SONOMA VALLEY COMMUNITY HEALTH CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SONOMA VALLEY COMMUNITY HEALTH CENTER (EIN 68-0286382)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-13
- IRS object ID
- 201203189349303095
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-13T17:36:55-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941585562 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PISENTI & BRINKER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 FIRST STREET SUITE 208 | AddressLine1 |
| City | PETALUMA | City |
| State | CA | State |
| ZIP Code | 94952 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680286382 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SONOMA VALLEY COMMUNITY HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SONO | NameControl |
| Phone | 7079396075 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 WEST NAPA STREET SUITE F | AddressLine1 |
| City | SONOMA | City |
| State | CA | State |
| ZIP Code | 95476 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHERYL JOHNSON | Name |
| Title | CEO | Title |
| Phone | 7079396075 | Phone |
| Date Signed | 2012-11-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RAYMOND POUNDS | Name |
| PTIN | P00459430 | PTIN |
| Phone | 7077629900 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CHERYL JOHNSON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 WEST NAPA STREET SUITE F | AddressLine1 |
| City | SONOMA | City |
| State | CA | State |
| ZIP Code | 95476 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 4455180 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SVCHC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDING HEALTH CARE SERVICES, ESPECIALLY TO THE UNDERSERVED, REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 57 | TotalNbrEmployees |
| Total Nbr Volunteers | 12 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1056265 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1370885 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3029021 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3081867 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6968 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2428 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 4092254 | TotalRevenuePriorYear |
| Total Revenue Current Year | 4455180 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2536239 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2680331 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1476631 | OtherExpensePriorYear |
| Other Expenses Current Year | 1600379 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4012870 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4280710 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 79384 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 174470 | RevenuesLessExpensesCY |
| Total Assets BOY | 2039359 | TotalAssetsBOY |
| Total Assets EOY | 2338224 | TotalAssetsEOY |
| Total Liabilities BOY | 495491 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 619886 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1543868 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1718338 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MISSION - To provide accessible quality health care to those who need it, especially the underserved.VISION - To be recognized as a leader in providing patient and community centered care in collaboration with other organizations. Sonoma Valley Community Health Center is a California nonprofit public benefit corporation organized to provide high quality heath care access to those in need, regardless of ability to pay, located in Sonoma, California. The Health Center provides routine health assessments, physical examinations, treatment and preventative services. Expanded services include urgent care, specialized procedures, pre and post operative care and follow-up. The center also operates a mobile medical van which makes site visits to the local schools, expanding services to children in need. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1747968 | Expense |
| Revenue | 2137543 | Revenue |
| Description | FAMILY PRACTICE SERVICES. The Health Center provides medical care services for infants through adults, with extended day and evening hours and is open 6 days per week. Services include routine examinations, immunizations, physicals, urgent care and diagnosis, and treatment of acute and chronic illness. The Health Center also operates a mobile medical clinic, a confidential teen clinic, and other enabling services. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 468244 | Expense |
| Revenue | 572602 | Revenue |
| Description | COMPREHENSIVE PERINATAL SERVICES: The Health Center provides pre- and post-natal OB services and education to pregnant women. Nurse educators and nutritionists are available full time to support patients. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 175120 | Expense |
| Revenue | 214150 | Revenue |
| Description | BEHAVIORAL HEALTH SERVICES. The Health Center provides behavioral health services utilizing a part time pyschiatrist, 2 part time psychologists and 1 part time licensed clinical social worker. The Health Center also has a substance abuse counseling program staffed by part time certified substance abuse counselors provided through a contract with the Drug Abuse Alternative Center. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | 157572 | Revenue |
| Description | OTHER PROGRAM SERVICES: Shared savings $122,994/MD On Call $22,800/All other $11,778. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Rev | 157572 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 2391332 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 36 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 57 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN TORRES CFO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7079396075 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 430 WEST NAPA STREET SUITE F | AddressLine1 |
| City | SONOMA | City |
| State | CA | State |
| ZIP Code | 95476 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| TOM ANDERSON | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| RICHARD GANTENBEIN | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MIKE GRETZ | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| PAT HARRISON | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MISTY RUSHING | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| MARC SCHWAGER | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| PAMELA STEPHENS | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| STEPHEN DALE | |||||||
| DIRECTOR/MEMBER | 2.00 | X | 0 | 0 | 0 | ||
| SUSAN DRAKE | |||||||
| CHAIR | 2.00 | 0 | 0 | 0 | X | ||
| LAURA STOVALL | |||||||
| VICE CHAIR | 2.00 | 0 | 0 | 0 | X | ||
| VICTORIA HALL | |||||||
| SECRETARY | 2.00 | 0 | 0 | 0 | X | ||
| LINDA MCTAGGART | |||||||
| TREASURER | 2.00 | 0 | 0 | 0 | X | ||
| PATRICIA TALBOT | |||||||
| CEO | 40.00 | 126708 | 0 | 14880 | X | ||
| SUSAN TORRES | |||||||
| CFO | 40.00 | 81710 | 0 | 33012 | X | ||
| CAROL AHERN | |||||||
| ACTING MEDICAL DIRECTOR | 24.00 | 81086 | 0 | 18658 | X | ||
| LINDA VEHLING | |||||||
| DIRECTOR OF OPERATIONS | 40.00 | 71713 | 0 | 11426 | X | ||
| JEROME SMITH | |||||||
| MEDICAL DIRECTOR | 40.00 | 138075 | 0 | 7507 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 499292 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 85483 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DR PAUL AMARA | NamePerson |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 475 | AddressLine1 |
| City | SONOMA | City |
| State | CA | State |
| ZIP Code | 95476 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | CONTRACTED MEDICAL SERVICES PROVIDER | DescriptionOfServices |
| Compensation | 132520 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Government Grants | 1158428 | GovernmentGrants |
| All Other Contributions | 212457 | AllOtherContributions |
| Total Contributions | 1370885 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENU | 624100 | 2924295 | 2924295 |
| OTHER PROGRAM SERVICE | 624100 | 157572 | 157572 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3081867 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2428 | TotalRevenueColumn |
| Exclusion | $2,428 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4455180 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3081867 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,428 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 584775 | Total |
| Program Services | 245326 | ProgramServices |
| Management And General | 339449 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1673248 | Total |
| Program Services | 1052627 | ProgramServices |
| Management And General | 620621 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14840 | Total |
| Program Services | 11318 | ProgramServices |
| Management And General | 3522 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221225 | Total |
| Program Services | 133583 | ProgramServices |
| Management And General | 87642 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186243 | Total |
| Program Services | 111019 | ProgramServices |
| Management And General | 75224 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30000 | Total |
| Management And General | 30000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 642106 | Total |
| Program Services | 317308 | ProgramServices |
| Management And General | 324798 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25319 | Total |
| Program Services | 6783 | ProgramServices |
| Management And General | 18536 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104010 | Total |
| Program Services | 17309 | ProgramServices |
| Management And General | 86701 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89130 | Total |
| Program Services | 30325 | ProgramServices |
| Management And General | 58805 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255228 | Total |
| Program Services | 114066 | ProgramServices |
| Management And General | 141162 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12852 | Total |
| Program Services | 1320 | ProgramServices |
| Management And General | 11532 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32077 | Total |
| Program Services | 1458 | ProgramServices |
| Management And General | 30619 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55401 | Total |
| Program Services | 34042 | ProgramServices |
| Management And General | 21359 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38530 | Total |
| Program Services | 25243 | ProgramServices |
| Management And General | 13287 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 208492 | 208492 | |
| BAD DEBT | 71655 | 71655 | |
| DUES & SUBSCRIPTIONS | 35579 | 9458 | 26121 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4280710 | Total |
| Program Services | 2391332 | ProgramServices |
| Management And General | 1889378 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 631674 | BOY |
| EOY | 670524 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 739611 | BOY |
| EOY | 590902 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28406 | BOY |
| EOY | 62818 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191253 | BOY |
| EOY | 210980 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8249 | BOY |
| EOY | 8215 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78819 | BOY |
| EOY | 100663 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1345676 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 746812 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 332447 | BOY |
| EOY | 598864 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28900 | BOY |
| EOY | 95258 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2039359 | BOY |
| EOY | 2338224 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 495491 | BOY |
| EOY | 619886 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 495491 | BOY |
| EOY | 619886 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1490556 | BOY |
| EOY | 1634900 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 53312 | BOY |
| EOY | 83438 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1543868 | BOY |
| EOY | 1718338 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2039359 | BOY |
| EOY | 2338224 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 174470 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1251443 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1081269 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 945356 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1056265 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1370885 | CurrentTaxYear |
| Total | 5705218 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2227622 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2616986 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2756270 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3029021 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3081867 | CurrentTaxYear |
| Total | 13711766 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3479065 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3698255 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3701626 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4085286 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4452752 | CurrentTaxYear |
| Total | 19416984 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 19416984 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 37801 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 31130 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11514 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6968 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2428 | CurrentTaxYear |
| Total | 89841 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 37801 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 31130 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 11514 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6968 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2428 | CurrentTaxYear |
| Total | 89841 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3516866 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3729385 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3713140 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4092254 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4455180 | CurrentTaxYear |
| Total | 19506825 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99540 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99420 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00460 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00580 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 1 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1: | ReturnReference |
| Explanation | The organization pays dues to the National Association of Community Health Centers (NACHC) and the California Primary Care Association (CPCA). A portion of these dues may be used for lobbying. Also, board members and staff have on occasion had direct contact with legislators and/or their staff. | Explanation |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 159439 | OtherCostOrOtherBasis |
| Depreciation | 124263 | Depreciation |
| Book Value | 35176 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 709001 | OtherCostOrOtherBasis |
| Depreciation | 622549 | Depreciation |
| Book Value | 86452 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 477236 | OtherCostOrOtherBasis |
| Book Value | 477236 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 598864 | TotalOfBookValueLandBuildings |
| Total Revenue | 4455180 | TotalRevenue |
| Total Expenses | 4280710 | TotalExpenses |
| Excess Or Deficit For Year | 174470 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 174470 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 4048110 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 4048110 | RevenueSubtotal |
| Other Revenues Not Included | 407070 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 407070 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 4455180 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4280710 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 4280710 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4280710 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part XII, Line 4b - Other Adjustments: | Identifier |
| Explanation | CAPITAL GRANTS AND CONTRIBUTIONS 376,944. CHANGE IN NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATIONS 30,126. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ELIZABETH EMMONS-GOSSELIN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | FAMILY MEMBER OF ORGANIZATION'S CEO | Relationship |
| Amount Of Transaction | 16442 | AmountOfTransaction |
| Description Of Transaction | EMPLOYEE COMPENSATION | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section B, line 11 | CEO and CFO do an initial review of Form 990 with preparer. This draft is then mailed and/or sent electronically to all Board members for their review prior to the final draft being issued. Draft is then finalized and filed. | |
| Form 990, Part VI, Section B, line 12c | The conflict of interest policy relating to the Board of Directors and Officers is included in the bylaws of the organization. Disclosure of any conflicts is required when a Board member is elected to serve on the Board. CEO maintains conflict of interest file. | |
| Form 990, Part VI, Section B, line 15a | The organization utilizes written employment contracts, compensation studies and surveys and approval by a board or compensation committee. The Board has final authority over the hiring, dismissing, and annual evaluation of the CEO. The CEO evaluates the CFO and the Medical Director. The CEO reviews the California Primary Care Association (CPCA) annual state wide salary survey for community health centers to set salary ranges and wages each year. | |
| Form 990, Part VI, Section C, line 18 | The organization makes its Forms 1023 and 990 available to the public upon request. | |
| 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. | |
| Form 990, Page 12, Part XII, Line 2c | The Audit Committee, under the governing Board's supervision, shall be responsible for making recommendations to the Board on the hiring and terminating of independent certified public accountants (CPAs). The Audit Committee can negotiate the independent CPA's compensation on behalf of the governing Board. The Audit Committe must: (1) Confer with the auditor to satisfy committee members that the financial affairs of the nonprofit organization are in order; (2) Review the audit and decide whether to accept it; and (3) approve non-audit services by the independent CPAs accounting firm, and ensure such services conform to approprate government standards. There has been no change to this practice during the current year. | Review & Selection of Independent Accountant |
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