SONOMA VALLEY COMMUNITY HEALTH CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- SONOMA VALLEY COMMUNITY HEALTH CENTER (EIN 68-0286382)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201623199349309972
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T16:07:40-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 680456752 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DILLWOOD BURKEL & MILLAR LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 CONCOURSE BLVD STE A | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680286382 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SONOMA VALLEY COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SONO | BusinessNameControlTxt |
| Phone | 7079396070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHERYL JOHNSON CEO | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7079396070 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PENNY MILLAR | PreparerPersonNm |
| PTIN | P00140274 | PTIN |
| Phone | 7075778806 | PhoneNum |
| Preparation | 2016-11-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHERYL JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,252,141 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SVCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESSIBLE QUALITY HEALTH CARE TO THOSE WHO NEED IT, ESPECIALLY THE UNDERSERVED.SONOMA VALLEY COMMUNITY HEALTH CENTER IS A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION ORGANIZED TO PROVIDE HIGH QUALITY HEALTH CARE ACCESS TO THOSE IN NEED, REGARDLESS OF ABILITY TO PAY. LOCATED IN SONOMA, CALIFORNIA, THE HEALTH CENTER PROVIDES ROUTINE HEALTH ASSESSMENTS, PHYSICAL EXAMINATIONS, TREATMENT AND PREVENTATIVE SERVICES. EXPANDED SERVICES INCLUDE URGENT CARE, SPECIALIZED PROCEDURES, PRE AND POST OPERATIVE CARE AND FOLLOW-UP. THE CENTER ALSO OWNS A MOBILE MEDICAL VAN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 86 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,935,251 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,948,656 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,029,556 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,303,210 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$38,716 | PYInvestmentIncomeAmt |
| CY Investment Income | $275 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,926,091 | PYTotalRevenueAmt |
| CY Total Revenue | $8,252,141 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,395,738 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,354,970 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $81,174 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $28,831 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $28,831 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,825,769 | PYOtherExpensesAmt |
| CY Other Expenses | $3,767,606 | CYOtherExpensesAmt |
| PY Total Expenses | $6,302,681 | PYTotalExpensesAmt |
| CY Total Expenses | $8,151,407 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$376,590 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $100,734 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,647,826 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,811,760 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,813,271 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,876,471 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,834,555 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,935,289 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MISSION - TO PROVIDE ACCESSIBLE QUALITY HEALTH CARE TO THOSE WHO NEED IT, ESPECIALLY THE UNDERSERVED. VISION - TO BE RECOGNIZED AS A LEADER IN PROVIDIG PATIENT AND COMMUNITY CENTERED CARE IN COLLABORATION WITH OTHER ORGANIZATIONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,114,834 | ExpenseAmt |
| Revenue | $3,709,631 | RevenueAmt |
| Desc | FAMILY PRACTICE SERVICES: THE HEALTH CENTER PROVIDES MEDICAL CARE SERVICES FOR INFANTS THROUGH ADULTS, WITH EXTENDED DAY AND EVENING HOURS AND IS OPEN 6 DAYS PER WEEK. SERVICES INCLUDE ROUTINE EXAMINATIONS, IMMUNIZATIONS, PHYSICALS, URGENT CARE AND DIAGNOSIS, AND TREATMENT OF ACUTE AND CHRONIC ILLNESS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $333,948 | ExpenseAmt |
| Revenue | $670,747 | RevenueAmt |
| Desc | COMPREHENSIVE PERINATAL SERVICES: THE HEALTH CENTER PROVIDES PRE- AND POST-NATAL OB SERVICES AND EDUCATION TO PREGNANT WOMEN. NURSE EDUCATORS AND NUTRITIONISTS ARE AVAILABLE FULL TIME TO SUPPORT PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $585,469 | ExpenseAmt |
| Revenue | $646,776 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH SERVICES: THE HEALTH CENTER PROVIDES BEHAVIORAL HEALTH SERVICES UTILIZING A PSYCHIATRIST, PSYCHOLOGISTS, LICENSED CLINICAL SOCIAL WORKERS, AND BEHAVIORAL HEALTH CANDIDATES. THE HEALTH CENTER ALSO HAS A SUBSTANCE ABUSE COUNSELING PROGRAM STAFFED BY PART TIME CERTIFIED SUBSTANCE ABUSE COUNSELORS PROVIDED THROUGH A CONTRACT WITH THE DRUG ABUSE ALTERNATIVE CENTER. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|
| $672,395 | $736,872 | DENTAL SERVICES: THE HEALTH CENTER EXPANDED ITS DENTAL SERVICES IN 2015 TO FULL SERVICE DENTISTRY PROVIDED BY DENTISTS AND REGISTERED DENTAL HYGENISTS. |
| $539,184 | OTHER PROGRAM SERVICES: INCLUDES QUALITY-SHARED SAVINGS $290,990/340B PROGRAM $141,207/ALL OTHERS $106,990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $672,395 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $1,276,056 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $5,706,646 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 86 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN TORRES CFO - (707) 939 - 6075 | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7079396071 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| RICHARD GANTENBEIN | |||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARC SCHWAGER | |||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAMELA STEPHENS | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LINDA MCTAGGART | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TOM ANDERSON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| VICTORIA HALL | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STANLEY PAWLAK | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICIA COLEMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AUDREY CHAPMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARTHA EVANS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHERYL JOHNSON | |||||||
| CEO | 40.00 | Yes (X) | $128,977 | $0 | $11,759 | ||
| SUSAN TORRES | |||||||
| CFO | 40.00 | Yes (X) | $94,790 | $0 | $17,731 | ||
| CAROL AHERN | |||||||
| MD | 30.00 | $109,251 | $0 | $21,315 | Yes (X) | ||
| DEBRA ARAUJO | |||||||
| DENTIST | 40.00 | $152,591 | $0 | $9,896 | Yes (X) | ||
| JANET BYRD | |||||||
| FNP | 40.00 | $115,590 | $0 | $7,274 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $601,199 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $67,975 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MD PLACEMENT | |||||
| 6101 LONG PRAIRIE RD | FLOWER MOUND | TX | 75028 | CONTRACTED PROVIDERS: LOCUMS | $227,749 |
| PARALLON LOCUMS | |||||
| PO BOX 742499 | ATLANTA | GA | 30374 | CONTRACTED PROVIDERS: LOCUMS | $178,516 |
| DR PAUL AMARA | |||||
| PO BOX 475 | SONOMA | CA | 95476 | CONTRACTED PROVIDER | $156,960 |
| BARTON AND ASSOCIATES | |||||
| PO BOX 417844 | BOSTON | MA | 02241 | CONTRACTED PROVIDERS: LOCUMS | $155,709 |
| JULIE M VLASIS CONSULTING | |||||
| 5172 E WOODWARD AVE | FRESNO | CA | 83727 | OPERATIONS/COMPLIANCE | $136,874 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,197,777 | GovernmentGrantsAmt |
| All Other Contributions | $750,879 | AllOtherContributionsAmt |
| Total Contributions | $1,948,656 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 624100 | $5,764,025 | $5,764,025 |
| OTHER PROGRAM SERVICE | 624100 | $539,185 | $539,185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,303,210 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $275 | TotalRevenueColumnAmt |
| Exclusion | $275 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,252,141 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,303,210 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $275 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $669,174 | TotalAmt |
| Program Services | $415,917 | ProgramServicesAmt |
| Management And General | $253,257 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,968,119 | TotalAmt |
| Program Services | $2,401,556 | ProgramServicesAmt |
| Management And General | $566,563 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Program Services | $1,937 | ProgramServicesAmt |
| Management And General | $563 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,328 | TotalAmt |
| Program Services | $331,011 | ProgramServicesAmt |
| Management And General | $96,317 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,849 | TotalAmt |
| Program Services | $222,970 | ProgramServicesAmt |
| Management And General | $64,879 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,425 | TotalAmt |
| Management And General | $125,425 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,512 | TotalAmt |
| Management And General | $11,512 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,378 | TotalAmt |
| Management And General | $74,378 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,831 | TotalAmt |
| Fundraising | $28,831 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,427,781 | TotalAmt |
| Program Services | $993,036 | ProgramServicesAmt |
| Management And General | $434,745 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,931 | TotalAmt |
| Program Services | $29,884 | ProgramServicesAmt |
| Management And General | $12,047 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,167 | TotalAmt |
| Program Services | $24,535 | ProgramServicesAmt |
| Management And General | $80,632 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,216 | TotalAmt |
| Program Services | $85,430 | ProgramServicesAmt |
| Management And General | $104,786 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,393 | TotalAmt |
| Program Services | $211,546 | ProgramServicesAmt |
| Management And General | $239,847 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,313 | TotalAmt |
| Program Services | $3,424 | ProgramServicesAmt |
| Management And General | $2,889 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,407 | TotalAmt |
| Program Services | $2,815 | ProgramServicesAmt |
| Management And General | $55,592 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,893 | TotalAmt |
| Management And General | $1,893 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,102 | TotalAmt |
| Program Services | $520,744 | ProgramServicesAmt |
| Management And General | $238,358 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,585 | TotalAmt |
| Program Services | $26,469 | ProgramServicesAmt |
| Management And General | $12,116 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $359,212 | $359,212 | |
| BAD DEBT | $49,989 | $49,989 | |
| DUES & SUBSCRIPTIONS | $45,459 | $5,328 | $40,131 |
| LOSS ON DISPOSTION OF A | $20,843 | $20,843 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,151,407 | TotalAmt |
| Program Services | $5,706,646 | ProgramServicesAmt |
| Management And General | $2,415,930 | ManagementAndGeneralAmt |
| Fundraising | $28,831 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,613 | BOYAmt |
| EOY | $855,579 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,295 | BOYAmt |
| EOY | $501,480 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,910 | BOYAmt |
| EOY | $296,314 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,896 | BOYAmt |
| EOY | $451,977 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,628 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,180 | BOYAmt |
| EOY | $46,482 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,331,987 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,672,199 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,364,164 | BOYAmt |
| EOY | $10,659,788 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | $140 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,647,826 | BOYAmt |
| EOY | $12,811,760 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680,463 | BOYAmt |
| EOY | $834,001 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,759,557 | BOYAmt |
| EOY | $4,553,623 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,270 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,981 | BOYAmt |
| EOY | $488,847 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,813,271 | BOYAmt |
| EOY | $5,876,471 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,554,193 | BOYAmt |
| EOY | $6,663,286 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $280,362 | BOYAmt |
| EOY | $272,003 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,834,555 | BOYAmt |
| EOY | $6,935,289 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,647,826 | BOYAmt |
| EOY | $12,811,760 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $100,734 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,370,885 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,159,618 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,811,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,935,251 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,948,656 | CurrentTaxYearAmt |
| Total | $8,226,379 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,370,885 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,159,618 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,811,969 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,935,251 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,948,656 | CurrentTaxYearAmt |
| Total | $8,226,379 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $8,226,379 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,428 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $559 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $475 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $275 | CurrentTaxYearAmt |
| Total | $4,050 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,230,429 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $13,668,157 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99950 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99850 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS DUES TO THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING. ALSO, BOARD MEMBERS AND STAFF HAVE ON OCCASION HAD DIRECT CONTACT WITH LEGISLATORS AND/OR THEIR STAFF. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,538,780 | OtherCostOrOtherBasisAmt |
| Book Value | $1,538,780 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,032,954 | OtherCostOrOtherBasisAmt |
| Depreciation | $228,534 | DepreciationAmt |
| Book Value | $3,804,420 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,779,701 | OtherCostOrOtherBasisAmt |
| Depreciation | $429,515 | DepreciationAmt |
| Book Value | $4,350,186 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,838,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $980,884 | DepreciationAmt |
| Book Value | $857,165 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $142,503 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,266 | DepreciationAmt |
| Book Value | $109,237 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,659,788 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CURRENT PORTION LTD | Desc |
| Amt | $488,847 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $488,847 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $8,252,141 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,252,141 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,252,141 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,151,407 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,151,407 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,151,407 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990. PG 12, PART XII, LN 2B | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DETERMINES WHETHER ITS TAX POSITIONS ARE "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY BASED ON THE TECHNICAL MERITS OF THE POSITIONS. AS OF DECEMBER 31, 2015, THE ORGANIZATION HAS REVIEWED ITS TAX POSITIONS AND HAS CONCLUDED NO RESERVE FOR UNCERTAIN TAX POSITIONS IS REQUIRED. THE ORGANIZATION'S EXEMPT ORGANIZATION INFORMATION RETURNS ARE SUBJECT TO REVIEW THROUGH THREE YEARS AFTER THE DATE OF FILING FOR FEDERAL AND FOUR YEARS AFTER THE DATE OF FILING FOR STATE. | ExplanationTxt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTINE DOHRMANN | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 531 CHASE STREET | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95476 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | FUNDRAISING CONSULTANT | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $220,000 | GrossReceiptsAmt |
| Retained By Contractor | $28,831 | RetainedByContractorAmt |
| Net To Organization | $191,169 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $220,000 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $28,831 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $191,169 | TotalNetToOrganizationAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBRA ARAUJO | PersonNm |
| Title | DENTIST | TitleTxt |
| Base Compensation Filing Org | $152,591 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $9,896 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $162,487 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA STEPHENS | PersonNm |
| Relationship With Org | BOARD MEMBER/SECRETARY | RelationshipWithOrgTxt |
| Cash Grant | $988 | CashGrantAmt |
| Type Of Assistance | INTERNET SERVICES | TypeOfAssistanceTxt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART III | FormAndLineReferenceDesc |
| Explanation | THE HEALTH CENTER PAID $988 IN 2015 FOR INTERNET SERVICES FOR BOARD MEMBER, P. STEPHENS, IN ORDER TO PROVIDE ALL OF THE BOARD MATERIAL, MEETING AGENDAS, ETC.... ELECTRONICALLY. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | CFO, SUSAN TORRES STEPPED DOWN TO NEWLY CREATED CONTROLLER POSITION AND HEALTH CENTER CONTRACTED WITH PRICEWATERMAN OF UKIAH, CALIFORNIA AS CFO |
| FORM 990, PART VI, SECTION A, LINE 4 | REVISION OF THE ORGANIZATIONS BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11 | CEO AND CFO DO AN INITIAL REVIEW OF FORM 990 WITH PREPARER. THIS DRAFT IS THEN MAILED AND/OR SENT ELECTRONICALLY TO ALL BOARD MEMBERS FOR THEIR REVIEW PRIOR TO THE FINAL DRAFT BEING ISSUED. DRAFT IS THEN FINALIZED AND FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY RELATING TO THE BOARD OF DIRECTORS AND OFFICERS IS INCLUDED IN THE BYLAWS OF THE ORGANIZATION. DISCLOSURE OF ANY CONFLICTS IS REQUIRED WHEN A BOARD MEMBER IS ELECTED TO SERVE ON THE BOARD. THE BOARD IS REQUIRED TO COMPLETE THE CONFLICT OF INTEREST STATEMENTS ANNUALLY. CEO MAINTAINS CONFLICT OF INTEREST FILE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION UTILIZES WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION STUDIES AND SURVEYS AN APPROVAL BY A BOARD OR COMPENSATION COMMITTEE. THE BOARD HAS FINAL AUTHORITY OVER THE HIRING, DISMISSAL, AND ANNUAL EVALUATION OF THE CEO. THE CEO EVALUATES THE CFO AND THE MEDICAL DIRECTOR. THE CEO REVIEWS THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) ANNUAL STATE WIDE SALARY SURVEY FOR COMMUNITY HEALTH CENTERS TO SET SALARY RANGES AND WAGES EACH YEAR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORMS 1023 AND 990 AVAILABLE TO THE PUBLIC UPON REQUEST |
| FORM 990, PART IX, LINE 11G | PROGRAM SERVICE EXPENSES: PROGRAM SERVICE EXPENSES 993,036. MANAGEMENT AND GENERAL EXPENSES 434,745. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,427,781. |
| FORM 990, PART XII, LINE 2C: | THE AUDIT COMMITTEE, UNDER THE BOARD'S SUPERVISION, IS RESPONSIBLE FOR MAKING RECOMMENDATIONS TO THE BOARD ON THE HIRING AND FIRING OF INDEPENDENT CERTIFIED PUBLIC ACCOUNTANTS (CPAS). THE AUDIT COMMITTEE CAN NEGOTIATE THE INDEPENDENT CPA'S COMPENSATION ON BEHALF OF THE BOARD. THE AUDIT COMMITTEE MUST: (1) CONFER WITH THE AUDITOR TO SATISFY COMMITTEE MEMBERS THAT THE FINANCIAL AFFAIRS OF THE HEALTH CENTER ARE IN ORDER; (2) REVIEW THE AUDIT AND DECIDE WHETHER TO ACCEPT IT; AND (3) APPROVE NON AUDIT SERVICES BY THE INDEPENDENT CPAS ACCOUNTING FIRM, AND ENSURE SUCH SERVICES CONFORM TO APPROPRIATE GOVERNMENT STANDARDS. |
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