2026-04-29T14:55:51-05:00 2025-06-30 390859910 BAKER TILLY ADVISORY GROUP LP 333 BUSH STREET STE 1000 SAN FRANCISCO CA 94104 990 2024-07-01 680437840 PETALUMA HEALTH CENTER INC PETA 7075597500 1016 CLEGG COURT PETALUMA CA 94954 MOLLY JOUANEH CFO 7075597500 2026-04-29 1 0 MICHAEL LUMSDEN P01262236 4159561500 2026-04-29 2024 2025-03-06 01:10:19Z PEDRO TOLEDO JD MA MHS 1016 CLEGG COURT PETALUMA CA 94954 85024740 0 X WWW.PHEALTHCENTER.ORG X 1999 CA TO ENSURE ACCESS & PROVIDE HIGH QUALITY PREVENTION-FOCUSED HEALTH CARE FOR THE COMMUNITIES WE SERVE. 12 11 610 74 52706 0 13416910 10447707 62917381 73161939 135554 115442 111642 142983 76581487 83868071 36760 51562 0 0 53423572 53006504 0 0 0 22675306 22970026 76135638 76028092 445849 7839979 55258656 63318905 23012552 23122273 32246104 40196632 X PETALUMA HEALTH CENTER'S MISSION IS TO ENSURE ACCESS TO HIGH-QUALITY HEALTH CARE AND ACHIEVE HEALTH EQUITY FOR THE COMMUNITIES WE SERVE. 0 0 28692139 0 36964446 FAMILY PRACTICE SERVICES PROVIDED TO PATIENTS. THE TOTAL NUMBER OF FAMILY PRACTICE VISITS DURING FISCAL YEAR-ENDING JUNE 30, 2025 WAS 118,845. 8738426 0 11979993 GENERAL DENTISTRY AND FLUORIDE VARNISHING SERVICES PROVIDED TO PATIENTS. THE TOTAL NUMBER OF DENTAL VISITS DURING THE FISCAL YEAR-ENDING JUNE 30, 2025 WAS 32,687. 3581575 0 5938766 OBSTETRIC AND GYNECOLOGY SERVICES PROVIDED TO PATIENTS, INCLUDING BIRTHING AND PREGNANCY SERVICES. THE TOTAL NUMBER OF OB/GYN VISITS DURING FISCAL THE FISCAL YEAR-ENDING JUNE 30, 2025 WAS 18,423. 18832521 51562 18278734 OTHER PROGRAM SERVICES INCLUDE INTEGRATED BEHAVIORAL HEALTH, VISION, WELLNESS, AND NUTRITION PROGRAMS FOR PATIENTS; ADDITIONALLY, THE ORGANIZATION OPERATES A NURSE PRACTITIONER AND PHYSICIAN'S ASSISTANT RESIDENCY PROGRAM TO TRAIN NEW NP/PA'S IN THE COMMUNITY MEDICINE MODEL OF CARE. 18832521 51562 18278734 59844661 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 72 0 1 610 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MOLLY JOUANEH 7075597578 1016 CLEGG COURT PETALUMA CA 94954 ROBERT RAMIREZ PRESIDENT 2.00 X X 0 0 0 TOM ISAAK VICE PRESIDENT 2.00 X X 0 0 0 PHOEBE ELLIS SECRETARY 2.00 X X 0 0 0 ELIZABETH GOLDBLATT TREASURER (THRU 2/2025) / DIRECTOR 2.00 X X 0 0 0 ANNE MIRANTE TREASURER (START 2/2025) 2.00 X X 0 0 0 WILLIAM BARRETT DIRECTOR 2.00 X 0 0 0 FERNANDO CARRILLO DIRECTOR 2.00 X 0 0 0 MARIANA GUERRERO DIRECTOR 2.00 X 0 0 0 SILVIA RODRIGUEZ DIRECTOR 2.00 X 0 0 0 DARLENE SANDOVAL DIRECTOR 2.00 X 0 0 0 TERESA TAYLOR-KING DIRECTOR 2.00 X 0 0 0 CATHERINE WEST DIRECTOR 2.00 X 0 0 0 NURIT LICHT MD CHIEF MEDICAL OFFICER 40.00 X 348046 0 46671 PEDRO TOLEDO JD MA MHSA CHIEF EXECUTIVE OFFICER 40.00 X 341314 0 51749 MOLLY JOUANEH CMA CHIEF FINANCIAL OFFICER 40.00 X 302876 0 37485 RAMONA ENGLISH DDS CHIEF DENTAL OFFICER 40.00 X 302204 0 36482 SVEINN SIGURDSSON MA MS-HSM CHIEF ADMINISTRATIVE OFFICER 40.00 X 201424 0 35344 KIMBERLY KELLER MBA CHIEF OPERATIONS OFFICER 40.00 X 173533 0 27488 ALAN CHAN PHARMD CHIEF PHARMACY OFFICER (START 1/2025) 40.00 X 0 0 0 REBECCA KATZ MD MED DIR OF PRIMARY CARE/CLINICAL INT 40.00 X 308082 0 43785 CARLIN CHI MD MEDICAL DIRECTOR, PRIMARY CARE 36.00 X 259855 0 42067 CHRISTINA GOMEZ-MIRA MD ASSOC MED DIR, RURAL HEALTH SERVICES 36.00 X 237581 0 13649 KEN WEINSTOCK MD DIRECTOR OF BEHAVIORAL HEALTH 40.00 X 338467 0 32513 SCOTT HOLMES MD MEDICAL DIRECTOR, PRIMARY CARE 40.00 X 305781 0 40552 JONATHAN CHOE MD FAMILY PHYSICIAN 30.00 X 289949 0 17713 IAN HOPPER DO PEDIATRICIAN 40.00 X 275269 0 31090 IUN-IU CHEN DO ASSOC MED DIR, PRIMARY CARE 34.00 X 274695 0 17943 KATHRYN POWELL MHA MA FORMER CEO (THRU 6/2024) 40.00 X 293299 0 14352 JOHN PENDLETON FORMER KEY EE / CURRENT PHYSICIAN 32.00 X 251040 0 28044 FIONA REDWOOD MD FORMER KEY EE / CURRENT PHYSICIAN 40.00 X 240345 0 33782 4743760 0 550709 131 1 1 0 CX ADVANCED SOLUTIONS LLC 3450 N TRIUMPH BOULEVARD SUITE 102 LEHI UT 84043 SOFTWARE SUPPORT/CONSULTING 329736 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 911891822 AUDIT & TAX SERVICES 135425 2 8886499 1561208 1237542 10447707 NET PATIENT SERVICE REVENUE 621400 59416102 59416102 PHARMACY REVENUE 621400 4936368 4936368 PIP REVENUE 621400 2615732 2615732 QIP REVENUE 621400 2487039 2487039 CAPITATION REVENUE 621400 721365 721365 2985333 2985333 73161939 119977 119977 16152 16152 1135982 1135916 20753 66 -20753 -20687 -20687 OTHER REVENUE 900099 90277 90277 ADMIN SERVICES - OUTSIDE ORGS 561000 48506 48506 PARKING LOT 812930 4200 4200 142983 83868071 73161939 52706 205719 51562 51562 3260457 1378465 1881992 122147 122147 36789017 32126724 4662293 1489354 1310365 178989 8199613 6777147 1422466 3145916 2636554 509362 156411 156411 64582 64582 5005889 4383518 622371 51842 50138 1704 650145 121754 528391 3446577 492397 2954180 3467699 2907739 559960 108825 47035 61790 175654 75920 99734 135380 79179 56201 2521502 1439878 1081624 574691 165900 408791 MEDICAL SUPPLIES/DRUGS 3968767 3968767 IN-KIND VACCINES 1234378 1234378 RECRUITMENT 592926 256270 336656 DUES AND SUBSCRIPTIONS 143633 49216 94417 671125 291755 379370 76028092 59844661 16183431 0 3881059 7955863 1581857 9562910 2293437 552883 6613847 5524991 1200 1100 131134 182433 888486 966173 39440044 18002612 22704403 21437432 3702997 3933488 13460236 13201632 55258656 63318905 9371180 10419591 1403739 1158317 4320035 4101595 1003616 0 6913982 7442770 23012552 23122273 X 32196104 40151632 50000 45000 32246104 40196632 55258656 63318905 7839979 110549 0 X 0 1 X 1 1 1 X 26697201 12319234 18644349 13416910 10447707 81525401 26697201 12319234 18644349 13416910 10447707 81525401 81525401 45442 26992 76779 128245 136129 413587 2008112 107856 40158 111642 90277 2358045 84297033 280511888 0.96710 0.95200 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2020 AMOUNT: $ 2,008,112. 2021 AMOUNT: $ 107,856. 2022 AMOUNT: $ 40,158. 2023 AMOUNT: $ 111,642. 2024 AMOUNT: $ 90,277. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 44192 0 0 1 17813 62005 0 PART II-B, LINE 1: THE ORGANIZATION PAYS MEMBERSHIP DUES TO THE CALIFORNIA PRIMARY CARE ASSOCIATION; A PORTION OF THOSE MEMBERSHIP DUES WERE DESIGNATED AS UTILIZED FOR LOBBYING ACTIVITIES FOR LEGISLATION PERTINENT TO THE HEALTH CARE FIELD. THE ORGANIZATION ALSO PROVIDED A GRANT TO CALIFORNIA PRIMARY CARE ASSOCIATION ADVOCATES FOR ADVOCACY WORK IN SUPPORT OF PROPOSITION 35. 2820000 2820000 19958620 8287267 11671353 4483996 2070125 2413871 5024398 3337624 1686774 7153030 4307596 2845434 21437432 OTHER RECEIVABLES 2732205 DEPOSITS 57592 ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS 4665116 OPERATING LEASE RIGHT-OF-USE ASSETS 5746719 13201632 ESTIMATED AMOUNTS DUE TO THIRD-PARTY PAYORS 1645864 OPERATING LEASE LIABILITIES 5796906 7442770 X 84142658 110549 164038 274587 83868071 0 83868071 76192130 164038 164038 76028092 0 76028092 PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2025 AND 2024, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. 1 CALIFORNIA PRIMARY CARE ASSOCIATION ADVOCATES 1231 I STREET SUITE 400 SACRAMENTO CA 95814 811326638 501(C)(4) 44192 0 ADVOCACY WORK IN SUPPORT OF PROPOSITION 35. 0 1 PART I, LINE 2: PROPER USE OF GRANT FUNDS IS MONITORED BY MAINTAINING A CLOSE, CONTINUOUS WORKING RELATIONSHIP WITH THE GRANTEE ORGANIZATION AND BY WITNESSING THE WORK THE GRANT FUNDS WERE INTENDED TO SUPPORT. X X X X 0 0 0 0 0 0 0 0 0 NURIT LICHT MD CHIEF MEDICAL OFFICER 333291 0 13524 0 1231 0 37464 0 9207 0 394717 0 0 0 PEDRO TOLEDO JD MA MHSA CHIEF EXECUTIVE OFFICER 340534 0 0 0 780 0 34538 0 17211 0 393063 0 0 0 KEN WEINSTOCK MD DIRECTOR OF BEHAVIORAL HEALTH 326340 0 9859 0 2268 0 17541 0 14972 0 370980 0 0 0 REBECCA KATZ MD MED DIR OF PRIMARY CARE/CLINICAL INT 301453 0 6010 0 619 0 13790 0 29995 0 351867 0 0 0 SCOTT HOLMES MD MEDICAL DIRECTOR, PRIMARY CARE 300322 0 5080 0 379 0 8522 0 32030 0 346333 0 0 0 MOLLY JOUANEH CMA CHIEF FINANCIAL OFFICER 277096 0 25385 0 395 0 35006 0 2479 0 340361 0 0 0 RAMONA ENGLISH DDS CHIEF DENTAL OFFICER 266244 0 35000 0 960 0 35148 0 1334 0 338686 0 0 0 JONATHAN CHOE MD FAMILY PHYSICIAN 275383 0 13780 0 786 0 13216 0 4497 0 307662 0 0 0 KATHRYN POWELL MHA MA FORMER CEO (THRU 6/2024) 184457 0 52169 0 56673 0 7119 0 7233 0 307651 0 0 0 IAN HOPPER DO PEDIATRICIAN 270953 0 4110 0 206 0 7045 0 24045 0 306359 0 0 0 CARLIN CHI MD MEDICAL DIRECTOR, PRIMARY CARE 249508 0 8705 0 1642 0 13695 0 28372 0 301922 0 0 0 IUN-IU CHEN DO ASSOC MED DIR, PRIMARY CARE 260528 0 13831 0 336 0 7070 0 10873 0 292638 0 0 0 JOHN PENDLETON FORMER KEY EE / CURRENT PHYSICIAN 225690 0 24546 0 804 0 13185 0 14859 0 279084 0 0 0 FIONA REDWOOD MD FORMER KEY EE / CURRENT PHYSICIAN 227853 0 10943 0 1549 0 12293 0 21489 0 274127 0 0 0 CHRISTINA GOMEZ-MIRA MD ASSOC MED DIR, RURAL HEALTH SERVICES 228541 0 8513 0 527 0 12361 0 1288 0 251230 0 0 0 SVEINN SIGURDSSON MA MS-HSM CHIEF ADMINISTRATIVE OFFICER 201141 0 0 0 283 0 11170 0 24174 0 236768 0 0 0 KIMBERLY KELLER MBA CHIEF OPERATIONS OFFICER 173269 0 0 0 264 0 9460 0 18028 0 201021 0 0 0 A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UET1 2016-09-13 5955305 REFUND OF BONDS ORIGINALLY ISSUED 6/2/2010 0 0 0 A 1575000 5955305 175271 115500 153716 5510817 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/18/2026 NORTH BAY OFFICE FURNITURE ENTITY IS SOLELY OWNED BY BOARD MEMBER ROBERT RAMIREZ 2193 THE ORGANIZATION PURCHASED OFFICE FURNITURE AT FAIR MARKET VALUE FROM NORTH BAY OFFICE FURNITURE, WHICH IS SOLELY OWNED BY BOARD MEMBER ROBERT RAMIREZ. 0 X 1 1234378 FAIR MARKET VALUE X DENTAL EQUIPMENT 1 3164 FAIR MARKET VALUE 0 0 1 0 PART I, COLUMN (B): THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED IN SCHEDULE M, PART I, COLUMN (B). FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN OUTSIDE TAX PREPARER IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM. THE CEO AND MEMBERS OF THE FINANCE AND ACCOUNTING STAFF OF THE ORGANIZATION THEN REVIEW THE FORM 990 AND, UPON APPROVAL, SUBMITS THE FORM 990 TO THE BOARD FINANCE COMMITTEE FOR REVIEW BEFORE FILING WITH THE IRS; THE FORM 990 IS ALSO MADE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C IT IS THE POLICY OF PETALUMA HEALTH CENTER THAT ALL FULL-TIME AND PART-TIME EMPLOYEES, CONTRACTORS, AND MEMBERS OF THE BOARD OF DIRECTORS AVOID CONFLICTS OF INTEREST, OR APPEARANCE OF CONFLICT, BETWEEN THEIR PERSONAL INTERESTS AND THE INTERESTS OF THE ORGANIZATION WHEN DEALING WITH ANY INDIVIDUAL OR OUTSIDE ORGANIZATION HAVING, OR SEEKING TO HAVE, A BUSINESS RELATIONSHIP WITH PETALUMA HEALTH CENTER. ALL MEMBERS OF THE PETALUMA HEALTH CENTER BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE THE CONFLICT OF INTEREST DISCLOSURE STATEMENT; ALL STAFF MEMBERS, VOLUNTEERS, AND CONTRACTORS ARE REQUIRED TO DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST THAT ARISES TO THE HUMAN RESOURCES DEPARTMENT WITHIN 10 BUSINESS DAYS OF LEARNING OF IT. AFTER DISCLOSURE OF A POSSIBLE CONFLICT OF INTEREST, THE CEO AFFORDS THE INTERESTED PERSON WHO MAKES THE DISCLOSURE AN OPPORTUNITY TO EXPLAIN TO THE SENIOR MANAGEMENT TEAM (FOR EMPLOYEES), OR THE EXECUTIVE COMMITTEE OF THE BOARD (FOR BOARD MEMBERS) THE FACTS AND CIRCUMSTANCES OF THE TRANSACTION OR ARRANGEMENT THAT LED TO SUCH DISCLOSURE. THE INTERESTED PERSON LEAVES THE SENIOR MANAGEMENT TEAM OR BOARD EXECUTIVE COMMITTEE MEETING WHILE THE INTEREST IS DISCUSSED AND VOTED UPON IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS AND CANNOT BE MITIGATED BY FURTHER ACTION. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE CHIEF EXECUTIVE OFFICER'S SALARY INCREASE INVOLVES A DISCUSSION AMONGST THE EXECUTIVE COMMITTEE OF THE BOARD, SALARY RESEARCH BY THE ORGANIZATION'S HR LEADERSHIP, AND RECOMMENDATION OF A NEW SALARY FROM THE EXECUTIVE COMMITTEE TO THE BOARD OF DIRECTORS FOR APPROVAL. THE CEO REVIEWS AND APPROVES THE COMPENSATION OF OTHER OFFICERS AND MANAGERS UTILIZING COMPARABILITY DATA. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.