State AbbreviationCAStateAbbreviationCd
ZIP90057ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CARLOS VAQUERANO
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
RAFAEL SWEET ESQ
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
KRYSSIA CAMPOS
SECRETARY1.00Yes (X)Yes (X)$0$0$0
MARCELO VILLAGOMEZ
TREASURER1.00Yes (X)Yes (X)$0$0$0
GABRIEL AGUILA-NOLAZCO
MEMBER1.00Yes (X)$0$0$0
JOSE AMBROCIO AGUILAR
MEMBER1.00Yes (X)$0$0$0
MARIA ELENA GARCIA
MEMBER1.00Yes (X)$0$0$0
KEITH MARTIN MSW
MEMBER1.00Yes (X)$0$0$0
VENTURA MENDOZA
MEMBER1.00Yes (X)$0$0$0
SANDRA RODRIGUEZ
MEMBER1.00Yes (X)$0$0$0
ADALY UGALDE
MEMBER1.00Yes (X)$0$0$0
SANDRA ROSSATO
EXECUTIVE DIRECTOR40.00Yes (X)$153,166$0$4,593
CHRISTINA BUGARIN
FINANCE DIRECTOR40.00Yes (X)$102,195$0$3,066
SAMUEL BENJAMIN
MEDICAL DIRECTOR (THROUGH DEC 2015)40.00Yes (X)$127,162$0$3,815
DR SAMUEL PIERCE
MEDICAL DIRECTOR (AS OF APRIL 2016)40.00Yes (X)$0$0$0
EDWARD ALEXANDER
PHYSICIAN40.00$148,593$0$4,458Yes (X)
ERIC MCCLOUD
PHYSICIAN40.00$139,163$0$4,175Yes (X)
FERNANDO RODRIGUEZ
DENTAL DIRECTOR40.00$136,188$0$4,086Yes (X)
DEISY MENDOZA
PHYSICIAN ASSISTANT40.00$126,520$0$3,796Yes (X)
JAMEY COREY
PHARMACIST32.00$125,712$0$3,771Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,058,699TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$31,760TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K15IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line17 LAYER IT SOLUTIONS INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line117701 CHATSWORTH STAddressLine1Txt
CityGRANADA HILLSCityNm
State AbbreviationCAStateAbbreviationCd
ZIP91344ZIPCd
FieldValueIRS element (for citing)
ServicesIT SERVICESServicesDesc
Compensation$244,804CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$3,325,533GovernmentGrantsAmt
All Other Contributions$521,385AllOtherContributionsAmt
Total Contributions$3,846,918TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL SERVICES621110$4,929,403$4,929,403
PHARMACY SERVICES621110$1,657,616$1,657,616
DENTAL SERVICES621110$1,499,223$1,499,223
FieldValueIRS element (for citing)
Total Program Service Revenue$8,086,242TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$783TotalRevenueColumnAmt
Exclusion$783ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$74,066RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$20,021RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$54,045RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$54,045TotalRevenueColumnAmt
Exclusion$54,045ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$409,907TotalRevenueColumnAmt
Exclusion$409,907ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$409,907OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,397,895TotalRevenueColumnAmt
Related Or Exempt Func Income$8,086,242RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$464,735ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$10,850TotalAmt
Program Services$10,850ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$393,948TotalAmt
Program Services$39,294ProgramServicesAmt
Management And General$354,654ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,551,782TotalAmt
Program Services$4,681,478ProgramServicesAmt
Management And General$796,910ManagementAndGeneralAmt
Fundraising$73,394FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,444,161TotalAmt
Program Services$1,166,045ProgramServicesAmt
Management And General$265,574ManagementAndGeneralAmt
Fundraising$12,542FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$510,860TotalAmt
Program Services$409,629ProgramServicesAmt
Management And General$96,830ManagementAndGeneralAmt
Fundraising$4,401FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$46,465TotalAmt
Management And General$46,465ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$113,392TotalAmt
Management And General$113,392ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$652,975TotalAmt
Program Services$535,362ProgramServicesAmt
Management And General$107,877ManagementAndGeneralAmt
Fundraising$9,736FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$35,296TotalAmt
Program Services$27,028ProgramServicesAmt
Management And General$7,290ManagementAndGeneralAmt
Fundraising$978FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$207,643TotalAmt
Program Services$130,910ProgramServicesAmt
Management And General$75,549ManagementAndGeneralAmt
Fundraising$1,184FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$337,588TotalAmt
Program Services$294,890ProgramServicesAmt
Management And General$41,350ManagementAndGeneralAmt
Fundraising$1,348FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$183,813TotalAmt
Program Services$97,768ProgramServicesAmt
Management And General$84,822ManagementAndGeneralAmt
Fundraising$1,223FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$606,420TotalAmt
Program Services$486,515ProgramServicesAmt
Management And General$114,963ManagementAndGeneralAmt
Fundraising$4,942FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$120,570TotalAmt
Program Services$64,130ProgramServicesAmt
Management And General$55,638ManagementAndGeneralAmt
Fundraising$802FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PROGRAM EXPENSES$1,650,504$1,633,494$16,419$591
MISCELLANEOUS$213,981$108,736$103,749$1,496
MAINTENANCE AND REPAIRS$140,878$121,658$18,936$284
DUES AND SUBSCRIPTIONS$51,746$30,069$21,674$3

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,272,872TotalAmt
Program Services$9,837,856ProgramServicesAmt
Management And General$2,322,092ManagementAndGeneralAmt
Fundraising$112,924FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$706,703BOYAmt
EOY$986,976EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$222,719BOYAmt
EOY$363,462EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,016,605BOYAmt
EOY$1,997,765EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$15,527BOYAmt
EOY$25,785EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$33,984BOYAmt
EOY$50,989EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,625,683LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,978,952LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,047,149BOYAmt
EOY$4,646,731EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$23,235BOYAmt
EOY$956EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,065,922BOYAmt
EOY$8,072,664EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,069,631BOYAmt
EOY$940,154EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$158,337BOYAmt
EOY$266,826EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,256,612BOYAmt
EOY$4,159,319EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$5,484,580BOYAmt
EOY$5,366,299EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,436,459BOYAmt
EOY$2,341,815EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$144,883BOYAmt
EOY$364,550EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,581,342BOYAmt
EOY$2,706,365EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,065,922BOYAmt
EOY$8,072,664EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$125,023ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,855,566CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,762,794CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,060,684CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,619,153CurrentTaxYearMinus1YearAmt
Current Tax Year$3,846,918CurrentTaxYearAmt
Total$17,145,115TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,855,566CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,762,794CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,060,684CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,619,153CurrentTaxYearMinus1YearAmt
Current Tax Year$3,846,918CurrentTaxYearAmt
Total$17,145,115TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$17,145,115PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$84,921CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$75,069CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$133,130CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,547CurrentTaxYearMinus1YearAmt
Current Tax Year$74,849CurrentTaxYearAmt
Total$430,516TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$95,245CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$47,949CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$180,448CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$378,315CurrentTaxYearMinus1YearAmt
Current Tax Year$409,907CurrentTaxYearAmt
Total$1,111,864TotalAmt
FieldValueIRS element (for citing)
Total Support$18,687,495TotalSupportAmt
Gross Receipts Rltd Activities$32,553,275GrossReceiptsRltdActivitiesAmt
Public Support CY1700.91750PublicSupportCY170Pct
Public Support PY1700.93880PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME MEANINGFUL USE REVENUEExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,618,324OtherCostOrOtherBasisAmt
Book Value$1,618,324BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,346,596OtherCostOrOtherBasisAmt
Depreciation$2,123,899DepreciationAmt
Book Value$2,222,697BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$786,978OtherCostOrOtherBasisAmt
Depreciation$786,978DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,873,785OtherCostOrOtherBasisAmt
Depreciation$2,068,075DepreciationAmt
Book Value$805,710BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,646,731TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,417,916TotalRevEtcAuditedFinclStmtAmt
Other Revenue$20,021OtherRevenueAmt
Revenue Not Reported$20,021RevenueNotReportedAmt
Revenue Subtotal$12,397,895RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,397,895TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,292,893TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$20,021OtherExpensesIncludedAmt
Expenses Not Reported$20,021ExpensesNotReportedAmt
Expenses Subtotal$12,272,872ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$12,272,872TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:CLINICA IS A NONPROFIT CORPORATION, EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, CLINICA IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. CLINICA FOLLOWS THE GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE FINANCIAL STATEMENTS. CLINICA'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 20,021.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 20,021.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationAMOUNTS GIVEN WERE SPONSORSHIPS FOR LOCAL CHARITIES. ALL AMOUNTS GIVEN WERE INTENDED FOR GENERAL OPERATING SUPPORT AND NO MONITORING OCCURRED SUBSEEQUENT TO THE EVENT.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SANDRA ROSSATO
EXECUTIVE DIRECTOR$153,166$0$0$0$0$0$0$0$4,593$0$157,759$0$0$0
EDWARD ALEXANDER
PHYSICIAN$148,593$0$0$0$0$0$0$0$4,458$0$153,051$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS AND IMMEDIATE PAST PRESIDENT OF THE BOARD OF DIRECTORS. THE EXECUTIVE DIRECTOR AND OTHER NON-DIRECTORS MAY BE DESIGNATED AS NON-VOTING ADVISORS TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE EXERCISES SUCH AUTHORITY AS IS DELEGATED TO IT BY THE BOARD OF DIRECTORS AND CAN ACT IN THE BOARD'S ABSENCE DURING AN EMERGENCY IF THE FULL BOARD IS UNABLE TO MEET.
FORM 990, PART VI, SECTION B, LINE 11CLINICA MSR OSCAR A ROMERO'S OUTSIDE AUDITORS AND FINANCIAL STAFF PREPARED THE FORM 990. THE FORM WAS THEN REVIEWED AND APPROVED BY THE ORGANIZATION'S CONTROLLER OR CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. THE FORM WAS THEN SENT TO THE FULL BOARD BEFORE FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCLINICA MSR OSCAR A ROMERO (CMOAR) REQUIRES ALL EMPLOYEES TO DISCLOSE, AT LEAST ANNUALLY, ALL SOURCES OF INCOME FROM COMPENSATION OR FROM OWNERSHIP OF EVERY OUTSIDE ENTITY THAT (A) SOLD, SUPPLIED OR PROVIDED SERVICES (B) OPERATED A COMPETING ENTERPRISE OR (C) PROVIDED GOODS OR SERVICES TO CMOAR IN THE LAST SIX MONTHS. CMOAR ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF CMOAR CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. CMOAR CONFLICT OF INTEREST POLICY DESCRIBES HOW CMOAR WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD REVIEWED ALL OF THE OFFICERS' COMPENSATION, INCLUDING THAT OF THE EXECUTIVE DIRECTOR. THE BOARD REVIEWED DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES. THE OCCURRENCE OF THESE DELIBERATION ARE NOTED IN THE BOARD MINUTES. THIS PROCESS LAST OCCURRED IN 2016.
FORM 990, PART VI, SECTION C, LINE 18IN ADDITION TO BEING AVAILABLE UPON REQUEST, THE ORGANIZATION'S FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

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