2017-02-27T15:45:27-06:00 2016-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2015-07-01 953222316 SHARE OUR SELVES CORPORATION SHAR 9492702100 1550 SUPERIOR AVENUE COSTA MESA CA 92627 KAREN MCGLINN CEO 9492702100 2017-02-15 1 LAUREN A HAVERLOCK P00545829 3108731600 2015 2021-01-29 14:40:06Z KAREN MCGLINN 1550 SUPERIOR AVENUE COSTA MESA CA 92627 15152627 0 X WWW. SHAREOURSELVES. ORG X 1970 CA WE ARE SERVANTS WHO PROVIDE CARE AND ASSISTANCE TO THOSE IN NEED AND ACT AS ADVOCATES FOR CHANGE. 9 9 138 1400 0 0 7040892 8669610 4016434 5989669 11718 19642 -38294 -18811 11030750 14660110 452684 520637 0 0 6432363 9073187 0 0 560951 4019965 4753892 10905012 14347716 125738 312394 7643414 8953262 2668542 3661232 4974872 5292030 X SOS PROVIDES VULNERABLE AND LOW-INCOME FAMILIES AND INDIVIDUALS WITH DIRECT ACCESS TO HEALTH, FOOD AND SAFETY NET SERVICES THEY NEED TO IMPROVE THEIR LIVES. SOS IS THE LARGEST COMMUNITY HEALTH CENTER IN ORANGE COUNTY TO COMBINE WRAP-AROUND SOCIAL SERVICES WITH HEALTHCARE. 0 0 9434682 5989669 CLINICS: ANNUALLY SOS PROVIDES CARE TO APPROXIMATELY 12,000UNDUPLICATED PATIENTS ACCOUNTING FOR OVER 38,200 PATIENT VISITS. SOSPROVIDES COMPREHENSIVE HEALTHCARE INCLUDING A FULL PROGRAM OF PRIMARY,SPECIALTY, SUB-SPECIALTY, DENTAL, INTEGRATED BEHAVIORAL HEALTH ANDCOMPLEMENTS ITS OUTPATIENT CARE WITH HOSPITALIST INPATIENT FOLLOW-UPS,TREATMENT ADHERENCE EDUCATION, CLINICAL CASE MANAGEMENT, DISEASEMANAGEMENT, COUNSELING, EDUCATION, AND TESTING. SOS OFFERS ONSITE LAB,NUTRITION AND DISPENSARY SERVICES COMPREHENSIVE QUALITY HEALTHCARE ISPROVIDED AT THREE CLINICAL SITES LOCATED IN COSTA MESA, SANTA ANA, ANDLAKE FOREST. SOS IS DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER(FQHC). FQHCS ARE COMMUNITY-BASED ORGANIZATIONS THAT PROVIDECOMPREHENSIVE PRIMARY CARE AND PREVENTIVE CARE, INCLUDING HEALTH, ORAL,AND MENTAL HEALTH SERVICES TO PERSONS OF ALL AGES, REGARDLESS OF THEIRABILITY TO PAY OR HEALTH INSURANCE STATUS, IN A MEDICALLY UNDERSERVEDAREA (MUA). 2299668 520637 SOCIAL SERVICES: PROVIDES BOTH CLINICAL AND SOCIAL CASE MANAGEMENT,EMERGENCY FINANCIAL AID, FOOD, LEGAL AID, HOMELESS OUTREACH PROGRAMS,RESOURCE AND LINKAGE TO BENEFIT ENROLLMENT, AND SEASONAL SUPPORTPROGRAMS. PROGRAMS SERVE ALL OF ORANGE COUNTY WITH 75% IN SANTA ANA ANDCOSTA MESA. RESIDENTS SEEKING SERVICES INCLUDE THE CHRONICALLYDISADVANTAGED AND THOSE ACCESSING SUPPORTIVE SERVICES FOR THE FIRSTTIME, CASUALTIES OF THE DEVASTATING RECESSION. S0S'S TARGET POPULATIONIS ETHNICALLY DIVERSE AND LIVES AT OR BELOW 100% OF THE FEDERAL POVERTYLEVEL; THE HOMELESS, SENIORS ON FIXED INCOMES, THE DISABLED, AND THOSEWITH MENTAL ILLNESS ARE A SIGNIFICANT PORTION OF THE POPULATION SERVED.SOCIAL SERVICES ANNUALLY SERVES OVER 100,000 ORANGE COUNTY RESIDENTS. 11734350 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 149 0 1 138 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SERGEY SERGEYEV 9492702135 20151 SW BIRCH STREET SUITE 250 NEWPORT BEACH CA 92660 DR GWYN P PARRY CHAIRMAN 2.00 X X 0 0 0 WILL KLATTE III VICE-CHAIR 2.00 X X 0 0 0 MIKE STEPHENS TREASURER 2.00 X X 0 0 0 SUSAN BAERG-EPSTEIN SECRETARY 2.00 X X 0 0 0 SKI HARRISON MEMBER 2.00 X 0 0 0 LAWRENCE N KUGELMAN MEMBER 2.00 X 0 0 0 GABRIELA ROBLES MEMBER 2.00 X 0 0 0 CATHEY RUSSELL MEMBER 2.00 X 0 0 0 JENNIFER NICOLALDE MEMBER 2.00 X 0 0 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 40.00 X 221624 0 5838 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER 40.00 X 177864 0 1000 ERIC HUANG CHIEF MEDICAL OFFICER 40.00 X 214624 0 9456 JILA NIKKHAH DENTAL DIRECTOR 40.00 X 173309 0 5699 TERESA HOLLANDER PHYSICIAN - AMD 36.00 X 186284 0 4735 JEREMY D ELKINS CHIEF OPERATIONS OFF. (LEFT 10/2015) 40.00 X 174262 0 4603 JOHN LE PHYSICIAN - AMD 40.00 X 173942 0 12010 DUC T VU DENTIST 40.00 X 161228 0 10679 MARY ANN HUNTSMAN PHARMACIST 40.00 X 136445 0 9179 1619582 0 63199 11 0 1 0 0 356579 2310175 6002856 1215214 8669610 CLINIC REVENUE 621400 5989669 5989669 5989669 21530 21530 282902 5000 286256 3534 -3354 1466 -1888 -1888 117188 356579 199727 -82539 -82539 2625 3000 -375 -375 MISCELLANEOUS INCOME 900099 64103 64103 64103 14660110 5989669 0 831 520637 520637 874180 699115 140132 34933 6842305 5468839 1099463 274003 75180 61490 10931 2759 754477 617091 109697 27689 527045 431073 76630 19342 57733 57733 42625 42625 1121 1121 458783 198442 207826 52515 236028 145512 26418 64098 1651 585 911 155 917173 831042 72263 13868 60837 31000 28778 1059 79539 40213 19658 19668 434910 408158 25378 1374 87650 55664 31237 749 CONTRIBUTED GOODS 1135355 1135355 ANCILLARY MEDICAL 640458 640458 PROPERTY AND EQUIPMENT 205426 170039 28664 6723 EHR MAINTENANCE AND HOS 118662 118662 275941 160975 72950 42016 14347716 11734350 2052415 560951 3167 82801 807719 1393864 248332 206494 1504988 1109625 37614 22797 691292 665130 6941311 2421499 3433354 4519812 907641 939139 9307 13600 7643414 8953262 953520 1640481 1400000 1476495 315022 544256 2668542 3661232 X 4155933 4283174 377229 562146 441710 446710 4974872 5292030 7643414 8953262 312394 4764 0 X 0 1 X 1 1 1 X 3973482 6361965 6501463 7045567 8669610 32552087 3973482 6361965 6501463 7045567 8669610 32552087 32552087 14497 18554 12974 11718 21530 79273 255 7643 12215 9228 64103 93444 32724804 14235064 0.99470 0.98550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 489646 5000 20940 515586 488674 2500 -1528 489646 459106 17500 12068 488674 419833 35700 3573 459106 430729 13700 -24596 419833 0.86640 0.13360 0 0 900000 900000 2500199 1415107 1085092 1727478 210391 1517087 1813634 796001 1017633 4519812 DEFERRED RENT 473452 OTHER LIABILITIES 70804 544256 16259797 4764 1594923 1599687 14660110 0 14660110 15942639 1594923 1594923 14347716 0 14347716 PART V, LINE 4: SOS HAS ADOPTED AN ENDOWMENT INVESTMENT POLICY, APPROVED BY THE BOARD, FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS SUPPORTED BY ITS ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THESE ENDOWMENT ASSETS OVER THE LONG TERM. THE INVESTMENT POLICY ESTABLISHES AN ACHIEVABLE RETURN OBJECTIVE THROUGH DIVERSIFICATION OF ASSET CLASSES. THE OBJECTIVE IS TO GROW THE AGGREGATE PORTFOLIO VALUE, NET OF SPENDING, AT THE RATE OF INFLATION OVER THE INVESTMENT HORIZON. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, SOS RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CAPITAL APPRECIATION (REALIZED AND UNREALIZED) AND CURRENT YIELD (INTEREST AND DIVIDENDS). SOS TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACES AN EMPHASIS ON EQUITY INVESTMENTS AND FIXED INCOME SECURITIES TO ACHIEVE ITS LONGTERM RATE OF RETURN OBJECTIVES WITHIN PRUDENT RISK PARAMETERS. CELEBRITY CHEF 330758 238550 92208 76858 24958 11502 18961 TACO NIGHT 86091 61111 24980 3256 200 12565 2 56918 56918 51427 473767 356579 117188 76858 28214 11702 82953 199727 -82539 1 RELIEF AND AID ASSISTANCE 6763 520637 FMV FOOD, RENT, UTILITIES, AND GIFT CARDS PART I, LINE 2: INDIVIDUALS WHO REQUIRE FINANCIAL ASSISTANCE ARE REQUIRED TO GO THROUGH A FINANCIAL ASSISTANCE APPLICATION. THE INDIVIDUAL MUST PROVIDE SUPPORTING DOCUMENTS TO SHOW THE NEED FOR ASSISTANCE. THE ORGANIZATION PROVIDES GIFTS CARDS AND OTHER HOUSING ASSISTANCE. X X 0 0 0 0 0 0 0 1 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 186624 0 35000 0 0 0 1000 0 4838 0 227462 0 0 0 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER 157864 0 20000 0 0 0 1000 0 0 0 178864 0 0 0 ERIC HUANG CHIEF MEDICAL OFFICER 214624 0 0 0 0 0 1000 0 8456 0 224080 0 0 0 JILA NIKKHAH DENTAL DIRECTOR 173309 0 0 0 0 0 1000 0 4699 0 179008 0 0 0 TERESA HOLLANDER PHYSICIAN - AMD 186284 0 0 0 0 0 0 0 4735 0 191019 0 0 0 JEREMY D ELKINS CHIEF OPERATIONS OFF. (LEFT 10/2015) 154262 0 20000 0 0 0 1000 0 3603 0 178865 0 0 0 JOHN LE PHYSICIAN - AMD 173942 0 0 0 0 0 1000 0 11010 0 185952 0 0 0 DUC T VU DENTIST 161228 0 0 0 0 0 0 0 10679 0 171907 0 0 0 PART I, LINE 7 BONUSES FOR THE CEO / EXECUTIVE TEAM ARE APPROVED BY THE BOARD AND ARE BASED ON PERFORMANCE REVIEWS AND MERIT. X 35 442000 FMV X 1 62631 FMV X SUPPLIES 1 545650 FMV X AUCTION ITEMS 47 76858 SALES PRICE X TICKETS 1 47880 FMV X DONATED UTILITIES 1 37195 FMV X RAFFLE ITEMS 1 3000 FMV 0 1 0 PART I, COLUMN (B): NON CASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONOR CONTRIBUTIONS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS FIRST REVIEWED BY THE CFO. A COPY OF THE 990 IS THEN PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY TO DISCLOSE ANY CONFLICTS OF INTERESTS. QUESTIONNAIRES ARE THEN RETURNED TO THE EXECUTIVE DIRECTOR. ANY CONFLICTS THAT ARE DISCLOSED ARE REVIEWED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 BOARD MEMBERS DETERMINE THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES BY GATHERING DATA ON THE COMPENSATION FOR NON-PROFIT ORGANIZATIONS IN ORANGE COUNTY AND SOUTHERN CALIFORNIA. THE DATA IS UTILIZED IN CONJUNCTION WITH THE BOARD MEMBERS' EVALUATION TO PRODUCE A COMPENSATION RECOMMENDATION INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE SHARE OUR SELVES FOUNDATION 1550 SUPERIOR AVENUE COSTA MESA CA 92627 813076983 TO SUPPORT SHARE OUR SELVES CA 501(C)(3) LINE 11A, I SHARE OUR SELVES 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0