CLINICAS DEL CAMINO REAL INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CLINICAS DEL CAMINO REAL INC (EIN 95-2977147)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201341359349305389
Schema version
2011v1.5
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-05-15T11:04:09-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Oscar G Armijo CPABusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line141-990 Cook St Suite 501AddressLine1
CityPalm DesertCity
StateCAState
ZIP Code92211ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952977147EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Clinicas Del Camino RealBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCLINNameControl
Phone8056591740Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 4566AddressLine1
CityVenturaCity
StateCAState
ZIP Code93007ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameChristina M VelascoName
TitleCFOTitle
Date Signed2013-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameOscar G Armijo CPAName
Phone7607734078Phone
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts45798876GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.clinicas.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTo provide quality, comprehensive and preventative, health care services to the underserved community in Ventura County. It is the explicit mission of Clinicas del Camino Real, Inc. to save lives and restore good health at rates that are consistent with a client's ability to pay. Moreover, bilingual and bicultural staff delivers its services on a personal and humane basis, and especially reaches out to members of the community who are traditionally underserved due to limited income, resources, cultural, and language barriers..ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees598TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year7405651ContributionsGrantsPriorYear
Contributions Grants Current Year12086088ContributionsGrantsCurrentYear
Program Service Revenue Prior Year26688637ProgramServiceRevenuePriorYear
Program Service Revenue CY33571911ProgramServiceRevenueCY
Investment Income Prior Year36352InvestmentIncomePriorYear
Investment Income Current Year33524InvestmentIncomeCurrentYear
Other Revenue Prior Year108936OtherRevenuePriorYear
Other Revenue Current Year107353OtherRevenueCurrentYear
Total Revenue Prior Year34239576TotalRevenuePriorYear
Total Revenue Current Year45798876TotalRevenueCurrentYear
Grants And Similar Amnts CY1251720GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year25449030SalariesEtcPriorYear
Salaries Etc Current Year29488590SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year11414317OtherExpensePriorYear
Other Expenses Current Year11743359OtherExpensesCurrentYear
Total Expenses Prior Year36863347TotalExpensesPriorYear
Total Expenses Current Year42483669TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2623771RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3315207RevenuesLessExpensesCY
Total Assets BOY40122027TotalAssetsBOY
Total Assets EOY44312686TotalAssetsEOY
Total Liabilities BOY19509741TotalLiabilitiesBOY
Total Liabilities EOY20385193TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20612286NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY23927493NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide quality, comprehensive and preventative, health care services to the underserved community in Ventura County. It is the explicit mission of Clinicas del Camino Real, Inc. to save lives and restore good health at rates that are consistent with a client's ability to pay. Moreover, bilingual and bicultural staff delivers its services on a personal and humane basis, and especially reaches out to members of the community who are traditionally underserved due to limited income, resources, cultural, and language barriers..MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense32100287Expense
Revenue33712788Revenue
DescriptionTo provide comprehensive and preventive health care services on a personal and humane basis to the people of Ventura County who are underserved due to income level or cultural/language barriers. Total patient encounters were 242,194.Description
Total Program Service Expense32100287TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096198NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees598NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCHRISTINE M VELASCO CFONamePerson
Telephone Number8056591740TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 S WELLS RD VENTURA CAAddressLine1
CityVenturaCity
StateCAState
ZIP Code93007ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
RAUL RAMOS
BOARD MEMBER1.00X000
Kristen Cady
Board Member1.00X000
JAVIER M OCHOA
Parliamentarian1.00X000
ANGEL ARREOLA
BOARD MEMBER1.00X000
ADOLFO MURILLO
Vice President1.00X000
CHARLES HOOKSTRA
President1.00X000X
KAREN R BURNHAM
Secretary1.00X000X
Nancy Carroll
Board Member1.00X000
BARBARA A JOURNET
Treasurer1.00X000X
Christina M Velasco
CFO40.00165462022408X
Roberto S Juarez
CEO40.00350597031859X
Antonio Alatorre
COO40.00162210021952X
Chawla Anil
Medical Director40.00290879025859X
MIRELA CERNAIANU
Physician40.00362969014156X
Nabeel Afzal Saeed
Physician40.0025107206416X
NASR ANEES
Physician40.00230190017735X
Johannes Ramirez
Physician40.00241085016887X
GUILLERMO RIOS
Physician40.00255046017551X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2309510TotalReportableCompFromOrg
Total Other Compensation174823TotalOtherCompensation
Number Individuals GT100 K36NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Nextgen Healthcare
PO Box 511449LOS ANGELESCA90051Computer Software468278
Community Health Centers
PO Box 430NipomoCA93444Health Care Provider463174
USC School of Pharmacy
1985 Zonal Ave PSC 700ALos AngelesCA90033Pharmacy Services283616
US Telepacific Corp
515 S Flower St 47th FloorLos AngelesCA90071Telephone Services216849
Laboratory Corp of America
PO Box 12140BurlingtonNC27216Medical Laboratory212932
FieldValueIRS element (for citing)
Number Of Contractors GT100 K12NumberOfContractorsGT100K
Government Grants11954457GovernmentGrants
All Other Contributions131631AllOtherContributions
Total Contributions12086088TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code621400BusinessCode
Total Revenue Column33571911TotalRevenueColumn
Related Or Exempt Function Income33571911RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue33571911TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column33524TotalRevenueColumn
Related Or Exempt Function Income33524RelatedOrExemptFunctionIncome

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISC. REVENUEDescription
Business Code561000BusinessCode
Total Revenue Column107353TotalRevenueColumn
Related Or Exempt Function Income107353RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue107353TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column45798876TotalRevenueColumn
Related Or Exempt Function Income33712788RelatedOrExemptFunctionIncome

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1251720Total
Program Services1251720ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total989167Total
Management And General989167ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total22552436Total
Program Services18598010ProgramServices
Management And General3954426ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total767544Total
Program Services600524ProgramServices
Management And General167020ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3340170Total
Program Services2613340ProgramServices
Management And General726830ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1839273Total
Program Services1439042ProgramServices
Management And General400231ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total676070Total
Program Services676070ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total178433Total
Management And General178433ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total75300Total
Management And General75300ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total837432Total
Program Services401909ProgramServices
Management And General435523ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1035255Total
Program Services714560ProgramServices
Management And General320695ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total188569Total
Program Services91378ProgramServices
Management And General97191ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total853400Total
Program Services416653ProgramServices
Management And General436747ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1671205Total
Program Services374226ProgramServices
Management And General1296979ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total247847Total
Program Services112188ProgramServices
Management And General135659ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Telephone428037289584138453
Promotion59196751426777700
Equipment Lease and Rental593469435307158162
Supplies28504682649921200547

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1515907Total
Program Services921588ProgramServices
Management And General594319ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total42483669Total
Program Services32100287ProgramServices
Management And General10383382ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6088727BOY
EOY4547027EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY999300BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7598183BOY
EOY9772252EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1721843BOY
EOY4604772EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY20436BOY
EOY115912EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY544377BOY
EOY562274EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis41088532LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec16411083LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY23149161BOY
EOY24677449EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY33000EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY40122027BOY
EOY44312686EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3406467BOY
EOY4513697EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY7144515BOY
EOY6689642EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8695712BOY
EOY8917778EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY263047BOY
EOY264076EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY19509741BOY
EOY20385193EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13052378BOY
EOY17334253EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY7559908BOY
EOY6593240EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20612286BOY
EOY23927493EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY40122027BOY
EOY44312686EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3315207ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6974022CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11283232CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10487871CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7405651CurrentTaxYearMinus1Year
Current Tax Year12086088CurrentTaxYear
Total48236864Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6974022CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11283232CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10487871CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7405651CurrentTaxYearMinus1Year
Current Tax Year12086088CurrentTaxYear
Total48236864Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total17048236864PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years163619CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years99647CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years64913CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year36352CurrentTaxYearMinus1Year
Current Tax Year33524CurrentTaxYear
Total398055Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years47622CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years103650CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years124168CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year108936CurrentTaxYearMinus1Year
Current Tax Year107353CurrentTaxYear
Total491729Total
FieldValueIRS element (for citing)
Total Support49126648TotalSupport
Public Support Pertcentage1700.98190PublicSupportPertcentage170
Public Support Pertcent Prior Year0.97740PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4126034OtherCostOrOtherBasis
Book Value4126034BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23856278OtherCostOrOtherBasis
Depreciation9547548Depreciation
Book Value14308730BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4424235OtherCostOrOtherBasis
Depreciation1994916Depreciation
Book Value2429319BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7346092OtherCostOrOtherBasis
Depreciation3898729Depreciation
Book Value3447363BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1335893OtherCostOrOtherBasis
Depreciation969890Depreciation
Book Value366003BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings24677449TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionBond Trust AccountDescription
Amount$264,076Amount
FieldValueIRS element (for citing)
Total Of Amounts264076TotalOfAmounts
Total Revenue45798876TotalRevenue
Total Expenses42483669TotalExpenses
Excess Or Deficit For Year3315207ExcessOrDeficitForYear
Excess Or Deficit Per FS3315207ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt45798876TotRevenueEtcAuditedFinclStmt
Revenue Subtotal45798876RevenueSubtotal
Total Revenue Per Form99045798876TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt42483669TotExpensesEtcAuditedFinclStmt
Expenses Subtotal42483669ExpensesSubtotal
Total Expenses Per Form99042483669TotalExpensesPerForm990

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Gardner Family Health Network
55 E JulianSan JoseCA95112941743078501(c)(3)5709070To fund EHR implementation expenses
Comm Health Ctrs of CC
150 Tejas PlaceNipomoCA93444953253302501(c)(3)3002090To fund EHR implementation expenses
Clinicas De Salud Del Valle D
440 Airport DrSalinasCA93905942652757501(c)(3)3806040To fund EHR implementation expenses
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationExpenditures and progress reports are required prior to the disbursements of any fundsExplanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgBonus Filing OrgBonusFilingOrg
Roberto S Juarez
3501844131106520794382456
NASR ANEES
1930512588562917324792536881
Nabeel Afzal Saeed
16120560641625748889807
MIRELA CERNAIANU
1936056086655491377125169304
Johannes Ramirez
170611907714917325797270384
GUILLERMO RIOS
1972911388378917327259757617
Christina M Velasco
165324138723515173187870
Chawla Anil
262675403110651479431673827801
Antonio Alatorre
16212090677915173184162

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonRoberto JuarezNamePerson
Purpose Of LoanBridge LoanPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$427,455OriginalPrincipalAmount
Balance Due13259BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due13259TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableForm 990 is available for review at the organizations administrative office during normal business hours. Other forms such as governing documents, conflict of interest policy, and financial statements are internal corporate documents.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesComparsion surveys are performed by the CEO and Human Resources Director using state and national databases. Annual reviews are performed by the Board of Directors for all officers, key employees, and other highly compensated employees.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe organization investigates potential conflicts of interest when they arise. any violations are handled in accordance with the written policies and procedures.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessThe Form 990 is prepared by an independent CPA, and then is reviewed by the CFO.

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