2023-11-14T17:19:49-06:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-01-01 412013739 CHILDREN'S SURGERY INTERNATIONAL CHIL 6127464082 99 5TH AVENUE NW 100 NEW BRIGHTON MN 55112 MEGAN SPARKS EXECUTIVE DIRECTOR 6127464082 2023-11-14 1 MEGAN SPARKS 999009999 0 MACKENZIE MCNAUGHTON P02025805 6123764500 2023-11-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MEGAN SPARKS 99 5TH AVENUE NW 100 NEW BRIGHTON MN 55112 507547 0 X CHILDRENSSURGERYINTL.ORG X 2001 MN TO PROVIDE SPECIALIZED MEDICAL AND SURGICAL SERVICES AND TO PROMOTE IN-COUNTRY SELF-SUFFICIENCY. 17 17 5 125 0 0 297593 400560 3000 32200 58219 1811 -28110 -10224 330702 424347 0 0 0 0 134720 130147 0 0 49536 49186 423578 183906 553725 146796 -129378 1319089 1090738 20827 0 1298262 1090738 X CHILDREN'S SURGERY INTERNATIONAL (CSI) PROVIDES FREE PEDIATRIC MEDICAL AND SURGICAL SERVICES, ALONG WITH PROFESSIONAL EDUCATION AND TRAINING TO COMMUNITIES IN NEED AROUND THE WORLD. 1 0 397724 0 32200 PLANNING AND EXECUTION OF FOUR (4) SURGICAL TRIPS TO ETHIOPIA, MEXICO AND TANZANIA WITH NEW COVID MITIGATION STRATEGIES IN PLACE: CSI VOLUNTEERS PROVIDED 2,000 HOURS OF DONATED PROFESSIONAL SERVICES TO TRAIN LOCAL MEDICAL STAFF AND PERFORM LIFE-CHANGING SURGERY FOR 112 CHILDREN VALUED AT $437,924. 23556 0 0 SAFE RETURN TO TRAVEL COVID PLANNING: MEDICAL AND NONMEDICAL VOLUNTEERS WORKED OVER THE YEAR TO DEVELOP, TEST AND REFINE NEW SAFETY PROTOCOLS AND TRIP LOGISTICS TO ALLOW FOR A SAFE RETURN TO TRAVEL. 13620 0 0 PLANNING AND PRESCREENING FOR ALL TRIPS IN LIGHT OF COVID PANDEMIC: A TEAM OF VOLUNTEERS WORKED WITH PARTNERS TO PLAN FOR FOUR (4) TRIPS. THIS INCLUDED PRESCREENING 100 PATIENTS FOR SURGERY. 13000 0 0 LAUNCHING A FIRST-OF-ITS-KIND PEDIATRIC ENT AND OTOLARYNGOLOGY FELLOWSHIP PROGRAM IN ETHIOPIA. STAFF AND VOLUNTEERS COMPLETED CURRICULUM DEVELOPMENT, ESTABLISHED PROGRAM BUDGET AND TIMELINES AND IDENTIFIED KEY FACULTY AND TRAINING/APPLICATION SCHEDULE. 13000 0 0 447900 1 1 0 0 0 0 0 0 0 0 1 0 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 1 0 0 0 0 0 0 0 0 1 0 0 5 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 0 0 0 MN X X CAROL HOLMES 6127464082 99 5TH AVENUE NW SUITE 100 NEW BRIGHTON MN 55112 SIVA CHINNADURAI CHAIR 2.00 X X 0 0 0 AMY FISCHER CO-CHAIR 1.00 X X 0 0 0 PETER FALKER TREASURER 1.00 X X 0 0 0 NEAL PETERSON SECRETARY 1.00 X X 0 0 0 DOROTHY BARR DIRECTOR 1.00 X 0 0 0 KATHY CLINCH DIRECTOR 1.00 X 0 0 0 JASON DESHAW DIRECTOR 1.00 X 0 0 0 KAREN RESCH DIRECTOR 1.00 X 0 0 0 MELANIE MCCALL DIRECTOR 1.00 X 0 0 0 CONRAD NGUYEN DIRECTOR 1.00 X 0 0 0 BRIANNE ROBY DIRECTOR 1.00 X 0 0 0 ZINDA SCHAEFER DIRECTOR 1.00 X 0 0 0 LINDA SEDGWICK DIRECTOR 1.00 X 0 0 0 TODD STINSON DIRECTOR 1.00 X 0 0 0 DAVID VANDERSTEEN DIRECTOR 1.00 X 0 0 0 GARRETT VINCENT DIRECTOR 1.00 X 0 0 0 NORIE WILSON DIRECTOR 1.00 X 0 0 0 JAMES ZIMMERMAN DIRECTOR 1.00 X 0 0 0 MEGAN SPARKS EXECUTIVE DIRECTOR 25.00 X 65000 0 0 DAVID TETZLAFF MEDICAL DIRECTOR 1.00 X 0 0 0 65000 0 0 0 0 0 0 0 176974 223586 44610 400560 TEAM FEES 900099 32200 32200 32200 1811 1811 57854 176974 78093 -20239 -20239 14432 500 13932 13932 690 4607 -3917 -3917 424347 32200 0 -8413 65000 32500 16250 16250 56295 47555 5583 3157 8852 5843 1593 1416 2676 1766 482 428 1111 733 200 178 48223 31827 8680 7716 18217 12023 3279 2915 73386 49810 12481 11095 8889 8889 188938 188938 9510 6276 1712 1522 MISSION SUPPLIES 35076 35076 MISCELLANEOUS 32992 22104 6029 4859 EQUIPMENT 2441 2441 FREIGHT 2119 2119 553725 447900 56289 49536 323016 165798 442231 442953 30093 10848 3000 3000 18290 34768 141263 141263 0 0 502459 433371 1319089 1090738 927 19900 20827 0 X 1298262 1090738 1298262 1090738 1319089 1090738 -129378 -78146 0 X 0 0 0 X 482253 725912 624819 297593 400560 2531137 20470 17074 32200 69744 6400 9292 13470 29162 488653 735204 658759 314667 432760 2630043 42698 86316 428764 75204 167773 800755 0 42698 86316 428764 75204 167773 800755 1829288 24618 12998 75359 58219 1811 173005 24618 12998 75359 58219 1811 173005 72476 72476 513271 748202 734118 372886 507047 2875524 0.63620 0.66140 0.06020 0.07680 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 141263 141263 0 0 GALA 234828 176974 57854 8000 43043 27050 234828 176974 57854 8000 43043 27050 78093 -20239 X 2 10022 FMV X AUCTION ITEMS 120 33988 FMV X RAFFLE 1 4000 FMV X IN-KIND 1 1600 FMV 0 0 0 FORM 990, PART III, LINE 2 DURING 2022, CHILDREN'S SURGERY INTERNATIONAL LAUNCHED A FIRST-OF-ITS-KIND PEDIATRIC ENT AND OTOLARYNGOLOGY FELLOWSHIP PROGRAM IN ETHIOPIA. FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE IS COMPRISED OF THE EXECUTIVE DIRECTOR, THE BOARD CHAIR, THE BOARD VICE CHAIR, SECRETARY, TREASURER, AND ONE MEDICAL BOARD MEMBER. THEY CAN ACT ON BEHALF OF THE BOARD IN-BETWEEN MONTHLY MEETINGS IF A NEED ARISES. FORM 990, PART VI, SECTION A, LINE 8B THE MEETINGS OF THE EXECUTIVE COMMITTEE ARE NOT DOCUMENTED BUT ANY ACTIONS THEY TAKE ARE DOCUMENTED IN THE BOARD MINUTES OF THE PROCEEDING MEETING. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT PUBLIC ACCOUNTING FIRM USING INFORMATION PROVIDED BY THE ORGANIZATION. ONCE A DRAFT OF THE RETURN IS READY, THE BOARD OF DIRECTORS REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY COVERS ALL DIRECTORS AND OFFICERS AS WELL AS ANY EMPLOYEES WHO CAN INFLUENCE ACTIONS OF THE ORGANIZATION. AT THE ANNUAL MEETING, THE CONFLICT OF INTEREST POLICY IS REVIEWED AND DIRECTORS DISCLOSE CONFLICTS OF INTEREST. THE BOARD CHAIR AND EXECUTIVE DIRECTOR MEET ANNUALLY WITH EACH DIRECTOR TO DISCUSS THE YEAR AND ANY CONCERNS THAT MIGHT ARISE. SHOULD A CONFLICT OF INTEREST ARISE, THE BOARD WILL DISCUSS THE MATTER WITHOUT THE PRESENCE OF THE INTERESTED PERSON AND DECIDE WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED. ALL DECISIONS ARE DOCUMENTED IN THE BOARD MEETING MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.