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Nonprofiteer
← EAST VALLEY COMMUNITY CLINIC INC

Form 990 for tax year 2022

Filed by EAST VALLEY COMMUNITY CLINIC INC.

Totals

Total revenue
$696,888
Total expenses
$2,535,206
Contributions and grants received
$46,034
Grants paid
$0
Program service revenue
$627,407
Investment income
$0
Other revenue
$23,447
Total assets, end of year
$2,208,240
Total liabilities, end of year
$473,362
Net assets or fund balances, end of year
$1,734,878
Program services expenses (Part IX)
$2,505,411
Management and general expenses
$29,795
Fundraising expenses
$0
Program service expenses (Part III)
$2,505,411

Program services were 98.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1f · All other contributions, gifts and grants

    $46,034

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $627,407 · related or exempt $627,407

  • 11a · Other revenue: MISCELLANEOUS REVENUE

    total $23,447 · excluded $23,447

  • 11e · Other revenue, total

    $23,447

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $1,273,508 · program services $1,273,508

  • 8 · Pension plan contributions

    total $49,037 · program services $49,037

  • 9 · Other employee benefits

    total $120,212 · program services $120,212

  • 10 · Payroll taxes

    total $90,866 · program services $90,866

  • 11c · Fees: accounting

    total $29,795 · management and general $29,795

  • 11g · Fees: other

    total $192,106 · program services $192,106

  • 12 · Advertising and promotion

    total $185 · program services $185

  • 13 · Office expenses

    total $59,223 · program services $59,223

  • 14 · Information technology

    total $7,728 · program services $7,728

  • 16 · Occupancy

    total $219,052 · program services $219,052

  • 17 · Travel

    total $1,309 · program services $1,309

  • 19 · Conferences, conventions and meetings

    total $5,098 · program services $5,098

  • 20 · Interest

    total $2,013 · program services $2,013

  • 22 · Depreciation, depletion and amortization

    total $11,739 · program services $11,739

  • 23 · Insurance

    total $23,189 · program services $23,189

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $408,100 · program services $408,100

  • 24b · Other expenses: EQUIP RENTAL & MAINT

    total $26,854 · program services $26,854

  • 24c · Other expenses: SUBSCRIPTIONS

    total $7,838 · program services $7,838

  • 24d · Other expenses: SALES TAX

    total $5,869 · program services $5,869

  • 24e · All other expenses

    total $1,485 · program services $1,485

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $849,082 · end of year $1,342,441

  • 3 · Pledges and grants receivable

    beginning of year $73,402 · end of year $0

  • 4 · Accounts receivable

    beginning of year $2,751,955 · end of year $532,978

  • 8 · Inventories for sale or use

    beginning of year $6,889 · end of year $32,068

  • 9 · Prepaid expenses and deferred charges

    beginning of year $17,051 · end of year $8,551

  • 10a · Land, buildings and equipment: cost or other basis

    $774,735

  • 10b · Land, buildings and equipment: accumulated depreciation

    $729,327

  • 10c · Land, buildings and equipment, net

    beginning of year $0 · end of year $45,408

  • 15 · Other assets

    beginning of year $125,970 · end of year $246,794

  • 17 · Accounts payable and accrued expenses

    beginning of year $247,558 · end of year $267,552

  • 25 · Other liabilities

    beginning of year $3,595 · end of year $205,810

  • 27 · Net assets without donor restrictions

    beginning of year $3,573,196 · end of year $1,734,878

Mission and programs · 2022

Mission

TO PROVIDE HEALTH CARE AND EDUCATION TO INDIVIDUALS AND FAMILIES IN EAST SAN JOSE.

  • PATIENT SERVICES - THE PRIMARY CARE CLINIC AND THE PEDIATRIC CARE CLINIC OFFER DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC ILLNESSES, PREVENTIVE HEALTH CARE, AND SCREENINGS FOR MEDICAL CONDITIONS SUCH AS DIABETES, HIGH BLOOD PRESSURE AND HIV INFECTION. THE COMPREHENSIVE PRENATAL AND OUTREACH PROGRAM PROVIDE SERVICES THAT CONTRIBUTE TO THE COUNTY OF SANTA CLARA'S EFFORT TO DEVELOP AND IMPLEMENT A PRENATAL OUTREACH AND CASE FINDING SYSTEM. THE REPRODUCTIVE HEALTH PROGRAM PROVIDES PRE-MARITAL BLOOD TESTS, DIAGNOSIS OF SEXUALLY TRANSMITTED DISEASE, HIV/AIDS RISK ASSESSMENT AND INFORMATION AND COUNSELING REGARDING FAMILY PLANNING. PATIENT SERVICES FUNDING SOURCES INCLUDE FEES PAID BY PATIENTS AND BY MEDI-CAL, AS WELL AS GRANTS FROM VARIOUS PUBLIC AND PRIVATE AGENCIES.

    Expenses $2,505,411 · Revenue $627,407

As filed on the 2022 return.

Listed in Part VII

  • Elizabeth Davila

    CHAIR

    Total calculated
    $0
    Hours/week
    1
  • Joan Gallo

    SECRETARY

    Total calculated
    $0
    Hours/week
    1
  • Stacy Cross

    BOARD MEMBER / EXECUTIVE DIRECTOR

    Total calculated
    $725,671
    From this org
    $0
    From related orgs
    $669,149
    Other
    $56,522
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $561,441 related
    Bonus
    $0 + $107,708 related
    Other
    $0
    Deferred
    $0 + $48,538 related
    Nontaxable benefits
    $0 + $7,984 related
    Filer's total
    $0 + $725,671 related
  • Tanuja Bahal

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1
  • Thomas Motsiff

    CHIEF ADMIN & FINANCIAL OFFICER

    Total calculated
    $476,300
    From this org
    $0
    From related orgs
    $446,134
    Other
    $30,166
    Hours/week
    5 + 45 related

    Schedule J breakdown matched by us

    Base
    $0 + $435,985 related
    Bonus
    $0 + $10,149 related
    Other
    $0
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $14,916 related
    Filer's total
    $0 + $476,300 related
  • Esther Kiang

    CLINICIAN

    Total calculated
    $115,441
    From this org
    $106,728
    From related orgs
    $0
    Other
    $8,713
    Hours/week
    40
  • Anh Pham

    CLINICIAN

    Total calculated
    $149,913
    From this org
    $139,104
    From related orgs
    $0
    Other
    $10,809
    Hours/week
    40
  • Teresa Robbins MD

    PHYSICIAN

    Total calculated
    $234,450
    From this org
    $226,995
    From related orgs
    $0
    Other
    $7,455
    Hours/week
    32

    Schedule J breakdown matched by us

    Base
    $226,197
    Bonus
    $798
    Other
    $0
    Deferred
    $7,455
    Nontaxable benefits
    $0
    Filer's total
    $234,450
  • Christine So

    CLINICIAN

    Total calculated
    $132,019
    From this org
    $119,780
    From related orgs
    $0
    Other
    $12,239
    Hours/week
    40
  • Miriam Zeledon

    HEALTH CENTER MANAGER

    Total calculated
    $123,508
    From this org
    $106,841
    From related orgs
    $0
    Other
    $16,667
    Hours/week
    40
  • Dominique Lee

    FORMER EXECUTIVE DIRECTOR

    Total calculated
    $515,139
    From this org
    $0
    From related orgs
    $505,249
    Other
    $9,890
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $30,904 related
    Bonus
    $0
    Other
    $0 + $474,345 related
    Deferred
    $0 + $8,952 related
    Nontaxable benefits
    $0 + $938 related
    Filer's total
    $0 + $515,139 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, and on a Form 990-PF Part VIII's — 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

  • 4a · Severance or change-of-control payment

Answered no

  • 4b · Supplemental nonqualified retirement plan
  • 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 EXECUTIVE DIRECTOR IS COMPENSATED BY PLANNED PARENTHOOD MAR MONTE, INC., A RELATED ORGANIZATION. PLANNED PARENTHOOD MAR MONTE, INC. UTILIZES THE FOLLOWING METHODS TO DETERMINE COMPENSATION OF THE EXECUTIVE DIRECTOR: COMPENSATION COMMITTEE; INDEPENDENT COMPENSATION CONSULTANT; COMPENSATION SURVEY OR STUDY; AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
PART I, LINE 4A
DOMINIQUE LEE RECEIVED A TAXABLE SEVERANCE PAYMENT OF $385,000 FROM A RELATED ORGANIZATION DURING THE 2022 CALENDAR YEAR, WHICH HAS BEEN REPORTED WITHIN "OTHER REPORTABLE COMPENSATION" ON SCHEDULE J, PART II, COLUMN (B)(III).

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.

  • PLANNED PARENTHOOD MAR MONTE INC

    501(C)(3) · TO PROVIDE HEALTH CARE AND EDUCATION, AND EXPAND RIGHTS AND ACCESS FOR ALL · CA

  • PLANNED PARENTHOOD ADVOCATES MAR MONTE INC

    501(C)(4) · ADVOCACY, EDUCATION, AND POLITICAL SUPPORT FOR REPRODUCTIVE HEALTH CARE · CA

    Directly controlled by PLANNED PARENTHOOD MAR MONTE INC

  • WE VOTE - NOSOTROS VOTAMOS POLITICAL ACTION COMMITTEE

    527 · TO ELECT OFFICIALS ADVOCATING FOR ACCESS TO QUALITY REPRODUCTIVE HEALTH CARE · CA

    Directly controlled by PPAMM

Provenance

Return type
form_990
Tax year
2022
Filed
22 April 2024
IRS schema version
2022v5.0
Source object
202411149349301626

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