SAMUEL DIXON FAMILY HEALTH CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SAMUEL DIXON FAMILY HEALTH CENTER INC (EIN 95-4278726)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-04-04
- IRS object ID
- 201620959349300122
- Schema version
- 2014v6.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-04-04T10:51:51-07:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vasin Heyn & Company | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 N Parkway Calabasas 201 | AddressLine1Txt |
| City | Calabasas | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91302 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954278726 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samuel Dixon Family Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAMU | BusinessNameControlTxt |
| Phone | 6612574008 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford | AddressLine1Txt |
| City | Valencia | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Philip Solomon | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2016-04-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rolland Vasin | PreparerPersonNm |
| PTIN | P00644882 | PTIN |
| Phone | 8182223500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Philip Solomon | PrincipalOfficerNm |
| Gross Receipts | $2,379,770 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | To provide a community clinic offering cost-free or reduced cost medical and dental services to uninsured and under insured persons and families for whom medical and dental services would otherwise not be available due to financial hardship or disadvantage. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 31 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,205,541 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,185,145 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $134,428 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $110,127 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,214 | PYOtherRevenueAmt |
| CY Other Revenue | $59,636 | CYOtherRevenueAmt |
| PY Total Revenue | $2,348,183 | PYTotalRevenueAmt |
| CY Total Revenue | $2,354,908 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,482,482 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,515,043 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $185,587 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,003,483 | PYOtherExpensesAmt |
| CY Other Expenses | $768,334 | CYOtherExpensesAmt |
| PY Total Expenses | $2,485,965 | PYTotalExpensesAmt |
| CY Total Expenses | $2,283,377 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$137,782 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $71,531 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $901,407 | TotalAssetsBOYAmt |
| Total Assets EOY | $919,682 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $217,712 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $156,761 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $683,695 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $762,921 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide a community clinic offering cost-free or reduced cost medical and dental services to uninsured and under insured persons and families for whom medical and dental services would otherwise not be available due to financial hardship or disadvantage. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,657,304 | ExpenseAmt |
| Desc | Provide medical services to all residents of the Santa Clarita Valley, with a special emphasis on the unserved and under served. The Family Health Center aims to build a healthier community. | Desc |
| Total Program Service Expenses | $1,657,304 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 31 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Tom Christensen | PersonNm |
| Phone | 6612574008 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25115 W Avenue Stanford Suite A-104 | AddressLine1Txt |
| City | Valencia | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91355 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| Gloria Mercado-Fortine | |||||||||
| President | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Mike Fisher | |||||||||
| Vice Chairman | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Edward Bolden Jr | |||||||||
| Vice Chairman | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PK Reibsamen | |||||||||
| Treasurer | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| David Goldberg DDS | |||||||||
| Secretary | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Amanda Calderon | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Irene Leon | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Maria Morales | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Carolina Orozco | |||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Philip Solomon MPA | |||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $91,843 | $0 | $3,726 | |||
| Fariba Mason | |||||||||
| Nurse Practitioner | 40.00 | 0.00 | $120,640 | $0 | $4,681 | Yes (X) | |||
| Taura Olfus | |||||||||
| Dr. of Osteopathi | 40.00 | 0.00 | $111,037 | $0 | $4,004 | Yes (X) | |||
| Ahmed Taher | |||||||||
| Medical Dr., CMO | 0.00 | 0.00 | $176,395 | $0 | $4,529 | Yes (X) | |||
| John Chris Mattingly | |||||||||
| Former CEO | 40.00 | 0.00 | $73,007 | $0 | $3,547 | Yes (X) | |||
| Cheryl Laymon | |||||||||
| Former CEO | 40.00 | 0.00 | $21,770 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $594,692 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $20,487 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,018,775 | GovernmentGrantsAmt |
| All Other Contributions | $166,370 | AllOtherContributionsAmt |
| Noncash Contributions | $54,195 | NoncashContributionsAmt |
| Total Contributions | $2,185,145 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Program Service Fees | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $110,127 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $110,127 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $110,127 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $45,509 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $24,862 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,647 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $38,989 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,989 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $38,989 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,354,908 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $149,116 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,569 | TotalAmt |
| Program Services | $67,854 | ProgramServicesAmt |
| Management And General | $16,247 | ManagementAndGeneralAmt |
| Fundraising | $11,468 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,227,864 | TotalAmt |
| Program Services | $871,783 | ProgramServicesAmt |
| Management And General | $214,016 | ManagementAndGeneralAmt |
| Fundraising | $142,065 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,531 | TotalAmt |
| Program Services | $62,617 | ProgramServicesAmt |
| Management And General | $15,063 | ManagementAndGeneralAmt |
| Fundraising | $9,851 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,079 | TotalAmt |
| Program Services | $73,896 | ProgramServicesAmt |
| Management And General | $18,111 | ManagementAndGeneralAmt |
| Fundraising | $12,072 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,168 | TotalAmt |
| Management And General | $6,168 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,500 | TotalAmt |
| Management And General | $14,500 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,720 | TotalAmt |
| Program Services | $9,275 | ProgramServicesAmt |
| Management And General | $9,314 | ManagementAndGeneralAmt |
| Fundraising | $131 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,450 | TotalAmt |
| Program Services | $133,315 | ProgramServicesAmt |
| Management And General | $57,135 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,555 | TotalAmt |
| Program Services | $2,100 | ProgramServicesAmt |
| Management And General | $11,455 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,236 | TotalAmt |
| Management And General | $7,236 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,512 | TotalAmt |
| Program Services | $119,512 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,820 | TotalAmt |
| Program Services | $48,764 | ProgramServicesAmt |
| Management And General | $12,422 | ManagementAndGeneralAmt |
| Fundraising | $4,634 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Professional Services | $77,153 | $67,721 | $9,432 |
| Supplies - Medical | $56,829 | $56,829 | |
| In-kind supplies - medical | $42,578 | $42,578 | |
| Outside Services | $23,757 | $1,728 | $22,029 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,056 | TotalAmt |
| Program Services | $99,332 | ProgramServicesAmt |
| Management And General | $27,358 | ManagementAndGeneralAmt |
| Fundraising | $5,366 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,283,377 | TotalAmt |
| Program Services | $1,657,304 | ProgramServicesAmt |
| Management And General | $440,486 | ManagementAndGeneralAmt |
| Fundraising | $185,587 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,594 | BOYAmt |
| EOY | $44,216 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $229,231 | BOYAmt |
| EOY | $309,876 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78 | BOYAmt |
| EOY | $79 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,361 | BOYAmt |
| EOY | $10,119 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,623,786 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,068,394 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $649,143 | BOYAmt |
| EOY | $555,392 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $901,407 | BOYAmt |
| EOY | $919,682 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,632 | BOYAmt |
| EOY | $29,002 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,274 | BOYAmt |
| EOY | $17,236 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,806 | BOYAmt |
| EOY | $110,523 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,712 | BOYAmt |
| EOY | $156,761 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,695 | BOYAmt |
| EOY | $762,921 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $683,695 | BOYAmt |
| EOY | $762,921 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $901,407 | BOYAmt |
| EOY | $919,682 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $71,531 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $7,695 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $1,226,025 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,436,008 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,747,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,339,969 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,295,272 | CurrentTaxYearAmt |
| Total | $9,045,065 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,226,025 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,436,008 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,747,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,339,969 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,295,272 | CurrentTaxYearAmt |
| Total | $9,045,065 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $9,045,065 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $168 | CurrentTaxYearMinus4YearsAmt |
| Total | $168 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,454 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $18,536 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $38,989 | CurrentTaxYearAmt |
| Total | $70,979 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,116,212 | TotalSupportAmt |
| Public Support CY170 | 0.99220 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99590 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $70,978 | InvestmentCostOrOtherBasisAmt |
| Book Value | $70,978 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $474,537 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $211,928 | DepreciationAmt |
| Book Value | $262,609 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $260,481 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $173,449 | DepreciationAmt |
| Book Value | $87,032 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $817,790 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $683,017 | DepreciationAmt |
| Book Value | $134,773 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $555,392 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Accountability for Govt-Funded Assets | $28,762 |
| Accrued Payroll and Rel Liabilities | $53,595 |
| Contracts payable | $28,166 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $110,523 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,387,715 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $250 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $32,557 | OtherRevenueAmt |
| Revenue Not Reported | $32,807 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,354,908 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,354,908 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,308,489 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $250 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $24,862 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $25,112 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,283,377 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,283,377 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X : FIN48 Footnote | Samuel Dixon Family Health Center, Inc. has adopted Financial Accounting Standards Board Accounting Standards Codification (ASC)Section 740-10, which clarifies the accounting for uncertainty in income taxes. ASC Section 740-10 prescribes a recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken in a tax return. ASC Section 740-10 requires that an organization recognize in the financial statements the impact of the tax position if that position will more likely than not be sustained on audit, based on the technical merits of the position. As of and for the year ended June 30, 2015, Samuel Dixon Family Health Center, Inc. had no material unrecognized tax benefits, tax penalties or interest. |
| Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990 | Fundraising Events Expenses $24862 Accountability for Government Funded Ass $7695 |
| Part XII, Line 2d: Other expenses and losses per audited F/S | Fundraising Events Expenses $24862 |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Rubber Ducky | Event1Nm |
| Gross Receipts Event1 | $45,509 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $45,509 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $4,937 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $2,509 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $17,416 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $45,509 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $45,509 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $4,937 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,509 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $17,416 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $24,862 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $20,647 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| Ahmed Taher | |||
| Medical Dr., CMO | $176,395 | $4,529 | $180,924 |
| Cheryl Laymon | |||
| Former CEO | $21,770 | $21,770 | |
| John Chris Mattingly | |||
| Former CEO | $73,007 | $3,547 | $76,554 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2172 | ContributionCnt |
| Noncash Contributions Rpt F990 | $49,195 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Advertising | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $5,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | The chief executive officer and chief financial officer review the 990 before finalizing and filing. There is no board review nor one will be conducted. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Monitored by the executive director, conflicts presented to the executive committee for resolution. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | Reviewed and established by the board of directors. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Reviewed and established by executive director. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Upon Request |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Accountability for Government Funded Assets = $7695 |
Comments