SONOMA COUNTY ACADEMIC FOUNDATION FOR EXCELLENCE IN MEDICINE: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: SONOMA COUNTY ACADEMIC FOUNDATION FOR EXCELLENCE IN MEDICINE (EIN 68-0136430)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-11-14
IRS object ID: 201943189349313604
Schema version: 2018v3.1
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
Form 990
Schedule A
Schedule B
Schedule I
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-11-14T17:02:35-06:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	680323663	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	THOMAS PORCH & GULLICKSON CPAS	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5213 EL MERCADO PKWY STE E	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	954031301	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	680136430	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SONOMA COUNTY ACADEMIC FOUNDATION	BusinessNameLine1Txt
Business Name Line2	FOR EXCELLENCE IN MEDICINE	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	SONO	BusinessNameControlTxt
Phone	7075276223	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3569 ROUND BARN CIRCLE NO 200	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95403	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TARA SCOTT MD	PersonNm
Person Title	PRESIDENT	PersonTitleTxt
Phone	7075276223	PhoneNum
Signature	2019-10-30	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MARLA GULLICKSON	PreparerPersonNm
PTIN	P00052647	PTIN
Phone	7075754236	PhoneNum
Preparation	2019-10-21	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	72.160.14.209	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2019-10-30	IPDt
IP Tm	18:48:29	IPTm
IP Timezone	MD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	1725DBE3BB13CC97068609F6ABD785DF2A0973E6	AtSubmissionCreationDeviceId
At Submission Filing Device Id	E835F731291D9787217D2A2819E5EC4D5A469E93	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Address Change	Yes (X)	AddressChangeInd
Principal Officer	TARA SCOTT MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3569 ROUND BARN CIRCLE STE 200	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95403	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$339,283	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Other	Yes (X)	TypeOfOrganizationOtherInd
Other Organization Dsc	501(C)(3) ORGANIZATION	OtherOrganizationDsc
Formation	1987	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	MEDICAL EDUCATION	ActivityOrMissionDesc
Voting Members Governing Body	5	VotingMembersGoverningBodyCnt
Voting Members Independent	5	VotingMembersIndependentCnt
Total Employee	1	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$759,971	PYContributionsGrantsAmt
CY Contributions Grants	$332,904	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,190	CYProgramServiceRevenueAmt
PY Investment Income	$59	PYInvestmentIncomeAmt
CY Investment Income	$3,162	CYInvestmentIncomeAmt
PY Other Revenue	$0	PYOtherRevenueAmt
CY Other Revenue	$27	CYOtherRevenueAmt
PY Total Revenue	$760,030	PYTotalRevenueAmt
CY Total Revenue	$339,283	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$46,400	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$15,486	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$24,252	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$255,151	PYOtherExpensesAmt
CY Other Expenses	$314,182	CYOtherExpensesAmt
PY Total Expenses	$270,637	PYTotalExpensesAmt
CY Total Expenses	$384,834	CYTotalExpensesAmt
PY Revenues Less Expenses	$489,393	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$45,551	CYRevenuesLessExpensesAmt
Total Assets BOY	$711,154	TotalAssetsBOYAmt
Total Assets EOY	$684,650	TotalAssetsEOYAmt
Total Liabilities BOY	$115,217	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$134,264	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$595,937	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$550,386	NetAssetsOrFundBalancesEOYAmt
Mission	TO FOSTER EXCELLENCE IN THE PRACTICE, RESEARCH, AND TEACHING OF MEDICINE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$365,240	ExpenseAmt
Grant	$46,400	GrantAmt
Desc	THE FOUNDATION PROVIDES GRANT ADMINISTRATION, CONTINUING MEDICAL EDUCATION COURSES AND OTHER MEDICAL TRAINING RELATED SERVICES.	Desc
Total Program Service Expenses	$365,240	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	0	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	1	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	5	GoverningBodyVotingMembersCnt
Independent Voting Member	5	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	0	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	0	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHRISTINE S FAUX	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7075276223	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3569 ROUND BARN CIRCLE STE 200	AddressLine1Txt
City	SANTA ROSA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95403	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
LISA WARD MD
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
CHERYL GREEN MD
BOARD MEMBER	2.00	Yes (X)	$0	$0	$0
TARA SCOTT MD
PRESIDENT	2.00		$0	$0	$0	Yes (X)
DAN MARRIN MD JD
VICE PRESIDENT	2.00		$0	$0	$0	Yes (X)
MARSHALL KUBOTA MD
SECRETARY-TREASURER	2.00		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Government Grants	$234,550	GovernmentGrantsAmt
All Other Contributions	$98,354	AllOtherContributionsAmt
Total Contributions	$332,904	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	CONFERENCE FEES	Desc
Business	611430	BusinessCd
Total Revenue Column	$3,190	TotalRevenueColumnAmt
Exclusion	$3,190	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,190	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,162	TotalRevenueColumnAmt
Exclusion	$3,162	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$27	TotalRevenueColumnAmt
Exclusion	$27	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$339,283	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$6,379	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$46,400	TotalAmt
Program Services	$46,400	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$21,318	TotalAmt
Program Services	$11,725	ProgramServicesAmt
Management And General	$9,593	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,191	TotalAmt
Program Services	$655	ProgramServicesAmt
Management And General	$536	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,743	TotalAmt
Program Services	$959	ProgramServicesAmt
Management And General	$784	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$2,065	TotalAmt
Management And General	$2,065	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$57	TotalAmt
Program Services	$28	ProgramServicesAmt
Management And General	$29	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$7,056	TotalAmt
Program Services	$5,562	ProgramServicesAmt
Management And General	$1,494	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$7,787	TotalAmt
Program Services	$7,787	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,520	TotalAmt
Program Services	$378	ProgramServicesAmt
Management And General	$2,142	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUBCONTRACTORS	$285,998	$285,998
POSTAGE & SUPPLIES	$4,219	$2,109	$2,110
PRINTING	$3,240	$2,399	$841
PROFESSIONAL DEVELOPMEN	$649	$649

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$591	TotalAmt
Program Services	$591	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$384,834	TotalAmt
Program Services	$365,240	ProgramServicesAmt
Management And General	$19,594	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$61,404	BOYAmt
EOY	$7,294	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$537,841	BOYAmt
EOY	$534,575	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$103,230	BOYAmt
EOY	$131,333	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$8,679	BOYAmt
EOY	$11,448	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$711,154	BOYAmt
EOY	$684,650	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$114,546	BOYAmt
EOY	$124,214	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$671	BOYAmt
EOY	$10,050	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$115,217	BOYAmt
EOY	$134,264	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$567,035	BOYAmt
EOY	$549,786	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$28,902	BOYAmt
EOY	$600	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$595,937	BOYAmt
EOY	$550,386	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$711,154	BOYAmt
EOY	$684,650	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$45,551	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$190,225	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$238,638	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$245,213	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$708,356	CurrentTaxYearMinus1YearAmt
Current Tax Year	$308,004	CurrentTaxYearAmt
Total	$1,690,436	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$190,225	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$238,638	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$245,213	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$708,356	CurrentTaxYearMinus1YearAmt
Current Tax Year	$308,004	CurrentTaxYearAmt
Total	$1,690,436	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$1,690,436	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$67	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$57	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$66	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$59	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,189	CurrentTaxYearAmt
Total	$3,438	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$67	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$57	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$66	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$59	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,189	CurrentTaxYearAmt
Total	$3,438	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$190,292	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$238,695	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$245,279	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$708,415	CurrentTaxYearMinus1YearAmt
Current Tax Year	$311,193	CurrentTaxYearAmt
Total	$1,693,874	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.99800	PublicSupportCY509Pct
Public Support PY509	0.99980	PublicSupportPY509Pct
Investment Income CY	0.00200	InvestmentIncomeCYPct
Investment Income PY	0.00020	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Non Cash AssistanceNonCashAssistanceAmt	Valuation Method UsedValuationMethodUsedDesc	Non Cash AssistanceNonCashAssistanceDesc	Purpose Of GrantPurposeOfGrantTxt
KAISER PERMANENTE SANTA ROSA MEDICAL CENTER
401 BICENTENNIAL WAY	SANTA ROSA	CA	95403	941340523	501(C)(3)	$17,173	FMV	MEDICAL TRAINING MODELS	DONATION OF MEDICAL MODELS FOR MEDICAL PERSONNEL TRAINING
SUTTER BAY HOSPITALS DBA SUTTER SANTA ROSA REGIONAL HOSPITAL
30 MARK WEST SPRINGS ROAD	SANTA ROSA	CA	95403	940562680	501(C)(3)	$28,948	FMV	MEDICAL TRAINING MODELS	DONATION OF MEDICAL MODELS FOR MEDICAL PERSONNEL TRAINING

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS REVIEWED BY THE ORGANIZATION'S EXECUTIVE DIRECTOR AND BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION C, LINE 19	INFORMATION INCLUDING GOVERNING DOCUMENTS, POLICIES AND CERTAIN FINANCIAL INFORMATION IS AVAILABLE UPON REQUEST.