2026-05-14T21:17:59-05:00 2025-06-30 951777440 GREEN HASSON & JANKS LLP 700 S FLOWER STREET SUITE 3300 LOS ANGELES CA 90017 990 2024-07-01 273484548 VENICE FAMILY CLINIC FOUNDATION VENI 3103928630 604 ROSE AVENUE VENICE CA 90291 MITESH POPAT CEO 3103928630 2026-04-03 1 1 LIZBETH G NEVAREZ P01399868 3108731600 2026-04-03 2024 2025-03-06 01:10:19Z MITESH POPAT 604 ROSE AVENUE VENICE CA 90291 5033170 0 X HTTP://WWW.VENICEFAMILYCLINIC.ORG/ X 2010 CA TO SUPPORT THE MISSION OF THE VENICE FAMILY CLINIC, TO PROVIDE QUALITY PRIMARY HEALTHCARE TO PEOPLE IN NEED. 30 30 0 135 0 0 4159679 4530088 0 0 645299 503082 -1081127 -388865 3723851 4644305 0 0 0 0 0 0 0 0 39905 177324 131349 177324 131349 3546527 4512956 17313767 21935015 24393 130920 17289374 21804095 THE FOUNDATION'S SPECIFIC PURPOSE IS TO SUPPORT THE MISSION OF THE VENICE FAMILY CLINIC, TO PROVIDE QUALITY PRIMARY HEALTHCARE TO PEOPLE IN NEED. 0 0 SUPPORTING THE EFFORTS OF THE VENICE FAMILY CLINIC. 1 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 22 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 X 30 30 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 CA X X SERGIO BAUTISTA 3106647941 604 ROSE AVENUE VENICE CA 90291 MARK GAVENS BOARD CHAIR 2.00 2.00 X X 0 0 0 FRANK MATRICARDI DR PH TREASURER 2.00 0.00 X X 0 0 0 FERN SEIZER SECRETARY 2.00 0.00 X X 0 0 0 CAROL L ARCHIE MD BOARD MEMBER 2.00 0.00 X 0 0 0 JOANN BOURNE BOARD MEMBER 2.00 2.00 X 0 0 0 LOWELL C BROWN ESQ BOARD MEMBER 2.00 0.00 X 0 0 0 SCOTT F BURNS BOARD MEMBER 2.00 0.00 X 0 0 0 MAYER B DAVIDSON MD BOARD MEMBER 2.00 2.00 X 0 0 0 SUSAN FLEISCHMAN MD BOARD MEMBER 2.00 2.00 X 0 0 0 WILLIAM FLUMENBAUM BOARD MEMBER 2.00 0.00 X 0 0 0 JOHN R GERESI BOARD MEMBER 2.00 2.00 X 0 0 0 ALLAN GORDON BOARD MEMBER 2.00 0.00 X 0 0 0 ELLEN GORDON BOARD MEMBER 2.00 0.00 X 0 0 0 CHESTER F GRIFFITHS MD BOARD MEMBER 2.00 0.00 X 0 0 0 JIMMY H HARA MD BOARD MEMBER 2.00 0.00 X 0 0 0 JOAN E HERMAN BOARD MEMBER 2.00 2.00 X 0 0 0 HENRY A HORTON BOARD MEMBER 2.00 0.00 X 0 0 0 DEBORAH LAUB BOARD MEMBER 2.00 0.00 X 0 0 0 BRYAN LEWITT BOARD MEMBER 2.00 0.00 X 0 0 0 HARLEY LIKER MD MBA BOARD MEMBER 2.00 0.00 X 0 0 0 VIREN MEHTA BOARD MEMBER 2.00 0.00 X 0 0 0 WENDY SMITH MEYER PHD LCSW BOARD MEMBER 2.00 0.00 X 0 0 0 ETAN CHAIM MILGROM MD MS BOARD MEMBER 2.00 0.00 X 0 0 0 NEIL H PARKER MD BOARD MEMBER 2.00 0.00 X 0 0 0 JEFFREY E SINAIKO BOARD MEMBER 2.00 2.00 X 0 0 0 JOHNESE SPISSO MPA BOARD MEMBER 2.00 0.00 X 0 0 0 ERIC STERN BOARD MEMBER 2.00 0.00 X 0 0 0 SUSAN TICK BOARD MEMBER 2.00 0.00 X 0 0 0 RUSSEL TYNER AIA BOARD MEMBER 2.00 0.00 X 0 0 0 MICHAEL S WILKES MD PHD BOARD MEMBER 2.00 0.00 X 0 0 0 MITESH GHANSHYAM POPAT CHIEF EXECUTIVE OFFICER 1.00 40.00 X 0 556405 159524 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 1.00 40.00 X 0 300327 103450 0 856732 262974 0 0 1 0 BLACK MARKET BUILDOUT LLC 5907 E HADRIANS CRES ANAHEIM CA 92807 EVENT PRODUCTION 182193 1 638796 3891292 200668 4530088 502978 502978 104 0 104 104 104 0 638796 388865 -388865 -388865 4644305 0 0 114217 X 4925 4925 43084 39484 3600 1557 972 585 27 27 5781 5781 LICENSES, FEES, & DUES 40255 40255 SPECIAL EVENTS 31755 31755 EVENT CONSULTANT 3965 3965 131349 0 91444 39905 377307 29718 10268840 9632749 8675 2999 43062 6664621 12220811 17313767 21935015 24393 130920 24393 130920 X 17289374 21804095 0 0 17289374 21804095 17313767 21935015 4512956 1765 0 X X 0 1 X 1 0 X 6197868 4269648 3516452 4192429 4530088 22706485 6197868 4269648 3516452 4192429 4530088 22706485 2090815 20615670 5263 3320 212345 645299 502978 1369205 193435 72710 266145 24341835 0.84690 0.85010 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 RECEIVABLE FROM VENICE FAMILY CLINIC 12220811 12220811 X PART X, LINE 2: THE VENICE FAMILY CLINIC FOUNDATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE CONSOLIDATED FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. DURING THE YEAR ENDED JUNE 30, 2025, THE VENICE FAMILY CLINIC FOUNDATION PERFORMED AN EVALUATION OF UNCERTAIN TAX POSITIONS AND DID NOT IDENTIFY ANY MATTERS THAT WOULD REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS OR WHICH MIGHT HAVE AN EFFECT ON ITS TAX-EXEMPT STATUS. ART WALK 638796 638796 64847 1905 6373 315740 638796 638796 64847 1905 6373 315740 388865 -388865 0 0 0 0 0 0 0 0 0 MITESH GHANSHYAM POPAT CHIEF EXECUTIVE OFFICER 0 485797 0 70608 0 0 0 76412 0 83112 0 715929 0 0 ANDREA B BLACKBIRD CHIEF FINANCIAL OFFICER 0 300327 0 0 0 0 0 49552 0 53898 0 403777 0 0 SCHEDULE J, PART II OFFICERS, ANDREA B. BLACKBIRD AND MITESH POPAT, ARE COMPENSATED BY THE RELATED ENTITY VENICE FAMILY CLINIC (VFC). THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. X 4 200668 FMV 0 1 0 PART I, COLUMN (B): NONCASH CONTRIBUTIONS ARE LISTED BY TOTAL NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION A, LINE 8B THIS QUESTION IS NOT APPLICABLE AS THE ORGANIZATION DOES NOT HAVE A COMMITTEE WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE INFORMATIONAL RETURN IS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE AUDIT COMMITTEE. ONCE APPROVED BY THE AUDIT COMMITTEE, THE RETURN IS THEN REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ELECTRONIC FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL QUESTIONNAIRES ARE GIVEN TO BOARD MEMBERS TO DISCLOSE ANY CONFLICTS. IF A CONFLICT IS DISCLOSED IN THE ANNUAL QUESTIONNAIRE, THE INDIVIDUAL WILL BE ASKED TO RECUSE THEMSELVES FROM ANY CONVERSATIONS PERTAINING TO THIS CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 OFFICERS, ANDREA B. BLACKBIRD AND MITESH POPAT, ARE COMPENSATED BY THE RELATED ENTITY VENICE FAMILY CLINIC (VFC). THE BOARD HIRES, OVERSEES, AND ANNUALLY EVALUATES THE PERFORMANCE AND COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION INDEPENDENTLY, WITH THE CEO'S PARTICIPATION. THE CFO & OTHER KEY EMPLOYEES' COMPENSATION IS BASED UPON SKILL SET & MARKET RATE. 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, PART IX, LINE 11G SUBCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 38,660. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,660. DESIGN SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 3,600. TOTAL EXPENSES 3,600. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 824. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 824. FORM 990, PART XII, LINE 2C: NO PROCESSES HAVE CHANGED FROM THE PRIOR YEAR. VENICE FAMILY CLINIC 604 ROSE AVENUE VENICE CA 90291 952769432 HEALTH CARE CA 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0