2015-05-11T16:59:05-05:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 20 E THOMAS RD STE 2300 PHOENIX AZ 85012 990 2013-07-01 953881333 CLINICA MSR OSCAR A ROMERO CLIN 3239871401 123 S ALVARADO ST LOS ANGELES CA 90057 SANDRA ROSSATO EXECUTIVE DIRECTOR 3239871401 2015-04-16 1 CHRISTINE ABELL P00279655 6022662248 2013 2016-02-25 16:41:14Z SANDRA ROSSATO 123 S ALVARADO ST LOS ANGELES CA 90057 10464265 0 X WWW.CLINICAROMERO.COM X 1983 CA PROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE & OTHER SERVICES TO THE UNINSURED, INSURED & UNDERSERVED COMMUNITIES OF GREATEER LOS ANGELES. 8 8 164 14 0 0 2762794 3060684 6248371 7090003 370 53140 112825 192639 9124360 10396466 150 0 0 0 5934065 6964057 0 0 97718 2789525 3130261 8723740 10094318 400620 302148 8828654 7806433 5355257 5337555 3473397 2468878 X OUR MISSION IS TO PROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE AND OTHER SERVICES TO THE UNINSURED, INSURED AND UNDERSERVED COMMUNITIES OF GREATER LOS ANGELES REGARDLESS OF THEIR ABILITY TO PAY BY UPHOLDING THE LEGACY AND TRADITION OF MONSENOR OSCAR ROMERO AND EDUCATING AND EMPOWERING SALVADORAN AND OTHER COMMUNITY MEMBERS THROUGH COMMUNITY ORGANIZING, HEALTH EDUCATION AND SOCIAL JUSTICE AND EXCHANGE PROGRAMS IN EL SALVADOR. 0 0 6786540 5105412 CLINICA ROMERO PROVIDES LOW-COST COMPREHENSIVE PRIMARY CARE AND DISEASE PREVENTION SERVICES FOR MEN, WOMEN AND CHILDREN OF ALL AGES. OUR DOCTORS STRIVE TO PROVIDE THE BEST LEVEL OF CARE IN ORDER TO IMPROVE THE QUALITY OF LIFE OF ALL PATIENTS. SERVICES INCLUDE: EXAMS: COMPLETE MEDICAL EXAMINATIONS.CANCER SCREENINGS: LAB TESTS, ULTRASOUNDS.CHRONIC DISEASE MANAGEMENT: MEDICATIONS AND LIFESTYLE REGIMENS FOR AVOIDING COMPLICATIONS ASSOCIATED WITH ASTHMA, HEART DISEASE, HYPERTENSION, HIGH BLOOD PRESSURE AND DIABETES.FAMILY PLANNING: PROGRAMS TO ASSIST YOUNG AND BEGINNING FAMILIES.PRENATAL CARE: PRENATAL CLASSES AND NUTRITIONAL GUIDANCE.PEDIATRICS: WELL-CHILD VISITS FOR HEALTHY GROWTH AND DEVELOPMENT.VACCINATIONS: PEDIATRIC IMMUNIZATIONS AND ADULT VACCINES. 1134338 638986 CLINICA ROMERO PROVIDES A LOW-COST DENTAL SERVICES FOR ADULTS AND CHILDREN IN A FRIENDLY ENVIRONMENT THAT PUTS OUR PATIENTS AT EASE. GOOD ORAL HEALTH REQUIRES REGULAR DENTAL EXAMINATION AND MAINTENANCE TO HELP PREVENT AND MANAGE DISEASE. OUR TEAM SPECIALIZES IN PREVENTATIVE CARE AND PROVIDES THE FOLLOWING SERVICES:SERVICES FOR ADULTS:COMPLETE ORAL EXAMINATIONS INCLUDING X-RAYS.PREVENTATIVE SERVICES AND PERIODIC PERIODONTAL MAINTENANCE TREATMENT:PROPHYLAXIS (CLEANINGS) AND NON-SURGICAL PERIODONTAL TREATMENT (SCALING AND ROOT PLANING), ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, CANAL TREATMENT LIMITED TO ANTERIOR TEETH, SIMPLE EXTRACTIONSSERVICES FOR CHILDREN:COMPLETE ORAL EXAMINATIONS AND X-RAYSPREVENTATIVE SERVICES:PROPHYLAXIS (CLEANINGS), FLUORIDE VARNISH APPLICATIONS, SEALANTS, ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, PULPOTOMIES, STAINLESS STEEL CROWNS, SPACE MAINTAINERS, SIMPLE EXTRACTIONS 677505 1345605 CLINICA IS COMMITTED TO PROVIDING PRESCRIPTION MEDICATION THAT FITS WITHIN A PATIENT'S BUDGET. OUR PHARMACEUTICAL STAFF IS COMMITTED TO PROVIDING ACCURATE AND EASY TO UNDERSTAND INFORMATION REGARDING THE MEDICATION PRESCRIBED TO OUR PATIENTS. SERVICES INCLUDE:ON-SITE FILLING OF PRESCRIPTIONS.PRESCRIPTION REFILLS.MEDICATION MANAGEMENT IN COORDINATION WITH PRIMARY CARE PHYSICIAN. 8598383 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 19 0 0 164 1 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 1 0 0 CA X X SANDRA ROSSATO 2132012737 123 S ALVARADO ST LOS ANGELES CA 90057 CARLOS VAQUERANO BOARD PRESIDENT 1.00 X X 0 0 0 ANA Y MARTINEZ BOARD VICE-PRESIDENT 1.00 X X 0 0 0 MARCELO VILLAGOMEZ TREASURER 1.00 X X 0 0 0 RODNEY SAMAAN SECRETARY 1.00 X X 0 0 0 RAFAEL SWEET MEMBER 1.00 X 0 0 0 ALICIA HERNANDEZ MEMBER 1.00 X 0 0 0 MARIA E GARCIA MEMBER 1.00 X 0 0 0 ADALY UGALDE MEMBER 1.00 X 0 0 0 FIRLEY SOCOY MEMBER (FORMER) 1.00 X 0 0 0 YVONNENANETTE MACHADO MEMBER (FORMER) 1.00 X 0 0 0 MARIN CASTILLO-VALLE MEMBER (FORMER) 1.00 X 0 0 0 ERLINDA SARABIA MEMBER (FORMER) 1.00 X 0 0 0 SANDRA ROSSATO EXECUTIVE DIRECTOR 40.00 X 109665 0 0 GEOFFREY BOOTH MEDICAL DIRECTOR 40.00 X 15556 0 0 CHRISTINA BUGARIN FINANCE DIRECTOR 40.00 X 84333 0 0 209554 0 0 1 0 0 0 7LAYERS IT SOLUTIONS INC 17701 CHATSWORTH ST GRANADA HILLS CA 91344 IT SERVICES 174406 1 2678768 381916 3060684 MEDICAL SERVICES 621110 5105412 5105412 HEALTH SERVICES 621110 1345605 1345605 DENTAL SERVICES 621110 638986 638986 7090003 53140 53140 79990 67799 12191 12191 12191 OTHER INCOME 900099 180448 180448 180448 10396466 7090003 0 245779 325865 105973 219892 4856020 4262975 523045 70000 1782172 1523394 242817 15961 325588 299131 15157 11300 15947 13766 2181 170525 120254 50261 10 174406 174406 575194 564875 10319 597331 509140 88050 141 PROGRAM EXPENSES 805640 791340 14144 156 MISCELLANEOUS 424333 379246 44937 150 DUES AND SUBSCRIPTIONS 21417 18329 3088 MAINTENANCE & REPAIRS 19880 9960 9920 10094318 8598383 1398217 97718 510062 320257 1186667 0 1474734 1904105 0 10784 15527 17188 16780 9293063 3781824 5579789 5511239 49430 38525 8828654 7806433 658046 780172 231844 194928 4465367 4362455 5355257 5337555 X 2069291 2468878 1404106 0 3473397 2468878 8828654 7806433 302148 -1306667 0 X 0 1 X 0 1 1 X 5732065 4822159 3855566 2762794 3060684 20233268 5732065 4822159 3855566 2762794 3060684 20233268 20233268 5017 1413 84921 75069 133130 299550 108625 122868 95245 47949 180448 555135 21087953 25178083 0.95950 0.97140 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2009 AMOUNT: $ 108,625. 2010 AMOUNT: $ 122,868. 2011 AMOUNT: $ 95,245. 2012 AMOUNT: $ 47,949. 2013 AMOUNT: $ 180,448. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1618324 1618324 4349871 1612701 2737170 763083 639551 123532 2561785 1529572 1032213 5511239 X 10464265 0 10464265 -67799 -67799 10396466 10162117 67799 67799 10094318 0 10094318 PART X, LINE 2: CLINICA IS A NONPROFIT CORPORATION EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, CLINICA IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. CLINICA HAS ELECTED TO ADOPT GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES FOR EVALUATING UNCERTAIN TAX POSITIONS. THE ADOPTION OF THIS STANDARD HAS NO EFFECT ON THE CONSOLIDATED FINANCIAL STATEMENTS. CLINICA'S TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. THE TAX RETURNS FOR THE YEARS 2011 TO 2013 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. PART XI, LINE 4B - OTHER ADJUSTMENTS: OFFSETTING EXPENSES RELATED TO REVENUE -67,799. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES TO OFFSET RENTAL REVENUE 67,799. FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL: A) CONSIST OF FOUR (4) OFFICERS AND THE IMMEDIATE PAST PRESIDENT OF THE BOARD. IF THERE IS NO IMMEDIATE PAST PRESIDENT OF THE BOARD THEN SERVING AS A DIRECTOR, THE PRESIDENT MAY, IN HIS OR HER DISCRETION, APPOINT AN ADDITIONAL MEMBER TO THE COMMITTEE FROM AMONG THE OTHER DIRECTORS THEN IN OFFICE. IN ADDITION, THE EXECUTIVE DIRECTOR AND SUCH OTHER NON-DIRECTORS AS ARE DESIGNATED FROM TIME TO TIME BY THE BOARD OF DIRECTORS, MAY BE NON- VOTING ADVISORS TO THE EXECUTIVE COMMITTEE. B) HAVE AND EXERCISE SUCH AUTHORITY AS MAY BE DELEGATED TO IT BY THE BOARD AND ACT IN ITS ABSENCE DURING AN EMERGENCY IF THE FULL BOARD IS UNABLE TO MEET. C) HAVE OVERSIGHT OVER STRATEGIC PLANNING FOR CLINICA. D) WORK WITH THE EXECUTIVE DIRECTOR AND DEVELOPMENT DEPARTMENT TO OBTAIN FUNDS FROM A BROAD RANGE OF SOURCES IN BOTH THE PUBLIC AND PRIVATE SECTORS INCLUDING: INDIVIDUALS, CORPORATIONS, FOUNDATIONS AND GOVERNMENT. E) MEET MONTHLY AT A TIME AND PLACE DETERMINED BY THE COMMITTEE. SPECIAL MEETINGS SHALL BE CALLED BY THE PRESIDENT, OR AT THE WRITTEN REQUEST OF AT LEAST TWO COMMITTEE MEMBERS. T) A MAJORITY OF THE MEMBERS SHALL CONSTITUTE A QUORUM. FORM 990, PART VI, SECTION B, LINE 11 CLINICA MSR OSCAR A ROMERO OUTSIDE AUDITORS AND FINANCIAL STAFF PREPARE THE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY THE ORGANIZATION'S CONTROLLER OR CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. THE FORM IS THEN SENT TO THE FULL BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CLINICA MSR OSCAR A ROMERO (CMOAR) REQUIRES ALL EMPLOYEES TO DISCLOSE, AT LEAST ANNUALLY, ALL SOURCES OF INCOME FROM COMPENSATION OR FROM OWNERSHIP OF EVERY OUTSIDE ENTITY THAT (A) SOLD, SUPPLIED OR PROVIDED SERVICES (B) OPERATED A COMPETING ENTERPRISE OR (C) PROVIDED GOODS OR SERVICES TO CMOAR IN THE LAST SIX MONTHS. CMOAR ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF CMOAR CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. CMOAR CONFLICT OF INTEREST POLICY DESCRIBES HOW CMOAR WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD REVIEWED CLINICA MSR OSCAR A ROMERO CEO'S COMPENSATION. THE BOARD REVIEWED DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES. THE OCCURRENCE OF THESE DELIBERATION ARE NOTED IN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 18 IN ADDITION TO BEING AVAILABLE UPON REQUEST, THE ORGANIZATION'S FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.