2023-05-12T14:44:04-05:00 2022-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2021-07-01 680149424 OLE HEALTH FOUNDATION OLEH 7076037100 1141 PEAR TREE LANE 100 NAPA CA 94558 ALICIA HARDY CEO 7076037100 2023-05-11 1 ALICIA HARDY 999009999 MICHAEL LUMSDEN P01262236 4159561500 2023-05-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ALICIA HARDY 1141 PEAR TREE LANE 100 NAPA CA 94558 2817797 0 X WWW.OLEHEALTH.ORG X 1987 CA FUNDRAISING AND OTHER SERVICES TO SUPPORT OLE HEALTH. 18 17 4 17 0 0 1056773 2278644 0 0 71397 252271 242216 261514 1370386 2792429 3629738 2298619 0 0 0 0 0 0 198 96982 14737 3726720 2313356 -2356334 479073 4734519 5556621 41292 1199998 4693227 4356623 OUR MISSION IS TO INSPIRE PHILANTHROPIC CONTRIBUTIONS TO ENSURE THAT OLE HEALTH IS ALWAYS HERE TO CARE FOR EVERYONE IN OUR BEAUTIFUL AND DIVERSE COMMUNITY. 0 0 2298619 2298619 0 OLE HEALTH FOUNDATION PERFORMS FUNDRAISING SERVICES IN SUPPORT OF OLE HEALTH, A HEALTH CENTER FOR LOW-INCOME INDIVIDUALS AND OTHERS WITHOUT HEALTH INSURANCE. DURING THE YEAR, OLE HEALTH FOUNDATION GAVE A $2,298,619 GRANT TO OLE HEALTH IN SUPPORT OF ITS ONGOING OPERATIONS AND SPECIAL PROJECTS TO CREATE LASTING RESERVE FUNDS, ENSURING THAT OLE HEALTH CAN CONTINUE TO PROVIDE HIGH QUALITY PRIMARY HEALTH CARE TO OUR ENTIRE COMMUNITY. 2298619 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 6 0 1 4 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 18 17 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X CINDY JOHNSON 7072541770 2650 NAPA VALLEY CORPORATE DRIVE NAPA CA 94558 ALICIA HARDY BOARD MEMBER / CEO OF OLE HEALTH 1.00 39.00 X X 0 332978 24171 ROSE MACISAAC CFO/COO THROUGH 2/2022 8.00 32.00 X 0 275658 22373 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 20.00 20.00 X 0 183150 5554 HEMANTA MUNGUR CHIEF FINANCIAL OFFICER START 2/2022 8.00 32.00 X 0 0 0 DARIOUSH KHALEDI CHAIR 1.00 0.00 X X 0 0 0 BLAKESLEY CHAPPELLET VICE CHAIR 1.00 0.00 X X 0 0 0 NAOKO DALLA VALLE SECRETARY 1.00 0.00 X X 0 0 0 RICK JONES TREASURER 1.00 2.00 X X 0 0 0 SUZANNE BESU TRUCHARD BOARD MEMBER 1.00 0.00 X 0 0 0 STEVE FINK BOARD MEMBER 1.00 0.00 X 0 0 0 LESLIE FRANK BOARD MEMBER 1.00 0.00 X 0 0 0 CLIFF LEDE BOARD MEMBER 1.00 0.00 X 0 0 0 DAN LYNCH BOARD MEMBER 1.00 0.00 X 0 0 0 CARLTON MCCOY BOARD MEMBER 1.00 0.00 X 0 0 0 PETER MCCREA BOARD MEMBER 1.00 0.00 X 0 0 0 FRANK NAEYMI-RAD BOARD MEMBER 1.00 0.00 X 0 0 0 WILL PHELPS BOARD MEMBER 1.00 0.00 X 0 0 0 PETE RICHMOND BOARD MEMBER 1.00 2.00 X 0 0 0 CLAIRE STULL BOARD MEMBER 1.00 0.00 X 0 0 0 BARRY WAITTE BOARD MEMBER 1.00 0.00 X 0 0 0 TODD ZAPOLSKI BOARD MEMBER 1.00 0.00 X 0 0 0 0 791786 52098 0 0 1 0 0 1359237 919407 29126 2278644 252400 252400 24524 24653 -129 -129 -129 262229 1359237 715 261514 261514 2792429 0 0 513785 2298619 2298619 14454 14454 198 198 STORAGE 85 85 2313356 2298619 14539 198 795987 1771477 114258 569882 89084 21805 3733050 3191317 2140 2140 4734519 5556621 41292 1199998 41292 1199998 X 4138529 4083658 554698 272965 4693227 4356623 4734519 5556621 479073 -815677 0 X 0 1 X 1 0 X 1100097 1486471 2399559 1056773 2278644 8321544 1100097 1486471 2399559 1056773 2278644 8321544 856423 7465121 20109 83438 69284 20111 252400 445342 122927 242216 365143 9132029 0.81750 0.54870 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED ORGANIZATION 1199998 1199998 X PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2022 AND 2021, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. SALUD 1621466 1359237 262229 715 1621466 1359237 262229 715 715 261514 SCHEDULE G, PART II DURING THE JUNE 30, 2022 FISCAL YEAR, OLE HEALTH (A RELATED ORGANIZATION) COVERED $439,466 OF ADDITIONAL EXPENSES NOT LISTED ON SCHEDULE G, PART II, BUT WHICH PERTAIN TO THE FUNDRAISING EVENT LISTED. ACCORDINGLY, SINCE THESE EXPENSES DO NOT APPEAR ON THE JUNE 30, 2022 STAND-ALONE FINANCIAL STATEMENTS FOR OLE HEALTH FOUNDATION, THEY ARE NOT BEING PRESENTED ON SCHEDULE G, PART II. THE ADDITIONAL EXPENSES ARE ALLOCATED AS FOLLOWS: $27,750 - NONCASH PRIZES $56,373 - RENT/FACILITY COSTS $73,382 - FOOD AND BEVERAGES $156,832 - ENTERTAINMENT $125,129 - OTHER EXPENSES 1 OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 501(C)(3) 2298619 0 GENERAL SUPPORT 1 0 PART I, LINE 2: DURING THE JUNE 30, 2022 TAX YEAR, THE ORGANIZATION PROVIDED GRANTS SOLELY TO OLE HEALTH, A RELATED ORGANIZATION. BOTH ORGANIZATIONS MAINTAIN AN OVERLAP OF OFFICERS, WHO MONITOR PROPER USE OF THE GRANT FUNDS. 0 0 0 0 0 0 0 0 0 ALICIA HARDY BOARD MEMBER / CEO OF OLE HEALTH 0 319390 0 1088 0 12500 0 11169 0 13002 0 357149 0 0 ROSE MACISAAC CFO/COO THROUGH 2/2022 0 274570 0 1088 0 0 0 9604 0 12769 0 298031 0 0 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 0 178150 0 5000 0 0 0 5231 0 323 0 188704 0 0 PART I, LINE 3 THE CEO IS COMPENSATED BY OLE HEALTH, A RELATED ORGANIZATION. OLE HEALTH UTILIZES THE FOLLOWING METHODS TO DETERMINE COMPENSATION OF THE CEO: COMPENSATION SURVEYS OR STUDIES; APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. X 2 29126 FAIR MARKET VALUE 0 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED (DEFINED AS EACH SEPARATE GIFT) IN SCHEDULE M, PART I, COLUMN (B). FORM 990, PART VI, SECTION A, LINE 6 OLE HEALTH FOUNDATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO, PURSUANT TO A PROVISION OF THE ORGANIZATION'S GOVERNING DOCUMENTS, HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE (INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY). ACCORDINGLY, OLE HEALTH FOUNDATION HAS ONE SOLE MEMBER: OLE HEALTH. FORM 990, PART VI, SECTION A, LINE 7A OLE HEALTH (OLE HEALTH FOUNDATION'S SUPPORTED ORGANIZATION) HAS THE POWER TO APPOINT EACH OF THE DIRECTORS OF OLE HEALTH FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B TO PREPARE THE FORM 990, THE ORGANIZATION UTILIZED A PROFESSIONAL ACCOUNTING FIRM WHO WORKED WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM TO GATHER THE REQUIRED INFORMATION. UPON REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT TEAM, A COPY OF THE FORM 990 WITH ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING IN ORDER TO ALLOW SUFFICIENT TIME FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS OF OLE HEALTH FOUNDATION HAVE A RESPONSIBILITY TO MAKE FULL DISCLOSURE OF INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN SATISFYING THEIR FIDUCIARY OBLIGATIONS TO OLE HEALTH FOUNDATION. IN THAT REGARD, IT IS THE POLICY OF OLE HEALTH FOUNDATION TO REFRAIN FROM CONSUMMATING ANY TRANSACTION INVOLVING A POTENTIAL CONFLICT OF INTEREST UNTIL ALL RELEVANT AND PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT HAVE BEEN DISCLOSED AND CONSIDERED, DURING WHICH TIME THE INTERESTED PARTY WOULD REFRAIN FROM DELIBERATIONS. DIRECTORS AND OFFICERS ARE REQUIRED TO REVIEW AND SIGN THE "STATEMENT PERTAINING TO CONFLICT OF INTEREST AND CONFIDENTIALITY" UPON APPOINTMENT, ELECTION AND HIRE, AND THEN ANNUALLY THEREAFTER. ACTIVITIES THAT MAY CAUSE A CONFLICT OF INTEREST ARE REPORTED TO AND MONITORED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT DIRECTLY COMPENSATE ANY INDIVIDUALS; ALL EMPLOYEES PERFORMING WORK FOR OLE HEALTH FOUNDATION ARE COMPENSATED BY OLE HEALTH CLINIC, A RELATED ORGANIZATION. AS SUCH, PART VI, SECTION B, LINES 15A AND 15B HAVE BEEN ANSWERED "NO" AS MANDATED BY THE FORM 990 INSTRUCTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE ALL AVAILABLE UPON REQUEST. OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 HEALTH CARE TO LOW INCOME AND UNINSURED RESIDENTS CA 501(C)(3) LINE 7 N/A 0 OLE HEALTH NMTC 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 815395044 SUPPORT THE CHARITABLE PURPOSES OF OLE HEALTH AND OLE HEALTH FOUNDATION CA 501(C)(3) LINE 12A, I OLE HEALTH 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0