Form 990 for tax year 2022
Filed by LA CLINICA VALLEJO GEORGIA STREET PROPERTY OWNER.
Totals
- Total revenue
- $230,460
- Total expenses
- $807,340
- Contributions and grants received
- $0
- Grants paid
- $0
- Program services expenses (Part IX)
- $783,599
- Management and general expenses
- $23,741
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $783,599
Program services were 97.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
RAMON TERRAZAS MD MPH
PRESIDENT
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
ROBERT CALVIN KATTER
VICE PRESIDENT
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
CHRISTOPHER OHMAN
SECRETARY
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
PAUL MARRIOTT SWENSON MBA
TREASURER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
SOPHIA BUCHELI
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
JON ELAM
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
MARIA DE LOS ANGELES ESPINOZA
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
ALVARO FUENTES
INDEPENDENT DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
BLANCA GOMEZ
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
NORMA GUADALUPE GUERRERO
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
AISHA HAMPTON-BOWSER
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
JO ANN INTILI
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
REVEREND RODNEY J LEGGET
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
CARMEN MARTINEZ
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
EMILY PRIETO-TSEREGOUNIS PHD
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
TINA RAINE-BENNETT MD MPH FACOG
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
JANE GARCIA
CHIEF EXECUTIVE OFFICER
- Total calculated
- $709,427
- From this org
- $0
- From related orgs
- $624,588
- Other
- $84,839
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $405,484 related
- Bonus
- $0 + $50,300 related
- Other
- $0 + $168,804 related
- Deferred
- $0 + $65,682 related
- Nontaxable benefits
- $0 + $19,157 related
- Filer's total
- $0 + $709,427 related
-
SUSAN MOORE
CFO (THROUGH 11/2022)
- Total calculated
- $216,165
- From this org
- $0
- From related orgs
- $196,637
- Other
- $19,528
- Hours/week
- 1 + 40 related
Schedule J breakdown matched by us
- Base
- $0 + $194,837 related
- Bonus
- $0 + $800 related
- Other
- $0 + $1,000 related
- Deferred
- $0 + $2,058 related
- Nontaxable benefits
- $0 + $17,470 related
- Filer's total
- $0 + $216,165 related
-
KANWAR SINGH
CFO (START 10/2022)
- Total calculated
- $49,369
- From this org
- $0
- From related orgs
- $39,472
- Other
- $9,897
- Hours/week
- 1 + 40 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4a · Severance or change-of-control payment
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 3
- THE ORGANIZATION'S CEO IS COMPENSATED BY LA CLINICA DA LA RAZA, INC., A RELATED ORGANIZATION. LA CLINICA DE LA RAZA, INC. UTILIZED THE FOLLOWING METHODS TO DETERMINE THE CEO'S COMPENSATION: COMPENSATION SURVEY OR STUDY; APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
- PART I, LINE 4B
- JANE GARCIA PARTICIPATES IN A SUPPLEMENTAL, NONQUALIFIED 457(F) RETIREMENT PLAN PROVIDED THROUGH LA CLINICA DE LA RAZA, INC., A RELATED ORGANIZATION. DURING THE 2022 CALENDAR YEAR, EMPLOYER CONTRIBUTIONS TO THE PLAN TOTALED $42,000, WHICH HAS BEEN REPORTED AS "DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C). IN ADDITION, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, $86,477 WAS RECOGNIZED AS TAXABLE COMPENSATION ON JANE GARCIA'S 2022 FORM W-2 WHICH HAS BEEN RECORDED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" ON SCHEDULE J, PART II, COLUMN (F).
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
501(C)(3) · FEDERALLY QUALIFIED HEALTH CENTER · CA · controlled entity
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 9 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202431319349301538
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