PAJARO VALLEY COMMUNITY HEALTH TR: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
PAJARO VALLEY COMMUNITY HEALTH TR (EIN 94-1149702)
Tax period
2015-07-01 to 2016-06-30
Filed
2016-12-19
IRS object ID
201603549349300020
Schema version
2015v2.0
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)
Return2016-12-19T12:01:37-08:00ReturnTs
Tax Period End2016-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HAYASHI WAYLAND Accounting & ConsultingBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11188 Padre Drive Suite 101AddressLine1Txt
CitySalinasCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93901ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN941149702EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PAJARO VALLEY COMMUNITY HEALTH TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPAJABusinessNameControlTxt
Phone8317615639PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1Txt
CityWATSONVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95076ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATHLEEN KINGPersonNm
Person TitleCEOPersonTitleTxt
Signature2016-12-19SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMike Nolan CPAPreparerPersonNm
PTINP00930869PTIN
Phone8317596300PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKATHLEEN KINGPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1Txt
CityWATSONVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95076ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,886,315GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.pvhealthtrust.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionIMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.ActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee18TotalEmployeeCnt
Total Volunteers75TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$172,005PYContributionsGrantsAmt
CY Contributions Grants$240,321CYContributionsGrantsAmt
PY Program Service Revenue$58,959PYProgramServiceRevenueAmt
CY Program Service Revenue$86,477CYProgramServiceRevenueAmt
PY Investment Income$1,631,711PYInvestmentIncomeAmt
CY Investment Income$1,149,364CYInvestmentIncomeAmt
PY Other Revenue$31,028PYOtherRevenueAmt
CY Other Revenue-$18,796CYOtherRevenueAmt
PY Total Revenue$1,893,703PYTotalRevenueAmt
CY Total Revenue$1,457,366CYTotalRevenueAmt
PY Grants And Similar Paid$175,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$185,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$712,468PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$829,824CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$113,413CYTotalFundraisingExpenseAmt
PY Other Expenses$327,234PYOtherExpensesAmt
CY Other Expenses$305,391CYOtherExpensesAmt
PY Total Expenses$1,214,702PYTotalExpensesAmt
CY Total Expenses$1,320,215CYTotalExpensesAmt
PY Revenues Less Expenses$679,001PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$137,151CYRevenuesLessExpensesAmt
Total Assets BOY$16,154,991TotalAssetsBOYAmt
Total Assets EOY$15,563,961TotalAssetsEOYAmt
Total Liabilities BOY$261,741TotalLiabilitiesBOYAmt
Total Liabilities EOY$410,867TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,893,250NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,153,094NetAssetsOrFundBalancesEOYAmt
MissionIMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$501,486ExpenseAmt
Revenue$86,477RevenueAmt
DescDIABETES HEALTH CENTER (DHC) - The Health Trust operates the Diabetes Health Center (DHC), a community-based health education and diabetes care program that provided culturally competent, empowering health promotion and diabetes self-management and prevention education. DHC staff conducted 13 workplace wellness, public health screenings, and job site education events and provided 2,399 individual health education sessions this year.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$376,460ExpenseAmt
Grant$185,000GrantAmt
DescGRANT MAKING - The Health Trust awarded 19 grants totaling $185,000 to community nonprofits whose programs promote active living & healthy eating as cornerstones of health. Grant funds also strengthened nonprofit providers that provide access to culturally competent oral, physical, and mental health care for those facing the greatest obstacles to care. Additionally, 17 students benefited from scholarship support to pursue careers in the health professions, fostering a local pipeline of diverse health professionals.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$77,638ExpenseAmt
DescREGIONAL DIABETES COLLABORATIVE (RDC) - The Health Trust leverages also builds and sustains strong partnerships with peer nonprofits promoting health and wellness in the tri-county region encompassing areas of Santa Cruz, Monterey and San Benito counties. The Health Trust leads two major collaboratives: the Regional Diabetes Collaborative (RDC), comprised of more than 40 agencies supporting and coordinating efforts to prevent and manage diabetes; and the Central Coast Oral Health Collaborative (OHC), which aims at providing and improving oral health treatment and preventive services as a part of whole health care for low-income adults and children.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$955,584TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G2IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee18EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonADDRESSEEPersonNm
Phone8317615639PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1Txt
CityWATSONVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95076ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
TRINA COFFMAN-GOMEZ
Director2.000.00Yes (X)$0$0$0
CAITLIN BRUNE
Director2.000.00Yes (X)$0$0$0
JAVIER CARRILLO
PAST CHAIR2.000.00Yes (X)$0$0$0
RON JONES
Director2.000.00Yes (X)$0$0$0
GINA GALLUCCI
Director2.000.00Yes (X)$0$0$0
SHEBREH KALANTARI JOHNSON
Director2.000.00Yes (X)$0$0$0
STAN HAJDUK MD
Director2.000.00Yes (X)$0$0$0
DOUG KEEGAN
VICE CHAIR2.000.00Yes (X)$0$0$0Yes (X)
DEVON CAROSELLI
Director2.000.00Yes (X)$0$0$0
BROOKE KONDO RAINS DDS
Director2.000.00Yes (X)$0$0$0
DAVID MESA
Director2.000.00Yes (X)$0$0$0
SUZANNE MINE-EGUCHI
CHAIR2.000.00Yes (X)$0$0$0Yes (X)
DAMIAN MALDONADO
Director2.000.00Yes (X)$0$0$0
ELSA MENDOZA JIMENEZ
Treasurer2.000.00Yes (X)$0$0$0Yes (X)
GRETCHEN MORRIS-COFFEY
Director2.000.00Yes (X)$0$0$0
MICHELE VIOLICH MD
Secretary2.000.00Yes (X)$0$0$0Yes (X)
MANUEL OSORIO
Director2.000.00Yes (X)$0$0$0
ALEC WASSON
Director2.000.00Yes (X)$0$0$0
BRUCE ZIEGELMAN
ACCOUNTING MNGR40.000.00$40,912$0$6,906Yes (X)
KATHLEEN KING
CEO40.000.00$115,158$0$24,623Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$156,070TotalReportableCompFromOrgAmt
Total Other Compensation$31,529TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UBS FINANCIAL SERVICES INCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8149AddressLine1Txt
CityWALNUT CREEKCityNm
State AbbreviationCAStateAbbreviationCd
ZIP945968149ZIPCd
FieldValueIRS element (for citing)
ServicesINVESTMENT MGMTServicesDesc
Compensation$126,035CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Fundraising$86,034FundraisingAmt
All Other Contributions$154,287AllOtherContributionsAmt
Noncash Contributions$42,385NoncashContributionsAmt
Total Contributions$240,321TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
DHC PATIENT FEES621300$61,897$61,897
MISCELLANEOUS621300$24,580$24,580
FieldValueIRS element (for citing)
Total Program Service Revenue$86,477TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$487,256TotalRevenueColumnAmt
Exclusion$487,256ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,015,418SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$353,310SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$662,108SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$662,108TotalRevenueColumnAmt
Related Or Exempt Func Income$662,108RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$42,743FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$86,034ContriRptFundraisingEventAmt
Fundraising Direct Expenses$62,255FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$19,512TotalRevenueColumnAmt
Exclusion-$19,512ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$14,100GamingGrossIncomeAmt
Gaming Direct Expenses$13,384GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$716TotalRevenueColumnAmt
Exclusion$716ExclusionAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,457,366TotalRevenueColumnAmt
Related Or Exempt Func Income$748,585RelatedOrExemptFuncIncomeAmt
Exclusion$468,460ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$185,000TotalAmt
Program Services$185,000ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$226,307TotalAmt
Program Services$169,730ProgramServicesAmt
Management And General$33,946ManagementAndGeneralAmt
Fundraising$22,631FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$474,947TotalAmt
Program Services$376,495ProgramServicesAmt
Management And General$36,986ManagementAndGeneralAmt
Fundraising$61,466FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,745TotalAmt
Program Services$24,338ProgramServicesAmt
Management And General$5,535ManagementAndGeneralAmt
Fundraising$2,872FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$47,112TotalAmt
Program Services$34,746ProgramServicesAmt
Management And General$8,728ManagementAndGeneralAmt
Fundraising$3,638FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$48,713TotalAmt
Program Services$36,206ProgramServicesAmt
Management And General$8,234ManagementAndGeneralAmt
Fundraising$4,273FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$21,000TotalAmt
Program Services$21,000ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$126,035TotalAmt
Management And General$126,035ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,247TotalAmt
Program Services$13,239ProgramServicesAmt
Management And General$6,831ManagementAndGeneralAmt
Fundraising$3,177FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,341TotalAmt
Program Services$20,484ProgramServicesAmt
Management And General$781ManagementAndGeneralAmt
Fundraising$2,076FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$41,892TotalAmt
Program Services$27,857ProgramServicesAmt
Management And General$4,062ManagementAndGeneralAmt
Fundraising$9,973FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$41,485TotalAmt
Program Services$30,415ProgramServicesAmt
Management And General$11,070ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,796TotalAmt
Program Services$943ProgramServicesAmt
Management And General$853ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,427TotalAmt
Management And General$6,427ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Printing and Publications$8,873$6,757$774$1,342
Postage and Shipping$7,033$5,129$584$1,320
DUPLICATING$4,262$3,245$372$645

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,320,215TotalAmt
Program Services$955,584ProgramServicesAmt
Management And General$251,218ManagementAndGeneralAmt
Fundraising$113,413FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$71,814BOYAmt
EOY$185,558EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$70,272BOYAmt
EOY$2,196EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,404BOYAmt
EOY$70,020EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$14,914BOYAmt
EOY$21,544EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$128,329LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$91,856LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$42,900BOYAmt
EOY$36,473EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$15,949,687BOYAmt
EOY$15,248,170EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,154,991BOYAmt
EOY$15,563,961EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$63,119BOYAmt
EOY$200,448EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$16,200EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$198,622BOYAmt
EOY$194,219EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$261,741BOYAmt
EOY$410,867EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,464,182BOYAmt
EOY$13,778,526EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$342,408BOYAmt
EOY$274,253EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,086,660BOYAmt
EOY$1,100,315EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,893,250BOYAmt
EOY$15,153,094EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,154,991BOYAmt
EOY$15,563,961EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$137,151ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$856,148NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$37,395PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$58,554OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

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$157,883CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$317,028CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$157,348CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$172,005CurrentTaxYearMinus1YearAmt
Current Tax Year$240,321CurrentTaxYearAmt
Total$1,044,585TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$157,883CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$317,028CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$157,348CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$172,005CurrentTaxYearMinus1YearAmt
Current Tax Year$240,321CurrentTaxYearAmt
Total$1,044,585TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$1,044,585PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$441,028CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$450,937CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$524,134CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$492,586CurrentTaxYearMinus1YearAmt
Current Tax Year$487,256CurrentTaxYearAmt
Total$2,395,941TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$47,983CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,986CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$29,965CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,028CurrentTaxYearMinus1YearAmt
Current Tax Year$716CurrentTaxYearAmt
Total$131,678TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$3,572,204TotalSupportAmt
Gross Receipts Rltd Activities$303,059GrossReceiptsRltdActivitiesAmt
Public Support CY1700.29240PublicSupportCY170Pct
Public Support PY1700.23890PublicSupportPY170Pct
Ten Pct Facts Crcmstncs Test CYYes (X)TenPctFactsCrcmstncsTestCYInd
Facts And Circumstances TestCurrent Year Facts and Circumstances: The Pajaro Valley Community Health Trust, a 501 (c) 3 public benefit health care foundation, meets the IRS Facts & Circumstances test through the following:Actively seeking public support: The Health Trust is operated to attract new and additional public or governmental support on a continuous basis by:Maintaining a continuous and comprehensive program for solicitation of funds from the general public, community businesses and others by meeting with potential donors, soliciting funds through direct mail, holding annual special event fundraisers, soliciting support through its website and other social media outlets and by actively seeking grants from private and public foundations as well as government funders. Percentage of financial support and sources of support: With 29% of its support during FY 2015-16 coming from a variety of public sources, the Health Trust is well above the minimum threshold of 10% required under the IRS Facts and Circumstances Test.Representative governing body: The Health Trusts Board of Directors is comprised of a broad cross-section of members who reflect the professional, gender and ethnic diversity of the community including the following:a.A member of the City Council appointed by the City of Watsonville b.One member each appointed by the Health Departments of Santa Cruz and Monterey Counties.c.Local physicians, nurses and health care advocates who provide special knowledge and expertise in the field of health, which is the primary charitable mission of the organization.d.Individuals who are considered leaders in the community from the fields of education, law, finance and agriculture who provide a broad cross section of community views and interests. Availability of public facilities or services: The Health Trust meets this standard in several ways: a.Facilities/Services: The Health Trust provides large conference and meeting space and furniture (tables and chairs) free of charge to nonprofit organizations for meetings, trainings and other events to which the public is invited. Examples include the Red Cross Blood Drive, School District Meetings, Health Collaborative Meetings, Medical Education Seminars and fund raising events.b.Publications: The Health Trust publishes an annual report and a health care newsletter on an annual basis. In addition, the Health Trust publishes its own healthcare survey research data on a biannual basis to inform other health care organizations and the public about local health care trends and challenges affecting the community. This data is widely used by public, private and governmental agencies to inform their health strategic planning efforts.c.Direct Program Service: The Health Trust operates a direct service health care program known as the Diabetes Health Center (DHC). The DHC provides diabetes self-management and prevention education as well as nutrition education for persons with or at risk of diabetes. The target populations served by this program are youth, low-income and underserved individuals and farm workers and their families. The staff of the DHC are licensed bilingual nurses and dietitians who are certified to provide the programs services. Their clinical standards are monitored by a highly qualified physician who also serves on the Health Trust Board. While the program accepts insurance reimbursement and sliding scale fees, patients are provided services regardless of their ability to pay. Accountability to Funders: The Health Trust regularly solicits grants from private and community foundations and occasionally from government funding sources. In each case, the Health Trust is contractually accountable to its funders for reporting progress of its program efforts and use of grant funds. Prior Year Facts and Circumstances: The Pajaro Valley Community Health Trust, a 501 (c) 3 public benefit health care foundation, meets the IRS Facts & Circumstances test through the following:Actively seeking public support: The Health Trust is operated to attract new and additional public or governmental support on a continuous basis by:Maintaining a continuous and comprehensive program for solicitation of funds from the general public, community businesses and others by meeting with potential donors, soliciting funds through direct mail, holding annual special event fundraisers, soliciting support through its website and other social media outlets and by actively seeking grants from private and public foundations as well as government funders. Percentage of financial support and sources of support: With 24% of its support during FY 2014-15 coming from a variety of public sources, the Health Trust is well above the minimum threshold of 10% required under the IRS Facts and Circumstances Test.Representative governing body: The Health Trusts Board of Directors is comprised of a broad cross-section of members who reflect the professional, gender and ethnic diversity of the community including the following:a.A member of the City Council appointed by the City of Watsonville b.One member each appointed by the Health Departments of Santa Cruz and Monterey Counties.c.Local physicians, nurses and health care advocates who provide special knowledge and expertise in the field of health, which is the primary charitable mission of the organization.d.Individuals who are considered leaders in the community from the fields of education, law, finance and agriculture who provide a broad cross section of community views and interests. Availability of public facilities or services: The Health Trust meets this standard in several ways: a.Facilities/Services: The Health Trust provides large conference and meeting space and furniture (tables and chairs) free of charge to nonprofit organizations for meetings, trainings and other events to which the public is invited. Examples include the Red Cross Blood Drive, School District Meetings, Health Collaborative Meetings, Medical Education Seminars and fund raising events.b.Publications: The Health Trust publishes an annual report and a health care newsletter on an annual basis. In addition, the Health Trust publishes its own healthcare survey research data on a biannual basis to inform other health care organizations and the public about local health care trends and challenges affecting the community. This data is widely used by public, private and governmental agencies to inform their health strategic planning efforts.c.Direct Program Service: The Health Trust operates a direct service health care program known as the Diabetes Health Center (DHC). The DHC provides diabetes self-management and prevention education as well as nutrition education for persons with or at risk of diabetes. The target populations served by this program are youth, low-income and underserved individuals and farm workers and their families. The staff of the DHC are licensed bilingual nurses and dietitians who are certified to provide the programs services. Their clinical standards are monitored by a highly qualified physician who also serves on the Health Trust Board. While the program accepts insurance reimbursement and sliding scale fees, patients are provided services regardless of their ability to pay. Accountability to Funders: The Health Trust regularly solicits grants from private and community foundations and occasionally from government funding sources. In each case, the Health Trust is contractually accountable to its funders for reporting progress of its program efforts and use of grant funds.FactsAndCircumstancesTestTxt

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,440,121BeginningYearBalanceAmt
Contributions$13,655ContributionsAmt
Investment Earnings Or Losses-$1,519InvestmentEarningsOrLossesAmt
Other Expenditures$52,379OtherExpendituresAmt
Administrative Expenses$14,707AdministrativeExpensesAmt
End Year Balance$1,385,171EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,448,135BeginningYearBalanceAmt
Contributions$12,850ContributionsAmt
Investment Earnings Or Losses$39,658InvestmentEarningsOrLossesAmt
Other Expenditures$48,000OtherExpendituresAmt
Administrative Expenses$12,524AdministrativeExpensesAmt
End Year Balance$1,440,119EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,258,701BeginningYearBalanceAmt
Contributions$10,725ContributionsAmt
Investment Earnings Or Losses$232,528InvestmentEarningsOrLossesAmt
Other Expenditures$43,735OtherExpendituresAmt
Administrative Expenses$10,084AdministrativeExpensesAmt
End Year Balance$1,448,135EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,137,421BeginningYearBalanceAmt
Contributions$15,487ContributionsAmt
Investment Earnings Or Losses$127,765InvestmentEarningsOrLossesAmt
Other Expenditures$14,640OtherExpendituresAmt
Administrative Expenses$7,332AdministrativeExpensesAmt
End Year Balance$1,258,701EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,147,222BeginningYearBalanceAmt
Contributions$12,240ContributionsAmt
Investment Earnings Or Losses$24,090InvestmentEarningsOrLossesAmt
Other Expenditures$36,653OtherExpendituresAmt
Administrative Expenses$9,478AdministrativeExpensesAmt
End Year Balance$1,137,421EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.01000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.79000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.20000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$46,977OtherCostOrOtherBasisAmt
Depreciation$17,586DepreciationAmt
Book Value$29,391BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,959OtherCostOrOtherBasisAmt
Depreciation$42,906DepreciationAmt
Book Value$7,053BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$31,393OtherCostOrOtherBasisAmt
Depreciation$31,364DepreciationAmt
Book Value$29BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$36,473TotalBookValueLandBuildingsAmt
Total Book Value Other Assets$15,248,170TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
ACCRUED WORKMANS COMPENSATION$193,388
CAPITAL LEASE OBLIGATIONS$831
FieldValueIRS element (for citing)
Total Liability$194,219TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$800,142TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$856,148NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$249,320DonatedServicesAndUseFcltsAmt
Other Revenue$75,639OtherRevenueAmt
Revenue Not Reported-$531,189RevenueNotReportedAmt
Revenue Subtotal$1,331,331RevenueSubtotalAmt
Investment Expenses Not Incld$126,035InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$126,035RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,457,366TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,519,142TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$249,320DonatedServicesUseFcltsAmt
Other Expenses Included$75,642OtherExpensesIncludedAmt
Expenses Not Reported$324,962ExpensesNotReportedAmt
Expenses Subtotal$1,194,180ExpensesSubtotalAmt
Investment Expenses Not Incld2$126,035InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$126,035ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,320,215TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4: Intended uses of the endowment fund.THE ENDOWMENT FUNDS ARE HELD IN ORDER TO GENERATE REVENUES IN SUPPORT OF HEALTH PROGRAMS FOR SENIORS AND CHILDREN, DENTAL NEEDS OF THOSE IN THE PAJARO VALLEY AND FOR THE UNRESTRICTED USE OF THE TRUST.
Part X : FIN48 FootnoteAs a tax-exempt not-for-profit organization, the Organization is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and from state franchise tax under California Revenue and Taxation Code Section 23701(d), but is subject to taxes on unrelated business income when earned. Management has considered its tax positions and believes that all of the positions taken in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organizations returns are subject to examination by federal and state taxing authorities, generally for three year and four years, respectively, after they are filed.
Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990SPECIAL EVENTS EXPENSE $62255 RAFFLE EXPENSES $13384
Part XII, Line 2d: Other expenses and losses per audited F/SSPECIAL EVENTS EXPENSE $62255 RAFFLE EXPENSES $13384 ROUNDING $3

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agrmt Prof Fundraising ActyfalseAgrmtProfFundraisingActyInd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1WINE & ROSES EVENTEvent1Nm
Gross Receipts Event1$118,237GrossReceiptsEvent1Amt
Charitable Contri Event1$86,034CharitableContriEvent1Amt
Gross Revenue Event1$32,203GrossRevenueEvent1Amt
Rent Facility Costs Event1$3,500RentFacilityCostsEvent1Amt
Food And Beverage Event1$6,626FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$42,006OtherDirectExpensesEvent1Amt
Event2MISCELLANEOUS EVENTSEvent2Nm
Gross Receipts Event2$10,540GrossReceiptsEvent2Amt
Gross Revenue Event2$10,540GrossRevenueEvent2Amt
Other Direct Expenses Event2$10,123OtherDirectExpensesEvent2Amt
Gross Receipts Total$128,777GrossReceiptsTotalAmt
Charitable Contributions Tot$86,034CharitableContributionsTotAmt
Gross Revenue Total Events$42,743GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$3,500RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$6,626FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$52,129OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$62,255DirectExpenseSummaryEventsAmt
Net Income Summary-$19,512NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
COASTAL KIDS HOME CARE
1172 S MAIN ST 125SALINASCA93901202549984501(C)(3)$13,500$0HEALTH INSURANCE ED & ACCESS
COMMUNITY AGROECOLOGY NETWORK
PO BOX 7653SANTA CRUZCA95061753003372501(C)(3)$10,000$0SUSTAIN RURAL LIVELIHOOD RESEARCH
DIENTES COMMUNITY DENTAL CARE
1830 COMMERCIAL WAYSANTA CRUZCA95065770311752501(C)(3)$14,500$0DENTAL SERVICES TO LOW INCOME ADULTS
ECOLOGY ACTION
877 CEDAR ST STE 240SANTA CRUZCA95060942584236501(C)(3)$10,000$0BOLTAGE HEALTH IMPROVEMENT PROJECT
EXTENDED LEARINGFITNESS 4 LF
294 GREEN VALLEY ROADWATSONVILLECA95076770375541GOV'T$15,000$0HEALTH EDUC
FAMILY SVCS AGENCY
104 WALNUT AVE STE 208SANTA CRUZCA95060941716354501(C)(3)$12,500$0CRISIS COUNSELING SESSIONS
FIRST 5 SANTA CRUZ COUNTY
4450 CAPITOLA RD STE 106CAPITOLACA95010946000534501(C)(3)$7,500$0FUND EDUCATION, HEALTH AND CHILD PR
FOOD WHAT
1156 HIGH STREETSANTA CRUZCA95064812590280501(c)(3)$15,000$0CHILD HEALTH
GIRL SCOUTS CA CENTRAL COAST
10550 MERRITT STREETCASTROVILLECA95012951567162501(C)(3)$8,000$0DIABETES & CONTRIBUTING FACTORS
GREEN WAYS TO SCHOOL
703 PACIFIC AVESANTA CRUZCA95060311748056501(c)(3)$6,000$0ENCOURAGE SAFE RIDING AND BIKING
SALUD PARA LA GENTE
195 AVIATION WAY SUITE 200WATSONVILLECA95076942705747501(C)(3)$14,500$0DENTAL CARE CHILDREN OF MIGRANT ED
UNITED WAY OF SANTA CRUZ COUNTY
PO BOX 1458CAPITOLACA95010941422471501(C)(3)$12,000$0COMMUNITY ASSESSMENT PROJECT
VOLUNTEER CENTER SANTA CRUZ
1740 17TH AVE SUITE 2SANTA CRUZCA95062941702678501(C)(3)$6,500$0BEAT BACK DIABETES PROGRAM
WATSAPTOS ADULT EDUCA
294 GREEN VALLEY ROADWATSONVILLECA95076770375541GOV'T$12,000$0HEALTH CAREER SCHOLARSHIPS
WATSONVILLE FAMILY YMCA
27 SUDDEN STREETWATSONVILLECA95076770020233501(C)(3)$15,000$0HEALTH FAMILY HOME PROGRAM
WATSONVILLE HIGH SCOOL
250 EAST BEACH STREETWATSONVILLECA95076770375541GOV'T$7,000$0SUPPORT HEALTH STUDIES
FieldValueIRS element (for citing)
Total501c3 Org14Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceGrantmaker's Description of How Grants are UsedFormAndLineReferenceDesc
ExplanationALL ORGANIZATIONS APPLYING FOR FUNDING MUST SUBMIT A DETAILED LINE-ITEM BUDGET, INCLUDING INCOME AND EXPENSES FOR THE PROPOSED PROJECT. THEY MUST INDICATE THE AMOUNT PROPOSED FOR FUNDING FROM THE TRUST BY LINE ITEM AND INCLUDE NOTES FOR ANY LINE ITEMS THAT REQUIRE ADDITIONAL EXPLANATION.IF APPROVED FOR FUNDING, GRANTEES MUST SIGN A GRANT CONTRACT IN WHICH THEY AGREE TO USE THE GRANT FUNDS TO ACCOMPLISH THE SPECIFIC OUTCOMES OUTLINED IN THEIR GRANT PROPOSAL. THEY ALSO AGREE TO INFORM THE TRUST IMMEDIATELY IF THEY ARE UNABLE TO PERFORM ON ANY ASPECT OF THE GRANT CONTRACT ACTIVITIES AS OUTLINED IN THE PROPOSAL. THE CONTRACT INDICATES THAT USE OF THESE FUNDS FOR ANY PURPOSE OTHER THAN SET FORTH IN THE GRANT PROPOSAL AND/OR FAILURE TO REPORT CHANGES IMMEDIATELY OR TO PERFORM ON THE CONTRACT OUTCOMES MAY RESULT IN FORFEITURE OF PART OR ALL OF THE GRANT AMOUNT. ALSO REQUIRE GRANTEES TO SUBMIT PROGRESS AND FINAL REPORTS IN WHICH THEY MUST PROVIDE A DETAILED PROGRAM BUDGET THAT COMPARES ACTUAL EXPENDITURES TO THE APPROVED BUDGET.ExplanationTxt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
DescAUCTION ITEMSDesc
Noncash Contributions Rpt F990$42,385NoncashContributionsRptF990Amt
Method Of Determining RevenuesSALES PRICEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessPajaro Valley Community Health Trust engages a CPA firm to assist with the preparation and filing of the Form 990, based on an audit engagement completed by the same CPA firm. Once the CPA firm has completed a draft of the form 990, a copy will be sent to the Board of Directors for review and approval before the tax return is filed.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsConflict of interest statements are updated annually as well as when grants are approved to monitor for potential conflicts of interest.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementFOR CEO AND TOP FINANCIAL PERSON, EXECUTIVE COMMITTEE COMPARES COMPENSATION WITH SIMILAR ORGANIZATIONS LOCALLY AND NATIONALLY; SALARY INCREASES ARE BASED ON COMPENSATION AND PERFORMANCE BASED. EXECUTIVE COMMITTEE EVALUATES CEO'S PERFORMANCE AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL, ANNUALLY, WITHIN BUDGETARY PARAMETERS.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesOTHER EMPLOYEE COMPENSATION IS DETERMINED BY THE CEO AND REVIEWED WITH THE EXECUTIVE COMMITTEE.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableGoverning docs are available upon request.
Other Changes In Net Assets Or Fund Balances - Other DecreasesDISCONTINUED OPERATIONS - NET ACTIVITY = -$58554

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