2024-05-10T16:13:34-05:00 2023-06-30 330700332 VASQUEZ & COMPANY LLP 655 N CENTRAL AVE STE 1550 GLENDALE CA 91203 990 2022-07-01 208191393 H STREET CLINIC INC HSTR 9093810803 2700 SOUTH GRAND AVE LOS ANGELES CA 90007 KENNETH M ORDUNA CEO 9093810803 2024-05-09 1 KENNETH ORDUNA 999009999 0 X REGINA PRINCE CPA P00576936 2138731700 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X KENNETH M ORDUNA 2700 SOUTH GRAND AVE LOS ANGELES CA 90007 5638728 0 X N/A X 2006 CA H STREET'S MISSION IS TO ADDRESS THE UNMET HEALTHCARE NEEDS OF UNDERSERVED AND HOMELESS POPULATIONS IN SAN BERNARDINO AND RIVERSIDE COUNTIES THROUGH THE PROVISION OF AFFORDABLE, CULTURALLY APPROPRIATE, HIGH-QUALITY, ANDACCESSIBLE HEALTH CARE SERVICES. 10 10 74 10 0 0 1096134 1479693 4298200 4159035 278 0 8638 0 5403250 5638728 0 0 0 0 3395804 3179652 0 0 0 2230989 2052195 5626793 5231847 -223543 406881 1003804 2547027 2752419 3888761 -1748615 -1341734 X THE ROLE AND MISSION OF H STREET CLINIC, INC. ("CORPORATION") IS TO PROVIDE:A. HIGH-QUALITY, COST-EFFECTIVE, ACCESSIBLE AND EFFICIENT HEALTH CARE SERVICES TO LOCAL AND SURROUNDING MEDICALLY UNDERSERVED POPULATIONS;B. A MEDICAL STAFF AND PERSONNEL CONSISTING OF CULTURALLY SENSITIVE AND MULTI-LINGUAL INDIVIDUALS FOR COMPREHENSIVE PATIENT COMMUNICATION;C. A SETTING WHICH UTILIZES ADVANCED FACILITIES AND MEDICAL TECHNOLOGIES IN PROVIDING OPTIMUM CARE; ANDD. AN ENVIRONMENT WHICH ASPIRES TO ACHIEVE SIGNIFICANT, MEASURABLE IMPROVEMENTS IN THE MORBIDITY AND MORTALITY STATISTICS OF ITS PATIENT POPULATION BY MEANS OF PREVENTIVE CARE SERVICES AND APPROPRIATE HEALTH INTERVENTIONS. 0 0 5184550 4159035 THE CLINIC PROVIDED A FULL RANGE OF SERVICES WHICH INCLUDE MEDICAL, DENTAL, VISION, MENTAL HEALTH, WOMEN'S HEALTH, OBSTETRICS AND GYNECOLOGY SERVICES, NUTRITION, HEALTH EDUCATION, SOCIAL SUPPORT, PHARMACY, LABORATORY, AND X-RAY SERVICES. THE CLINIC ADDRESSED THE UNMET HEALTHCARE NEEDS OF UNDERSERVED AND HOMELESS POPULATIONS IN SAN BERNARDINO AND RIVERSIDE COUNTIES AND SERVED APPROXIMATELY 7,211 PATIENTS DURING THE FISCAL YEAR. 5184550 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 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 1 22 0 1 74 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 CA X MARIA MEDINA 2135365815 2700 SOUTH GRAND AVE LOS ANGELES CA 90007 CRYSTAL LAUTRUP BOARD MEMBER 2.00 1.00 X 0 0 0 JAMES MACKEY BOARD CHAIR 2.00 1.00 X X 0 0 0 RICHARD MAYER BOARD TREASURER 2.00 1.00 X X 0 0 0 WANDA THOMPSON BOARD SECRETARY 2.00 1.00 X X 0 0 0 MARY WINNERS BOARD VICE CHAIR 2.00 1.00 X X 0 0 0 KAYRETHA HALE WILLIS BOARD MEMBER 2.00 1.00 X 0 0 0 VICTOR GARCIA BOARD MEMBER 2.00 1.00 X 0 0 0 OSCAR LOPEZ BOARD MEMBER 2.00 1.00 X 0 0 0 FRANK YBARRA BOARD MEMBER 2.00 1.00 X 0 0 0 NANCY OCHOA BOARD MEMBER 2.00 1.00 X 0 0 0 KENNETH M ORDUNA CHIEF EXECUTIVE OFFICER 2.00 40.00 X 0 468578 927 CHUDWUKA CHIDI A CHIEF FINANCIAL OFFICER 2.00 40.00 X 0 284222 0 ABDOULAYE DIOP CHIEF MEDICAL OFFICER 2.00 40.00 X 0 363381 106 ELEANOR PEREZ CHIEF OPERATING OFFICER 2.00 40.00 X 0 236971 7193 FAREEHA ASIF SIAL PHYSICIAN ASSISTANT 40.00 0.00 X 129525 0 3059 MARIA MEDINA CONTROLLER 2.00 40.00 X 0 203529 1593 SEJAD ZAID AL-TAHAN INTERNIST PHYSICIAN 40.00 0.00 X 275500 0 4121 VANESSA CHARMEIN OLTON FAMILY PRACTICE PHYSICIAN 40.00 0.00 X 245940 0 4936 LUCIAN OPREA INTERNIST PHYSICIAN 40.00 0.00 X 220500 0 3628 RAVISHANKAR NEHRU KOPPADA PHYSICIAN PEDIATRICS 40.00 0.00 X 178000 0 20 1049465 1556681 25583 8 0 1 0 JAVIER R RIOS A PROFESSIONAL CORPORATIO 9939 MAGNOLIA AVE RIVERSIDE CA 92503 CONTRACTED OBGYN 169960 LT CONSTRUCTION & DEVELOPMENT INC 8296 SOFT WIND DRIVE CORONA CA 92883 CONSTRUCTION 165000 FOUNTAIN SECURITY INC 2930 W IMPERIAL HWY STE 510 INGLEWOOD CA 90303 SECURITY 135513 6 1479693 1479693 PATIENT REVENUE, NET 621400 2290865 2290865 CAPITATION 621400 1216388 1216388 INCENTIVES 621400 651782 651782 4159035 5638728 4159035 0 0 X 2758180 2731999 26181 212591 210714 1877 208881 206898 1983 349139 349139 194713 184213 10500 785981 785981 46930 46930 100 100 6756 6756 111097 111097 52213 52213 MEDICAL COSTS 443507 443507 EDUCATION & AWARENESS 36114 36114 BUSINESS TAXES & LICENS 13517 13517 DUES & SUBSCRIPTIONS 12128 12128 5231847 5184550 47297 0 120914 109640 7188 6903 642932 1176921 5000 4996 438036 169060 207182 268976 20588 979591 1003804 2547027 377620 221707 2374799 3667054 2752419 3888761 X -1748615 -1341734 -1748615 -1341734 1003804 2547027 406881 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 287561 84683 202878 133581 67483 66098 16894 16894 0 268976 DEPOSITS AND OTHER ASSETS 19988 RIGHT OF USE ASSETS 959603 979591 DUE TO RELATED TAX-EXEMPT ENTITY 1157686 THIRD PARTY SETTLEMENTS PAYABLE 1525728 LEASE LIABILITIES 983640 3667054 X 33719686 28080958 28080958 5638728 0 5638728 32775759 27543912 27543912 5231847 0 5231847 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. HOWEVER, THE ORGANIZATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS TAKEN AS A WHOLE. U.S. GAAP PRESCRIBES 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. IT REQUIRES THAT AN ORGANIZATION RECOGNIZE IN THE FINANCIAL STATEMENTS THE IMPACT OF THE TAX POSITION IF THAT POSITION WILL MORE LIKELY THAN NOT BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF AND FOR THE YEARS ENDED JUNE 30, 2023 AND 2022, THE ORGANIZATION ASSERTS THAT IT HAD NO UNRECOGNIZED TAX BENEFITS OR PENALTIES OR INTEREST. THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION REMAINS SUBJECT TO INCOME TAX EXAMINATION FOR 2019 AND SUBSEQUENT YEARS FOR FEDERAL; AND 2018 AND SUBSEQUENT YEARS FOR THE STATE. PART XI, LINE 2D - OTHER ADJUSTMENTS: INCOME OF RELATED TAX-EXEMPT ORGANIZATION 28,080,958. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES OF RELATED TAX-EXEMPT ORGANIZATION 27,543,912. 0 0 0 0 0 0 0 0 0 KENNETH M ORDUNA CHIEF EXECUTIVE OFFICER 0 340502 0 128076 0 0 0 0 0 927 0 469505 0 0 ABDOULAYE DIOP CHIEF MEDICAL OFFICER 0 305881 0 57500 0 0 0 0 0 106 0 363487 0 0 CHUDWUKA CHIDI A CHIEF FINANCIAL OFFICER 0 224940 0 59282 0 0 0 0 0 0 0 284222 0 0 SEJAD ZAID AL-TAHAN INTERNIST PHYSICIAN 275000 0 500 0 0 0 0 0 4121 0 279621 0 0 0 VANESSA CHARMEIN OLTON FAMILY PRACTICE PHYSICIAN 245440 0 500 0 0 0 0 0 4936 0 250876 0 0 0 ELEANOR PEREZ CHIEF OPERATING OFFICER 0 235971 0 1000 0 0 0 0 0 7193 0 244164 0 0 LUCIAN OPREA INTERNIST PHYSICIAN 220000 0 500 0 0 0 0 0 3628 0 224128 0 0 0 MARIA MEDINA CONTROLLER 0 132937 0 70592 0 0 0 0 0 1593 0 205122 0 0 RAVISHANKAR NEHRU KOPPADA PHYSICIAN PEDIATRICS 172500 0 5500 0 0 0 0 0 20 0 178020 0 0 0 PART I, LINE 3 EXECUTIVE COMPENSATION, INCLUDING PERFORMANCE BASED COMPENSATION, IS REVIEWED AND DETERMINED BY THE RELATED ORGANIZATION'S EXECUTIVE COMMITTEE OF THE BOARD, OR THE COMPENSATION SUBCOMMITTEE IN THE CASE OF THE CEO'S COMPENSATION. THE APPLICABLE COMMITTEE USED COMPARABILITY DATA OBTAINED FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION WHICH IS PREPARED BY AN INDEPENDENT THIRD PARTY. THE DATA REPRESENTS WHAT 125 SIMILARLY SITUATED ORGANIZATIONS BASED ON LOCATION, BUDGET AND SIZE, PAY EXECUTIVES FOR FUNCTIONALLY COMPARABLE POSITIONS. THE APPLICABLE COMMITTEE COLLECTS THE COMPARABLE COMPENSATION DATA, DEBATES THE ISSUE, AND USES IT TOGETHER WITH THE ORGANIZATIONS STRATEGY AND THE EXECUTIVES QUALIFICATIONS TO MAKE COMPENSATION RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR APPROVAL BY VOTING. THE FINDINGS OF THE APPLICABLE COMMITTEE, TOGETHER WITH THE RELATED ORGANIZATION'S BOARD'S CONSIDERATION AND APPROVAL AND RECORDED IN THE RELATED ORGANIZATION'S MEETING MINUTES. THIS PROCESS IS REPEATED ANNUALLY FOR THE PURPOSE OF MAKING ADJUSTMENTS TO COMPENSATION OR THE AWARD OF PERFORMANCE BASED COMPENSATION. FORM 990, PART VI, SECTION B, LINE 11B H STREET CLINIC'S CFO AND CEO REVIEW THE FORM 990, SUBSEQUENTLY FORM 990 COMPLETE WITH SCHEDULES IS THEN PROVIDED TO THE FULL BOARD BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT COVERS ALL OFFICERS, DIRECTORS, AND KEY EMPLOYEES (COVERED PERSONS). POLICIES DEVELOPED BY THE BOARD OF DIRECTORS TO ENSURE COMPLIANCE WITH THE POLICY INCLUDE THE COMPLETION OF AN ANNUAL CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE TO DISCLOSE ANY ON-GOING RELATIONSHIPS AND INTERESTS THAT MAY PRESENT ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. IF THE BOARD IDENTIFIES ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST, SUCH PERSONS ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS IN THE TRANSACTION. DUTY TO SELF-DISCLOSE. AN INTERESTED PERSON IS REQUIRED TO MAKE AN APPROPRIATE DISCLOSURE OF ALL MATERIAL FACTS, INCLUDING THE EXISTENCE OF ANY FINANCIAL INTEREST, AT ANY TIME THAT ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. THIS DISCLOSURE OBLIGATION INCLUDES INSTANCES IN WHICH AN INTERESTED PERSON WHO IS A DIRECTOR KNOWS OF THE POTENTIAL FOR A SELF-DEALING TRANSACTION, OR A TRANSACTION INVOLVING COMMON DIRECTORSHIP RELATED TO HIS OR HER INTERESTS. IT ALSO INCLUDES INSTANCES IN WHICH THE INTERESTED PERSON PLANS NOT TO ATTEND A MEETING OF THE BOARD OR A BOARD COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS AT WHICH HE OR SHE HAS REASON TO BELIEVE THAT THE BOARD OR COMMITTEE WILL ACT REGARDING A MATTER ABOUT WHICH HE OR SHE MAY HAVE A CONFLICT. DISCLOSURE OF CONFLICTS OF OTHERS. IF AN INTERESTED PERSON BECOMES AWARE OF ANY POTENTIAL SELF-DEALING OR COMMON DIRECTORSHIP TRANSACTION OR OTHER CONFLICT OF INTEREST INVOLVING ANOTHER INTERESTED PERSON, HE OR SHE SHOULD REPORT IT. EVALUATION OF POTENTIAL CONFLICT. THE ORGANIZATION HAS A STRUCTURED PROCESS IN EVALUATING POTENTIAL OR ACTUAL CONFLICTS OF INTEREST WITH THE FOLLOWING STEPS: (1) INTERESTED PERSONS MUST DISCLOSE THE POTENTIAL CONFLICT TO THE GENERAL COUNSEL, THE CHAIRMAN OF THE BOARD, OR THE PRESIDENT AND CEO, RESPECTIVELY. (2) THE GENERAL COUNSEL WILL ASSESS ANY IMPACT OF THE CONFLICT. (3) IF NECESSARY, THE GENERAL COUNSEL WILL DISCUSS THE CONFLICT AND PROPOSED REMEDIAL ACTION WITH THE CHAIRMAN OF THE BOARD, OR THE PRESIDENT AND CEO. AFTER DISCLOSURE OF ALL MATERIAL FACTS AND ANY FOLLOW-UP DISCUSSION WITH THE INTERESTED PERSON WITH A POTENTIAL CONFLICT, A DETERMINATION IS MADE ABOUT WHETHER A MATERIAL FINANCIAL INTEREST, SELF-DEALING TRANSACTION OR OTHER KIND OF CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WHICH ALSO CONSTITUTES A SELF-DEALING TRANSACTION, THEN THE TRANSACTION OR MATTER IN QUESTION CAN ONLY BE AUTHORIZED IF APPROVED BY A VOTE OF A MAJORITY OF THE DIRECTORS IN OFFICE, WITH ANY INTERESTED DIRECTOR ABSTAINING. A TRANSACTION IN WHICH AN ACTUAL CONFLICT OF INTEREST EXISTS BUT IS NOT A SELF-DEALING TRANSACTION MUST RECEIVE PRIOR APPROVAL BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS OF COMMITTEE MEMBERS PRESENT AT A MEETING AT WHICH A QUORUM IS PRESENT. PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST. PRIOR TO VOTING ON A CONTRACT, TRANSACTION OR MATTER IN WHICH AN ACTUAL CONFLICT OF INTEREST IS FOUND TO EXIST, THE BOARD OR COMMITTEE WILL FOLLOW THESE PROCEDURES: (A) THE INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING AT WHICH SUCH TRANSACTION IS BEING CONSIDERED, BUT AFTER THE PRESENTATION, HE OR SHE WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. (B) THE CHAIRPERSON OF THE BOARD OR COMMITTE MAY, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. (C) AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE WILL DETERMINE WHETHER THE CORPORATION COULD OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO CONFLICT OF INTEREST. (D) IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE WILL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, THE BOARD SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO TRANSACTION OR ARRANGEMENT. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT WILL INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTEREST PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INTERESTED PERSON'S RESPONSE AND AFTER MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE BOARD DETERMINES THE INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL RECORDS ARE MADE AVAILABLE UPON REQUEST DURING NORMAL BUSINESS HOURS ON LOCATION AT THE ORGANIZATION'S ADDRESS AS LISTED ON PAGE ONE OF THE 990 FORM. HOWEVER, CURRENT TAX LAW DOES NOT REQUIRE THAT THE CONFLICT OF INTEREST POLICY, THE GOVERNING DOCUMENTS OR THE FINANCIAL STATEMENTS BE MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PAYROLL PROCESSING FEES: PROGRAM SERVICE EXPENSES 5,094. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,094. CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 186,977. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 186,977. CONTRACTED REFERRALS: PROGRAM SERVICE EXPENSES 93,379. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 93,379. CONTRACTED ADMIN SERVICES: PROGRAM SERVICE EXPENSES 11,989. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,989. CONTRACTED CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 51,700. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 51,700. CENTRAL NEIGHBORHOOD HEALTH FOUNDATION 714 W OLYMPIC BLVD STE 801 LOS ANGELES CA 90015 752986675 MEDICAL SERVICES CA 501(C)(3) LINE 7 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 CENTRAL NEIGHBORHOOD HEALTH FOUNDATION Q 606968 COST