CONSOLIDATED TRIBAL HEALTH PROJECT INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- CONSOLIDATED TRIBAL HEALTH PROJECT INC (EIN 94-2891496)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201803199349312795
- Schema version
- 2017v2.3
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T14:56:19-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10960 WILSHIRE BLVD SUITE 1100 | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90024 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942891496 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONSOLIDATED TRIBAL HEALTH PROJECT INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONS | BusinessNameControlTxt |
| Phone | 7074855115 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 387 | AddressLine1Txt |
| City | CALPELLA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95418 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RICHARD W MATENS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7074855115 | PhoneNum |
| Signature | 2018-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAUREN A HAVERLOCK | PreparerPersonNm |
| PTIN | P00545829 | PTIN |
| Phone | 3104770450 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 172.90.17.200 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-15 | IPDt |
| IP Tm | 11:49:36 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9B589DF8CAC91EBD49B6CFB2BE63A5A0BB42B02C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 41F3D51277C721D7E64869098416E4BAA04E310D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBRA RAMIREZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 387 | AddressLine1Txt |
| City | CALPELLA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95418 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,497,500 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CTHP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | HEALTH CARE TO NATIVE AMERICANS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 72 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,720,564 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,868,072 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,572,237 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,261,248 | CYProgramServiceRevenueAmt |
| PY Investment Income | $275,501 | PYInvestmentIncomeAmt |
| CY Investment Income | $47,993 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $320,187 | CYOtherRevenueAmt |
| PY Total Revenue | $9,568,302 | PYTotalRevenueAmt |
| CY Total Revenue | $9,497,500 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,444,563 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,210,561 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,136,958 | PYOtherExpensesAmt |
| CY Other Expenses | $4,915,126 | CYOtherExpensesAmt |
| PY Total Expenses | $9,581,521 | PYTotalExpensesAmt |
| CY Total Expenses | $10,125,687 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$13,219 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$628,187 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,496,091 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,996,698 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $857,563 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $713,887 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,638,528 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,282,811 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HEALTH CARE TO NATIVE AMERICANS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,716,981 | ExpenseAmt |
| Revenue | $3,261,248 | RevenueAmt |
| Desc | OPERATE LOCAL HEALTH & DENTAL CLINIC; PROVIDE TRAINING & SCREENING FOR DIABETES; NUTRITION; HIV & COMMUNITY WELLNESS. | Desc |
| Total Program Service Expenses | $7,716,981 | 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 | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | 226 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 72 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7074855115 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6991 NORTH STATE STREET | AddressLine1Txt |
| City | REDWOOD VALLEY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95470 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DEBRA RAMIREZ | ||||||||
| CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $4,850 | $0 | $0 | ||
| BRANDI BROWN | ||||||||
| VICE CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $8,950 | $0 | $0 | ||
| ERICA CARSON JR | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $7,150 | $0 | $0 | ||
| BERNADETTE MORA | ||||||||
| TREASURER (FROM 5/20/17) | 2.00 | Yes (X) | Yes (X) | $4,750 | $0 | $0 | ||
| MELANIE RAFANAN | ||||||||
| TREASURER (THRU 5/19/17) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANGELA JAMES PINOLEVILLE YTH GRP | ||||||||
| MEMBER | 2.00 | Yes (X) | $4,800 | $0 | $0 | |||
| COREY JAMES | ||||||||
| MEMBER | 2.00 | Yes (X) | $1,700 | $0 | $0 | |||
| COURTNEY SANCHEZ | ||||||||
| MEMBER | 2.00 | Yes (X) | $2,700 | $0 | $0 | |||
| MARLENE SANCHEZ | ||||||||
| MEMBER | 2.00 | Yes (X) | $2,700 | $0 | $0 | |||
| MICHAEL HUNTER | ||||||||
| MEMBER | 2.00 | Yes (X) | $3,650 | $0 | $0 | |||
| MICHAEL L KNIGHT | ||||||||
| MEMBER | 2.00 | Yes (X) | $4,900 | $0 | $0 | |||
| OLIVIA ROSALES | ||||||||
| MEMBER | 2.00 | Yes (X) | $3,700 | $0 | $0 | |||
| PATRICK NAREDO | ||||||||
| MEMBER | 2.00 | Yes (X) | $4,450 | $0 | $0 | |||
| SONNY ELLIOTT | ||||||||
| MEMBER | 2.00 | Yes (X) | $3,800 | $0 | $0 | |||
| TRACY WRIGHT | ||||||||
| MEMBER | 2.00 | Yes (X) | $2,300 | $0 | $0 | |||
| KATHY RED HORSE | ||||||||
| MEMBER | 2.00 | Yes (X) | $3,700 | $0 | $0 | |||
| CHERIE-SMITH GIBSON | ||||||||
| MEMBER (THRU 1/31/17) | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD MATENS | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | $152,379 | $0 | $18,886 | Yes (X) | |||
| MARY ANN GONZALEZ-OTT | ||||||||
| DENTAL DIRECTOR | 40.00 | $240,919 | $0 | $17,774 | Yes (X) | |||
| MELANIE ULVILA | ||||||||
| BEHAVIORAL HEALTH DIRECTOR | 40.00 | $121,262 | $0 | $5,066 | Yes (X) | |||
| JAMES FLAHERTY | ||||||||
| STAFF PHYSICIAN | 40.00 | $213,240 | $0 | $12,584 | Yes (X) | |||
| JOOYOUN YI | ||||||||
| DENTIST | 40.00 | $155,399 | $0 | $17,538 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $947,299 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $71,848 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BARTON & ASSOCIATES INC | |||||
| PO BOX 417844 | BOSTON | MA | 022417844 | MEDICAL LOCUM TENENS | $606,909 |
| JARED FORTMAN DDS | |||||
| 1100 SONOMA AVENUE STE B | SANTA ROSA | CA | 95405 | REFERRED DENTAL SERVICES | $172,630 |
| STEVEN BOETTGER DDS | |||||
| 620 S DORA STREET STE 205 | UKIAH | CA | 95482 | REFERRED DENTAL SERVICES | $135,314 |
| ANDREW I CORBETT DDS INC | |||||
| 135 HOSPITAL DRIVE | UKIAH | CA | 95482 | REFERRED DENTAL SERVICES | $107,235 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,836,072 | GovernmentGrantsAmt |
| All Other Contributions | $32,000 | AllOtherContributionsAmt |
| Total Contributions | $5,868,072 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE FEES | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $3,261,248 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,261,248 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,261,248 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,993 | TotalRevenueColumnAmt |
| Exclusion | $47,993 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 990099 | BusinessCd |
| Total Revenue Column | $320,187 | TotalRevenueColumnAmt |
| Exclusion | $320,187 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $320,187 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,497,500 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,261,248 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $368,180 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,114,545 | TotalAmt |
| Program Services | $3,005,962 | ProgramServicesAmt |
| Management And General | $1,108,583 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,096,016 | TotalAmt |
| Program Services | $798,200 | ProgramServicesAmt |
| Management And General | $297,816 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,063,546 | TotalAmt |
| Program Services | $883,553 | ProgramServicesAmt |
| Management And General | $179,993 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237,708 | TotalAmt |
| Program Services | $94,433 | ProgramServicesAmt |
| Management And General | $143,275 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,777 | TotalAmt |
| Management And General | $158,777 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL SERVICES | $2,280,077 | $2,244,233 | $35,844 |
| OTHER OPERATING EXPENSE | $602,980 | $348,446 | $254,534 |
| SUPPLIES | $338,114 | $274,868 | $63,246 |
| UTILITIES | $233,924 | $67,286 | $166,638 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,125,687 | TotalAmt |
| Program Services | $7,716,981 | ProgramServicesAmt |
| Management And General | $2,408,706 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,805,707 | BOYAmt |
| EOY | $1,652,237 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,529,725 | BOYAmt |
| EOY | $4,831,808 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,855 | BOYAmt |
| EOY | $30,033 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,067,660 | BOYAmt |
| EOY | $1,564,286 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,184 | BOYAmt |
| EOY | $20,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,469,100 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,653,887 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,792,595 | BOYAmt |
| EOY | $1,815,213 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,365 | BOYAmt |
| EOY | $82,382 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,496,091 | BOYAmt |
| EOY | $9,996,698 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $833,363 | BOYAmt |
| EOY | $688,887 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,200 | BOYAmt |
| EOY | $25,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857,563 | BOYAmt |
| EOY | $713,887 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,638,528 | BOYAmt |
| EOY | $9,282,811 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,638,528 | BOYAmt |
| EOY | $9,282,811 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,496,091 | BOYAmt |
| EOY | $9,996,698 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$628,187 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $272,470 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,208,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,195,025 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,944,950 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,720,564 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,868,072 | CurrentTaxYearAmt |
| Total | $31,936,792 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,208,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,195,025 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,944,950 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,720,564 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,868,072 | CurrentTaxYearAmt |
| Total | $31,936,792 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $31,936,792 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,695 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $131,642 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $275,501 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $47,993 | CurrentTaxYearAmt |
| Total | $473,831 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $320,187 | CurrentTaxYearAmt |
| Total | $320,187 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $32,730,810 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $17,399,856 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97570 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98680 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $690,000 | OtherCostOrOtherBasisAmt |
| Book Value | $690,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,151,903 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,388,498 | DepreciationAmt |
| Book Value | $763,405 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $239,210 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,539 | DepreciationAmt |
| Book Value | $212,671 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $355,655 | OtherCostOrOtherBasisAmt |
| Depreciation | $212,311 | DepreciationAmt |
| Book Value | $143,344 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $32,332 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,539 | DepreciationAmt |
| Book Value | $5,793 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,815,213 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,769,970 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $272,470 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $272,470 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,497,500 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,497,500 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,125,687 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,125,687 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,125,687 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | 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 DECEMBER 31, 2017, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD MATENS | ||||||||||||||
| EXECUTIVE DIRECTOR | $152,379 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,886 | $0 | $171,265 | $0 | $0 | $0 |
| MARY ANN GONZALEZ-OTT | ||||||||||||||
| DENTAL DIRECTOR | $240,919 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,774 | $0 | $258,693 | $0 | $0 | $0 |
| JAMES FLAHERTY | ||||||||||||||
| STAFF PHYSICIAN | $213,240 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,584 | $0 | $225,824 | $0 | $0 | $0 |
| JOOYOUN YI | ||||||||||||||
| DENTIST | $155,399 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,538 | $0 | $172,937 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS REVIEWED BY THE FINANCE DIRECTOR BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THROUGH ENFORCEMENT OF POLICIES AND PROCEDURES, HR OFFICE AND COMPLIANCE OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 15 | CONSULTANT HIRED FOR SALARY SURVEY. RECOMMENDATIONS TAKEN TO BOARD FOR APPROVAL BY MOTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 883,553. MANAGEMENT AND GENERAL EXPENSES 179,993. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,063,546. |