2014-05-14T20:46:26-05:00 2013-06-30 261659234 CW ASSOCIATES CPAS 700 BISHOP STREET SUITE 1040 HONOLULU HI 96813 990 2012-07-01 990149797 KOKUA KALIHI VALLEY COMPREHENSIVE FAMILY SERVICES KOKU 8087919411 2239 NORTH SCHOOL STREET HONOLULU HI 96819 DAVID DERAUF 8087919411 2014-05-14 1 MARK A HAYES P00085205 8085311040 2012 2015-11-30 17:44:51Z DAVID DERAUF 2239 NORTH SCHOOL STREET HONOLULU HI 96819 10940809 0 X WWW.KKV.NET X 1972 HI KOKUA KALIHI VALLEY AND AFFILIATE (THE "CENTER") WERE INCORPORATED IN THE STATE OF HAWAII IN MAY 1972 TO PROMOTE HEALTH AND TO PROVIDE COMPREHENSIVE FAMILY SERVICES IN THE KALIHI VALLEY COMMUNITY IN THE CITY & COUNTY OF HONOLULU, HAWAII. THE CENTER IS A FEDERALLY-QUALIFIED HEALTH CENTER THAT PROVIDES A BROAD RANGE OF HEALTH AND SOCIAL SERVICES TO A LARGELY MEDICALLY-UNDERSERVED IMMIGRANT POPULATION. 11 11 192 82 0 0 9824923 6493263 4006498 4349961 6859 10053 25314 87532 13863594 10940809 0 0 0 0 7632834 7612117 0 0 122341 2295272 2814313 9928106 10426430 3935488 514379 16721919 16157966 2156372 1078040 14565547 15079926 TOGETHER WE WORK TOWARD HEALING, RECONCILIATION AND THE ALLEVIATION OF SUFFERING IN KALIHI VALLEY, BY SERVING COMMUNITIES, FAMILIES AND INDIVIDUALS THROUGH STRONG RELATIONSHIPS THAT HONOR CULTURE AND FOSTER HEALTH AND HARMONY. 0 0 7635232 4437493 SERVICES PERFORMED TO PROVIDE ACCESS TO MEDICAL, DENTAL AND SOCIAL SERVICES IN THE KALIHI VALLEY COMMUNITY. 7635232 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 47 0 192 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 HI X DALLYS SALAS CHIEF FINANCIAL OFFIC 8087919411 2239 NORTH SCHOOL STREET HONOLULU HI 96819 RICKEY MURASHIGE 1.00 X X 0 0 0 DAVID NAKAMOTO 1.00 X X 0 0 0 KAREN FOX 1.00 X X 0 0 0 GRACE COBB 1.00 X X 0 0 0 JEFFREY ACIDO 1.00 X 0 0 0 PUA AUYONG 1.00 X 0 0 0 EDWARD KEMPER 1.00 X 0 0 0 GEOFFREY PANG 1.00 X 0 0 0 SHARON ROUPPET 1.00 X 0 0 0 MISKE KONY 1.00 X 0 0 0 THOMAS KUSATSU 1.00 X 0 0 0 DAVID DERAUF 40.00 X 145815 0 12878 CYNTHIA STURDEVANT 40.00 X 64142 0 7303 DALLYS SALAS 40.00 X 76271 0 5653 LAURA DEVILBISS 40.00 X 154556 0 9158 BRADLEY CHUN 40.00 X 125108 0 7581 JASON Y HIRAMOTO 40.00 X 105872 0 6927 JONAS NAVICKAS 40.00 X 120253 0 10375 MYA M HLA 40.00 X 109705 0 10344 901722 0 70219 6 0 1 0 MARYLKPRS 55 MERCHANT STREET SUITE 2900 HONOLULU HI 96813 CONTRUCTION PROJECT 4226067 JW INC 630 LAUMAKA STREET HONOLULU HI 96819 CABINETS & X-RAY EQUIP WALL INSTALL 578370 GREENPATH TECHNOLGIES 754 ILANIWAI STREET HONOLULU HI 96813 PV INSTALLATION & RENOVATION PROJECT 199630 3 4475345 2017918 61 6493263 MEDICAID 624110 3095169 3095169 PRIVATE INSURANCE 624110 569961 569961 MEDICARE 624110 401478 401478 SELF-PAY 624110 167111 167111 PHARMACY 624110 62134 62134 54108 54108 4349961 10053 10053 INCENTIVE PAYMENTS 624110 46082 46082 OTHER INCOME AND FEES 624110 40577 40577 CARETAKER HOUSING 900099 873 873 87532 10940809 4437493 0 10053 524882 431140 85736 8006 4979349 4090881 813508 74960 666671 545713 120958 908076 758869 149207 533139 439921 93218 3394 3394 31518 31518 629605 285808 343797 918364 763657 145028 9679 231481 517 215838 15126 71113 63802 7311 578307 119985 443752 14570 58692 20378 38314 REPAIRS AND MAINTENANCE 120320 41763 78557 MISCELLANEOUS 80410 24144 56266 TRAINING 36727 19506 17221 RENTAL EQUIPMENT 33908 21558 12350 20474 7590 12884 10426430 7635232 2668857 122341 962953 545064 1820652 830533 1130847 723456 959063 1064997 18928 79025 16885354 3970463 11829476 12914891 16721919 16157966 1906372 928040 250000 150000 2156372 1078040 X 13977830 14170799 587717 909127 14565547 15079926 16721919 16157966 514379 0 X 0 1 X 1 1 1 X 3450251 6146036 4968434 9824923 6493263 30882907 3450251 6146036 4968434 9824923 6493263 30882907 1181366 29701541 10489 6859 10053 27401 101151 97657 51959 25314 87532 363613 31273921 20344290 0.94970 0.94840 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME AND FEES - 2008 AMOUNT: $ 101,151. 2009 AMOUNT: $ 97,657. 2010 AMOUNT: $ 51,959. 2012 AMOUNT: $ 40,577. MEDICAL RECORD CHARGES - 2011 AMOUNT: $ 24,404. CARETAKER HOUSING - 2011 AMOUNT: $ 910. 2012 AMOUNT: $ 873. INCENTIVE PAYMENTS - 2012 AMOUNT: $ 46,082. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2288000 2288000 12603236 2811025 9792211 17500 17500 0 1976618 1141938 834680 12914891 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE UNCERTAIN TAX POSITIONS TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THEY ARE MORE LIKELY THAN NOT TO FAIL UPON REGULATORY EXAMINATION. MANAGEMENT HAS EVALUATED THE TAX POSITIONS OF KKV AND AFFILIATE AS OF JUNE 30, 2013 AND 2012 AND FOR THE YEARS THEN ENDED BY REVIEWING THEIR INCOME TAX RETURNS AND CONFERRING WITH THEIR TAX ADVISORS, AND DETERMINED THAT THERE WERE NO UNCERTAIN TAX POSITIONS REQUIRED TO BE REPORTED IN ACCORDANCE WITH SUCH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. SUCH RETURNS ARE OPEN FOR EXAMINATION BY TAXING AUTHORITIES UNTIL THE STATUTES OF LIMITATIONS EXPIRE. X X X 0 0 0 0 0 0 0 0 0 DAVID DERAUF 145815 0 0 0 0 0 6197 0 6681 0 158693 0 0 0 LAURA DEVILBISS 154556 0 0 0 0 0 6747 0 2411 0 163714 0 0 0 FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION ADOPTED AMENDED BYLAWS ON AUGUST 22, 2013 AND SIGNIFICANT CHANGES WERE MADE TO THE NUMBER, COMPOSITION, AUTHORITY AND DUTIES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE EXECUTIVE DIRECTOR REVIEWS THE 990 IN CONJUNCTION WITH THE CFO BEFORE PRESENTING TO THE FINANCE COMMITTEE FOR REVIEW. THE FINANCE COMMITTEE REVIEWS THE 990 AND MAKES A RECOMMENDATION TO THE BOARD OF DIRECTORS FOR APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C A COPY OF THIS POLICY IS GIVEN TO ALL BOARD MEMBERS UPON COMMENCEMENT OF SUCH PERSON'S RELATIONSHIP WITH THE ORGANIZATION. EACH BOARD MEMBER SIGNS AND DATES THE POLICY AT THE BEGINNING OF HER/HIS TERM OF SERVICE OR EMPLOYMENT AND EACH YEAR THEREAFTER. FAILURE TO SIGN DOES NOT NULLIFY THE POLICY. THE POLICY AND DISCLOSURE FORM MUST BE FILED ANNUALLY BY ALL SPECIFIED PARTIES. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE DIRECTOR'S SALARY IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD AND APPROVED BY THE FULL BOARD. ALL OTHER STAFF COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE AND APPROVED BY THE EXECUTIVE DIRECTOR AND THE BOARD OF DIRECTORS. COMPARABLE DATA IS OBTAINED FROM HAWAII PRIMARY CARE ASSOCIATION AND HAWAII ALLIANCE OF NONPROFIT ORGANIZATIONS (HANO). THIS PROCESS IS DOCUMENTED IN THE SALARY COMMITTEE MINUTES AND HR RECORDS. THIS WAS LAST UNDERTAKEN IN MAY 2013. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. KALIHI VALLEY COMMUNITY FOUNDATION 2239 NORTH SCHOOL STREET HONOLULU HI 96819 990329894 PROVIDE FINANCIAL SUPPORT TO CENTER HI 501(C)(3) LINE 7 KOKUA KALIHI VALLEY COMP FAMILY SVCS 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0