PAJARO VALLEY COMMUNITY HEALTH TR: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: PAJARO VALLEY COMMUNITY HEALTH TR (EIN 94-1149702)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2013-11-15
IRS object ID: 201323199349304687
Schema version: 2012v2.0
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule I
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T08:58:02-08:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Hayashi & Wayland CPAs	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1188 Padre Drive Suite 101	AddressLine1
City	Salinas	City
State	CA	State
ZIP Code	93901	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	941149702	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	PAJARO VALLEY COMMUNITY HEALTH TRUST	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	PAJA	NameControl
Phone	8317615639	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	85 NIELSON ST	AddressLine1
City	WATSONVILLE	City
State	CA	State
ZIP Code	95076	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	KATHLEEN KING	Name
Title	CEO	Title
Date Signed	2013-11-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Michael Briley	Name
PTIN	P00038425	PTIN
Phone	8317596300	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KATHLEEN KING	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	85 NIELSON ST	AddressLine1
City	WATSONVILLE	City
State	CA	State
ZIP Code	95076	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	7153593	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	www.pvhealthtrust.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1998	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	IMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	20	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	20	NbrIndependentVotingMembers
Total Nbr Employees	16	TotalNbrEmployees
Total Nbr Volunteers	40	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	157883	ContributionsGrantsPriorYear
Contributions Grants Current Year	317028	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	57801	ProgramServiceRevenuePriorYear
Program Service Revenue CY	44345	ProgramServiceRevenueCY
Investment Income Prior Year	915541	InvestmentIncomePriorYear
Investment Income Current Year	996475	InvestmentIncomeCurrentYear
Other Revenue Prior Year	47983	OtherRevenuePriorYear
Other Revenue Current Year	21986	OtherRevenueCurrentYear
Total Revenue Prior Year	1179208	TotalRevenuePriorYear
Total Revenue Current Year	1379834	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	150000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	125000	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	706568	SalariesEtcPriorYear
Salaries Etc Current Year	680338	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	83671	TotalFundrsngExpCurrentYear
Other Expense Prior Year	296204	OtherExpensePriorYear
Other Expenses Current Year	278859	OtherExpensesCurrentYear
Total Expenses Prior Year	1152772	TotalExpensesPriorYear
Total Expenses Current Year	1084197	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	26436	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	295637	RevenuesLessExpensesCY
Total Assets BOY	14657301	TotalAssetsBOY
Total Assets EOY	15298741	TotalAssetsEOY
Total Liabilities BOY	559713	TotalLiabilitiesBOY
Total Liabilities EOY	640267	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	14097588	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	14658474	NetAssetsOrFundBalancesEOY
Mission Description	IMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	461956	Expense
Revenue	44345	Revenue
Description	DIABETES HEALTH CENTER (DHC) - THE DHC IS A DIRECT SERVICE PROGRAM OPERATED BY THE HEALTH TRUST TO PROVIDE DIABETES PREVENTION, SELF MANAGEMENT EDUCATION AND MEDICAL NUTRITION THERAPY TO ALL WHO NEED THESE SERVICES REGARDLESS OF THEIR ABILITY TO PAY FOR THEM. DURING THE 2012-13 FISCAL YEAR, THE DHC PROVIDED OUTREACH AND EDUCATIONAL SERVICES TO OVER 800 PEOPLE AND PROVIDED OVER 1,700 VISITS TO PATIENTS WITH AND WITHOUT DIABETES. THE DHC HAD A SUCCESSFUL LAUNCH OF "SHARED MEDICAL APPOINTMENTS" IN A COMMUNITY CLINIC SETTING, AND ALSO SUCCESSFULLY LAUNCHED AN ELECTRONIC MEDICAL RECORDS SYSTEM.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	235172	Expense
Grants	125000	Grants
Description	GRANT MAKING - THE HEALTH TRUST AWARDED $125,000 DURING THE 2012-13 FISCAL YEAR, INCLUDING $5,000 IN SCHOLARSHIPS TO LOCAL HIGH SCHOOL STUDENTS SEEKING CAREERS IN HEALTH PROFESSIONS. THESE GRANTS SUPPORTED THE STRATEGIC PROGRAM AREAS AND POPULATION GROUPS TARGETED BY THE TRUST.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	57617	Expense
Description	REGIONAL DIABETES COLLABORATIVE (RDC) - THE RDC IS A COLLABORATIVE CONVENED BY THE HEALTH TRUST IN 2002 TO BRING STAKEHOLDERS TOGETHER TO SUPPORT, PROMOTE AND COORDINATE EFFORTS TO PREVENT AND MANAGE DIABETES IN MONTEREY, SAN BENITO AND SANTA CRUZ COUNTIES. WITH 35 MEMBER AGENCIES FROM THE TRI-COUNTY AREA, THE RDC HOLDS GENERAL MEETINGS BI-ANNUALLY AND SPONSORS ACTIVITIES THROUGHOUT THE YEAR TO INCREASE PUBLIC AWARENESS OF DIABETES IN THE REGION, TO PROMOTE BEST PRACTICES IN CLINICAL MANAGEMENT OF DIABETES AND TO IMPROVE ACCESSIBILITY TO TREATMENT, MEDICINES AND EDUCATION. DURING THE 2012-13 FISCAL YEAR, THE RDC CONVENED THE RDC GENERAL MEMBERSHIP AND STEERING COMMITTEE MEETINGS, AS WELL AS HOSTED THE TENTH ANNUAL DIABETES FORUM, TENTH ANNUAL DIABETES HEALTH FAIR AND HOSTED SCHOOL HEALTH PERSONNEL TRAINING.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	754745	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	true	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	true	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	4	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	16	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Form990-T Filed	false	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	20	NbrVotingGoverningBodyMembers
Number Independent Voting Members	20	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ADDRESSEE	NamePerson
Telephone Number	8317615639	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	85 NIELSON ST	AddressLine1
City	WATSONVILLE	City
State	CA	State
ZIP Code	95076	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer
CARLOS RIVERA
Director	2.00	0.00	X	0	0	0
ERIC TAYLOR
Director	2.00	0.00	X	0	0	0
JOSE CHIBRAS MD
Director	2.00	0.00	X	0	0	0
SALLY ANDERSON
Director	2.00	0.00	X	0	0	0
MICHELE VIOLICH MD
Secretary	2.00	0.00	X	0	0	0
BARBARA PALLA
Director	2.00	0.00	X	0	0	0
EDUARDO MONTESINO
Director	2.00	0.00	X	0	0	0
ELSA MENDOZA JIMENEZ
Director	2.00	0.00	X	0	0	0
RICH OTTO
Director	2.00	0.00	X	0	0	0
SUZANNE MINE-EGUCHI
Director	2.00	0.00	X	0	0	0
DAVID MESA
Treasurer	2.00	0.00	X	0	0	0	X
GERALD KONDO DDS
Director	2.00	0.00	X	0	0	0
RONALD JONES
Director	2.00	0.00	X	0	0	0
ROSIE IBARRA
Director	2.00	0.00	X	0	0	0
STAN HAJDUK MD
Director	2.00	0.00	X	0	0	0
CAROLINE EISKAMP
Chairman	2.00	0.00	X	0	0	0	X
GINA GALLUCCI
Director	2.00	0.00	X	0	0	0
CATHLEEN CHANDLER-ECKHARDT
Director	2.00	0.00	X	0	0	0
JAVIER CARRILLO
VICE CHAIR	2.00	0.00	X	0	0	0	X
JUDY CAREY
Director	2.00	0.00	X	0	0	0
TRINA COFFMAN-GOMEZ
Director	2.00	0.00	X	0	0	0
STEVE SCHURAY
FINANCE DIREC	18.00	0.00		35027	0	5262	X
KATHLEEN KING
CEO	40.00	0.00		109870	0	19609	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	144897	TotalReportableCompFromOrg
Total Other Compensation	24871	TotalOtherCompensation
Number Individuals GT100 K	1	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	UBS FINANCIAL SERVICES INC	BusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8149	AddressLine1
City	WALNUT CREEK	City
State	CA	State
ZIP Code	945968149	ZIPCode

Field	Value	IRS element (for citing)
Description Of Services	INVESTMENT MGMT	DescriptionOfServices
Compensation	131009	Compensation

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	1	NumberOfContractorsGT100K
Fundraising Events	34950	FundraisingEvents
All Other Contributions	282078	AllOtherContributions
Noncash Contributions	32735	NoncashContributions
Total Contributions	317028	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISCELLANEOUS	621300	1590	1590
DHC PATIENT FEES	621300	42755	42755

Field	Value	IRS element (for citing)
Total Program Service Revenue	44345	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	450937	TotalRevenueColumn
Exclusion	$450,937	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	6259847	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	5713243	Securities
Other	1066	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	546604	Securities
Other	-1066	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	545538	TotalRevenueColumn
Related Or Exempt Function Income	545538	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	81436	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	34950	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	59450	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	21986	TotalRevenueColumn
Exclusion	$21,986	ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Field	Value	IRS element (for citing)
Total Other Revenue	0	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1379834	TotalRevenueColumn
Related Or Exempt Function Income	589883	RelatedOrExemptFunctionIncome
Exclusion	$472,923	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	125000	Total
Program Services	125000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	156769	Total
Program Services	117576	ProgramServices
Management And General	23516	ManagementAndGeneral
Fundraising	15677	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	412256	Total
Program Services	330098	ProgramServices
Management And General	35392	ManagementAndGeneral
Fundraising	46766	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	29429	Total
Program Services	23308	ProgramServices
Management And General	3798	ManagementAndGeneral
Fundraising	2323	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	33361	Total
Program Services	27467	ProgramServices
Management And General	3784	ManagementAndGeneral
Fundraising	2110	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	48523	Total
Program Services	38430	ProgramServices
Management And General	6262	ManagementAndGeneral
Fundraising	3831	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	18700	Total
Program Services	18700	ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	131009	Total
Management And General	131009	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	9750	Total
Program Services	5291	ProgramServices
Management And General	1678	ManagementAndGeneral
Fundraising	2781	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	6153	Total
Program Services	4129	ProgramServices
Management And General	357	ManagementAndGeneral
Fundraising	1667	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	24871	Total
Program Services	11211	ProgramServices
Management And General	11601	ManagementAndGeneral
Fundraising	2059	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	50374	Total
Program Services	37789	ProgramServices
Management And General	12585	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	2159	Total
Program Services	1016	ProgramServices
Management And General	1095	ManagementAndGeneral
Fundraising	48	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	0	Total

Interest Interest

Field	Value	IRS element (for citing)
Total	274	Total
Management And General	274	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	5052	Total
Management And General	5052	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	0	Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	FundraisingFundraising	Management And GeneralManagementAndGeneral
BAD DEBT	2660	2380	280
DUPLICATING	3647	3647
Postage and Shipping	10050	5115	4335	600
Printing and Publications	14160	3588	1794	8778

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	0	Total

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	1084197	Total
Program Services	754745	ProgramServices
Management And General	245781	ManagementAndGeneral
Fundraising	83671	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	103486	BOY
EOY	107869	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1357	BOY
EOY	25585	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	23014	BOY
EOY	110000	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	744339	BOY
EOY	1968	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	7977	BOY
EOY	7918	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	124795	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	71724	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	29811	BOY
EOY	53071	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	13747317	BOY
EOY	14992330	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	14657301	BOY
EOY	15298741	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	260985	BOY
EOY	80670	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	298728	BOY
EOY	559597	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	559713	BOY
EOY	640267	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	12941029	BOY
EOY	13299503	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	119616	BOY
EOY	303579	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1036943	BOY
EOY	1055392	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14097588	BOY
EOY	14658474	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	14657301	BOY
EOY	15298741	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	295637	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	557058	ReconciliationUnrealizedInvest
Reconcilation Other Changes	-291809	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Separate	X	FinancialStatementSeparate

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	231266	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	443079	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	247605	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	157883	CurrentTaxYearMinus1Year
Current Tax Year	282078	CurrentTaxYear
Total	1361911	Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

Field	Value	IRS element (for citing)
Total	0	Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

Field	Value	IRS element (for citing)
Total	0	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	231266	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	443079	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	247605	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	157883	CurrentTaxYearMinus1Year
Current Tax Year	282078	CurrentTaxYear
Total	1361911	Total

Field	Value	IRS element (for citing)
Amounts Subst Contributors Total	0	AmountsSubstContributorsTotal
Public Support Total170	1361911	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	677003	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	585829	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	917498	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	441028	CurrentTaxYearMinus1Year
Current Tax Year	450937	CurrentTaxYear
Total	3072295	Total

Net UBI NetUBI

Field	Value	IRS element (for citing)
Total	0	Total

Other Income170 OtherIncome170

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Total Support	4434206	TotalSupport
Public Support Pertcentage170	0.30710	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.30020	PublicSupportPertcentPriorYear
Ten Percent Test Current Year	X	TenPercentTestCurrentYear
Facts And Circumstances Test	Part II, Line 17a--The Pajaro Valley Community Health Trust, a 501 (c) 3 public benefit health care foundation, meets the IRS Facts & Circumstances test through the following:Actively seeking public support: The Health Trust is operated to attract new and additional public or governmental support on a continuous basis by:Maintaining a continuous and comprehensive program for solicitation of funds from the general public, community businesses and others by meeting with potential donors, soliciting funds through direct mail, holding annual special event fundraisers, soliciting support through its website and other social media outlets and by actively seeking grants from private and public foundations as well as government funders. Percentage of financial support and sources of support: With 30% of its support during FY 2012-13 coming from a variety of public sources, the Health Trust is well above the minimum threshold of 10% required under the IRS Facts and Circumstances Test.Representative governing body: The Health Trusts Board of Directors is comprised of a broad cross-section of members who reflect the professional, gender and ethnic diversity of the community including the following:a.A member of the City Council appointed by the City of Watsonville b.One member each appointed by the Health Departments of Santa Cruz and Monterey Counties.c.Local physicians, nurses and health care advocates who provide special knowledge and expertise in the field of health, which is the primary charitable mission of the organization.d.Individuals who are considered leaders in the community from the fields of education, law, finance and agriculture who provide a broad cross section of community views and interests. Availability of public facilities or services: The Health Trust meets this standard in several ways: a.Facilities/Services: The Health Trust provides large conference and meeting space and furniture (tables and chairs) free of charge to nonprofit organizations for meetings, trainings and other events to which the public is invited. Examples include the Red Cross Blood Drive, School District Meetings, Health Collaborative Meetings, Medical Education Seminars and fund raising events.b.Publications: The Health Trust publishes an annual report and a health care newsletter on an annual basis. In addition, the Health Trust publishes its own healthcare survey research data on a biannual basis to inform other health care organizations and the public about local health care trends and challenges affecting the community. This data is widely used by public, private and governmental agencies to inform their health strategic planning efforts.c.Direct Program Service: The Health Trust operates a direct service health care program known as the Diabetes Health Center (DHC). The DHC provides diabetes self-management and prevention education as well as nutrition education for persons with or at risk of diabetes. The target populations served by this program are youth, low-income and underserved individuals and farm workers and their families. The staff of the DHC are licensed bilingual nurses and dietitians who are certified to provide the programs services. Their clinical standards are monitored by a highly qualified physician who also serves on the Health Trust Board. While the program accepts insurance reimbursement and sliding scale fees, patients are provided services regardless of their ability to pay. Accountability to Funders: The Health Trust regularly solicits grants from private and community foundations and occasionally from government funding sources. In each case, the Health Trust is contractually accountable to its funders for reporting progress of its program efforts and use of grant funds.	FactsAndCircumstancesTest

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1137421	BeginningOfYearBalance
Contributions	15487	Contributions
Investment Earnings Or Losses	127765	InvestmentEarningsOrLosses
Other Expenditures	14640	OtherExpenditures
Administrative Expenses	7332	AdministrativeExpenses
End Of Year Balance	1258701	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1147222	BeginningOfYearBalance
Contributions	12240	Contributions
Investment Earnings Or Losses	24090	InvestmentEarningsOrLosses
Other Expenditures	36653	OtherExpenditures
Administrative Expenses	9478	AdministrativeExpenses
End Of Year Balance	1137421	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	958805	BeginningOfYearBalance
Contributions	14880	Contributions
Investment Earnings Or Losses	182883	InvestmentEarningsOrLosses
Administrative Expenses	9346	AdministrativeExpenses
End Of Year Balance	1147222	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	776860	BeginningOfYearBalance
Contributions	103245	Contributions
Investment Earnings Or Losses	88070	InvestmentEarningsOrLosses
Administrative Expenses	9370	AdministrativeExpenses
End Of Year Balance	958805	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4040	BeginningOfYearBalance
Contributions	1252	Contributions
Administrative Expenses	909862	AdministrativeExpenses
End Of Year Balance	909862	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.01000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.84000	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.15000	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	false	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	false	AreRelatedOrgsListedScheduleR

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	43443	OtherCostOrOtherBasis
Depreciation	13743	Depreciation
Book Value	29700	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	49959	OtherCostOrOtherBasis
Depreciation	27643	Depreciation
Book Value	22316	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	31393	OtherCostOrOtherBasis
Depreciation	30338	Depreciation
Book Value	1055	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	53071	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	WORKERS COMP DEPOSIT	Description
Book Value	231275	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	14992330	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescription	AmountAmount
CAPITAL LEASE OBLIGATIONS	$12,754
ACCRUED WORKMANS COMPENSATION	$546,843

Field	Value	IRS element (for citing)
Total Of Amounts	559597	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	2115778	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	557058	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	249379	DonatedSrvcAndUseOfFacilities
Other Revenues	60516	OtherRevenues
Revenue Not Rptd F990	866953	RevenueNotRptdF990
Revenue Subtotal	1248825	RevenueSubtotal
Investment Expenses Not Included	131009	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	131009	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	1379834	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	1263083	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	249379	DonatedServicesUseOfFacilities
Other Expenses Included	60516	OtherExpensesIncluded
Expenses Not Rptd F990	309895	ExpensesNotRptdF990
Expenses Subtotal	953188	ExpensesSubtotal
Investment Expenses Not Included2	131009	InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt	131009	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	1084197	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Part XII, Line 2d	Part XII, Line 2d: Other expenses and losses per audited F/S	SPECIAL EVENTS EXPENSE $59450 LOSS ON DISPOSAL OF PROPERTY $1066
Part XI, Line 2d	Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990	SPECIAL EVENTS EXPENSE $59450 LOSS ON DISPOSAL OF PROPERTY $1066
Part X	Part X : FIN48 Footnote	As a tax-exempt not-for-profit organization, the Organization is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and from state franchise tax under California Revenue and Taxation Code Section 23701(d), but is subject to taxes on unrelated business income when earned. Management has considered its tax positions and believes that all of the positions taken in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organizations returns are subject to examination by federal and state taxing authorities, generally for three year and four years, respectively, after they are filed.
Part V, Line 4	Part V, Line 4: Intended uses of the endowment fund.	THE ENDOWMENT FUNDS ARE HELD IN ORDER TO GENERATE REVENUES IN SUPPORT OF HEALTH PROGRAMS FOR SENIORS AND CHILDREN, DENTAL NEEDS OF THOSE IN THE PAJARO VALLEY AND FOR THE UNRESTRICTED USE OF THE TRUST.

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Agreement Ref Fundraising	false	AgreementRefFundraising

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	WINE & ROSES EVENT	NameOfEvent1
Gross Receipts Event1	102755	GrossReceiptsEvent1
Charitable Contributions Event1	34950	CharitableContributionsEvent1
Gross Revenue Event1	67805	GrossRevenueEvent1
Rent Facility Costs Event1	2734	RentFacilityCostsEvent1
Food And Beverage Event1	5140	FoodAndBeverageEvent1
Entertainment Event1	500	EntertainmentEvent1
Other Direct Expenses Event1	36394	OtherDirectExpensesEvent1
Name Of Event2	MISCELLANEOUS EVENTS	NameOfEvent2
Gross Receipts Event2	13631	GrossReceiptsEvent2
Gross Revenue Event2	13631	GrossRevenueEvent2
Other Direct Expenses Event2	14682	OtherDirectExpensesEvent2
Gross Receipts Total	116386	GrossReceiptsTotal
Charitable Contributions Total	34950	CharitableContributionsTotal
Gross Revenue Total Events	81436	GrossRevenueTotalEvents
Rent Facility Costs Total Events	2734	RentFacilityCostsTotalEvents
Food And Beverage Total Events	5140	FoodAndBeverageTotalEvents
Entertainment Total Events	500	EntertainmentTotalEvents
Other Direct Expenses Total Events	51076	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	59450	DirectExpenseSummaryEvents
Net Income Summary	21986	NetIncomeSummary

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
WATSONVILLE FAMILY YMCA
27 SUDDEN STREET	WATSONVILLE	CA	95076	770020233	10000	0	HEALTH FAMILY HOME PROGRAM
WATSAPTOS ADULT EDUCA
294 GREEN VALLEY ROAD	WATSONVILLE	CA	95076	770375541	7450	0	HEALTH CAREER SCHOLARSHIPS
UNITED WAY OF SANTA CRUZ COUNTY
PO BOX 1458	CAPITOLA	CA	95010	941422471	8000	0	COMMUNITY ASSESSMENT PROJECT
SALUD PARA LA GENTE
195 AVIATION WAY SUITE 200	WATSONVILLE	CA	95076	942705747	7200	0	DENTAL CARE CHILDREN OF MIGRANT ED
PVUSDSTARLGHT & CESAR CHAVEZ
225 HAMMER DRIVE	WATSONVILLE	CA	95076		15000	0	DIABETES & CONTRIBUTING FACTORS
MESA VERDE GARDENS
2120 N PACIFIC AVE 91	SANTA CRUZ	CA	95060		10000	0	DIABETES & CONTRIBUTING FACTORS
LA MANZANA COMMUNITY RESOURCE
521 MAIN STREET SUITE Y	WATSONVILLE	CA	95076		7500	0	ACCESS TO CARE
JACOBS HEART
2007 FREEDOM BLVD	WATSONVILLE	CA	95076		6250	0	ACCESS TO CARE
HEALTHY KIDS SANTA CRUZ CNTY
1600 GREEN HILLS RD SUITE 101	SCOTTS VALLEY	CA	95066	770395311	12000	0	PROVIDE HEALTH INSURANCE TO KIDS
GIRL SCOUTS CA CENTRAL COAST
10550 MERRITT STREET	CASTROVILLE	CA	95012		7000	0	DIABETES & CONTRIBUTING FACTORS
FAMILY SVCS AGENCY
104 WALNUT AVE STE 208	SANTA CRUZ	CA	95060	941716354	10000	0	CRISIS COUNSELING SESSIONS
DIENTES COMMUNITY DENTAL CARE
1830 COMMERCIAL WAY	SANTA CRUZ	CA	95065	770311752	7200	0	DENTAL SERVICES TO LOW INCOME ADULTS
COMMUNITY ACTION BOARD
406 MAIN STREET STE 207	WATSONVILLE	CA	95076	942523780	10000	0	REAL DIABETES PREVENTION PROJECT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	8	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	5	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Grantmaker's Description of How Grants are Used	Identifier
Explanation	ALL ORGANIZATIONS APPLYING FOR FUNDING MUST SUBMIT A DETAILED LINE-ITEM BUDGET, INCLUDING INCOME AND EXPENSES FOR THE PROPOSED PROJECT. THEY MUST INDICATE THE AMOUNT PROPOSED FOR FUNDING FROM THE TRUST BY LINE ITEM AND INCLUDE NOTES FOR ANY LINE ITEMS THAT REQUIRE ADDITIONAL EXPLANATION.IF APPROVED FOR FUNDING, GRANTEES MUST SIGN A GRANT CONTRACT IN WHICH THEY AGREE TO USE THE GRANT FUNDS TO ACCOMPLISH THE SPECIFIC OUTCOMES OUTLINED IN THEIR GRANT PROPOSAL. THEY ALSO AGREE TO INFORM THE TRUST IMMEDIATELY IF THEY ARE UNABLE TO PERFORM ON ANY ASPECT OF THE GRANT CONTRACT ACTIVITIES AS OUTLINED IN THE PROPOSAL. THE CONTRACT INDICATES THAT USE OF THESE FUNDS FOR ANY PURPOSE OTHER THAN SET FORTH IN THE GRANT PROPOSAL AND/OR FAILURE TO REPORT CHANGES IMMEDIATELY OR TO PERFORM ON THE CONTRACT OUTCOMES MAY RESULT IN FORFEITURE OF PART OR ALL OF THE GRANT AMOUNT. ALSO REQUIRE GRANTEES TO SUBMIT PROGRESS AND FINAL REPORTS IN WHICH THEY MUST PROVIDE A DETAILED PROGRAM BUDGET THAT COMPARES ACTUAL EXPENDITURES TO THE APPROVED BUDGET.	Explanation

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	true	ReviewProcessUnusualNCGifts
Third Parties Used	false	ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990, Part XI, Line 9	Other Changes In Net Assets Or Fund Balances - Other Decreases	DISCONTINUED OPERATIONS - NET ACTIVITY = -$291809
Form 990, Part VI, Line 19	Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Governing docs are available upon request.
Form 990, Part VI, Line 15b	Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	OTHER EMPLOYEE COMPENSATION IS DETERMINED BY THE CEO AND REVIEWED WITH THE EXECUTIVE COMMITTEE.
Form 990, Part VI, Line 15a	Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management	FOR CEO AND TOP FINANCIAL PERSON, EXECUTIVE COMMITTEE COMPARES COMPENSATION WITH SIMILAR ORGANIZATIONS LOCALLY AND NATIONALLY; SALARY INCREASES ARE BASED ON COMPENSATION AND PERFORMANCE BASED. EXECUTIVE COMMITTEE EVALUATES CEO'S PERFORMANCE AND MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL, ANNUALLY, WITHIN BUDGETARY PARAMETERS.
Form 990, Part VI, Line 12c	Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	Conflict of interest statements are updated annually as well as when grants are approved to monitor for potential conflicts of interest.
Form 990, Part VI, Line 11b	Form 990, Part VI, Line 11b: Form 990 Review Process	Pajaro Valley Community Health Trust engages a CPA firm to assist with the preparation and filing of the Form 990, based on an audit engagement completed by the same CPA firm. Once the CPA firm has completed a draft of the form 990, a copy will be sent to the Board of Directors for review and approval before the tax return is filed.