2020-10-05T10:26:16-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2019-01-01 223914738 POMONA COMMUNITY HEALTH CENTER POMO 9098659501 1450 HOLT AVENUE POMONA CA 91767 DAVID KADAR DDS CEO 9098659501 2020-09-15 1 KURT BENNION CPA P01469618 4252506100 2020-09-15 67.137.57.251 2020-09-15 12:49:50 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2019 2021-01-29 14:40:06Z PARKTREE COMMUNITY HEALTH CENTER DAVID KADAR DDS 1450 HOLT AVENUE POMONA CA 91767 9820381 0 X WWW.PARKTREECHC.ORG X 2005 CA TO PROVIDE PREVENTIVE AND PRIMARY CARE SERVICES TO THE NEEDY IN THE COMMUNITY. 9 9 152 38 0 0 4537368 3475857 6790693 6310509 0 0 23833 34015 11351894 9820381 0 0 0 0 6758050 7973484 0 0 0 2685756 3039154 9443806 11012638 1908088 -1192257 6752993 6665463 4704663 5809390 2048330 856073 POMONA COMMUNITY HEALTH CENTER'S MISSION IS TO SERVE THE MEDICALLY UNDERSERVED AREA (MUA) PROVIDING A SAFETY NET OF MEDICAL AND DENTAL CARE REGARDLESS OF THE PATIENTS' ABILITY TO PAY. 0 0 8951902 0 6310509 POMONA COMMUNITY HEALTH CENTER IS A COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CLINIC PROVIDING MEDICAL AND DENTAL SERVICES AND MEDICINE AT NO OR LOW COST TO LOW INCOME INDIVIDUALS AND FAMILIES (NO COST, LOW FEE OR MEDI-CAL / MEDI-CARE ACCEPTED BASED ON INCOME). 8951902 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 18 0 152 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X ALFONSO AGUILERA 9098659501 1450 HOLT AVENUE POMONA CA 91767 CHRIS ALDWORTH CHAIR 2.00 X X 0 0 0 FLOY BIGGS VICE-CHAIR 2.00 X X 0 0 0 JENNIFER SANCEN SECRETARY (THROUGH APRIL 2019) 2.00 X X 0 0 0 AVA PHILLIPS SECRETARY 2.00 X X 0 0 0 PEGGY SANCHEZ TREASURER 2.00 X X 0 0 0 JAMES ALIG BOARD MEMBER 2.00 X 0 0 0 SONIA BURNS BOARD MEMBER 2.00 X 0 0 0 JE BOARD MEMBER (THROUGH SEP 2019) 2.00 X 0 0 0 GWENDOLYN KEYS BOARD MEMBER 2.00 X 0 0 0 MICHAEL NELSON BOARD MEMBER 2.00 X 0 0 0 ELVIA RIVAS BOARD MEMBER 2.00 X 0 0 0 AUSA TUASINA BOARD MEMBER (THROUGH SEP 2019) 2.00 X 0 0 0 ELLEN SILVER NP CEO 40.00 X 213242 0 14059 ALFONSO AGUILERA CFO 40.00 X 131573 0 19624 DAVID KADAR DDS CHIEF DENTAL OFFICER 40.00 X 190943 0 13290 RANJIT SHENOY MD INTERNAL MEDICINE PHYSICIA 40.00 X 254050 0 10883 RAKHI SINHA DO PHYSICIAN 40.00 X 198859 0 10402 LORRAINE WALKER PHYSICIAN 40.00 X 174130 0 3985 DIANNE QUINTANA PHYSICIAN 40.00 X 166951 0 19241 ENRIQUE MELGOZA DENTIST 40.00 X 154003 0 12032 1483751 0 103516 13 0 1 0 INSPERITY 6 POINTE DRIVE SUITE 150 BREA CA 928216320 PROFESSIONAL EMPLOYER ORGANIZATION 231513 1 2657923 817934 269460 3475857 PATIENT REVENUE 621110 6234009 6234009 INCENTIVE PROGRAM REVE 621110 76500 76500 6310509 MISCELLANEOUS 900099 34015 34015 34015 9820381 6310509 0 34015 582731 204233 378498 5876307 4774866 1101441 86281 85407 874 3514 2726 788 1424651 1102284 322367 1190 1190 20900 20900 371926 321296 50630 125830 101289 24541 418321 336348 81973 504749 478709 26040 34197 27496 6701 43705 35141 8564 1941 1941 382543 362807 19736 25832 20904 4928 MEDICAL SUPPLIES 963196 963196 REPAIRS AND MAINTENANCE 116724 110702 6022 DUES & SUBSCRIPTIONS 35234 28330 6904 LICENSES & PERMITS -7134 -5773 -1361 11012638 8951902 2060736 0 1956530 1656654 895834 1390183 74129 91748 4481825 1016147 3765300 3465678 61200 61200 6752993 6665463 1952114 3298846 257494 5539 2402017 2402017 93038 102988 4704663 5809390 X 2048330 856073 2048330 856073 6752993 6665463 -1192257 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3148832 642572 2506260 1332993 373575 959418 3465678 DEFERRED LEASE LIABILITIES 102988 102988 X 9550921 0 9550921 269460 269460 9820381 10743178 0 10743178 269460 269460 11012638 PART X, LINE 2: PCHC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC AND BY THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. PCHC'S REVENUE COMES FROM PROVIDING OUTPATIENT PRIMARY MEDICAL CARE TO LOW-INCOME UNINSURED MEMBERS OF THE COMMUNITY AND IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. PCHC HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO PCHC'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. PCHC FILES INFORMATIONAL RETURNS IN THE U.S. FEDERAL JURISDICTION, AND THE STATE OF CALIFORNIA. THE STATUTE OF LIMITATIONS FOR FEDERAL AND CALIFORNIA STATE PURPOSES IS GENERALLY THREE AND FOUR YEARS, RESPECTIVELY. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONATED VACCINES 269,460. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATED VACCINES 269,460. X X 0 0 0 0 0 0 0 0 0 ELLEN SILVER NP CEO 213242 0 0 0 0 0 9702 0 4357 0 227301 0 0 0 ALFONSO AGUILERA CFO 131573 0 0 0 0 0 16833 0 2791 0 151197 0 0 0 DAVID KADAR DDS CHIEF DENTAL OFFICER 190943 0 0 0 0 0 9419 0 3871 0 204233 0 0 0 RANJIT SHENOY MD INTERNAL MEDICINE PHYSICIA 254050 0 0 0 0 0 5802 0 5081 0 264933 0 0 0 RAKHI SINHA DO PHYSICIAN 198859 0 0 0 0 0 9174 0 1228 0 209261 0 0 0 LORRAINE WALKER PHYSICIAN 174130 0 0 0 0 0 502 0 3483 0 178115 0 0 0 DIANNE QUINTANA PHYSICIAN 166951 0 0 0 0 0 15755 0 3486 0 186192 0 0 0 ENRIQUE MELGOZA DENTIST 154003 0 0 0 0 0 8952 0 3080 0 166035 0 0 0 X 4746 269460 INVOICE PRICE 0 0 1 0 PART I, COLUMN (B): THE NUMBER REPORTED IN PART I, COLUMN B IS THE NUMBER OF DONATED ITEMS RECEIVED. FORM 990, PART VI, SECTION A, LINE 1 THE OFFICERS OF THE BOARD CONSTITUTE AN EXECUTIVE COMMITTEE. THE BOARD OF DIRECTORS MAY DELEGATE TO THE EXECUTIVE COMMITTEE ANY OF THE BOARD'S POWERS AND AUTHORITY IN THE MANAGEMENT OF THE ORGANIZATION'S BUSINESS AND AFFAIRS BETWEEN MEETINGS OF THE BOARD, EXCEPT THE POWER TO ADOPT, AMEND OR REPEAL THE BYLAWS. THE FINANCE COMMITTEE AND AUDIT COMMITTEE HAVE ALSO BEEN DELEGATED CERTAIN AUTHORITY TO ACT ON BEHALF OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN APRIL AND DECEMBER 2019, MAKING THE FOLLOWING SIGNIFICANT CHANGES: A. THE SECRETARY AND TREASURER POSITIONS MAY BE FILLED BY A SINGLE INDIVIDUAL; AND B. THE CONFLICT OF INTEREST RULES ARE MODIFIED TO ALLOW A FORMER BOARD MEMBER TO BECOME AN EMPLOYEE WITHIN 6 MONTHS OF LEAVING THE BOARD IF APPROVED BY MANGEMENT AND THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS REVIEWED BY THE CEO, THE AUDIT COMMITTEE OF THE BOARD, AND THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS AND ALL EMPLOYEES ARE COVERED AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. DETERMINATIONS AND RESTRICTIONS ARE ASSESSED ON A CASE BY CASE SCENARIO. ALL FORMS WILL BE AVAILABLE FOR REVIEW UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD ANNUALLY APPROVES A SALARY SCALE FOR ALL POSITIONS IN THE ORGANIZATION. THE SALARY SCALE IS PREPARED USING THE CALIFORNIA PRIMARY CARE ASSOCIATION'S SALARY SCALE. THE BOARD REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE CEO REVIEWS AND APPROVES OTHER EXECUTIVES' COMPENSATION IN CONJUNCTION WITH H.R. THIS PROCESS WAS LAST COMPLETED IN 2019. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST.