2022-04-29T18:56:05-05:00 2021-06-30 953001179 WINDES INC PO BOX 87 LONG BEACH CA 908010087 990 2020-07-01 954536824 COMMUNITY HEALTH ALLIANCE OF PASADENA COMM 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 MARGARET B MARTINEZ CEO 6263986300 2022-04-27 1 MARGARET MARTINEZ 999009999 P00286656 5624351191 2022-04-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHAPCARE MARGARET B MARTINEZ 455 WEST MONTANA STREET PASADENA CA 91103 24947791 0 X WWW.CHAPCARE.ORG X 1995 CA PROVIDE MEDICAL, DENTAL, BEHAVORIAL HEALTH, AND OPTOMETRY SERVICES TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 12 12 237 13 0 0 8820620 10191350 13038391 14724045 320 2080 27720 30316 21887051 24947791 0 0 0 0 11658373 11341078 0 0 144338 9236395 10272624 20894768 21613702 992283 3334089 17756043 18827487 11425875 9163230 6330168 9664257 TO PROVIDE EXCELLENT, COMPREHENSIVE, INNOVATIVE HEALTH CARE THAT IS ACCESSIBLE TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. 0 0 13436055 13083240 CHAPCARE 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 55,000 MEDICAL VISITS TO OVER 14,000 UNDUPLICATED PATIENTS DURING THE FISCAL YEAR, JUNE 30, 2021. 1995912 1519951 CHAPCARE OFFERS DENTAL SERVICES FOR CHILDREN AND ADULTS. SERVICES INCLUDE ROUTINE CLEANING, EXAMINATION AND RESTORATIVE WORK. IN THE REPORTING YEAR, OVER 5,400 DENTAL VISITS WERE PROVIDED TO OVER 2,500 UNDUPLICATED PATIENTS. 772101 120854 CHAPCARE PROVIDES WELLNESS SERVICES AVAILABLE TO ALL THROUGH EXPERT PROFESSIONALS IN THE AREA OF DIABETES, WEIGHT MANAGEMENT, NUTRITION COUNSELING, SALSA COURSES, AS WELL AS PHARMACY CONSULTATION OUTREACH FOR DIRECT MEDICAL SERVICES AT SPECIFIC LOCATIONS FOR HOMELESS SERVICES AS WELL AS SCREENING AT HEALTH FAIRS. 16204068 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 237 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X FRANCISCO BENAVIDES 6263986300 455 WEST MONTANA STREET PASADENA CA 91103 DEBORAH VILLAR CHAIR 1.00 0.00 X X 0 0 0 DR PAMELA WALD CO-CHAIR 1.00 0.00 X X 0 0 0 JAY LEE TREASURER 1.00 0.00 X X 0 0 0 MAURICETTE MONTREDON SECRETARY 1.00 0.00 X X 0 0 0 HAKIM BAXTER MEMBER 1.00 0.00 X X 0 0 0 THOMAS THORMAN MEMBER 1.00 0.00 X X 0 0 0 PORFIRIO FRAUSTO MEMBER 1.00 0.00 X X 0 0 0 MICHAEL OLIVARES MEMBER 1.00 0.00 X X 0 0 0 BERNABETH HO MEMBER 1.00 0.00 X X 0 0 0 ARMANDO LUNA MEMBER 1.00 0.00 X X 0 0 0 SARAH SPYKSMA MEMBER 1.00 0.00 X X 0 0 0 DR CONSUELO CASILLAS MEMBER 1.00 0.00 X X 0 0 0 DAVID LEE MEMBER THRU 12/2020 1.00 0.00 X X 0 0 0 SCOTT YUNG KIM CHIEF CARE OFFICER 40.00 0.00 X 345169 0 42578 MARGARET B MARTINEZ CEO 40.00 0.00 X 285175 0 35178 IRIS MARQUEZ PAISO CHIEF CARE OFFICER/DENTAL DIRECTOR 40.00 0.00 X 189616 0 23390 FRANCISCO JAVIER BENAVIDES CHIEF FINANCE OFFICER 40.00 0.00 X 189017 0 23316 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFICER 40.00 0.00 X 189017 0 23316 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 40.00 0.00 X 207332 0 25575 GILMER JOHN YOUN PHYSICIAN 40.00 0.00 X 239235 0 29511 JILL MARIE LEKOVIC PEDIATRICIAN 40.00 0.00 X 237712 0 29323 EMMELINE CHAN PHYSICIAN 40.00 0.00 X 230127 0 28387 ENRIQUE HUGO VALLOTA MEDICAL DIRECTOR/PHYSICIAN 40.00 0.00 X 229627 0 28325 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 40.00 0.00 X 228946 0 28241 2570973 0 317140 29 0 1 0 AMERISOURCEBERGEN CHAP PO BOX 100565 PASADENA CA 91189 PHARMACEUTICALS 1427374 KAISER FOUNDATION HEALTH PLAN INC FILE 5915 LOS ANGELES CA 90074 MEDICAL HEALTH PLAN 1070333 CSI ELECTRICAL CONTRACTOR SERVICES INC 4195 CHINO HILLS PARKWAY 544 CHINO HILLS CA 91709 GENERAL CONTRACTOR 542660 OCHIN 1881 SW NAITO PARKWAY PORTLAND CA 97201 ELECTRONIC HEALTH RECORD PROVIDER 538313 GO RN LLC 313 N BIRCH ST UNIT 102 SANTA ANA CA 92701 MEDICAL SERVICES 445040 30 8025776 2165574 10191350 PATIENT FEES 624100 9683569 9683569 PHARMACY 624100 4395413 4395413 OTHER PROGRAM INCOME 624100 590461 590461 PROGRAM PARTICIPANT INCENTIVES 624100 54602 54602 14724045 2080 2080 30316 0 30316 30316 30316 24947791 14724045 0 32396 1512536 1215074 284072 13390 8303961 6098765 2129652 75544 919923 674625 236925 8373 604658 449898 149280 5480 594825 243182 348681 2962 1614177 854265 756839 3073 92849 79565 3934 9350 151958 113065 37516 1377 1183543 1135614 47929 10888 8583 2270 35 377818 188909 188909 1238402 921437 305742 11223 157176 29623 127553 SUPPLIES - PHARMACY 1187416 1187416 0 0 UTILITIES 723711 626541 97170 0 SUPPLIES - CLINICAL 696511 696511 0 0 ELECTRONIC HEALTH RECOR 497143 497143 0 0 1746207 1183852 548824 13531 21613702 16204068 5265296 144338 1159230 4678542 398035 118312 65946 86812 2032578 1898003 410161 444504 49671 124420 18896860 10191804 9483135 8705056 4157287 2771838 17756043 18827487 2399094 2069576 9026781 7093654 11425875 9163230 X 5769284 9433007 560884 231250 6330168 9664257 17756043 18827487 3334089 0 X 0 1 X 1 1 1 X 7774080 7663187 10110128 8820620 10191350 44559365 536887 617935 630483 587902 2373207 8310967 8281122 10740611 9408522 10191350 46932572 46932572 23221 23246 24458 28040 32396 131361 47063933 65222729 0.99720 0.99720 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1268878 1268878 5266963 4183269 1083694 5061123 1732125 3328998 7221748 4276410 2945338 78148 78148 8705056 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS 2617950 DEPOSITS 153888 2771838 X 24947791 0 24947791 0 24947791 21613702 0 21613702 0 21613702 PART X, LINE 2: FIN 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. 1 X X X 0 0 0 0 0 0 0 0 0 SCOTT YUNG KIM CHIEF CARE OFFICER 345169 0 0 0 0 0 0 0 42578 0 387747 0 0 0 MARGARET B MARTINEZ CEO 285175 0 0 0 0 0 0 0 35178 0 320353 0 0 0 GILMER JOHN YOUN PHYSICIAN 239235 0 0 0 0 0 0 0 29511 0 268746 0 0 0 JILL MARIE LEKOVIC PEDIATRICIAN 237712 0 0 0 0 0 0 0 29323 0 267035 0 0 0 EMMELINE CHAN PHYSICIAN 230127 0 0 0 0 0 0 0 28387 0 258514 0 0 0 ENRIQUE HUGO VALLOTA MEDICAL DIRECTOR/PHYSICIAN 229627 0 0 0 0 0 0 0 28325 0 257952 0 0 0 DOROTHY JOAN MARQUEZ-MANEJA PHYSICIAN 228946 0 0 0 0 0 0 0 28241 0 257187 0 0 0 STEVEN IAN ABRAMSON CHIEF OPERATING OFFICER 207332 0 0 0 0 0 0 0 25575 0 232907 0 0 0 IRIS MARQUEZ PAISO CHIEF CARE OFFICER/DENTAL DIRECTOR 189616 0 0 0 0 0 0 0 23390 0 213006 0 0 0 FRANCISCO JAVIER BENAVIDES CHIEF FINANCE OFFICER 189017 0 0 0 0 0 0 0 23316 0 212333 0 0 0 DEYNER ZAPATA CHIEF ADMINISTRATIVE OFFICER 189017 0 0 0 0 0 0 0 23316 0 212333 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B DESCRIBE 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 12C DESCRIBE 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 15 DESCRIBE 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. FORM 990, PART VI, SECTION C, LINE 19 DESCRIBE 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.