2024-11-13T13:33:04-06:00 2023-12-31 770165080 MICHAEL P FISCHER CPA 65 WEST EASY ST SUITE 205 SIMI VALLEY CA 930656202 990 2023-01-01 237108154 FREE CLINIC OF SIMI VALLEY FREE 8055223733 2003 ROYAL AVE SIMI VALLEY CA 93065 FRED BAUERMEISTER EXECUTIVE DIRECTOR 8055223733 2024-11-13 1 0 MICHAEL P FISCHER P00223947 8055223771 X 2023 2024-10-15 13:58:12Z FRED BAUERMEISTER 2003 ROYAL AVENUE SIMI VALLEY CA 93065 1145615 0 X WWW.FREECLINICSV.COM X 1971 CA MEDICAL, DENTAL, COUNSELING & LEGAL SERVICES FOR THE GENERAL PUBLIC 15 15 8 152 0 0 448778 984523 118130 116894 800 7271 -3359 21397 564349 1130085 0 0 0 0 261763 303379 0 0 60466 268974 315496 530737 618875 33612 511210 2700727 3211509 1089 661 2699638 3210848 X TO PROVIDE MEDICAL CARE, COUNSELING, DENTAL AND LEGAL ASSISTANCE TO INDIVIDUALS AND FAMILIES, REGARDLESS OF THEIR ABILITY TO PAY. THIS INCLUDES THOSE OF ALL AGES, ETHNICITIES, RELIGIONS AND SOCIOECONOMIC BACKGROUNDS, WHO ARE UNABLE TO USE TRADITIONAL SOURCES WITHIN THE COMMUNITY 0 0 147594 32359 MEDICAL 150849 28618 FAMILY COUNSELING SERVICES 182600 51182 DENTAL SERVICES 12006 LEGAL $ 3,174OPHTHALMIC $1,561INVESTMENT INCOME $7,271 12006 481043 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7 0 1 8 0 0 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 1 1 1 0 CA X X FRED BAUERMEISTER 8055223733 2003 ROYAL AVE SIMI VALLEY CA 93065 MAGGIE KESTLY PAST PRESIDENT 1.00 X X 0 0 0 HARRY VANDYCK DIRECTOR 1.00 X 0 0 0 FRED BAUERMEISTER EXECUTIVE DIRECTOR 40.00 X 80693 0 0 PHYLLIS WILSON MA MFT DIRECTOR 1.00 X 0 0 0 VINCENT DULCICH PRESIDENT 1.00 X X 0 0 0 POLLY VLASSIC DIRECTOR 1.00 X 0 0 0 BJ ADERSON SECRETARY 1.00 X X 0 0 0 CURT WITEBY DIRECTOR 1.00 X 0 0 0 KELLY ANN GAINES TREASURER 1.00 X X 0 0 0 JOHN LINDSEY DIRECTOR 1.00 X 0 0 0 JILL HANEY PAST PRESIDENT 1.00 X X 0 0 0 SYLVIA FOWLER DIRECTOR 1.00 X 0 0 0 KATHERINE HILLARD DIRECTOR 1.00 X 0 0 0 TOM KUDLICK DIRECTOR 1.00 X 0 0 0 JONATHAN KUROHARA MD VICE PRESIDENT 1.00 X 0 0 0 REV RON HYRCHUK HONORARY BAORD MEMEBER 1.00 X 0 0 0 80693 0 0 0 0 0 0 0 133235 271995 579293 984523 PROGRAM SERVICE FEES 624100 116894 116894 116894 7271 7271 0 133235 15530 -15530 -15530 SUBLET RENTAL INCOME 531120 36927 36927 36927 1130085 124165 0 21397 80693 60877 10940 8876 201127 152856 26147 22124 21559 16385 2803 2371 698 530 91 77 39749 30210 5167 4372 35669 31726 3943 2464 1873 320 271 72261 54918 9394 7949 572 435 74 63 2712 2061 353 298 77503 58903 10075 8525 11006 8364 1431 1211 REPAIRS 27076 20578 6498 MEDICAL SUPPLIES 7888 7888 TAXES & LICENSES 7161 5442 1719 TELEPHONE 7013 6260 408 345 23724 21737 1946 41 618875 481043 77366 60466 414262 610532 242361 374071 2526156 323290 2019289 2202866 24815 24040 2700727 3211509 1089 661 1089 661 X 0 0 0 0 2699638 3210848 2699638 3210848 2700727 3211509 511210 0 X 0 0 0 X 1531993 985015 583484 448778 991794 4541064 1531993 985015 583484 448778 991794 4541064 4541064 1042 3366 754 800 7271 13233 4554297 0.99710 0.99840 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2380946 209633 2171313 24667 17925 6742 120543 95732 24811 2202866 PART XI, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT FOR ACCRUAL TO CASH BASIS CONVERSIONS PART XII, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT FOR ACCRUAL TO CASH BASIS CONVERSIONS DEPRECIATION VARIANCE PART XII, LINE 4B - OTHER ADJUSTMENTS: DEPRECIATION VARIANCE ADJUSTMENT FOR ACCRUAL TO CASH BASIS CONVERSIONS LINE 15-OTHER ASSETS-PREPAID RENT & DUE FROM SIMI VALLEY COMMUNITY FOUNDATI OTHER ASSETS-PREPAID RENT $515 OTHER ASSETS-DUE FROM SIMI VALLEY COMMUNITY FUND $ 23,500 X X X X X 1 CA ASSN OF FREE & CHARITABLE CLINICS 2752 ABEJORRO ST CALRSBAD CA 92009 FUNDRAISING MANAGEMENT FEE RE CAFCC GRANT 0 90000 0 90000 90000 90000 FREDRICK MICHAEL 5K/10K 59206 59206 1700 6957 FRIENDS OF THE FREE CLINIC 49316 49316 2472 2 24713 24713 4401 133235 133235 1700 13830 15530 -15530 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION EMPLOYS AN EXECTUTIVE DIRECTOR WHO TAKES CARE OF THE DAY TO DAY OPERATIONS OF THE ORGANIZATION INCLUDING THE HIRING, THE FIRING & SUPERVISION OF EMPLOYEES, PREPARATION OF OPERTATING BUDGETS FOR APPROVAL BY THE BOARD & FINANCIAL OPERATIONS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S OUTSIDE CPA DELIVERS THE FORM 990 TO THE ORGANIZATION'S EXECUTIVE DIRECTOR FOR THE BOARD'S REVIEW. THE EXECUTIVE DIRECTOR COMMUNICATES WITH BOARD MEMBERS AND ANY CORRECTIONS OR CHANGES ARE NOTED AND COMMUNICATED TO THE CPA. ONCE ANY REQUIRED CORRECTIONS ARE MADE A FINAL DRAFT OF THE RETURN IS SENT TO THE EXECUTIVE DIRECTOR ALONG WITH THE ELECTRONIC E-FILE AUTHORIZATION FORM. ONCE THE SIGNED E-FILE AUTHORIZATION FORM IS RECEIVED BY THE CPA, THE ORGANIZATION'S RETURN IS ELECTRONICALLY TRANSMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12 PROCEDURES TO MANAGE CONFLICTS. A. FOR EACH INTEREST DISCLOSED TO THE CHAIRMAN OF THE BOARD OF DIRECTORS, THE CHAIRMAN WILL DETERMINE WHETHER TO: (A) TAKE NO ACTION, (B) ASSURE FULL DISCLOSURE TO THE BOARD OF DIRECTORS AND OTHER INDIVIDUALS COVERED BY THIS POLICY, (C) ASK THE PERSON TO RECUSE FROM PARTICIPATION IN RELATED DISCUSSIONS OR DECISIONS WITHIN THE ORGANIZATION, OR (D) ASK THE PERSON TO RESIGN FROM HIS OR HER POSITION IN THE ORGANIZATION OR, IF THE PERSON REFUSES TO RESIGN, BECOME SUBJECT TO POSSIBLE REMOVAL IN ACCORDANCE WITH THE ORGANIZATIONS REMOVAL PROCEDURES. THE ORGANIZATION'S EMPLOYED EXECUTIVE DIRECTOR WILL MONITOR PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND DISCLOSE THEM TO THE CHAIRMAN OF THE BOARD OF DIRECTORS IN ORDER TO DEAL WITH POTENTIAL OR ACTUAL CONFLICTS, WHETHER DISCOVERED BEFORE OR AFTER THE TRANSACTION HAS OCCURRED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION'S BUDGET & FINANCE COMMITTEE REVIEWS AND APPROVES THE EXECUTIVE DIRECTOR'S COMPENSATION CONTRACT FOR PRESENTATION TO AND APPROVAL BY THE FULL BOARD OF DIRECTORS. THE COMMITTEE COMPARES THE EXECUTIVE DIRECTOR'S COMPENSATION CONTRACT WITH OTHER INDUSTRY STANDARDS AND STATISTICS FROM OTHER LOCAL PUBLIC CHARITIES TO DETERMINE THE FAIR ARM'S LENGTH COMPETITIVE COMPENSATION CONTRACT. FORM 990, PART VI, SECTION C, LINE 18 THE ORGANIZATION'S FINANCIAL STATEMENTS AND TAX RETURN INFORMATION ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.