2024-05-14T19:44:50-05:00 2023-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-07-01 680149424 OLE HEALTH FOUNDATION OLEH 7076037100 1141 PEAR TREE LANE 100 NAPA CA 94558 ROSE MACISAAC CFO 7076037100 2024-05-14 1 ROSE MACISAAC 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALICIA HARDY 1141 PEAR TREE LANE 100 NAPA CA 94558 3328574 0 X WWW.OLEHEALTH.ORG X 1987 CA FUNDRAISING AND OTHER SERVICES TO SUPPORT OLE HEALTH. 16 15 3 18 0 0 2278644 2878216 0 0 252271 156255 261514 152563 2792429 3187034 2298619 1045033 0 0 0 329817 0 0 953564 14737 655911 2313356 2030761 479073 1156273 5556621 6453389 1199998 738454 4356623 5714935 OUR MISSION IS TO INSPIRE PHILANTHROPIC CONTRIBUTIONS TO ENSURE THAT OLE HEALTH IS ALWAYS HERE TO CARE FOR EVERYONE IN OUR BEAUTIFUL AND DIVERSE COMMUNITY. 0 0 1045033 1045033 0 OLE HEALTH FOUNDATION PERFORMS FUNDRAISING SERVICES IN SUPPORT OF OLE HEALTH, A HEALTH CENTER FOR LOW-INCOME INDIVIDUALS AND OTHERS WITHOUT HEALTH INSURANCE. DURING THE YEAR, OLE HEALTH FOUNDATION GAVE A $1,045,033 GRANT TO OLE HEALTH IN SUPPORT OF ITS ONGOING OPERATIONS AND SPECIAL PROJECTS TO CREATE LASTING RESERVE FUNDS, ENSURING THAT OLE HEALTH CAN CONTINUE TO PROVIDE HIGH QUALITY PRIMARY HEALTH CARE TO OUR ENTIRE COMMUNITY. 1045033 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 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 3 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 16 15 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X X CINDY JOHNSON 7072541770 2650 NAPA VALLEY CORPORATE DRIVE NAPA CA 94558 ALICIA HARDY DIRECTOR / CEO OF OLE HEALTH 1.00 39.00 X X 0 377325 13077 DARIOUSH KHALEDI CHAIR THRU 6/2023 / DIRECTOR 1.00 0.00 X X 0 0 0 NAOKO DALLA VALLE SECR THRU 6/2023 / CHAIR START 6/2023 1.00 0.00 X X 0 0 0 BLAKESLEY CHAPPELLET VICE CHAIR THRU 6/2023 1.00 0.00 X X 0 0 0 WILL PHELPS VICE CHAIR START 6/2023 1.00 0.00 X X 0 0 0 RICK JONES TREASURER 1.00 3.00 X X 0 0 0 SUZANNE BESU TRUCHARD SECRETARY START 6/2023 1.00 0.00 X X 0 0 0 STEVEN FINK DIRECTOR 1.00 0.00 X 0 0 0 LESLIE FRANK DIRECTOR THRU 6/2023 1.00 0.00 X 0 0 0 SARAH HANSEN DIRECTOR 1.00 0.00 X 0 0 0 CLIFF LEDE DIRECTOR THRU 6/2023 1.00 0.00 X 0 0 0 DAN LYNCH DIRECTOR 1.00 0.00 X 0 0 0 CARLTON MCCOY DIRECTOR 1.00 0.00 X 0 0 0 PETER MCCREA DIRECTOR 1.00 0.00 X 0 0 0 DR FRANK NAEYMI-RAD DIRECTOR 1.00 0.00 X 0 0 0 PETE RICHMOND DIRECTOR 1.00 2.00 X 0 0 0 CLAIRE STULL DIRECTOR 1.00 0.00 X 0 0 0 BARRY WAITTE DIRECTOR 1.00 0.00 X 0 0 0 TODD ZAPOLSKI DIRECTOR 1.00 0.00 X 0 0 0 HEMANTA MUNGUR CFO THROUGH 5/2023 8.00 32.00 X 0 229821 9419 ROSE MACISAAC CFO THROUGH 2/2022; START 5/2023 8.00 32.00 X 0 66536 5066 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 14.00 26.00 X 0 251733 9665 0 925415 37227 0 0 1 0 0 1084004 1794212 2878216 82573 82573 73682 0 73682 73682 73682 294086 1084004 141540 152546 152546 MISCELLANEOUS REVENUE 900099 17 17 17 3187034 0 0 308818 1045033 1045033 86261 86261 183482 183482 6455 6455 38047 38047 15572 15572 32164 32164 108887 108887 56084 56084 22426 22426 22110 22110 1111 1111 4217 4217 EVENT LOGISTICS 373850 373850 DUES & SUBSCRIPTIONS 20264 20264 STORAGE 3240 3240 MINOR EQUIPMENT 2766 2766 8792 8792 2030761 1045033 32164 953564 1771477 2549795 569882 320000 21805 12513 3191317 3568941 2140 2140 5556621 6453389 1199998 738454 1199998 738454 X 4083658 4316470 272965 1398465 4356623 5714935 5556621 6453389 1156273 202039 0 X 0 1 X 1 0 X 1486471 2399559 1056773 2278644 2878216 10099663 1486471 2399559 1056773 2278644 2878216 10099663 1868558 8231105 83438 69284 20111 252400 82573 507806 242216 242216 17 17 10849702 0.75860 0.81750 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2022 AMOUNT: $ 17. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED ORGANIZATION 738454 738454 X 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, 2023 AND 2022, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. VIDA OLE 1378090 1084004 294086 141540 1378090 1084004 294086 141540 141540 152546 SCHEDULE G, PART II DURING THE JUNE 30, 2023 FISCAL YEAR, OLE HEALTH (A RELATED ORGANIZATION) COVERED $439,466 OF ADDITIONAL EXPENSES NOT LISTED ON SCHEDULE G, PART II, BUT WHICH PERTAIN TO THE FUNDRAISING EVENT LISTED. ACCORDINGLY, SINCE THESE EXPENSES DO NOT APPEAR ON THE JUNE 30, 2023 STAND-ALONE FINANCIAL STATEMENTS FOR OLE HEALTH FOUNDATION, THEY ARE NOT BEING PRESENTED ON SCHEDULE G, PART II. THE ADDITIONAL EXPENSES ARE ALLOCATED AS FOLLOWS: $157,563 - NONCASH PRIZES $82,750 - RENT/FACILITY COSTS $103,024 - FOOD AND BEVERAGES $43,500 - ENTERTAINMENT $52,629 - OTHER EXPENSES 1 OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 501(C)(3) 1045033 0 SUPPORT HEALTHCARE FOR VULNERABLE INDIVIDUALS 1 0 PART I, LINE 2: DURING THE JUNE 30, 2023 TAX YEAR, THE ORGANIZATION PROVIDED GRANTS SOLELY TO OLE HEALTH, A RELATED ORGANIZATION. BOTH ORGANIZATIONS MAINTAIN AN OVERLAP OF OFFICERS, WHO MONITOR PROPER USE OF THE GRANT FUNDS. X X 0 0 0 0 0 0 0 0 0 ALICIA HARDY DIRECTOR / CEO OF OLE HEALTH 0 338640 0 35085 0 3600 0 10863 0 2214 0 390402 0 0 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 0 207803 0 43930 0 0 0 8364 0 1301 0 261398 0 0 HEMANTA MUNGUR CFO THROUGH 5/2023 0 221051 0 8770 0 0 0 0 0 9419 0 239240 0 0 PART I, LINE 3 THE CEO IS COMPENSATED BY OLE HEALTH, A RELATED ORGANIZATION. OLE HEALTH UTILIZES THE FOLLOWING METHODS TO DETERMINE COMPENSATION OF THE CEO: COMPENSATION SURVEYS OR STUDIES; APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 6 OLE HEALTH FOUNDATION DOES NOT HAVE "MEMBERS" BY DEFINITION OF THE BYLAWS; HOWEVER, THE FORM 990 INSTRUCTIONS ALSO DEFINE A "MEMBER" AS ANY PERSON (INCLUDING A CORPORATION OR OTHER LEGAL ENTITY) WHO, PURSUANT TO A PROVISION OF THE ORGANIZATION'S GOVERNING DOCUMENTS, HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE (INCLUDING ELECTING MEMBERS OF THE GOVERNING BODY). ACCORDINGLY, OLE HEALTH FOUNDATION HAS ONE SOLE MEMBER: OLE HEALTH. FORM 990, PART VI, SECTION A, LINE 7A OLE HEALTH (OLE HEALTH FOUNDATION'S SUPPORTED ORGANIZATION) HAS THE POWER TO APPOINT EACH OF THE DIRECTORS OF OLE HEALTH FOUNDATION. FORM 990, PART VI, SECTION B, LINE 11B TO PREPARE THE FORM 990, THE ORGANIZATION UTILIZED A PROFESSIONAL ACCOUNTING FIRM WHO WORKED WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM TO GATHER THE REQUIRED INFORMATION. UPON REVIEW OF THE FORM 990 BY THE ORGANIZATION'S MANAGEMENT TEAM, A COPY OF THE FORM 990 WITH ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING IN ORDER TO ALLOW SUFFICIENT TIME FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C DIRECTORS AND OFFICERS OF OLE HEALTH FOUNDATION HAVE A RESPONSIBILITY TO MAKE FULL DISCLOSURE OF INTERESTS THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN SATISFYING THEIR FIDUCIARY OBLIGATIONS TO OLE HEALTH FOUNDATION. IN THAT REGARD, IT IS THE POLICY OF OLE HEALTH FOUNDATION TO REFRAIN FROM CONSUMMATING ANY TRANSACTION INVOLVING A POTENTIAL CONFLICT OF INTEREST UNTIL ALL RELEVANT AND PERTINENT FACTS REGARDING THE POTENTIAL CONFLICT HAVE BEEN DISCLOSED AND CONSIDERED, DURING WHICH TIME THE INTERESTED PARTY WOULD REFRAIN FROM DELIBERATIONS. DIRECTORS AND OFFICERS ARE REQUIRED TO REVIEW AND SIGN THE "STATEMENT PERTAINING TO CONFLICT OF INTEREST AND CONFIDENTIALITY" UPON APPOINTMENT, ELECTION AND HIRE, AND THEN ANNUALLY THEREAFTER. ACTIVITIES THAT MAY CAUSE A CONFLICT OF INTEREST ARE REPORTED TO AND MONITORED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT DIRECTLY COMPENSATE ANY INDIVIDUALS; ALL EMPLOYEES PERFORMING WORK FOR OLE HEALTH FOUNDATION ARE COMPENSATED BY OLE HEALTH, A RELATED ORGANIZATION. AS SUCH, PART VI, SECTION B, LINES 15A AND 15B HAVE BEEN ANSWERED "NO" AS MANDATED BY THE FORM 990 INSTRUCTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE ALL AVAILABLE UPON REQUEST. OLE HEALTH 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 237221695 HEALTH CARE TO LOW INCOME AND UNINSURED RESIDENTS CA 501(C)(3) LINE 7 N/A 0 OLE HEALTH NMTC 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 815395044 SUPPORT THE CHARITABLE PURPOSES OF OLE HEALTH AND OLE HEALTH FOUNDATION CA 501(C)(3) LINE 12A, I OLE HEALTH 0 NAPA VALLEY VINTNERS COMMUNITY HEALTH CENTER 1141 PEAR TREE LANE SUITE 100 NAPA VA 94558 680467715 LEASE OF HEALTHCARE FACILITIES TO OLE HEALTH CA 501(C)(3) LINE 12A, I OLE HEALTH 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0