2012-11-05T11:04:41-06:00 2011-12-31 330783700 PDM LLP 3460 TORRANCE BLVD STE 200 TORRANCE CA 90503 990 2011-01-01 271316512 FRIENDS OF FAMILY HEALTH CENTER FRIE 5626904001 501 S IDAHO STREET NO 100 LA HABRA CA 90631 DAWN TRAN 5626904001 2012-10-26 1 SCOTT J DONNELLY CPA P00366806 3105404118 2011 2016-02-24 21:20:13Z DAWN TRAN 501 S IDAHO ST STE 100 LA HABRA CA 90631 4543537 0 X WWW.FOFHEALTHCENTER.ORG X 2010 CA TO OPERATE A STATE-LICENSED COMMUNITY HEALTH CLINIC IN LA HABRA, CA FOR FAMILIES. 10 10 55 9 0 0 1508409 3411757 569073 1131780 0 0 0 0 2077482 4543537 0 0 0 0 1104761 2459519 0 0 151344 743637 1915975 1848398 4375494 229084 168043 603952 743741 370126 341872 233826 401869 TO MAINTAIN AND OPERATE A STATE-LICENSED COMMUNITY HEALTH CLINIC IN LA HABRA FOR FAMILIES. 0 0 3523718 1131780 THE ORGANIZATION PROVIDES MEDICAL AND DENTAL SERVICES FOR CHILDREN, AND GENERAL MEDICAL SERVICES FOR ADULTS AND SENIORS REGARDLESS OF WHERE THEY RESIDE. THE ORGANIZATION CONTRACTS DIRECTLY OR INDIRECTLY WITH GOVERNMENTAL AGENCIES AND RECEIVES GRANTS TO SUPPORT SERVICE DELIVERY AND SPECIAL PROGRAMS. 3523718 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 55 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X DAWN TRAN 5626904001 501 S IDAHO ST SUITE 100 LA HABRA CA 90631 ROBERT GIRE 1.00 X X 0 0 0 DORIS BUTLER 1.00 X X 0 0 0 SALVADOR CERVANTES 1.00 X X 0 0 0 VALENTINA MOJICA- DUQUE 1.00 X X 0 0 0 CRISTINA DUQUE 1.00 X 0 0 0 CRYSTAL COMELY 1.00 X 0 0 0 EMMA HERNANDEZ 1.00 X 0 0 0 FRED LENTZ 1.00 X 0 0 0 STEPHANIE RUIZ 1.00 X 0 0 0 DAWN TRAN 40.00 X 114800 0 0 WANG SUSAN JENE 40.00 X 173822 0 0 OBA CHISATO 40.00 X 155812 0 0 ARMAN KAMBIZ 40.00 X 126263 0 0 NGUYEN MAI-TRAM KIEU 40.00 X 144712 0 0 RAYA-MORONES RUBY 40.00 X 196664 0 0 912073 0 0 6 0 1 0 HENRY SCHEIN 135 DURYEA ROAD MELVILLE NY 11747 MEDICAL SUPPLIES 144583 UNITED HEALTHCARE 5701 KATELLA AVENUE CYPRESS CA 90630 HEALTH INSURANCE 115674 2 1232248 2179509 3411757 PATIENT SERVICES 621110 1131780 1131780 1131780 4543537 1131780 0 0 114800 45920 68880 2048081 1857415 190666 74538 65593 8945 60517 53255 7262 161583 142193 19390 6366 6366 13301 13301 505435 113426 240665 151344 30102 30102 32568 27683 4885 247105 217452 29653 1237 1051 186 36839 35924 915 11575 11575 45543 38712 6831 216439 190466 25973 UNCOMPENSATED PAT SVCS 264142 264142 EQUIPMENT 151134 131478 19656 IMMUNIZATION 150690 150690 MEDICAL SUPPLIES & LAB 122061 122061 81438 66257 15181 4375494 3523718 700432 151344 155022 82659 359895 458344 67254 49183 189347 46330 11243 143017 10538 10538 603952 743741 278331 313262 28610 91795 0 370126 341872 X 233826 401869 233826 401869 603952 743741 168043 0 X X 0 1 1 X 0 X 2077482 4543537 6621019 2077482 4543537 6621019 6621019 6621019 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: IN JULY 1, 2010, THE ORGANIZATION COMMENCED OPERATIONS AS A SEPARATE NONPROFIT ENTITY, AFTER THE NET ASSETS WERE TRANSFERRED TO THE ORGANIZATION FROM INSTITUTE FOR HEALTHCARE ADVANCEMENT. THUS, THE TAX YEAR 2010 COVERED THE SIX MONTHS FROM JULY 1, 2010 THROUGH DECEMBER 31, 2010. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 183332 45127 138205 6015 1203 4812 143017 4543537 4375494 168043 168043 4543537 0 4543537 0 4543537 4375494 0 4375494 0 4375494 THE ORGANIZATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT OF BEING SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. TO DATE, THE ORGANIZATION HAS NOT RECORDED ANY UNCERTAIN TAX POSITIONS. THE ORGANIZATION RECOGNIZES POTENTIAL ACCRUED INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS IN INCOME TAX EXPENSE. DURING THE YEAR ENDED DECEMBER 31, 2011, THE ORGANIZATION DID NOT RECOGNIZE ANY AMOUNT IN POTENTIAL INTEREST AND PENALTIES ASSOCIATED WITH UNCERTAIN TAX POSITIONS. X X X 0 0 0 0 0 0 0 0 0 WANG SUSAN JENE 160213 0 13609 0 0 0 0 0 0 0 173822 0 0 0 OBA CHISATO 142292 0 13520 0 0 0 0 0 0 0 155812 0 0 0 RAYA-MORONES RUBY 178215 0 18449 0 0 0 0 0 0 0 196664 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE TAX RETURN IS PRESENTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTORS MEMBERS SIGN THE CONFLICT OF INTEREST STATEMENTS CONFIRMING THAT THEY UNDERSTAND THE CONFLICT OF INTEREST POLICY. THE SECRETARY OF THE BOARD MONITORS THIS PROCEDURE TO ASSURE THAT THERE ARE NO CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPROVES THE AUDITED FINANCIAL STATEMENTS AS OF DECEMBER 31, 2011. IN ADDITION, THE BOARD APPROVES THE SALARIES, WAGES, AND OTHER COMPENSATION PAID TO TOP MANAGEMENT EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ANY GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS UPON REQUEST. TAX RETURNS ARE ALSO AVAILABLE ON GUIDESTAR. FORM 990, PART XII, LINE C THE ORGANIZATION FORMED AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT.