2024-05-14T13:40:29-05:00 2023-06-30 330700332 VASQUEZ COMPANY LLP 655 N CENTRAL AVE STE 1550 GLENDALE CA 91203 990 2022-07-01 954116680 PEDIATRIC AND FAMILY MEDICAL FOUNDATION PEDI 2137461037 1530 S OLIVE STREET LOS ANGELES CA 90015 MONICA GUTIERREZ-MCCARTHY INTERIM CEO/COO 2137475542 2024-05-10 1 MONICA GUTIERREZ-MCCARTHY 999009999 0 REGINA PRINCE CPA P00576936 2138731700 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MONICA GUTIERREZ-MCCARTHY 1530 SOUTH OLIVE ST LOS ANGELES CA 90015 44188 0 X N/A X 1987 CA TO OPERATE EXCLUSIVELY FOR THE BENEFIT AND SUPPORT OF THE GOALS AND OBJECTIVES OF THE PEDIATRIC AND FAMILY MEDICAL CENTER. 11 10 0 10 0 0 0 0 0 0 38588 44188 0 0 38588 44188 132957 101470 0 0 0 0 0 0 0 20049 14102 153006 115572 -114418 -71384 2134263 2297043 0 0 2134263 2297043 THE SPECIFIC PURPOSES OF THIS CORPORATION IS TO OPERATE EXCLUSIVELY FOR THE BENEFIT AND SUPPORT OF THE GOALS AND OBJECTIVES OF PEDIATRIC AND FAMILY MEDICAL CENTER. 0 0 101470 101470 DURING THE YEAR, THE ORGANIZATION SUPPORTED PEDIATRIC AND FAMILY MEDICAL CENTER, DBA: EISNER HEALTH, WHICH IS A FREE STANDING LICENSED COMMUNITY CLINIC AND CERTIFIED AS A MEDI-CAL PROVIDER. 101470 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 CA X SERGEY NAVOLNEV 2137475542 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 RUPERT GRANT BOARD TREASURER 1.00 1.00 X X 0 0 0 JOSHUA ENGLANDER BOARD MEMBER 1.00 0.00 X 0 0 0 ALEXES DEGENFELDER BOARD CHAIR 1.00 0.00 X X 0 0 0 CHRIS ISOLA BOARD SECRETARY 1.00 1.00 X X 0 0 0 PEJMAN SALIMPOUR BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN B KROEKER BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN ROSSI BOARD MEMBER 1.00 1.00 X 0 0 0 STAN BERKMAN BOARD MEMBER 1.00 1.00 X 0 0 0 TRENT STAMP BOARD MEMBER 1.00 0.00 X 0 0 0 WARREN J BRODINE PRESIDENT/CEO 1.00 40.00 X X 0 385635 22813 SHIREEN MOTIVALA BOARD MEMBER 1.00 0.00 X 0 0 0 SERGEY NAVOLNEV CFO 1.00 40.00 X 0 229352 22758 0 614987 45571 0 0 1 0 0 44188 44188 44188 0 0 44188 101470 101470 14102 14102 115572 101470 14102 0 2134263 2297043 2134263 2297043 0 0 X 2134263 2297043 2134263 2297043 2134263 2297043 -71384 234164 0 X 0 1 X 1 0 X X 1 PEDIATRIC AND FAMILY MEDICAL CENTER 951690966 3 1 101470 0 1 101470 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 SCHEDULE A, SECTION C TYPE II SUPPORTING ORGANIZATION THE PEDIATRIC AND FAMILY MEDICAL FOUNDATION (FOUNDATION) IS ORGANIZED TO OPERATE EXCLUSIVELY FOR THE BENEFIT OF AND TO SUPPORT THE GOALS AND OBJECTIVES OF PEDIATRIC AND FAMILY MEDICAL CENTER, DBA: EISNER HEALTH. THE BYLAWS OF THE FOUNDATION PROVIDE IN PART AS FOLLOWS: "FOUNDATION IS RESPONSIBLE FOR RAISING THE RESOURCES NECESSARY TO SUPPORT THE OPERATIONS OF EISNER . . . . . AND IS ALSO RESPONSIBLE FOR OVERSEEING EISNER'S INVESTMENTS." THE FOUNDATION IS OPERATED, SUPERVISED, MANAGED, AND CONTROLLED IN CONNECTION WITH EISNER HEALTH. AND ACCORDINGLY, EISNER HEALTH'S AUDITED FINANCIAL STATEMENTS ARE PREPARED ON A CONSOLIDATED BASIS INCLUDING THE FOUNDATION'S ACTIVITIES. FIVE OF THE FOUNDATION'S ELEVEN BOARD MEMBERS ARE ALSO ON THE SUPPORTED ORGANIZATION'S BOARD. THE PRESIDENT OF THE FOUNDATION IS ALSO THE PRESIDENT OF EISNER HEALTH. THE CHAIRMAN OF EISNER HEALTH IS ON THE BOARD OF THE FOUNDATION. THE TREASURER OF THE FOUNDATION IS ON THE BOARD OF EISNER HEALTH. THE SECRETARY OF THE FOUNDATION IS ON THE BOARD OF EISNER HEALTH. THE IMMEDIATE PAST PRESIDENT OF EISNER HEALTH IS ON THE BOARD OF THE FOUNDATION, AND ANOTHER BOARD MEMBER OF EISNER HEALTH IS ON THE FOUNDATION'S BOARD. THE FOUNDATION BOARD CHAIR SERVES AS THE CHAIR OF THE FOUNDATION EXECUTIVE COMMITTEE. PER THE BYLAWS, THE EXECUTIVE COMMITTEE MAY EXERCISE ALL THE AUTHORITY OF THE BOARD IN THE MANAGEMENT OF BUSINESS AND AFFAIRS OF THE FOUNDATION BETWEEN MEETINGS OF THE BOARD. IN ADDITION TO SHARING BOARD MEMBERS, KEY LEADERSHIP POSITIONS OVERLAP BETWEEN THE FOUNDATION AND ITS SUPPORTED ORGANIZATION. E.G., THE FOUNDATION SHARES THE SAME CHIEF EXECUTIVE OFFICER, VICE PRESIDENT OF DEVELOPMENT, AND CHIEF FINANCIAL OFFICER WITH EISNER HEALTH. ALL OF THE FOUNDATION'S DAY-TO-DAY OPERATIONAL AND FINANCIAL ACTIVITIES ARE HANDLED ENTIRELY BY EISNER HEALTH'S KEY MANAGEMENT TEAM. ACCORDINGLY, THE FOUNDATION IS RESPONSIVE TO THE NEEDS AND REQUIREMENTS OF EISNER HEALTH AND QUALIFIES AS A TYPE II SUPPORTING ORGANIZATION. 0 X 63783042 234164 63518792 63752956 30086 14102 14102 44188 66311537 66311537 66311537 0 14102 101470 115572 115572 PART X, LINE 2: EISNER AND ITS AFFILIATE (PEDIATRIC & FAMILY MEDICAL FOUNDATION) ARE NONPROFIT CORPORATIONS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF ANY AUDIT BY TAXING AUTHORITIES AT 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 UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS 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 FOR ALL TAX YEARS ENDED ON OR AFTER DECEMBER 31, 2018 WITH REGARD TO ALL TAX POSITIONS AND RESULTS REPORTED. PART XI, LINE 2D - OTHER ADJUSTMENTS: PROGRAM SERVICE REVENUE OF SUPPORTED ORGANIZATION 63,087,230. INVESTMENT INCOME OF SUPPORTED ORGANIZATION 431,562. PART XII, LINE 2D - OTHER ADJUSTMENTS: PROGRAM EXPENSES OF SUPPORTED ORGANIZATION 66,311,537. PART XII, LINE 4B - OTHER ADJUSTMENTS: SUPPORTING ORGANIZATION EXPENSES 101,470. 0 PEDIATRIC AND FAMILY MEDICAL CENTER 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 951690966 501(C)(3) 101470 0 BOOK TO SUPPORT GOALS AND OBJECTIVES OF EISNER HEALTH. 1 0 0 0 0 0 0 0 0 0 0 WARREN J BRODINE PRESIDENT/CEO 0 336484 0 6127 0 43024 0 22650 0 163 0 408448 0 0 SERGEY NAVOLNEV CFO 0 188350 0 0 0 41002 0 15888 0 6870 0 252110 0 0 PART I, LINE 3 THE FOUNDATION DOES NOT UNDERTAKE ANY COMPENSATION PROCEDURES BECAUSE THE FOUNDATION DOES NOT COMPENSATE ANY EMPLOYEES. THE OFFICERS ARE COMPENSATED BY THE RELATED ORGANIZATION, PEDIATRIC & FAMILY MEDICAL CENTER. THE GOVERNANCE COMMITTEE OF THE RELATED ORGANIZATION USES AN INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS THEN PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS GIVEN TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12 THE FOUNDATION FOLLOWS ITS SUPPORTED ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANNUAL QUESTIONAIRES ARE GIVEN TO ALL DIRECTORS AND OFFICERS. THE GOVERNANCE COMMITTEE OF EISNER HEALTH THEN REVIEWS THE QUESTIONAIRES TO ENSURE THE COMPLIANCE OF THE CONFLICT OF INTEREST POLICY OF EISNER HEALTH. IF A CONFLICT ARISES, IT IS RESOLVED THROUGH BOARD DISCUSSION. FORM 990, PART VI, SECTION B, LINE 15 THE FOUNDATION DOES NOT UNDERTAKE ANY COMPENSATION PROCEDURES BECAUSE THE FOUNDATION DOES NOT COMPENSATE ANY EMPLOYEES. THE OFFICERS ARE COMPENSATED BY THE RELATED ORGANIZATION, PEDIATRIC & FAMILY MEDICAL CENTER. THE GOVERNANCE COMMITTEE OF THE RELATED ORGANIZATION USES AN INDEPENDENT CONSULTANT AND A COMPENSATION SURVEY STUDY IN ORDER TO DETERMINE THE COMPENSATION FOR THE CEO, OFFICERS, AND KEY EMPLOYEES. ONCE THE COMPENSATION IS DETERMINED, IT IS THEN PRESENTED TO THE ENTIRE BOARD FOR APPROVAL INDEPENDENTLY, WITHOUT THE PARTICIPATION OF INTERESTED PERSONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. PEDIATRIC AND FAMILY MEDICAL CENTER 1530 SOUTH OLIVE STREET LOS ANGELES CA 90015 951690966 COMMUNITY CLINIC CA 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PEDIATRIC AND FAMILY MEDICAL CENTER B 101470 BOOK