2025-08-18T18:49:15-05:00 2024-06-30 330700332 VASQUEZ & COMPANY LLP 655 N CENTRAL AVE STE 1550 GLENDALE CA 91203 990 2023-07-01 952289916 JWCH INSTITUTE INC JWCH 3232014516 5650 JILLSON STREET COMMERCE CA 90040 JEANNE LAM CFO 3232014516 2025-08-18 1 0 REGINA L PRINCE CPA P00576936 2138731700 2023 2025-03-06 01:10:19Z JEANNE LAM 5650 JILLSON STREET COMMERCE CA 90040 146342710 0 X WWW.JWCHINSTITUTE.ORG X 1960 CA TO IMPROVE THE HEALTH STATUS AND WELL BEING OF UNDERSERVED SEGMENTS OF THE POPULATION OF LOS ANGELES AREA THROUGH THE DIRECT PROVISION OR COORDINATION OF HEALTH CARE, HEALTH EDUCATION SERVICES AND RESEARCH. 13 13 1364 94 0 0 61150991 52856636 77278945 92451630 151279 829405 35104 94056 138616319 146231727 117439 130069 0 0 79597390 90826405 0 0 110983 34817072 41319377 114531901 132275851 24084418 13955876 118823569 137730666 36174209 41074142 82649360 96656524 X THE SPECIFIC PURPOSES OF THIS ORGANIZATION ARE:(A) TO PROVIDE OUTPATIENT PRIMARY HEALTH SERVICE IN UNDERSERVED AREAS AND/OR FOR MEDICALLY UNDERSERVED POPULATIONS AS A COMMUNITY CLINIC. (B) TO DEVELOP, PROMOTE, AND MANAGE HEALTH CARE FACILITIES, SERVICES, AND PROGRAMS WITH AN EMPHASIS ON COMPREHENSIVE HEALTH CARE, PREVENTATIVE MEDICINE, AND HEALTH MAINTENANCE. (C) TO EDUCATE THE PUBLIC ON THE PRINCIPLES OF HEALTH PROTECTION AND PROMOTE OTHER PROJECTS IN THE INTEREST OF THE PUBLIC'S HEALTH. (D) TO ENGAGE IN ANCILLARY MEDICAL, REHABILITATION, AND RESIDENTIAL TREATMENT PROGRAMS FOR UNDERSERVED POPULATIONS.(E) TO PROMOTE MUTUALLY ACCEPTABLE AND SATISFYING RELATIONSHIPS BETWEEN THE ORGANIZATION AND OTHER PROVIDERS OF HEALTH CARE TO DEVELOP AN EFFICIENT AND EFFECTIVE DELIVERY OF HEALTH CARE. (F) TO PARTICIPATE IN AND COOPERATE WITH ANY GOVERNMENTAL AGENCY OR OTHER ORGANIZATION ENGAGED IN SIMILAR OR LIKE ACTIVITIES. (G) TO ENGAGE IN SUCH OTHER ACTIVITIES AS DIRECTED BY THE BOARD. 0 0 81301153 90559820 JWCH INSTITUTE, INC., DBA WESLEY HEALTH CENTERS (JWCH OR WESLEY) IS APPROVED AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND PROVIDES A FULL CONTINUUM OF CARE FOR MEN, WOMEN AND CHILDREN IN THE LOS ANGELES AREA. THE SERVICES INCLUDE PRIMARY HEALTH CARE, BEHAVIORAL HEALTH CARE, HOMELESS HEALTH CARE, HIV SERVICES, ORAL HEALTH CARE, PHARMACY SERVICES, VISION CARE AND SUPPORTIVE SERVICES WHICH INCLUDES OUR CHRONIC DISEASE CASE MANAGEMENT, YOUTH SERVICES, HOUSING ASSISTANCE, HEALTH EDUCATION, NUTRITIONAL ASSISTANCE AND RESEARCH. THE WESLEY HEALTH CENTERS ARE PLACES OF EXCELLENCE FOR YOU AND YOUR FAMILY. THROUGH THE 17 AREA HEALTH CENTERS, THE ORGANIZATION PROVIDES COMPREHENSIVE MEDICAL CARE, PHYSICAL EXAMS, ROUTINE SCREENINGS AND TREATMENT OF INJURIES AND ILLNESSES FOR MEN, WOMEN, AND CHILDREN OF LOS ANGELES COUNTY.THE WEINGART CLINIC AT CENTER FOR COMMUNITY HEALTH PROVIDED 51,410 MEDICAL VISIT ASSESSMENTS TO LOW INCOME AND HOMELESS INDIVIDUALS. 7,445 PATIENTS RECEIVED HEALTH CARE SERVICES AT THE CLINIC INCLUDING PRIMARY CARE, X-RAYS, EKGS, FAMILY PLANNING, MALE WELLNESS, CASE MANAGEMENT, HIV TESTING, MENTAL HEALTH, AND DENTAL SERVICES.THE BELLFLOWER HEALTH CENTER PROVIDES PRIMARY CARE SERVICES TO LOW INCOME INDIVIDUALS REGARDLESS OF ABILITY TO PAY. ALL PRIMARY CARE SERVICES FOR FAMILIES, WOMEN AND CHILDREN WILL BE AVAILABLE. CASE MANAGEMENT, MENTAL HEALTH, AND OPTOMETRY SERVICES WILL BE PROVIDED ON SITE AS WELL AS ACCESS TO ELIGIBILITY ASSISTANCE FOR PUBLIC MEDICAL BENEFITS PROGRAMS. BELLFLOWER HEALTH CENTER PROVIDED 33,147 MEDICAL VISITS TO 6,549 PATIENTS. THE DOWNTOWN WOMEN'S CENTER CLINIC SERVES HOMELESS WOMEN AND PROVIDES PRIMARY HEALTH CARE SERVICES, REPRODUCTIVE HEALTH SERVICES, CANCER SCREENING AND ACCESS TO SPECIALTY CARE AND MENTAL HEALTH. THE JWCH CLINIC IS EMBEDDED IN THIS HOMELESS RESIDENTIAL FACILITY AND PROVIDED 292 PATIENTS 722 MEDICAL VISITS. THE DOWNEY CLINIC PROVIDED 26,866 MEDICAL VISITS TO 6,084 PATIENTS. SERVICES PROVIDED AT THE DOWNEY CLINIC INCLUDED PRIMARY CARE, FAMILY PLANNING SERVICES & PROCEDURES, BEHAVIORAL HEALTH SERVICES, COMPREHENSIVE PRENATAL SERVICES, OB/GYN SERVICES, PODIATRY, HIV/STD TESTING & TREATMENT, AND GERIATRIC PRIMARY CARE SERVICES. THE WESLEY HEALTH CENTERS-HACIENDA HEIGHTS PROVIDED 10,680 VISITS TO 2,124 PATIENTS. SERVICES OFFERED AT THE HACIENDA HEIGHTS CLINIC INCLUDED PRIMARY CARE, FAMILY & PEDIATRIC MEDICINE, CHIROPRACTIC SERVICES, REPRODUCTIVE HEALTH, OB/GYN, BEHAVIORAL HEALTH, SUBSTANCE ABUSE SERVICES, HIV/STD TESTING & TREATMENT, PREP SERVICES, AND LABORATORY SERVICES. THE WESLEY HEALTH CENTERS-LYNWOOD (NEW) PROVIDED 33,690 MEDICAL VISITS TO 5,756 PATIENTS. SERVICES OFFERED AT THE NEW LYNWOOD CLINIC INCLUDED PRIMARY CARE, FAMILY MEDICINE, DENTAL/ORAL HEALTH, BEHAVIORAL HEALTH, CHIROPRACTIC SERVICES, HIV/STD TESTING & TREATMENT, PREP SERVICES, PODIARY, AND LABORATORY.JWCH CLINIC AT BELL GARDENS PROVIDED 23,885 VISITS TO 4,669 PATIENTS FOR MEDICAL SERVICES IN THE MOST INDIGENT AREA IN LA COUNTY. THE FOLLOWING SERVICES ARE OFFERED: FAMILY MEDICINE, FAMILY PLANNING, COMPREHENSIVE PRENATAL CARE, PEDIATRICS, OBSTETRICS, X-RAYS, EKGS, MALE WELLNESS SERVICES, HIV TESTING AND LABORATORY SERVICES.THE LYNWOOD PRIMARY CARE CLINIC PROVIDED 14,091 VISITS TO 3,615 PATIENTS RESIDING IN LYNWOOD AND THE SURROUNDING AREA OF COMPTON. BECAUSE THE MAJORITY OF THE CLINIC'S CLIENTELE ARE PEOPLE OF CHILDBEARING AGE, THEIR PRIMARY NEEDS INCLUDE FAMILY PLANNING SERVICES AND ACCESS TO ADEQUATE PRENATAL CARE. IN ADDITION, THE WOMEN ARE AT HIGH RISK OF CERVICAL CANCER, MAKING SCREENING AND TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS AN IMPORTANT SERVICE AT THE CLINIC. THE FOLLOWING SERVICES ARE OFFERED: PHYSICAL/GYNECOLOGICAL EXAMINATIONS, SCREENING FOR CERVICAL AND BREAST CANCER, DIAGNOSIS AND TREATMENT OF SEXUALLY TRANSMITTED DISEASES, PREGNANCY TESTING AND REFERRALS FOR PRENATAL SERVICES, BIRTH CONTROL METHODS, DIAGNOSIS AND TREATMENT OF COMMON GYNECOLOGICAL PROBLEMS, HEALTH EDUCATION, REFERRALS FOR OTHER HEALTH AND SOCIAL SERVICES AS NEEDED.THE NORWALK CLINIC PROVIDED 35,817 VISITS TO 7,300 PATIENTS FOR MEDICAL SERVICES IN THE MOST INDIGENT AREA IN LA COUNTY. THE FOLLOWING SERVICES ARE OFFERED: FAMILY MEDICINE, FAMILY PLANNING, COMPREHENSIVE PRENATAL CARE, PEDIATRICS, OBSTETRICS, X-RAYS, EKGS, MALE WELLNESS SERVICES, HIV TESTING AND LABORATORY SERVICES. THE VERMONT CLINIC PROVIDED 37,513 VISITS TO 7,478 HOMELESS PATIENTS. THE CLINIC OFFERS MEDICAL SERVICES TO HOMELESS AND MEDICALLY INDIGENT PERSONS INCLUDING FAMILY MEDICINE, FAMILY PLANNING, CHILD HEALTH DISABILITY PREVENTION, PEDIATRICS, GERIATRIC PRIMARY CARE, EKGS. SPECIALTY REFERRALS, HIV TESTING, AND LABORATORY SERVICES.THE ANTELOPE VALLEY CLINICS CONSISTED OF WESLEY HEALTH CENTERS (LANCASTER), WESLEY HEALTH CENTERS (PALMDALE CENTRAL) AND WESLEY HEALTH CENTERS (PALMDALE EAST). THEY PROVIDED A COMBINED TOTAL OF 143,033 VISITS TO A TOTAL OF 37,586 PATIENTS. THE FOLLOWING SERVICES ARE OFFERED: PRIMARY HEALTH CARE, REPRODUCTIVE HEALTH, DENTAL & ORAL HEALTH, BEHAVIORAL HEALTH, PEDIATRICS, PODIATRY, ENDOCRINOLOGY, DERMATOLOGY, DRUG, ALCOHOL AND OPIOID DETOX SERVICES, LABORATORY SERVICES, AND SPECIALTY REFERRALS. 18910663 1658039 RECUPERATIVE CARE PROGRAM. THE RECUPERATIVE CARE PROGRAM PROVIDES BED SPACE FOR 286 PATIENTS. PATIENTS MUST BE HOMELESS, HAVE AN ACUTE MEDICAL CONDITION, AND BE MEDICALLY AND PHYSICALLY STABLE. THIS RESPITE PROGRAM PROVIDES MEDICAL CARE, CASE MANAGEMENT, PERSONAL CARE, 3 MEALS PER DAY, ACCESS TO LONG-TERM HOUSING RESOURCES AND PLACEMENT, AND REUNIFICATION SERVICES FOR CLIENTS WHO HAVE FALLEN OUT OF TOUCH WITH THEIR FAMILY OR SUPPORT NETWORK. WESLEY ALSO PROVIDES THESE PATIENTS WITH TRANSPORTATION TO AND FROM MEDICAL VISITS AND TO SPECIALISTS AND OTHER SOCIAL SERVICES AGENCIES IN THE COUNTY. IN ADDITION TO THE NURSING CARE AVAILABLE IN RECUPERATIVE CARE, THE WEINGART CENTER AND BELL SHELTER SITES THAT HOUSE THE PROGRAM OFFER MANY OTHER SERVICES TO HELP BREAK THE CYCLE OF HOMELESSNESS, INCLUDING HOUSING PLACEMENT, SUBSTANCE ABUSE TREATMENT, HEALTH EDUCATION, AND COUNSELING SERVICES. RECUPERATIVE CARE PROGRAMS INCLUDE THE ZONAL AVENUE, MLK, AND THE SAN JULIAN OASIS CARE CENTERS. 6449441 BPHC-HEALTH CARE CENTER CLUSTER. JWCH IS ONE OF THE LARGEST HOMELESS HEALTH CARE PROVIDERS IN LOS ANGELES COUNTY AND PROVIDES SPECIALIZED CARE AND PROGRAMMING AIMED AT CARING FOR THE UNIQUE NEEDS OF THE PATIENTS EXPERIENCING HOMELESSNESS. THE ORGANIZATION PROVIDES THESE SERVICES AT THE DEDICATED ONE-STOP-SHOP HOMELESS HEALTH CARE CLINICS, MINI-CLINICS CO-LOCATED WITHIN HOUSING, RECUPERATIVE CARE FACILITIES, AND THROUGH THE INNOVATIVE STREET MEDICINE PROGRAM WHICH TRAVELS BEYOND THE TRADITIONAL CLINIC WALLS TO DELIVER CARE RIGHT WHERE THE PATIENTS NEED IT. THE HOMELESS HEALTH LOCATIONS ARE FRIENDLY AND WELCOMING AND OFFER PATIENTS ACCESS TO THE FULL SUITE OF COMPREHENSIVE HEALTH CARE SERVICES AS WELL AS SPECIALIZED SERVICES SUCH AS FOOD PANTRY, SHOWER FACILITIES, MAIL ROOM, HOUSING NAVIGATION, AMONG OTHERS. 13265393 130069 233771 AIDS PREVENTION & EDUCATION - PROVIDES PREVENTION, EDUCATION, AND REFERRALS TO TREATMENT AMONG HIGH RISK POPULATIONS. SUBSTANCE ABUSE TREATMENT - THE MINI 12 STEP HOUSE OFFERS RESIDENTIAL AND OUTPATIENT SUBSTANCE ABUSE TREATMENT FOR WOMEN AND WOMEN WITH CHILDREN FOR ALCOHOL AND DRUG ABUSE. THE PROGRAM OFFERS AN INTENSIVE RESIDENTIAL PROGRAM FOR WOMEN WHICH INVOLVES SUBSTANCE ABUSE TREATMENT IN INDIVIDUAL AND GROUP CLASSES, CASE MANAGEMENT, MENTAL HEALTH AND REFERRAL TO MEDICAL CARE AND COMMUNITY SUPPORT SERVICES. THE RESIDENTIAL PROGRAM CAN ACCOMODATE UP TO 31 WOMEN DAILY IN THIS 24-HOUR FACILITY. THE OUTPATIENT PROGRAM OFFERS A LONGER TERM PROGRAM FOR MEN AND WOMEN BASED ON THE 12 STEP PROGRAM OF ALCOHOL AND DRUG ABSTENTION. THE PROGRAM IS SUPPORTED BY NUMEROUS LOCAL AND STATE GRANTS SPECIFICALLY FOR ALCOHOL AND DRUG TREATMENT.OTHER PROGRAM SERVICES - PROVIDES EMERGENCY AND TRANSITIONAL HOUSING SERVICES TO PEOPLE LIVING WITH HIV/AIDS WITH 18 BEDS NIGHTLY LOCATED AT SRO HOUSING TRUST. THE SERVICES INCLUDE: COMPLETE PSYCHOSOCIAL ASSESSMENT, INDIVIDUAL CARE PLAN DEVELOPMENT, APPROPRIATE REFERRALS TO HOUSING, MENTAL HEALTH AND DRUG TREATMENT, MEALS AND NUTRITIONAL SUPPLEMENTATION, AND HYGIENE ITEMS AND CLOTHING. JWCH ALSO OPERATES A STREET MEDICINE TEAM AND TWO MOBILE MEDICAL UNITS WHICH PROVIDE CARE TO PERSONS ON THE STREETS.CARE - CDC - JWCH'S CARE PROGRAM OR (CULTURALLY-AFFIRMING, RESPONSIVE EMPOWERMENT PROJECT) PROVIDES HIV TESTING AND HEALTH EDUCATION ACTIVITIES TO PERSONS AT HIGH RISK OF ACQUIRING HIV IN SKID ROW. HE MAJORITY OF THE PARTICIPANTS ARE HOMELESS OR FORMERLY HOMELESS PERSONS, LIVING IN SHELTERS, MISSIONS AND ON THE STREETS. PARTICIPANTS ARE PROVIDED RAPID HIV TESTING, IMMEDIATE ACCESS TO MEDICAL SPECIALISTS AND EDUCATION TO ASSIST THEM IN HEALTHY LIVING.HIV CASE MANAGEMENT - PROVIDES HIV MEDICAL CARE THROUGH CASE MANAGEMENT, COUNSELING AND TESTING, PREVENTION EDUCATION, REFERRALS TO EMERGENCY AND TRANSITIONAL HOUSING. 13265393 130069 233771 119926650 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 161 0 1 1364 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JEANNE LAM 3232014516 5650 JILLSON STREET COMMERCE CA 90040 ANNETTE SULLIVAN BOARD MEMBER 1.00 X 0 0 0 CHRISTOPHER EWING BOARD MEMBER 1.00 X 0 0 0 EDUARDO SAUCEDO BOARD MEMBER 1.00 X 0 0 0 HERBERT TORRANCE BOARD MEMBER 1.00 X 0 0 0 JOE CASTEL SECRETARY 1.00 X X 0 0 0 KATHLEEN J HOUSE VICE CHAIRPERSON 2.00 X X 0 0 0 KEITH TERASAKI MD CHAIRPERSON 2.00 X X 0 0 0 LAWRENCE FERNANDEZ JR BOARD MEMBER 1.00 X 0 0 0 MARIA PADRON BOARD MEMBER 1.00 X 0 0 0 MARIE S TORRES PHD LCSW BOARD MEMBER 1.00 X 0 0 0 SHEILA SHIMA EATON TREASURER 2.00 X X 0 0 0 SILVIA L HERNANDEZ BOARD MEMBER 1.00 X 0 0 0 TOM GRODE BOARD MEMBER 1.00 X 0 0 0 ALVARO BALLESTEROS CEO 40.00 X 481822 0 20026 ANDY IRIE CHIEF ADMINISTRATIVE OFFICER 40.00 X 218743 0 15568 JEANNE LAM CFO 40.00 X 268259 0 13074 ANA ORTIZ CHIEF DENTAL OFFICER 40.00 X 249052 0 17425 BENJAMIN MONROE MEDICAL DIRECTOR/OB/GYN 40.00 X 240405 0 15086 BRENDA L VELASQUEZ CHIEF OPERATING OFFICER 40.00 X 235344 0 16827 HAROLD GLEN SAN AGUSTIN ASSO. MEDICAL DIRECTOR-HIV 40.00 X 271860 0 18790 KIM TRAN DIRECTOR OF QUALITY ASSURANCE 40.00 X 214274 0 15214 LINDA AROUS ASSOCIATE MEDICAL DIRECTOR 40.00 X 271713 0 18645 PAUL GREGERSON CMO 40.00 X 436024 0 13995 PAUL ROUND ASSO. MEDICAL DIRECTOR 40.00 X 311779 0 9026 PHILIP LE ASSOCIATE MEDICAL DIRECTOR 40.00 X 300503 0 19913 TIEN DANG CIO 40.00 X 215937 0 15991 ARIEL MONSANTO GAVINO MEDICAL DIRECTOR PSYCHIATRY 40.00 X 385470 0 20537 JUHI AMREEN UDDIN PHYSICIAN SPECIALIST PED 40.00 X 256006 0 6993 LUCIEN ALEXANDRE PHYSICIAN SPECIALIST 40.00 X 263354 0 15619 OLUWAMUYIWA O BOLONDURO PHYSICIAN SPECIALIST 40.00 X 421459 0 13914 PAWEL KASZUBOWSKI PHYSICIAN SPECIALIST 40.00 X 254762 0 9653 ROBILA ASHFAQ PHYSICIAN SPECIALIST 40.00 X 264812 0 18029 5561578 0 294325 131 0 1 0 COY BUILDER 11555 TELEGRAPH ROAD SANTA FE SPRINGS CA 90670 RENOVATION 775186 TRIO COMMUNITY MEALS LLC PO BOX 742992 ATLANTA GA 303742992 MEAL SERVICES 479359 CITIGUARD INC 22736 VANOWEN ST SUITE 300 WEST HILLS CA 91307 SECURITY GUARD SERVICES 305760 SOUTHERN SOUL LA 358 W 38TH STREET LOS ANGELES CA 90037 MEAL SERVICES 246075 REGENTS OF THE UNIVERSITY OF CALIFORNIA 400 MINOR HALL BERKELEY CA 947202020 RETINAL SCREENING SERVICES 175018 10 164909 47710164 4981563 1590000 52856636 PATIENT SERVICES, NET 621400 82091340 82091340 PHARMACY REVENUES 621400 7113988 7113988 IPA REVENUES 621400 2248336 2248336 OTHER PROGRAM REVENUE 621400 997966 997966 92451630 829405 829405 94056 0 94056 94056 94056 110983 164909 110983 0 146231727 92451630 0 923461 X 130069 130069 4417487 4089117 328370 70868133 65929602 4938531 1939851 1631589 308262 7872267 6621284 1250983 5728667 4818324 910343 260497 238206 20303 1988 121501 111104 9470 927 12818587 11721662 999075 97850 71588 42363 29198 27 2468800 2026623 437918 4259 411780 338028 73042 710 3750903 3446879 304024 334946 288430 46516 212227 147798 64381 48 846100 500688 345087 325 2007817 1755065 252752 663621 774 662847 MEDICAL AND LABORATORY 10940238 10940238 PATIENT WELFARE 2464784 2464784 REPAIRS AND MAINTENANCE 831577 684085 147492 FEES 720704 432116 285769 2819 2393707 1567822 823855 2030 132275851 119926650 12238218 110983 9254717 7216780 23587713 24400654 7996899 8809139 23149486 27533910 848317 267883 135593 281532 64181465 11098880 40814602 53082585 6061731 5661019 6974511 10477164 118823569 137730666 3327891 3395101 1848493 656861 19425958 22768112 11571867 14254068 36174209 41074142 X 79656187 93841248 2993173 2815276 82649360 96656524 118823569 137730666 13955876 51288 0 X 0 1 X 1 1 1 X 32041442 43043545 41098844 61150991 52856636 230191458 32041442 43043545 41098844 61150991 52856636 230191458 230191458 5572 14938 85179 186383 923461 1215533 119500 110983 230483 231637474 360418624 0.99380 0.98980 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - FUNDRAISING INCOME - 2019 AMOUNT: $ 119,500. 2023 AMOUNT: $ 110,983. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21209619 21209619 32558510 5697296 26861214 7692866 5401584 2291282 2720470 2720470 53082585 DEPOSIT 633185 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS 5046874 RIGHT-OF-USE ASSETS 4797105 10477164 PAYROLL & RELATED LIABILITIES 8053470 ESTIMATED AMOUNTS DUE TO THIRD PARTY PAYERS 1304760 LEASE LIABILITIES 4717796 FINANCE LIABILITIES 178042 14254068 X 146283015 51288 51288 146231727 0 146231727 132275851 0 132275851 0 132275851 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM TAXATION UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D AND IS GENERALLY NOT SUBJECT TO INCOME TAXES. THE ORGANIZATION IS CLASSIFIED AS A PUBLIC CHARITY PURSUANT TO SECTIONS 509(A)(1) AND 170(B)(1)(A)(VI). US GAAP PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AND THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO THE ORGANIZATION'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE SUBSTANTIAL UNRELATED TRADE OR BUSINESS INCOME ACTIVITIES WHICH WOULD AFFECT CONTINUED TAX-EXEMPT STATUS OR PRODUCE MATERIAL INCOME TAX. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS, BASED ON THE TECHNICAL MERITS OF THE POSITION, WILL MORE-LIKELY-THAN-NOT BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION. THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. THE ORGANIZATION'S INCOME TAX RETURNS REMAIN SUBJECT TO EXAMINATION GENERALLY FOR THREE AND FOUR YEARS AFTER THEY WERE FILED FOR FEDERAL AND STATE, RESPECTIVELY. WESLEY BENEFIT DINNER 275892 164909 110983 992 39217 33624 5000 32150 275892 164909 110983 992 39217 33624 5000 32150 110983 0 1 CALIFORNIA PRIMARY CARE ASSOCIATION 1231 I ST 400 SACRAMENTO CA 95814 943215565 501(C)(3) 100000 0 TO SUPPORT COMMITTEE TO PROTECT PATIENT ACCESS TO CARE 1 0 PART I, LINE 2: THE ORGANIZATION ENTERS INTO WRITTEN AGREEMENTS WITH THE GRANTEES SPECIFYING HOW THE GRANT MONIES ARE TO BE SPENT. THE GRANTEES ARE REQUIRED TO SUBMIT BUDGETS FOR THE GRANTS AND REPORTS ARE OBTAINED QUARTERLY OR SEMI-ANNUALLY TO ENSURE THAT MONIES ARE BEING CONSISTENT WITH THE GRANT TERMS AND THE BUDGET. X X X 0 0 0 0 0 0 0 0 0 ALVARO BALLESTEROS CEO 446422 0 21000 0 14400 0 13200 0 6826 0 501848 0 0 0 PAUL GREGERSON CMO 431424 0 1000 0 3600 0 13200 0 795 0 450019 0 0 0 OLUWAMUYIWA O BOLONDURO PHYSICIAN SPECIALIST 391459 0 30000 0 0 0 7088 0 6826 0 435373 0 0 0 ARIEL MONSANTO GAVINO MEDICAL DIRECTOR PSYCHIATRY 384470 0 1000 0 0 0 13200 0 7337 0 406007 0 0 0 PAUL ROUND ASSO. MEDICAL DIRECTOR 310779 0 1000 0 0 0 6346 0 2680 0 320805 0 0 0 PHILIP LE ASSOCIATE MEDICAL DIRECTOR 299503 0 1000 0 0 0 12575 0 7338 0 320416 0 0 0 HAROLD GLEN SAN AGUSTIN ASSO. MEDICAL DIRECTOR-HIV 270860 0 1000 0 0 0 11964 0 6826 0 290650 0 0 0 LINDA AROUS ASSOCIATE MEDICAL DIRECTOR 270713 0 1000 0 0 0 11819 0 6826 0 290358 0 0 0 ROBILA ASHFAQ PHYSICIAN SPECIALIST 263812 0 1000 0 0 0 11203 0 6826 0 282841 0 0 0 JEANNE LAM CFO 267259 0 1000 0 0 0 10455 0 2619 0 281333 0 0 0 LUCIEN ALEXANDRE PHYSICIAN SPECIALIST 262354 0 1000 0 0 0 8918 0 6701 0 278973 0 0 0 ANA ORTIZ CHIEF DENTAL OFFICER 248052 0 1000 0 0 0 10416 0 7009 0 266477 0 0 0 PAWEL KASZUBOWSKI PHYSICIAN SPECIALIST 253762 0 1000 0 0 0 8183 0 1470 0 264415 0 0 0 JUHI AMREEN UDDIN PHYSICIAN SPECIALIST PED 255006 0 1000 0 0 0 6350 0 643 0 262999 0 0 0 BENJAMIN MONROE MEDICAL DIRECTOR/OB/GYN 239405 0 1000 0 0 0 8284 0 6802 0 255491 0 0 0 BRENDA L VELASQUEZ CHIEF OPERATING OFFICER 234344 0 1000 0 0 0 9673 0 7154 0 252171 0 0 0 ANDY IRIE CHIEF ADMINISTRATIVE OFFICER 214743 0 1000 0 3000 0 8742 0 6826 0 234311 0 0 0 TIEN DANG CIO 214937 0 1000 0 0 0 9165 0 6826 0 231928 0 0 0 KIM TRAN DIRECTOR OF QUALITY ASSURANCE 208474 0 1000 0 4800 0 8472 0 6742 0 229488 0 0 0 X 1 1590000 SALE OF COMPARABLE PROP. 0 0 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING IN PART I, COLUMN (B), THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 AND ITS ATTACHMENTS ARE REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE EXTENT OF THE REVIEW INCLUDES A LINE-BY-LINE REVIEW OF THE FORM 990. THE REVIEW IS BASED ON GUIDANCE PROVIDED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE FINAL FORM 990 IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS FOR FINAL REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, AND EXECUTIVE MANAGEMENT OF THE ORGANIZATION ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. EACH BOARD MEMBER AND MEMBER OF THE EXECUTIVE MANAGEMENT STAFF SIGNS AN ANNUAL CONFLICT OF INTEREST STATEMENT. A CONFLICT OF INTEREST POLICY WAS REVIEWED AND HAS BEEN APPROVED BY THE BOARD OF DIRECTORS, AND IS IMPLEMENTED AT THE BOARD MANAGEMENT LEVEL. TRAINING ON THE POLICY WAS ALSO CONDUCTED. DETERMINATIONS OF POTENTIAL CONFLICT OF INTEREST ARE MADE AT THE BOARD LEVEL AND AT THE EXECUTIVE STAFF LEVEL. IF A POTENTIAL CONFLICT IS IDENTIFIED, AGENCY POLICY DICTATES THAT THE SUBJECT INDIVIDUAL SHALL REMOVE THEMSELVES FROM DISCUSSIONS REGARDING THE MATTER AT HAND. ALL CONFLICTS WILL BE DOCUMENTED IN MINUTES OF THE GOVERNING BOARD. ANNUALLY, THE JWCH CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD OF DIRECTORS AS PART OF THE ANNUAL REVIEW OF POLICIES AND PROCEDURES. FORM 990, PART VI, SECTION B, LINE 15 THE JWCH BOARD OF DIRECTORS SETS-UP A COMPENSATION COMMITTEE TO EVALUATE THE CEO'S SALARY BASED ON THE FOLLOWING: AN EXTENSIVE ANNUAL PERFORMANCE REVIEW IS UNDERTAKEN BY THE BOARD OF DIRECTORS VIA THIS COMMITTEE, WITH INPUT BY THE WHOLE BOARD. SHOULD A SALARY INCREASE BE WARRANTED, THE PERFORMANCE EVALUATION IS USED TOGETHER WITH SALARY COMPARISONS OF OTHER COMMUNITY HEALTH CENTERS PROVIDED BY THE CALIFORNIA PRIMARY CARE ASSOCIATION AND THE LOCAL COMMUNITY CLINIC ACCOSIATION TO REVIEW COMPARATIVE COMPENSATION LEVELS. A DETERMINATION IS THEN MADE BASED ON BOTH AND BROUGHT TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO IMPLEMENTATION OF ANY SALARY CHANGES. THE BOARD OF DIRECTORS ONLY SETS THE SALARY FOR THE CEO. THE BOARD OF DIRECTORS REVIEW AND APPROVE A SALARY COMPENSATION GRADE SCHEDULE FOR ALL OTHER AGENCY STAFF, INCLUDING THE CFO. THIS COMPENSATION GRADE SCHEDULE IS PERIODICALLY REVIEWED BY THE BOARD OF DIRECTORS SO THAT SALARIES OF AGENCY STAFF IS CONSISTENT WITH INDUSTRY STANDARDS. THE SETTING OF SALARIES FOR STAFF OTHER THAN THE CEO IS DELEGATED TO THE CEO AND HIS DESIGNEES TOGETHER WITH HUMAN RESOURCES ACCORDING TO THE AFOREMENTIONED SALARY SCHEDULE. THE DELIBERATION AND DECISION ON EACH OF THE COMPENSATION PACKAGES WAS PROPERLY SUBSTANTIATED. 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 REQUEST. FORM 990, PART IX, LINE 11G MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 8,497,842. MANAGEMENT AND GENERAL EXPENSES 724,299. FUNDRAISING EXPENSES 70,938. TOTAL EXPENSES 9,293,079. TRANSPORTATION: PROGRAM SERVICE EXPENSES 301,381. MANAGEMENT AND GENERAL EXPENSES 25,688. FUNDRAISING EXPENSES 2,516. TOTAL EXPENSES 329,585. PAYROLL SERVICES: PROGRAM SERVICE EXPENSES 288,924. MANAGEMENT AND GENERAL EXPENSES 24,626. FUNDRAISING EXPENSES 2,412. TOTAL EXPENSES 315,962. OUTSIDE SERVICES SECURITY: PROGRAM SERVICE EXPENSES 507,519. MANAGEMENT AND GENERAL EXPENSES 43,257. FUNDRAISING EXPENSES 4,237. TOTAL EXPENSES 555,013. OUTSIDE SERVICES TRANSLATION: PROGRAM SERVICE EXPENSES 105,286. MANAGEMENT AND GENERAL EXPENSES 8,974. FUNDRAISING EXPENSES 879. TOTAL EXPENSES 115,139. SUBCONTRACTORS: PROGRAM SERVICE EXPENSES 849,378. MANAGEMENT AND GENERAL EXPENSES 72,395. FUNDRAISING EXPENSES 7,090. TOTAL EXPENSES 928,863. OTHER PROFESSIONAL SERVICE: PROGRAM SERVICE EXPENSES 1,171,332. MANAGEMENT AND GENERAL EXPENSES 99,836. FUNDRAISING EXPENSES 9,778. TOTAL EXPENSES 1,280,946. FORM 990, PART IX, LINE 24E RECRUITMENT: PROGRAM SERVICE EXPENSES 356,471. MANAGEMENT AND GENERAL EXPENSES 335,337. FUNDRAISING EXPENSES 316. TOTAL EXPENSES 692,124. SMALL TOOLS AND SUPPLIES: PROGRAM SERVICE EXPENSES 565,399. MANAGEMENT AND GENERAL EXPENSES 49,458. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 614,857. PROPERTY & SALES TAX: PROGRAM SERVICE EXPENSES 220,336. MANAGEMENT AND GENERAL EXPENSES 145,714. FUNDRAISING EXPENSES 1,438. TOTAL EXPENSES 367,488. LAUNDRY: PROGRAM SERVICE EXPENSES 188,826. MANAGEMENT AND GENERAL EXPENSES 130,144. FUNDRAISING EXPENSES 122. TOTAL EXPENSES 319,092. MEMBERSHIPS & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 40,803. MANAGEMENT AND GENERAL EXPENSES 85,771. FUNDRAISING EXPENSES 49. TOTAL EXPENSES 126,623. UNIFORMS: PROGRAM SERVICE EXPENSES 62,901. MANAGEMENT AND GENERAL EXPENSES 43,353. FUNDRAISING EXPENSES 41. TOTAL EXPENSES 106,295. PROGRAM EXPENSES: PROGRAM SERVICE EXPENSES 83,642. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 32. TOTAL EXPENSES 83,674. EMPLOYEE ACKNOWLEDGEMENTS: PROGRAM SERVICE EXPENSES 35,316. MANAGEMENT AND GENERAL EXPENSES 24,341. FUNDRAISING EXPENSES 23. TOTAL EXPENSES 59,680. OTHER EXPENSES: PROGRAM SERVICE EXPENSES 14,128. MANAGEMENT AND GENERAL EXPENSES 9,737. FUNDRAISING EXPENSES 9. TOTAL EXPENSES 23,874.