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COMMUNITY HEALTH ALLIANCE OF PASADENA: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH ALLIANCE OF PASADENA (EIN 95-4536824)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-07-18
IRS object ID
202341999349300244
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2023-07-18T18:10:45-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN953001179PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WINDES INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 87AddressLine1Txt
CityLONG BEACHCityNm
State AbbreviationCAStateAbbreviationCd
ZIP908010087ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN954536824EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH ALLIANCE OF PASADENABusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone6263986300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1455 WEST MONTANA STREETAddressLine1Txt
CityPASADENACityNm
State AbbreviationCAStateAbbreviationCd
ZIP91103ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDEYNER ZAPATAPersonNm
Person TitleCEOPersonTitleTxt
Phone6263986300PhoneNum
Signature2023-07-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDEYNERPersonFirstNm
Person LastZAPATAPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDONITA JOSEPHPreparerPersonNm
PTINP00286656PTIN
Phone5624351191PhoneNum
Preparation2023-07-14PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1CHAPCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDEYNER ZAPATAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1455 WEST MONTANA STREETAddressLine1Txt
CityPASADENACityNm
State AbbreviationCAStateAbbreviationCd
ZIP91103ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,284,131GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHAPCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionPROVIDE MEDICAL, DENTAL, BEHAVORIAL HEALTH, AND OPTOMETRY SERVICES TO THE RESIDENTS OF THE SAN GABRIEL VALLEY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee236TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$10,191,350PYContributionsGrantsAmt
CY Contributions Grants$10,389,474CYContributionsGrantsAmt
PY Program Service Revenue$14,724,045PYProgramServiceRevenueAmt
CY Program Service Revenue$17,862,184CYProgramServiceRevenueAmt
PY Investment Income$2,080PYInvestmentIncomeAmt
CY Investment Income$1,321CYInvestmentIncomeAmt
PY Other Revenue$30,316PYOtherRevenueAmt
CY Other Revenue$31,152CYOtherRevenueAmt
PY Total Revenue$24,947,791PYTotalRevenueAmt
CY Total Revenue$28,284,131CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$11,341,078PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,475,887CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$184,110CYTotalFundraisingExpenseAmt
PY Other Expenses$10,272,624PYOtherExpensesAmt
CY Other Expenses$11,530,442CYOtherExpensesAmt
PY Total Expenses$21,613,702PYTotalExpensesAmt
CY Total Expenses$26,006,329CYTotalExpensesAmt
PY Revenues Less Expenses$3,334,089PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,277,802CYRevenuesLessExpensesAmt
Total Assets BOY$18,827,487TotalAssetsBOYAmt
Total Assets EOY$21,216,461TotalAssetsEOYAmt
Total Liabilities BOY$9,163,230TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,274,402TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,664,257NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,942,059NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE EXCELLENT, COMPREHENSIVE, INNOVATIVE HEALTH CARE THAT IS ACCESSIBLE TO THE RESIDENTS OF THE SAN GABRIEL VALLEY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$17,205,774ExpenseAmt
Revenue$15,904,055RevenueAmt
DescCHAPCARE OFFERS A FULL RANGE OF PRIMARY MEDICAL CARE SERVICES, PHYSICAL EXAMINATIONS FOR PEOPLE OF ALL AGES, CHOLESTEROL CHECKS, CANCER SCREENING, COMMUNICABLE DISEASE SCREENING, VISION AND HEARING TESTING, FAMILY PLANNING, BLOOD PRESSURE SCREENING, LAB AND RADIOLOGY, MEDICATIONS, PRESCRIPTIONS, AND CASE MANAGEMENT SERVICES. CHAPCARE PROVIDED OVER 59,000 MEDICAL VISITS TO OVER 14,000 UNDUPLICATED PATIENTS DURING THE FISCAL YEAR, JUNE 30, 2022.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,200,782ExpenseAmt
Revenue$1,958,129RevenueAmt
DescCHAPCARE OFFERS DENTAL SERVICES FOR CHILDREN AND ADULTS. SERVICES INCLUDE ROUTINE CLEANING, EXAMINATION AND RESTORATIVE WORK. IN THE REPORTING YEAR, OVER 6,500 DENTAL VISITS WERE PROVIDED TO OVER 2,500 UNDUPLICATED PATIENTS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$19,406,556TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee236EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAM ORTIZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6263986300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1455 WEST MONTANA STREETAddressLine1Txt
CityPASADENACityNm
State AbbreviationCAStateAbbreviationCd
ZIP91103ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DR PAMELA WALD
CHAIR1.00Yes (X)Yes (X)$0$0$0
JAY LEE
CO-CHAIR/TREASURER1.00Yes (X)Yes (X)$0$0$0
MAURICETTE MONTREDON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
HAKIM BAXTER
MEMBER1.00Yes (X)Yes (X)$0$0$0
THOMAS THORMAN
MEMBER1.00Yes (X)Yes (X)$0$0$0
PORFIRIO FRAUSTO
MEMBER1.00Yes (X)Yes (X)$0$0$0
MICHAEL OLIVARES
MEMBER1.00Yes (X)Yes (X)$0$0$0
BERNABETH HO
MEMBER1.00Yes (X)Yes (X)$0$0$0
ARMANDO LUNA
MEMBER1.00Yes (X)Yes (X)$0$0$0
SARAH SPYKSMA
MEMBER1.00Yes (X)Yes (X)$0$0$0
DR CONSUELO CASILLAS
MEMBER1.00Yes (X)Yes (X)$0$0$0
DEBORAH VILLAR
MEMBER1.00Yes (X)Yes (X)$0$0$0
DR ERIC TAM
MEMBER1.00Yes (X)Yes (X)$0$0$0
SCOTT YUNG KIM
CHIEF CARE OFFICER40.00Yes (X)$351,736$0$49,243
MARGARET B MARTINEZ
CEO40.00Yes (X)$274,478$0$38,427
STEVEN IAN ABRAMSON
CHIEF OPERATING OFFICER40.00Yes (X)$224,278$0$31,399
FRANCISCO JAVIER BENAVIDES
CHIEF FINANCE OFFICER40.00Yes (X)$210,009$0$29,401
DEYNER ZAPATA
CHIEF ADMINISTRATIVE OFFICER40.00Yes (X)$203,868$0$28,542
IRIS MARQUEZ PAISO
CHIEF CARE OFFICER/DENTAL40.00$201,428$0$28,200Yes (X)
GILMER JOHN YOUN
PHYSICIAN40.00$247,575$0$34,661Yes (X)
EMMELINE CHAN
PHYSICIAN40.00$240,955$0$33,734Yes (X)
ENRIQUE HUGO VALLOTA
MEDICAL DIRECTOR/PHYSICIAN40.00$240,955$0$33,734Yes (X)
DOROTHY JOAN MARQUEZ-MANEJA
PHYSICIAN40.00$239,874$0$33,582Yes (X)
ONNIG JOHN PANOSIAN
PHYSICIAN32.00$195,495$0$27,369Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,630,651TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$368,292TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K29IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AMERISOURCEBERGEN CHAP
PO BOX 100565PASADENACA91189PHARMACEUTICALS$1,580,414
KAISER FOUNDATION HEALTH PLAN INC
FILE 5915LOS ANGELESCA90074MEDICAL HEALTH PLAN$1,070,118
OCHIN
1881 SW NAITO PARKWAYPORTLANDCA97201ELECTRONIC HEALTH RECORD PROVIDER$685,345
CITY OF PASADENA
PO BOX 7115PASADENACA91109PROPERTY LEASE$563,209
GLOBAL IT COMMUNICATIONS
6720 BRIGHT AVENUEWHITTIERCA90601NETWORK & IT SERVICES$554,985
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K29CntrctRcvdGreaterThan100KCnt
Government Grants$8,637,406GovernmentGrantsAmt
All Other Contributions$1,752,068AllOtherContributionsAmt
Total Contributions$10,389,474TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT FEES624100$13,468,440$13,468,440
PHARMACY624100$4,071,814$4,071,814
OTHER PROGRAM INCOME624100$306,109$306,109
PROGRAM PARTICIPANT INCENTIVES624100$15,821$15,821
FieldValueIRS element (for citing)
Total Program Service Revenue$17,862,184TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,321TotalRevenueColumnAmt
Exclusion$1,321ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$31,152RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$31,152RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,152TotalRevenueColumnAmt
Exclusion$31,152ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,284,131TotalRevenueColumnAmt
Related Or Exempt Func Income$17,862,184RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$32,473ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,671,008TotalAmt
Program Services$565,500ProgramServicesAmt
Management And General$1,105,508ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$10,921,940TotalAmt
Program Services$8,834,096ProgramServicesAmt
Management And General$2,012,170ManagementAndGeneralAmt
Fundraising$75,674FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$992,458TotalAmt
Program Services$832,608ProgramServicesAmt
Management And General$152,533ManagementAndGeneralAmt
Fundraising$7,317FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$890,481TotalAmt
Program Services$670,689ProgramServicesAmt
Management And General$214,352ManagementAndGeneralAmt
Fundraising$5,440FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$590,409TotalAmt
Program Services$279,894ProgramServicesAmt
Management And General$308,389ManagementAndGeneralAmt
Fundraising$2,126FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,073,598TotalAmt
Program Services$1,054,363ProgramServicesAmt
Management And General$1,016,185ManagementAndGeneralAmt
Fundraising$3,050FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$184,700TotalAmt
Program Services$159,785ProgramServicesAmt
Management And General$24,915ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$185,236TotalAmt
Program Services$87,474ProgramServicesAmt
Management And General$96,385ManagementAndGeneralAmt
Fundraising$1,377FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,151,307TotalAmt
Program Services$1,064,104ProgramServicesAmt
Management And General$87,203ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,961TotalAmt
Program Services$6,880ProgramServicesAmt
Management And General$5,081ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$384,529TotalAmt
Program Services$192,966ProgramServicesAmt
Management And General$191,563ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,191,455TotalAmt
Program Services$905,915ProgramServicesAmt
Management And General$274,316ManagementAndGeneralAmt
Fundraising$11,224FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$186,566TotalAmt
Program Services$78,786ProgramServicesAmt
Management And General$107,780ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES - PHARMACY$1,394,592$1,394,592$0$0
SUPPLIES - CLINICAL$709,222$709,222$0$0
UTILITIES$668,950$601,559$67,391$0
ELECTRONIC HEALTH RECOR$581,775$581,775$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,216,142TotalAmt
Program Services$1,386,348ProgramServicesAmt
Management And General$751,892ManagementAndGeneralAmt
Fundraising$77,902FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$26,006,329TotalAmt
Program Services$19,406,556ProgramServicesAmt
Management And General$6,415,663ManagementAndGeneralAmt
Fundraising$184,110FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,678,542BOYAmt
EOY$5,032,323EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$118,312BOYAmt
EOY$1,619,585EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$86,812BOYAmt
EOY$17,674EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,898,003BOYAmt
EOY$2,508,200EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$444,504BOYAmt
EOY$448,665EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$124,420BOYAmt
EOY$262,531EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$19,819,645LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,383,259LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$8,705,056BOYAmt
EOY$8,436,386EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,771,838BOYAmt
EOY$2,891,097EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$18,827,487BOYAmt
EOY$21,216,461EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,069,576BOYAmt
EOY$1,795,432EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,093,654BOYAmt
EOY$7,478,970EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,163,230BOYAmt
EOY$9,274,402EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,433,007BOYAmt
EOY$11,918,811EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$231,250BOYAmt
EOY$23,248EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,664,257BOYAmt
EOY$11,942,059EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,827,487BOYAmt
EOY$21,216,461EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,277,802ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,663,187CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,110,128CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,820,620CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,191,350CurrentTaxYearMinus1YearAmt
Current Tax Year$10,389,474CurrentTaxYearAmt
Total$47,174,759TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$617,935CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$630,483CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$587,902CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$1,836,320TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,281,122CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,740,611CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,408,522CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,191,350CurrentTaxYearMinus1YearAmt
Current Tax Year$10,389,474CurrentTaxYearAmt
Total$49,011,079TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$49,011,079PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$23,246CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,458CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$28,040CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$32,396CurrentTaxYearMinus1YearAmt
Current Tax Year$32,473CurrentTaxYearAmt
Total$140,613TotalAmt
FieldValueIRS element (for citing)
Total Support$49,151,692TotalSupportAmt
Gross Receipts Rltd Activities$70,786,820GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99710PublicSupportCY170Pct
Public Support PY1700.99710PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,268,878OtherCostOrOtherBasisAmt
Book Value$1,268,878BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,539,126OtherCostOrOtherBasisAmt
Depreciation$4,672,307DepreciationAmt
Book Value$866,819BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,078,623OtherCostOrOtherBasisAmt
Depreciation$1,934,616DepreciationAmt
Book Value$3,144,007BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,645,260OtherCostOrOtherBasisAmt
Depreciation$4,776,336DepreciationAmt
Book Value$2,868,924BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$287,758OtherCostOrOtherBasisAmt
Book Value$287,758BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$8,436,386TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS$2,822,909
DEPOSITS$68,188
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,891,097TotalBookValueOtherAssetsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$28,284,131TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$28,284,131RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,284,131TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$26,006,329TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$26,006,329ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$26,006,329TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN 48: THE ORGANIZATION HAS BEEN DESIGNATED AS TAX-EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), IS ALSO EXEMPT FROM STATE FRANCHISE TAXES UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, AND IS NOT GENERALLY SUBJECT TO FEDERAL OR STATE INCOME TAXES. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IT REQUIRES THAT AN ORGANIZATION RECOGNIZE IN THE FINANCIAL STATEMENTS THE IMPACT OF THE TAX POSITION IF THAT POSITION WILL MORE LIKELY THAN NOT BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF AND FOR THE YEAR ENDED JUNE 30, 2021, THE ORGANIZATION HAD NO UNRECOGNIZED TAX BENEFITS, TAX PENALTIES, OR INTEREST. THE ORGANIZATION IS SUBJECT TO POTENTIAL INCOME TAX AUDITS ON OPEN TAX YEARS BY ANY TAXING JURISDICTION IN WHICH IT OPERATES. THE STATUTE OF LIMITATIONS FOR FEDERAL PURPOSES IS THREE YEARS AND FOR CALIFORNIA IS FOUR YEARS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SCOTT YUNG KIM
CHIEF CARE OFFICER$351,736$0$0$0$0$0$0$0$49,243$0$400,979$0$0$0
MARGARET B MARTINEZ
CEO$274,478$0$0$0$0$0$0$0$38,427$0$312,905$0$0$0
GILMER JOHN YOUN
PHYSICIAN$247,575$0$0$0$0$0$0$0$34,661$0$282,236$0$0$0
EMMELINE CHAN
PHYSICIAN$240,955$0$0$0$0$0$0$0$33,734$0$274,689$0$0$0
ENRIQUE HUGO VALLOTA
MEDICAL DIRECTOR/PHYSICIAN$240,955$0$0$0$0$0$0$0$33,734$0$274,689$0$0$0
DOROTHY JOAN MARQUEZ-MANEJA
PHYSICIAN$239,874$0$0$0$0$0$0$0$33,582$0$273,456$0$0$0
STEVEN IAN ABRAMSON
CHIEF OPERATING OFFICER$224,278$0$0$0$0$0$0$0$31,399$0$255,677$0$0$0
FRANCISCO JAVIER BENAVIDES
CHIEF FINANCE OFFICER$210,009$0$0$0$0$0$0$0$29,401$0$239,410$0$0$0
DEYNER ZAPATA
CHIEF ADMINISTRATIVE OFFICER$203,868$0$0$0$0$0$0$0$28,542$0$232,410$0$0$0
IRIS MARQUEZ PAISO
CHIEF CARE OFFICER/DENTAL$201,428$0$0$0$0$0$0$0$28,200$0$229,628$0$0$0
ONNIG JOHN PANOSIAN
PHYSICIAN$195,495$0$0$0$0$0$0$0$27,369$0$222,864$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BDESCRIBE THE PROCESS THE ORGANIZATION USES TO REVIEW FORM 990. IT IS THE RESPONSIBILITY OF THE FINANCE COMMITTEE TO ACCEPT AND MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. THE APPROVED 990 IS SIGNED BY THE CEO AND MAILED TO THE APPROPRIATE TAX AGENCY.
FORM 990, PART VI, SECTION B, LINE 12CDESCRIBE THE PROCESS THE ORGANIZATION USES TO MONITOR AND ENFORCE COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY. REVIEW OF POLICY IS PERFORMED BY THE BOARD OF DIRECTORS AND ANY POTENTIAL CONFLICTS ARE IDENTIFIED. EACH BOARD MEMBER SIGNS AN ETHICS AND CONFLICT OF INTEREST FORM ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15DESCRIBE THE PROCESS USED TO DETERMINE COMPENSATION OF THE OFFICERS AND EMPLOYEES OF THE ORGANIZATION. THE BOARD USES A CPCA REPORT AND A LOCAL CLINIC SURVEY TO DETERMINE THE COMPENSATION PACKAGE FOR THE CEO. THE BOARD APPROVES THE COMPENSATION PACKAGE, WHICH IS DOCUMENTED IN THE MINUTES. THE FINANCE COMMITTEE PRESENTS TO THE BOARD A COMPREHENSIVE BUDGET, WHICH INCLUDES THE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES. MANAGEMENT USES A CPCA REPORT AND A LOCAL CLINIC SURVEY TO DETERMINE THE COMPENSATION PACKAGE FOR THE OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE CEO APPROVES THE COMPENSATION PACKAGE, WHICH IS DOCUMENTED IN THE MLNUTES OF THE GOVERNANCE COMMITTEE. THE FINANCE COMMITTEE PRESENTS TO THE BOARD A COMPREHENSIVE BUDGET, WHICH INCLUDES THE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19DESCRIBE HOW THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. ALL ITEMS ARE AVAILABLE UPON REQUEST. THE ITEMS SHOULD BE REQUESTED, IN WRITING, TO THE ATTENTION OF MARGARET B MARTINEZ, CEO. FORM 990 IS ALSO AVAILABLE ON WWW.GUIDESTAR.COM.