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CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO INC (EIN 95-2801772)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-15
IRS object ID
201312899349300811
Schema version
2012v2.0
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)
Timestamp2013-10-15T15:24:51-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN202707086EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1TCA Partners LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11111 E Herndon Avenue Suite 211AddressLine1
CityFresnoCity
StateCAState
ZIP Code93720ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952801772EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Centro De Salud La Communidad De San Ysidro IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone6194281330Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14004 Beyer BlvdAddressLine1
CitySan YsidroCity
StateCAState
ZIP Code92173ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKevin MattsonName
TitlePresident and CEOTitle
Phone6194281330Phone
Date Signed2013-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJeremy WareName
PTINP00642659PTIN
Phone5594317708Phone
Date Prepared2013-05-08DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1San Ysidro Health CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonKevin MattsonNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14004 Beyer BlvdAddressLine1
CitySan YsidroCity
StateCAState
ZIP Code92173ZIPCode
FieldValueIRS element (for citing)
Gross Receipts78711044GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.syhc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1971YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionCentro De Salud De La Communidad De San Ysidro Inc (DBA- San Ysidro Health Center) operates community health centers located in San Diego, CA. the organization's mission is to improve health and well being of the community's traditionally under served and culturally diverse people.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees974TotalNbrEmployees
Total Nbr Volunteers216TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year21520013ContributionsGrantsPriorYear
Contributions Grants Current Year19945811ContributionsGrantsCurrentYear
Program Service Revenue Prior Year50123199ProgramServiceRevenuePriorYear
Program Service Revenue CY55913311ProgramServiceRevenueCY
Investment Income Prior Year15575InvestmentIncomePriorYear
Investment Income Current Year11490InvestmentIncomeCurrentYear
Other Revenue Prior Year1067099OtherRevenuePriorYear
Other Revenue Current Year2840432OtherRevenueCurrentYear
Total Revenue Prior Year72725886TotalRevenuePriorYear
Total Revenue Current Year78711044TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year41703888SalariesEtcPriorYear
Salaries Etc Current Year48062651SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year37280TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year21451505OtherExpensePriorYear
Other Expenses Current Year25089336OtherExpensesCurrentYear
Total Expenses Prior Year63192673TotalExpensesPriorYear
Total Expenses Current Year73151987TotalExpensesCurrentYear
Revenues Less Expenses Prior Year9533213RevenuesLessExpensesPriorYear
Revenues Less Expenses CY5559057RevenuesLessExpensesCY
Total Assets BOY55528321TotalAssetsBOY
Total Assets EOY61184440TotalAssetsEOY
Total Liabilities BOY23925389TotalLiabilitiesBOY
Total Liabilities EOY24022451TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY31602932NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY37161989NetAssetsOrFundBalancesEOY
Mission DescriptionThe Mission of San Ysidro Health Center is to improve the health and well being of our community's traditionally under served and culturally diverse people. The Health Center saw 82,779 patients who produced 322,157 medical and dental visits in the current period.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense59039445Expense
Grants0Grants
Revenue78711044Revenue
DescriptionThe mission of San Ysidro Health Center is to improve the health and well being of our community's traditionally under served and culturally diverse people.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense59039445TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096118NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees974NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure0QuidProQuoDisclosure
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMichael PendarvisNamePerson
Telephone Number6192056339TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11275 30th StreetAddressLine1
CitySan DiegoCity
StateCAState
ZIP Code92154ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per Week RelatedAverageHoursPerWeekRelatedOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Macario Gutierrez
Chairman2X000
Victor Nieto
Vice Chair2X0000
Laura Andrews
Board Member2X0000
Mercedes Bernal
Board Member2X0000
Roy Cazares
Board Member2X0000
Ruth Covell
Board Member2X0000
Raul Eribez
Board Member2X0000
Gilbert Fimbres
Treasurer2X0000
Margarita Navarro
Board Member2X0000
Michael Owens
Board Member2X0000
Magdalena Peraza
Board Member2X0000
Reynaldo Perez
Board Member2X0000
Gloria Ramirez
2nd Vice Chairman2X0000
Yolanda Santana
Secretary2X0000
Tomas Urtasun
Board Member2X0000
Efrain Ibarra
Board Member2X0000
Edward A Martinez
CEO40402092000X
Kevin Mattson
SVP Finance40348887000X
Maria Carriedo
CMO40212443000X
Terry Whitaker
VP Health Center Operations40236960000X
Lesley Nurse
MD40344425000X
Oscar Rivera
Director Satellite Dental Clinics40253157000X
My-thanh Thi Dinh
MD40254956000X
Sergio Cuevas
Director Dental Clinics40220074000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2272994TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K42NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Consolidated Contracting Service
181 Avenida La PataSan ClementeCA92763Construction6262482
The City Link Foundation
1125 Presioca CourtSpring ValleyCA91977Shuttle Services506548
NextGen Healthcare
PO Box 511449Los AngelesCA90051Electronic Medical Records664022
Quest Diagnostics
File Number 50368Los AngelesCA90368Lab Services471581
Therapy Specialists
3760 Convoy StreetSan DiegoCA92111Therapy337103
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events364350FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants15196169GovernmentGrants
All Other Contributions4385292AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions19945811TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient Service RevenueDescription
Business Code621400BusinessCode
Total Revenue Column55913311TotalRevenueColumn
Related Or Exempt Function Income55913311RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue55913311TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11490TotalRevenueColumn
Related Or Exempt Function Income11490RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real55540Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real55540Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column55540TotalRevenueColumn
Related Or Exempt Function Income55540RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events364350CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOther RevenuesDescription
Business Code621400BusinessCode
Total Revenue Column2784892TotalRevenueColumn
Related Or Exempt Function Income2784892RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2784892TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column78711044TotalRevenueColumn
Related Or Exempt Function Income58765233RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total40215711Total
Program Services31205477ProgramServices
Management And General9010234ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7846940Total
Program Services5638258ProgramServices
Management And General2208682ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5873580Total
Program Services4997762ProgramServices
Management And General875818ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1972978Total
Program Services1371957ProgramServices
Management And General601021ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3033718Total
Program Services2704681ProgramServices
Management And General329037ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total418741Total
Program Services334993ProgramServices
Management And General83748ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total847639Total
Program Services537964ProgramServices
Management And General309675ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1988668Total
Program Services1519608ProgramServices
Management And General469060ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total343483Total
Program Services115280ProgramServices
Management And General228203ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical Supplies75022827502248340
Equipment rental and maintenance7227335781861445470
Loss on disposal of building71095007109500
Admin Allocation0858467-8584670

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1674564Total
Program Services1674564ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total73151987Total
Program Services59039445ProgramServices
Management And General14112542ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8875BOY
EOY9713EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY7819925BOY
EOY3761125EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY3068086BOY
EOY1860089EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4428410BOY
EOY5149223EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY332746BOY
EOY335693EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY422751BOY
EOY503415EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis62280716LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec14734495LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY39065952BOY
EOY47546221EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY381576BOY
EOY2018961EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY55528321BOY
EOY61184440EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7017390BOY
EOY7422354EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY418170BOY
EOY294349EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY16489829BOY
EOY14961597EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
EOY1344151EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY23925389BOY
EOY24022451EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY31497406BOY
EOY36869900EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY105526BOY
EOY292089EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31602932BOY
EOY37161989EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY55528321BOY
EOY61184440EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses5559057ReconcilationRevenueExpenses
Reconciliation Unrealized Invest0ReconciliationUnrealizedInvest
Reconcilation Donated Services0ReconcilationDonatedServices
Reconcilation Invest Expenses0ReconcilationInvestExpenses
Reconcilation Prior Adjustment0ReconcilationPriorAdjustment
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11767425CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14234800CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years17758107CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21520013CurrentTaxYearMinus1Year
Current Tax Year19708128CurrentTaxYear
Total84988473Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years11767425CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years14234800CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years17758107CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year21520013CurrentTaxYearMinus1Year
Current Tax Year19708128CurrentTaxYear
Total84988473Total
FieldValueIRS element (for citing)
Public Support Total17084988473PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years200146CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years72075CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8244CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year15575CurrentTaxYearMinus1Year
Current Tax Year67030CurrentTaxYear
Total363070Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1579003CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1984003CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years134221CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Total3697227Total
FieldValueIRS element (for citing)
Total Support89048770TotalSupport
Public Support Pertcentage1700.95440PublicSupportPertcentage170
Public Support Pertcent Prior Year0.93079PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationNoneGeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1116361OtherCostOrOtherBasis
Book Value1116361BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis44113156OtherCostOrOtherBasis
Depreciation7033091Depreciation
Book Value37080065BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2421964OtherCostOrOtherBasis
Depreciation908170Depreciation
Book Value1513794BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis13892206OtherCostOrOtherBasis
Depreciation6793234Depreciation
Book Value7098972BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis737029OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value737029BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings47546221TotalOfBookValueLandBuildings
Tot Revenue Etc Audited Fincl Stmt78711044TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal78711044RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99078711044TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt73151987TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal73151987ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99073151987TotalExpensesPerForm990

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SYHC Golf TournamentNameOfEvent1
Gross Receipts Event1364350GrossReceiptsEvent1
Charitable Contributions Event10CharitableContributionsEvent1
Gross Revenue Event1364350GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event129000RentFacilityCostsEvent1
Food And Beverage Event10FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event10OtherDirectExpensesEvent1
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Gross Receipts Total364350GrossReceiptsTotal
Charitable Contributions Total0CharitableContributionsTotal
Gross Revenue Total Events364350GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events29000RentFacilityCostsTotalEvents
Food And Beverage Total Events0FoodAndBeverageTotalEvents
Entertainment Total Events0EntertainmentTotalEvents
Other Direct Expenses Total Events0OtherDirectExpensesTotalEvents
Direct Expense Summary Events29000DirectExpenseSummaryEvents
Net Income Summary335350NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Sergio Cuevas
Director Dental Clinics220074000000000220074000
My-thanh Thi Dinh
MD254596000000000254596000
Oscar Rivera
Director Satellite Dental Clinics253157000000000253157000
Lesley Nurse
MD344425000000000344425000
Terry Whitaker
VP Health Center Operations236960000000000236960000
Maria Carriedo
CMO212443000000000212443000
Kevin Mattson
SVP Finance348887000000000348887000
Edward A Martinez
CEO402092000000000402092000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P06_S0B_L11bForm 990, Part VI, Section B, Line 11bThe form 990 tax return is made available to all board members. Board members requesting a copy then review the return, and all questions or concerns are addressed by the SVP/CFO prior to filing. The return is reviewed in detail by the Controller and SVP/CFO prior to filing.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cConflicts are discussed as possible conflicts arise. Annually verified.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Review compensation data of similar sized health centers and CPCA salary surveys.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Available upon request.

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationNAExplanation