2016-05-13T20:15:28-05:00 2015-06-30 951777440 GREEN HASSON & JANKS LLP 10990 WILSHIRE BLVD 16TH FLOOR LOS ANGELES CA 900243929 990 2014-07-01 953222316 SHARE OUR SELVES CORPORATION SHAR 9492702100 1550 SUPERIOR AVENUE COSTA MESA CA 92627 KAREN MCGLINN CEO 9492702100 2016-05-13 1 LAUREN A HAVERLOCK P00545829 3108731600 2014 2016-08-17 19:52:53Z KAREN MCGLINN 1550 SUPERIOR AVENUE COSTA MESA CA 92627 11191632 0 X WWW. SHAREOURSELVES. ORG X 1970 CA WE ARE SERVANTS WHO PROVIDE CARE AND ASSISTANCE TO THOSE IN NEED AND ACT AS ADVOCATES FOR CHANGE. 9 9 95 1400 0 0 6501463 7044567 1946466 4016434 12974 11718 12215 -41969 8473118 11030750 0 452684 0 0 4866411 6432363 0 0 414802 2999338 4019965 7865749 10905012 607369 125738 5870022 7643414 1011515 2668542 4858507 4974872 X SOS PROVIDES VULNERABLE AND LOW-INCOME FAMILIES AND INDIVIDUALS WITH DIRECT ACCESS TO HEALTH, FOOD AND SAFETY NET SERVICES THEY NEED TO IMPROVE THEIR LIVES. SOS IS THE LARGEST COMMUNITY HEALTH CENTER IN ORANGE COUNTY TO COMBINE WRAP-AROUND SOCIAL SERVICES WITH HEALTHCARE. 0 0 7340995 452684 4016434 CLINICS: ANNUALLY SOS PROVIDES CARE TO APPROXIMATELY 12,000 UNDUPLICATED PATIENTS ACCOUNTING FOR OVER 38,200 PATIENT VISITS. SOS PROVIDES COMPREHENSIVE HEALTHCARE INCLUDING A FULL PROGRAM OF PRIMARY, SPECIALTY, SUB-SPECIALTY, DENTAL, INTEGRATED BEHAVIORAL HEALTH AND COMPLEMENTS ITS OUTPATIENT CARE WITH HOSPITALIST INPATIENT FOLLOW-UPS, TREATMENT ADHERENCE EDUCATION, CLINICAL CASE MANAGEMENT, DISEASE MANAGEMENT, COUNSELING, EDUCATION, AND TESTING. SOS OFFERS ONSITE LAB, NUTRITION AND DISPENSARY SERVICES COMPREHENSIVE QUALITY HEALTHCARE IS PROVIDED AT THREE CLINICAL SITES LOCATED IN COSTA MESA, SANTA ANA, AND LAKE FOREST. SOS IS DESIGNATED AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). FQHCS ARE COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE COMPREHENSIVE PRIMARY CARE AND PREVENTIVE CARE, INCLUDING HEALTH, ORAL, AND MENTAL HEALTH SERVICES TO PERSONS OF ALL AGES, REGARDLESS OF THEIR ABILITY TO PAY OR HEALTH INSURANCE STATUS, IN A MEDICALLY UNDERSERVED AREA (MUA). 2097672 SOCIAL SERVICES: PROVIDES BOTH CLINICAL AND SOCIAL CASE MANAGEMENT, EMERGENCY FINANCIAL AID, FOOD, LEGAL AID, HOMELESS OUTREACH PROGRAMS, RESOURCE AND LINKAGE TO BENEFIT ENROLLMENT, AND SEASONAL SUPPORT PROGRAMS. PROGRAMS SERVE ALL OF ORANGE COUNTY WITH 75% IN SANTA ANA AND COSTA MESA. RESIDENTS SEEKING SERVICES INCLUDE THE CHRONICALLY DISADVANTAGED AND THOSE ACCESSING SUPPORTIVE SERVICES FOR THE FIRST TIME, CASUALTIES OF THE DEVASTATING RECESSION. S0S'S TARGET POPULATION IS ETHNICALLY DIVERSE AND LIVES AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL; THE HOMELESS, SENIORS ON FIXED INCOMES, THE DISABLED, AND THOSE WITH MENTAL ILLNESS ARE A SIGNIFICANT PORTION OF THE POPULATION SERVED. SOCIAL SERVICES ANNUALLY SERVES OVER 100,000 ORANGE COUNTY RESIDENTS. 9438667 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 162 0 1 95 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SERGEY SERGEYEV 9492702100 20151 SW BIRCH STREET NEWPORT BEACH CA 92660 DR GWYN P PARRY CHAIRMAN 2.00 X X 0 0 0 WILL KLATTE III VICE-CHAIR 2.00 X X 0 0 0 MIKE STEPHENS TREASURER 2.00 X X 0 0 0 SUSAN BAERG-EPSTEIN SECRETARY 2.00 X X 0 0 0 SKI HARRISON MEMBER 2.00 X 0 0 0 LAWRENCE N KUGELMAN MEMBER 2.00 X 0 0 0 GABRIELA ROBLES MEMBER 2.00 X 0 0 0 CATHEY RUSSELL MEMBER 2.00 X 0 0 0 JENNIFER NICOLALDE MEMBER 2.00 X 0 0 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 40.00 X 199109 0 5382 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER 40.00 X 158634 0 1000 JOSE MAYORGA CHIEF MEDICAL OFFICER 40.00 X 235714 0 8896 JILA NIKKHAH DENTAL DIRECTOR 40.00 X 163925 0 5254 ERIC HUANG PHYSICIAN - AMD 40.00 X 184479 0 8824 JOHN LE PHYSICIAN - AMD 40.00 X 175646 0 11291 DUC T VU DENTIST 40.00 X 141762 0 9864 DIANE BEYAOJU DENTIST 40.00 X 132259 0 10680 JEREMY D ELKINS CHIEF OPERATIONS OFFICER 40.00 X 128389 0 11178 1519917 0 72369 11 0 1 0 0 250560 1274988 5519019 1434136 7044567 CLINIC REVENUE 621400 4016434 4016434 4016434 11718 11718 103585 250560 155634 -52049 -52049 6100 5248 852 852 MISCELLANEOUS INCOME 900099 9228 9228 9228 11030750 4016434 0 -30251 452684 452684 776853 653528 90019 33306 4640007 3900843 540187 198977 22012 18877 2198 937 629055 539456 62815 26784 364436 312528 36391 15517 71850 71850 38500 38500 458 458 596459 550414 46045 213995 116109 42318 55568 577221 510089 48975 18157 58754 42544 13174 3036 7786 4408 2675 703 284919 281016 3152 751 74472 42376 31876 220 CONTRIBUTED GOODS 1379201 1364455 13945 801 ANCILLARY MEDICAL 340536 340521 15 EHR MAINTENANCE AND HOS 142513 142513 PROPERTY AND EQUIPMENT 70385 61226 6578 2581 162916 105080 46417 11419 10905012 9438667 1051543 414802 29157 3167 457018 807719 1597078 248332 1504988 17470 37614 39625 700599 5423036 1989682 2683370 3433354 958676 907641 87628 0 5870022 7643414 773277 953520 5000 1400000 233238 315022 1011515 2668542 X 3950403 4155933 468894 377229 439210 441710 4858507 4974872 5870022 7643414 125738 -9373 0 X 0 1 X 1 1 1 X 4257374 3947255 6356647 6501463 7045567 28108306 4257374 3947255 6356647 6501463 7045567 28108306 28108306 17682 14497 18554 12974 11718 75425 67 255 7643 12215 9228 29408 28213139 8318306 0.99630 0.53020 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 488674 2500 -1528 489646 459106 17500 12068 488674 419833 35700 3573 459106 430729 13700 -24596 419833 377839 6373 51936 5519 430629 0.90210 0.09790 0 0 900000 900000 2474770 1297976 1176794 839706 70545 769161 1029876 600903 428973 178684 20258 158426 3433354 DEFERRED RENT 315022 315022 12276005 -9373 1254628 1245255 11030750 0 11030750 12159640 1254628 1254628 10905012 0 10905012 CELEBRITY CHEF 259535 198500 61035 21918 993 11156 67669 TACO NIGHT 94610 52060 42550 2941 200 50757 354145 250560 103585 24859 993 11356 118426 155634 -52049 1 RELIEF AND AID ASSISTANCE 12000 452684 FMV FOOD, RENT, UTILITIES, AND GIFT CARDS PART I, LINE 2: INDIVIDUALS WHO REQUIRE FINANCIAL ASSISTANCE ARE REQUIRED TO GO THROUGH A GRANT APPLICATION PROCESS. THE INDIVIDUAL MUST PROVIDE SUPPORTING DOCUMENTS TO SHOW THE NEED FOR ASSISTANCE. THE ORGANIZATION PROVIDES GIFTS CARDS AND OTHER HOUSING ASSISTANCE. X X 0 0 0 0 0 0 0 0 0 KAREN MCGLINN CHIEF EXECUTIVE OFFICER 169109 0 30000 0 0 0 1000 0 4382 0 204491 0 0 0 SERGEY SERGEYEV CHIEF FINANCIAL OFFICER 148634 0 10000 0 0 0 1000 0 0 0 159634 0 0 0 JOSE MAYORGA CHIEF MEDICAL OFFICER 235714 0 0 0 0 0 1000 0 7896 0 244610 0 0 0 JILA NIKKHAH DENTAL DIRECTOR 163925 0 0 0 0 0 1000 0 4254 0 169179 0 0 0 ERIC HUANG PHYSICIAN - AMD 183779 0 700 0 0 0 1000 0 7824 0 193303 0 0 0 JOHN LE PHYSICIAN - AMD 175646 0 0 0 0 0 1000 0 10291 0 186937 0 0 0 DUC T VU DENTIST 141762 0 0 0 0 0 0 0 9864 0 151626 0 0 0 X 2 417600 FMV X 2 53663 FMV X SUPPLIES 1300 770878 FMV X FAIR TICKETS 1 137060 FMV X AUCTION ITEMS 144 49835 SALES PRICE X RAFFLE ITEMS 3 5100 FMV 0 1 0 PART I, COLUMN (B): NON CASH DONATIONS ARE LISTED BY TOTAL NUMBER OF DONOR CONTRIBUTIONS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS FIRST REVIEWED BY THE CFO. A COPY OF THE 990 IS THEN PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C A QUESTIONNAIRE IS DISTRIBUTED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES ANNUALLY TO DISCLOSE ANY CONFLICTS OF INTERESTS. QUESTIONNAIRES ARE THEN RETURNED TO THE EXECUTIVE DIRECTOR. ANY CONFLICTS THAT ARE DISCLOSED ARE REVIEWED BY THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 BOARD MEMBERS DETERMINE THE COMPENSATION OF OFFICERS AND KEY EMPLOYEES BY GATHERING DATA ON THE COMPENSATION FOR NON-PROFIT ORGANIZATIONS IN ORANGE COUNTY AND SOUTHERN CALIFORNIA. THE DATA IS UTILIZED IN CONJUNCTION WITH THE BOARD MEMBERS' EVALUATION TO PRODUCE A COMPENSATION RECOMMENDATION INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.