2017-08-15T16:11:14-05:00 2016-09-30 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2015-10-01 942797447 Valley Children's Healthcare Foundation THEC 5593533000 9300 VALLEY CHILDRENS PLACE Madera CA 936368761 michele waldron Treasurer 5593533000 2017-08-11 1 Tracy S Paglia P00366884 2099556100 2017-08-11 2015 2021-01-29 14:40:06Z MICHELE WALDRON 9300 VALLEY CHILDRENS PLACE Madera CA 936368761 14085255 0 X N/A X 1981 CA TO GENERATE FUNDS TO SUPPORT THE GOALS OF VALLEY CHILDREN'S Healthcare and its affiliated entities. 27 23 15 0 0 0 10884323 12447687 0 0 497349 387076 88786 44490 11470458 12879253 5834455 7311479 0 0 1764514 2139579 226793 308460 2005419 590967 543127 8416729 10302645 3053729 2576608 22539928 26304743 402525 459305 22137403 25845438 X VALLEY CHILDREN'S HEALTHCARE FOUNDATION IS A CHARITABLE TAX-EXEMPT ORGANIZATION BENEFITING VALLEY CHILDREN'S Healthcare and its affiliated entities. THE FOUNDATION'S MISSION IS TO GENERATE FUNDS TO SUPPORT THE GOALS OF VALLEY CHILDREN'S Healthcare and its affiliated entities. 0 0 7233250 7233250 0 Distribution to Valley Children's Hospital, a nonprofit 501(c)(3) organization, for equipment and operational expenses: $7,233,250 78229 78229 0 Distribution to Valley Children's Medical Group, a nonprofit 501(c)(3) organization, for equipment and operational expenses: $78,229 0 0 0 See Schedule O. 7311479 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 15 0 0 0 0 0 0 1 1 1 1 0 0 0 X 27 23 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MICHELE WALDRON 5593533000 9300 Valley Childrens Place Madera CA 93636 Todd Suntrapak President, CEO 2.50 47.50 X X 0 1007348 198763 Michele R Waldron Treasurer, CFO 2.50 47.50 X X 0 611109 141992 Dan Adams Board Member 1.00 X 0 0 0 Erin Berberian-Gleason Board Member 1.00 40.00 X 0 149876 22652 Blair Cunnings Board Member 1.00 X 0 0 0 Marty Flaming Board Member 1.00 X 0 0 0 Kenneth Jue Board Member 1.00 X 0 0 0 Linda Bliss Board Member 1.00 X 0 0 0 Paul McDougal Chairman 1.00 1.00 X X 0 0 0 Patrick Murphy Board Member 1.00 X 0 0 0 Caren Myers Board Member 1.00 X 0 0 0 Vicki Burkhalter Board Member 1.00 X 0 0 0 Skip Nugent Board Member 1.00 X 0 0 0 Carl Refuerzo Board Member 1.00 X 0 0 0 Kim Ruiz-Beck Vice Chairman 1.00 2.00 X X 0 0 0 Debbie Smades-Henes Board Member 1.00 X 0 0 0 Bill Smittcamp Board Member 1.00 3.00 X 0 0 0 Dr Nadarasa Visveshwara Board Member 1.00 X 0 0 0 Richard Shehadey Board Member 1.00 X 0 0 0 Kevin Williams Board Member 1.00 X 0 0 0 Jody Young Board Member 1.00 X 0 0 0 Jeannine Grech Secretary 1.00 3.00 X X 0 0 0 Danielle Parnagian Board Member 1.00 X 0 0 0 Jeff Marchant Board Member 1.00 X 0 0 0 Kathy Horstmann-Huebert Board Member 1.00 X 0 0 0 Lance Mouw Board Member 1.00 X 0 0 0 Ken Ramos Board Member 1.00 X 0 0 0 Allison Karahadian Board Member - Thru 12/31/15 1.00 X 0 0 0 Robert Saroyan VP, Foundation/CDO 40.00 X 0 386204 53195 0 2154537 416602 0 0 1 0 CHILDREN'S MIRACLE NETWORK 4525 S 2300 EAST SALT LAKE CITY UT 84112 FUNDRAISING 322727 1 1362521 920081 10165085 1165400 12447687 402242 402242 864666 879832 -15166 -15166 -15166 370660 920081 326170 44490 44490 12879253 0 0 431566 7311479 7311479 1492906 548962 943944 233979 133603 100376 326050 85456 240594 86644 27859 58785 17187 17187 308460 308460 82095 82095 23233 5808 17425 3957 989 2968 122920 7880 115040 1500 375 1125 27431 16763 10668 7317 7317 10735 10735 PURCHASED SERVICES 84628 84628 TAXES & LICENSES 36360 9090 27270 Bank Charges 20566 5329 15237 Dues & Subscriptions 14685 3671 11014 90513 22628 67885 10302645 7311479 985747 2005419 300 300 4584308 5403490 125141 122150 55660 36504 22825 19156 8083752 8682147 8498303 11005262 1225299 1072238 22539928 26304743 402525 459305 402525 459305 X 1559832 1257260 4250526 6726581 16327045 17861597 22137403 25845438 22539928 26304743 X 2576608 1390241 -258814 X 0 1 X 1 0 X 9223675 5815550 8127504 10864323 12447687 46478739 9223675 5815550 8127504 10864323 12447687 46478739 1420429 45058310 964574 946534 1027173 355152 402242 3695675 287241 91773 82929 88786 44490 595219 50769633 0.88750 0.79600 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 16327045 1534552 17861597 13901775 2425270 16327045 13419203 482572 13901775 12825387 593816 13419203 12097790 727597 12825387 1.00000 0 1 1 55660 36504 19156 19156 Limited Partnerships 11005262 F 11005262 Part V, Line 4: TO PROVIDE A PERPETUAL AND PREDICTABLE SOURCE OF REVENUE FOR THE USE AND BENEFIT OF VARIOUS PROGRAMS, OPERATING AND CAPITAL NEEDS OF VALLEY CHILDREN'S HEALTHCARE AND ITS AFFILIATED ENTITIES. X X X X X X X 1 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 COORDINATE DIRECT MAIL PROGRAM AND OTHER CAMPAIGN 1 328182 308460 19722 328182 308460 19722 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY kid's day 616776 395351 221425 150287 HARVEST BALL 673965 524730 149235 71595 104288 0 1290741 920081 370660 71595 254575 326170 44490 1 Valley Children's Hospital 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 941294954 501(c)(3) 6067850 1165400 FMV Various Items DISTRIBUTION TO CHILDREN'S HOSPITAL CENTRAL CA FOR EQUIPMENT AND OPERATIONAL EXPENSES Valley Children's Medical group 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 464150987 501(c)(3) 78229 Distribution to Valley Children's Medical group for Operational Expenses 2 0 Part I, Line 2: VALLEY CHILDREN'S HEALTHCARE FOUNDATION MAKES GRANTS ONLY TO RELATED ORGANIZATIONS. NO MONITORING OF THE USE OF GRANT FUNDS, OTHER THAN TO MEET DONOR RESTRICTIONS, IS NEEDED. 0 1 0 0 0 0 0 0 0 Todd Suntrapak President, CEO 0 729510 0 228374 0 49464 0 181513 0 17250 0 1206111 0 0 Michele R Waldron Treasurer, CFO 0 457726 0 120346 0 33037 0 129054 0 12938 0 753101 0 0 Erin Berberian-Gleason Board Member 0 149776 0 0 0 100 0 10935 0 11717 0 172528 0 0 Robert Saroyan VP, Foundation/CDO 0 341773 0 35989 0 8442 0 44570 0 8625 0 439399 0 0 Part I, Line 4b VALLEY CHILDREN'S HOSPITAL, A RELATED ORGANIZATION, HAS THREE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS INCLUDING A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND A NON-CONTRIBUTORY, NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EXEC RETIREMENT PLAN (DC SERP). NO AMOUNTS WERE PAID OUT OF THE PLANS DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN, EMPLOYER CONTRIBUTION TO THE DCSERP AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/16 ARE AS FOLLOWS: MICHELE WALDRON - DEFERRED COMPENSATION PLAN $18,000; DCSERP $69,064; CHANGE IN SERP ACTUARIAL VALUE $20,397 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $0; DCSERP $128,337; CHANGE IN SERP ACTUARIAL VALUE $17,928 Robert Saroyan - DEFERRED COMPENSATION PLAN $0; DCSERP $35,058; CHANGE IN SERP ACTUARIAL VALUE $0 PART I, LINE 3: THE FOUNDATION RELIED ON A RELATED ORGANIZATION, VALLEY CHILDREN'S HOSPITAL, TO ESTABLISH THE COMPENSATION AND BENEFITS OF THE FOUNDATION'S CEO, USING ALL OF THE METHODS INCLUDED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS AND "WRITTEN EMPLOYMENT CONTRACT". X 1 1160000 FMV X Mobile Gaming System 1 5400 FMV 0 1 0 Form 990, Part VI, Section A, line 6 Valley Children's Healthcare is the sole member of the corporation. Certain member rights include the right to approve, elect, and remove elected board members of the Foundation. Form 990, Part VI, Section A, line 7a SEE ANSWER FOR LINE 6 ABOVE Form 990, Part VI, Section A, line 7b SEE ANSWER FOR LINE 6 ABOVE Form 990, Part VI, Section B, line 11 THE BOARD TREASURER PRESENTS THE DRAFT FORM 990 AT THE BOARD MEETING THAT IS HELD BEFORE THE FILING DATE AND ANSWERS QUESTIONS OR ADDRESSES ANY CONCERNS AT THIS MEETING. HARDCOPY IS MADE AVAILABLE FOR REVIEW AT THE MEETING AND IN THE FOUNDATION OFFICE. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. Form 990, Part VI, Section B, line 12c THE FOUNDATION BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE FOUNDATION'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING HOSPITAL GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. FOUNDATION SUPPORT STAFFS ARE EMPLOYED BY Valley CHILDREN'S HOSPITAL AND ARE THEREFORE SUBJECT TO THE HOSPITAL'S CONFLICT OF INTEREST POLICY. Form 990, Part VI, Section B, line 15 THE OFFICERS AND SUPPORT STAFFS OF THE FOUNDATION ARE EMPLOYED BY THE HOSPITAL. AS SUCH, THE FOUNDATION DOES NOT HAVE EMPLOYEES THAT IT PAYS DIRECTLY. AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THIS COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE Form 990, Part VI, Section C, line 19 A COPY OF FOUNDATION'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF THE FOUNDATION IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE HOSPITAL PREPARES CONSOLIDATED ANNUAL FINANCIAL STATEMENTS WHICH ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM. THESE STATEMENTS ARE AVAILABLE UPON REQUEST. Form 990, Part XI, line 9: Change in fair value of gift annuity 6,658. reserve for uncollectible pledges -265,472. FORM 990, PART III, LINE 4C The Valley Children's Healthcare Foundation is a charitable tax-exempt organization benefiting Valley Children's Healthcare and its affiliated entities, Valley Children's Hospital and Valley Children's Medical Group. The Foundation's mission is clear and unequivocal: "Generate funds to support the goals of Valley Children's Healthcare and its affiliated entities, Valley Children's Hospital and Valley Children's Medical Group." As the fundraising arm of the Hospital, the Foundation utilizes a variety of programs to raise philanthropic funds to meet the Hospital's mission. The Foundation is a participating member of the Children's Miracle Network, and other widely anticipated Valley events, including the annual Kid's Day and the Harvest Ball. In addition, the Foundation has developed corporate, annual cause-marketing, outside special events, tributes, direct mail, and major and planned gift programs. While the only "member" of the Foundation is Valley Children's Healthcare, the work of the Foundation is directed and assisted by the Board of Directors comprising 28 volunteer community members. Founded in 1981, the Foundation has developed and led community-based philanthropic efforts to support the Hospital in addition to the work of the Hospital Guilds. In its initial years, the Foundation's fund raising efforts were largely focused on special events and annual programs. Presently the Foundation is focused on building programs to support a Major Gifts culture to compliment the core annual funding programs. VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 941294954 HOSPITAL CA 501(c)(3) 3 Valley Children's Healthcare 0 Valley Children's Medical Group 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 464150987 HEALTH CARE CA 501(c)(3) Line 9 Valley Children's Healthcare 0 Valley Children's Healthcare 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 464158433 HEALTH CARE CA 501(c)(3) Line 11b, II N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0