2015-08-14T13:32:25-05:00 2014-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 100 STOCKTON CA 952192367 990 2013-10-01 942797447 VALLEY CHILDREN'S HEALTHCARE FOUNDATION FKA CHILDREN'S HOSPITAL CENTRAL CA FDN THEC 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 MICHELE WALDRON TREASURER 5593533000 2015-08-12 1 TRACY S PAGLIA P00366884 2099556100 2013 2016-03-07 17:11:31Z MICHELE WALDRON 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 12724735 0 X N/A X 1981 CA TO GENERATE FUNDS TO SUPPORT THE GOALS OF VALLEY CHILDREN'S HOSPITAL. 23 19 0 0 0 0 5878955 8173155 0 0 1118364 2220975 91773 82929 7089092 10477059 2210272 46444666 0 0 1307878 1554607 311876 313521 1774900 683624 624653 4513650 48937447 2575442 -38460388 57901482 21217845 427426 476215 57474056 20741630 VALLEY CHILDREN'S HEALTHCARE FOUNDATION IS A CHARITABLE TAX-EXEMPT ORGANIZATION BENEFITING VALLEY CHILDREN'S HOSPITAL. THE FOUNDATION'S MISSION IS TO GENERATE FUNDS TO SUPPORT THE GOALS OF VALLEY CHILDREN'S HOSPITAL. 0 0 46444666 46444666 0 SEE SCHEDULE O. 46444666 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 X 23 19 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X MICHELE WALDRON 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 TODD SUNTRAPAK PRESIDENT, CEO EFF. 7/19/12 10.00 40.00 X X 0 703774 73481 MICHELE R WALDRON TREASURER 5.00 45.00 X X 0 562868 81158 DAN ADAMS BOARD MEMBER 1.00 X 0 0 0 ERIN BERBERIAN-GLEASON BOARD MEMBER 1.00 X 0 144161 19996 BLAIR CUNNINGS BOARD MEMBER 1.00 X 0 0 0 MARTY FLAMING BOARD MEMBER 1.00 X 0 0 0 KENNETH JUE BOARD MEMBER 1.00 X 0 0 0 ALLISON KARAHADIAN BOARD MEMBER 1.00 X 0 0 0 PAUL MCDOUGAL VICE CHAIRMAN 1.00 X X 0 0 0 GEORGE MURPHY BOARD MEMBER - TERMED 10/14 1.00 X 0 0 0 PATRICK MURPHY BOARD MEMBER 1.00 X 0 0 0 CAREN MYERS BOARD MEMBER 1.00 X 0 0 0 DAVID NALCHAJIAN CHAIRMAN 1.00 1.00 X X 0 0 0 SKIP NUGENT BOARD MEMBER 1.00 X 0 0 0 CARL REFUERZO BOARD MEMBER 1.00 X 0 0 0 KIM RUIZ-BECK SECRETARY 1.00 1.00 X X 0 0 0 DEBBIE SMADES-HENES BOARD MEMBER 1.00 X 0 0 0 BILL SMITTCAMP BOARD MEMBER 1.00 1.00 X 0 0 0 DR NADARASA VISVESHWARA BOARD MEMBER 1.00 X 0 272221 26830 RICHARD SHEHADEY IMMEDIATE PAST CHAIRMAN 1.00 1.00 X X 0 0 0 NOREEN WADE BOARD MEMBER - TERMED 12/13 1.00 X 0 0 0 LISA WHITE BOARD MEMBER - TERMED 11/13 1.00 X 0 0 0 KEVIN WILLIAMS BOARD MEMBER 1.00 X 0 0 0 JODY YOUNG BOARD MEMBER 1.00 X 0 0 0 GEORGE BERTOLUCCI BOARD MEMBER - TERMED 9/14 1.00 X 0 0 0 DAVID GALASSO BOARD MEMBER - TERMED 1/14 1.00 X 0 0 0 JEANNINE GRECH BOARD MEMBER 1.00 X 0 0 0 NINA KRUSE BOARD MEMBER - TERMED 6/14 1.00 X 0 0 0 DANIELLE PARNAGIAN BOARD MEMBER 1.00 X 0 0 0 JAMES MILLER VP & CDO, 11/5/12-11/15/13 40.00 X 0 343051 637 ROBERT SAROYAN VP, FOUNDATION/CDO, EFF. 3/17/14 40.00 X 0 0 0 GORDON ALEXANDER FORMER CEO, TERMED 11/13/11 6.00 34.00 X 0 271154 0 0 2297229 202102 0 1 1 0 CHILDREN'S MIRACLE NETWORK 4525 S 2300 EAST SALT LAKE CITY UT 84112 FUNDRAISING 330755 1 1255287 735254 6182614 61318 8173155 1027173 1027173 3183041 1989239 1193802 1193802 1193802 341366 735254 258437 82929 82929 10477059 0 0 2303904 46444666 46444666 977812 258078 719734 58165 16883 41282 444160 117902 326258 74470 21615 52855 281 281 20150 20150 313521 313521 197802 197802 104399 26100 78299 119233 6946 112287 1500 375 1125 16511 12097 4414 11643 11643 6397 6397 PURCHASED SERVICES 60284 60284 TAXES & LICENSES 35581 8895 26686 BANK CHARGES 13050 3262 9788 DUES & SUBSCRIPTIONS 5522 1380 4142 32300 8075 24225 48937447 46444666 717881 1774900 300 300 3674320 3696016 143485 123298 55660 26437 35620 29223 32962672 8104667 20002073 8248576 1083012 1015765 57901482 21217845 427426 476215 427426 476215 X 40540567 1947664 3514286 4892191 13419203 13901775 57474056 20741630 57901482 21217845 X -38460388 1831535 -103573 X 0 1 X 1 0 X 5561054 11729957 9223675 5815550 8171822 40502058 5561054 11729957 9223675 5815550 8171822 40502058 5714506 34787552 959309 1048431 964574 946534 1027173 4946021 69997 152150 287241 91773 82929 684090 46132169 0.75410 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13419203 482572 13901775 12825387 593816 13419203 12097790 727597 12825387 11661203 436587 12097790 11510492 150711 11661203 1.00000 0 1 1 55660 26437 29223 29223 LIMITED PARTNERSHIPS 8248576 F 8248576 PART V, LINE 4: TO PROVIDE A PERPETUAL AND PREDICTABLE SOURCE OF REVENUE FOR THE USE AND BENEFIT OF VARIOUS PROGRAMS, OPERATING AND CAPITAL NEEDS OF VALLEY CHILDREN'S HOSPITAL. X X X X X X X 1 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 COORDINATE DIRECT MAIL PROGRAM AND OTHER CAMPAIGN 1 377298 313521 63777 377298 313521 63777 AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY KID'S DAY 505916 306811 199105 123959 HARVEST BALL 570704 428443 142261 49310 85168 0 1076620 735254 341366 49310 209127 258437 82929 1 VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 941294954 501(C)(3) 46439266 5400 FMV FUN CENTER DISTRIBUTION TO CHILDREN'S HOSPITAL CENTRAL CA FOR EQUIPMENT AND OPERATIONAL EXPENSES 1 0 PART I, LINE 2: VALLEY CHILDREN'S HEALTHCARE FOUNDATION IS A SUPPORTING ORGANIZATION TO VALLEY CHILDREN'S HOSPITAL. NO MONITORING OF THE USE OF GRANT FUNDS, OTHER THAN TO MEET DONOR RESTRICTIONS, IS NEEDED. ALL GRANTS ARE MADE TO VALLEY CHILDREN'S HOSPITAL AND REPRESENT A TRANSFER OF DONATIONS TO BE USED FOR EQUIPMENT AND OPERATIONAL EXPENSES. 1 1 0 0 0 0 0 0 0 TODD SUNTRAPAK PRESIDENT, CEO EFF. 7/19/12 0 552982 0 119790 0 31002 0 56800 0 16681 0 777255 0 0 MICHELE R WALDRON TREASURER 0 426167 0 126493 0 10208 0 68647 0 12511 0 644026 0 0 ERIN BERBERIAN-GLEASON BOARD MEMBER 0 141662 0 0 0 2499 0 11120 0 8876 0 164157 0 0 DR NADARASA VISVESHWARA BOARD MEMBER 0 272221 0 0 0 0 0 21675 0 5155 0 299051 0 0 JAMES MILLER VP & CDO, 11/5/12-11/15/13 0 285151 0 0 0 57900 0 0 0 637 0 343688 0 0 GORDON ALEXANDER FORMER CEO, TERMED 11/13/11 0 0 0 0 0 271154 0 0 0 0 0 271154 0 0 PART I, LINES 4A-B PART I, LINE 4A A RELATED ORGANIZATION MADE SEVERANCE PAYMENTS TO GORDON ALEXANDER, FORMER CEO AND JAMES MILLER, FORMER VICE PRESIDENT. THE TERMS OF THE SEVERANCE AGREEMENT ARE SUBJECT TO A CONFIDENTIALITY CLAUSE. PART I, LINE 4B VALLEY CHILDREN'S HOSPITAL, A RELATED ORGANIZATION, HAS THREE SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS INCLUDING A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND A NON-CONTRIBUTORY, NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EXEC RETIREMENT PLAN (DC SERP). NO AMOUNTS WERE PAID OUT OF THE PLANS DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN, EMPLOYER CONTRIBUTION TO THE DCSERP AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/14 ARE AS FOLLOWS: GORDON ALEXANDER - DEFERRED COMPENSATION PLAN $0; DEFINED CONTRIBUTION SERP PLAN $0 MICHELE WALDRON - DEFERRED COMPENSATION PLAN $17,500; DCSERP $29,058; CHANGE IN SERP ACTUARIAL VALUE $23,773 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $8,750; DCSERP $43,135; CHANGE IN SERP ACTUARIAL VALUE $20,531 JAMES MILLER - DEFERRED COMPENSATION PLAN $0; CHANGE IN SERP ACTUARIAL VALUE $0 PART I, LINE 3: THE FOUNDATION RELIED ON A RELATED ORGANIZATION, VALLEY CHILDREN'S HOSPITAL, TO ESTABLISH THE COMPENSATION AND BENEFITS OF THE FOUNDATION'S CEO, USING ALL OF THE METHODS INCLUDED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS" AND "WRITTEN EMPLOYMENT CONTRACT". X 2 55918 FMV X FUN CENTER 1 5400 FMV 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 VALLEY CHILDREN'S HOSPITAL IS THE SOLE MEMBER OF THE CORPORATION. CERTAIN MEMBER RIGHTS INCLUDE THE RIGHT TO APPROVE, ELECT, AND REMOVE ELECTED BOARD MEMBERS OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION A, LINE 7B SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION B, LINE 11 THE BOARD TREASURER PRESENTS THE DRAFT FORM 990 AT THE BOARD MEETING THAT IS HELD BEFORE THE FILING DATE AND ANSWERS QUESTIONS OR ADDRESSES ANY CONCERNS AT THIS MEETING. HARDCOPY IS MADE AVAILABLE FOR REVIEW AT THE MEETING AND IN THE FOUNDATION OFFICE. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE FOUNDATION BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE FOUNDATION'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING HOSPITAL GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. FOUNDATION SUPPORT STAFF ARE EMPLOYED BY VALLEY CHILDREN'S HOSPITAL AND ARE THEREFORE SUBJECT TO THE HOSPITAL'S CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE OFFICERS AND SUPPORT STAFF OF THE FOUNDATION ARE EMPLOYED BY THE HOSPITAL. AS SUCH, THE FOUNDATION DOES NOT HAVE EMPLOYEES THAT IT PAYS DIRECTLY. AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THIS COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE FORM 990, PART VI, SECTION C, LINE 19 A COPY OF FOUNDATION'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF THE FOUNDATION IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE HOSPITAL PREPARES CONSOLIDATED ANNUAL FINANCIAL STATEMENTS WHICH ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO SUBMITTAL TO RELEVANT STATE AGENCIES. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF GIFT ANNUITY -20,686. RESERVE FOR UNCOLLECTIBLE PLEDGES -82,887. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE DISTRIBUTION TO VALLEY CHILDREN'S HOSPITAL, A NONPROFIT 501(C)(3) ORGANIZATION, FOR EQUIPMENT AND OPERATIONAL EXPENSES: $46,444,660 THE VALLEY CHILDREN'S HEALTHCARE FOUNDATION IS A CHARITABLE TAX-EXEMPT ORGANIZATION BENEFITING VALLEY CHILDREN'S HOSPITAL. THE FOUNDATION'S MISSION IS CLEAR AND UNEQUIVOCAL: "GENERATE FUNDS TO SUPPORT THE GOALS OF VALLEY CHILDREN'S HOSPITAL." AS THE FUNDRAISING ARM OF THE HOSPITAL, THE FOUNDATION UTILIZES A VARIETY OF PROGRAMS TO RAISE PHILANTHROPIC FUNDS TO MEET THE HOSPITAL'S MISSION. THE FOUNDATION IS A PARTICIPATING MEMBER OF THE CHILDREN'S MIRACLE NETWORK, AND OTHER WIDELY ANTICIPATED VALLEY EVENTS, INCLUDING THE ANNUAL KID'S DAY AND THE HARVEST BALL. IN ADDITION, THE FOUNDATION HAS DEVELOPED CORPORATE, ANNUAL CAUSE-MARKETING, OUTSIDE SPECIAL EVENTS, TRIBUTES, DIRECT MAIL, AND MAJOR AND PLANNED GIFT PROGRAMS. WHILE THE ONLY "MEMBER" OF THE FOUNDATION IS THE HOSPITAL'S BOARD OF TRUSTEES, THE WORK OF THE FOUNDATION IS DIRECTED AND ASSISTED BY THE BOARD OF DIRECTORS COMPRISING 24 VOLUNTEER COMMUNITY MEMBERS. FOUNDED IN 1981, THE FOUNDATION HAS DEVELOPED AND LED COMMUNITY-BASED PHILANTHROPIC EFFORTS TO SUPPORT THE HOSPITAL IN ADDITION TO THE WORK OF THE HOSPITAL GUILDS. IN ITS INITIAL YEARS, THE FOUNDATION'S FUND RAISING EFFORTS WERE LARGELY FOCUSED ON SPECIAL EVENTS AND ANNUAL PROGRAMS. PRESENTLY THE FOUNDATION IS FOCUSED ON BUILDING PROGRAMS TO SUPPORT A MAJOR GIFTS CULTURE TO COMPLIMENT THE CORE ANNUAL FUNDING PROGRAMS. VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 941294954 HOSPITAL CA 501(C)(3) 3 VALLEY CHILDREN'S HEALTHCARE 0 VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 464150987 HEALTH CARE CA 501(C)(3) LINE 9 VALLEY CHILDREN'S HEALTHCARE 0 VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA CA 93630 464158433 HEALTH CARE CA 501(C)(3) LINE 11B, II N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0