2024-11-07T17:27:57-06:00 2023-12-31 330700332 VASQUEZ COMPANY LLP 655 N CENTRAL AVE STE 1550 GLENDALE CA 91203 990 2023-01-01 452424322 COMMUNITY MEDICAL WELLNESS CENTERS USA COMM 8448882692 1360 EAST ANAHEIM STREET 101 LONG BEACH CA 90813 SOMPIA PAIGNE CEO 8448882692 2024-11-06 1 0 REGINA L PRINCE CPA P00576936 2138731700 2023 2024-10-15 13:58:12Z SOMPIA PAIGNE 1360 EAST ANAHEIM STREET 101 LONG BEACH CA 90813 17498796 0 X WWW.CMWCUSA.ORG X 2011 CA TO PROVIDE QUALITY HEALTH CARE AND HEALTH EDUCATION TO PERSONS & COMMUNITIES NATIONALLY RECOGNIZED AS HAVING SIGNIFICANT BARRIERS TO ACCESS TO QUALITY CARE & EDUCATION. 10 10 0 10 0 0 4596741 4320848 10835379 13098782 222 87 15722 79079 15448064 17498796 0 0 0 0 7375977 9547418 0 0 0 6064326 7526140 13440303 17073558 2007761 425238 12808775 18156268 6609694 11531949 6199081 6624319 X THE ORGANIZATION IS ORGANIZED FOR THE PURPOSE OF PROVIDING, SUPPORTING AND ENCOURAGING HEALTH CARE AND HEALTH EDUCATION TO PERSONS AND COMMUNITIES NATIONALLY RECOGNIZED AS HAVING SIGNIFICANT BARRIERS TO ACCESS OF SUCH CARE AND EDUCATION. THE ORGANIZATION WILL DEVELOP AND OPERATE COMPREHENSIVE HEALTH CARE CLINICS AND EDUCATION CENTERS IN IMPOVERISHED URBAN COMMUNITIES WHERE AN ESTABLISHED NEED IS PRESENT. 0 0 13186387 13098782 COMMUNITY MEDICAL WELLNESS CENTER USA ("CMWC" A NON-PROFIT CORPORATION ESTABLISHED ON APRIL 16, 2011), HAS A MISSION TO PROVIDE QUALITY HEALTH CARE AND HEALTH EDUCATION IN IMPOVERISHED COMMUNITIES. CMWC OPERATES 5 COMPREHENSIVE HEALTH CARE CLINICS IN THE CITIES OF LONG BEACH, SYLMAR, AND WHITTIER. CMWC PROVIDES GENERAL AND PRIMARY CARE SERVICES, DENTAL, OPTOMETRY, AND SPECIALTY SERVICES TO LOW INCOME FAMILIES, IN UNDERSERVED COMMUNITIES. THE MAIN CLINIC IS LOCATED IN THE HEART OF CAMBODIA TOWN, WHERE CMWC'S STAFF SPECIALIZES IN UNDERSTANDING AND WORKING WITH PATIENTS SUFFERING WITH POST-TRAUMATIC STRESS SYNDROME AND OTHER MENTAL HEALTH ILLNESS. CMWC WAS APPROVED AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) AS OF OCTOBER 13, 2015. AS A RESULT CMWC HAS BEEN ABLE TO PROVIDE MEDICAL SERVICES TO 9,432 PATIENTS DURING 2022. 13186387 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 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 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X VERONICA SANFORD 8448882692 1360 EAST ANAHEIM STREET 101 LONG BEACH CA 90813 KENNETH HARLEY BOARD CHAIRPERSON 2.00 X X 0 0 0 NORITH SOTH BOARD SECRETARY 2.00 X X 0 0 0 CRYSTAL HOLLINGSWORTH BOARD MEMBER 2.00 X 0 0 0 MICHELLE LARIOS BOARD TREASURER 2.00 X X 0 0 0 BUN SOK BOARD MEMBER 2.00 X 0 0 0 LANY SOK BOARD MEMBER 2.00 X 0 0 0 SOK SAN BOARD MEMBER 2.00 X 0 0 0 MALCOLM TRAN BOARD MEMBER 2.00 X 0 0 0 UBERTO JESUS HERNANDEZ BOARD MEMBER 2.00 X 0 0 0 VISETH VANN BOARD MEMBER 2.00 X 0 0 0 SOMPIA PAIGNE CEO 40.00 X 244633 0 3342 PAUL RAMOS CFO - TERM ENDED 2023 20.00 X 68332 0 0 RIZVI SYED CFO 40.00 X 80408 0 5538 PHENG BAKHENG CMO 40.00 X 384425 0 0 JAVIER QUESADA PHYSICIAN 40.00 X 280609 0 19866 MAURICE ZEITLIN PSYCHIATRIST 40.00 X 481625 0 9219 CEASAR VALLE PEDIATRICIAN 40.00 X 303425 0 6211 LYNN JASMINE OPTOMETRIST 40.00 X 217571 0 9593 JOHN ADAMS VP MEDICAL OPERATION 12.00 X 121778 0 5279 2182806 0 59048 7 0 1 0 ADVANCED CONTRACTORS 935 W 223RD STREET TORRANCE CA 90502 CONSTRUCTION SERVICE 1003802 PHENG BAKHENG 8041 E ROSINA ST LONG BEACH CA 90808 CMO 384425 KITTYA PAIGNE 29870 KNOLL VIEW DRIVE RANCHO PALOS VERDES CA 90275 MEDICAL PROVIDER 337300 JEFFERY GRADY COKER PO BOX 500 LONG BEACH CA 90801 MEDICAL PROVIDER 251550 ALLIED FINANCIAL SERVICES 10229 LOWER AZUZA ROAD TEMPLE CITY CA 91780 BILLING SERVICES 243282 5 3655330 665518 4320848 NET PATIENT SERVICE REVENUES 621400 11838033 11838033 PHARMACY REVENUES 621400 1146314 1146314 OTHER PROGRAM REVENUE 621400 114435 114435 13098782 87 87 79079 0 79079 79079 79079 17498796 13098782 0 79166 X 786679 673927 112752 7220981 5196940 2024041 149052 107273 41779 859862 618843 241019 530844 382049 148795 51541 37094 14447 298944 215150 83794 2477553 2438859 38694 28983 20859 8124 339440 244295 95145 431872 310818 121054 882223 634936 247287 105598 75999 29599 396476 285344 111132 804788 579206 225582 131991 94994 36997 MEDICAL/DENTAL SUPPLIES 481731 481731 REPAIRS & MAINTENANCE 396549 285396 111153 EDUCATION AND TRAINING 211533 152240 59293 MINOR EQUIPMENT 183288 131912 51376 303630 218522 85108 17073558 13186387 3887171 0 181959 411779 790332 122742 412750 474535 857638 1869956 5926 64613 13204325 973657 5858711 12230668 1215869 900566 3485590 2081409 12808775 18156268 1456646 1270191 392500 242500 2148143 8070040 700000 700000 1912405 1249218 6609694 11531949 X 6199081 6624319 6199081 6624319 12808775 18156268 425238 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3508041 3508041 4781757 464261 4317496 4119020 509396 3609624 783907 783907 11600 11600 12230668 SECURITY DEPOSITS 130109 SETTLEMENT DUE FROM THIRD-PARTY PAYERS 723983 RIGHT-OF-USE ASSETS, NET 1031126 OTHER RECEIVABLES 196191 2081409 ESTIMATED AMOUNTS DUE TO THIRD-PARTY PAYERS 188013 LEASE LIABILITY 1061205 1249218 X 17498796 0 17498796 0 17498796 17073558 0 17073558 0 17073558 PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER THE INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. ACCORDINGLY, A PROVISION FOR FEDERAL OR STATE INCOME TAXES IS NOT RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION IS CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION PURSUANT TO SECTION 170(B)(1)(A)(III) OF THE IRC. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP) PRESCRIBE 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. THE ORGANIZATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN 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 IS A MATERIAL UNRELATED TRADE OR BUSINESS INCOME TAX LIABILITY. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS, BASED ON THE TECHNICAL MERITS OF THE POSITION, 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 GENERALLY FOR THREE AND FOUR YEARS AFTER THEY WERE FILED FOR FEDERAL AND STATE, RESPECTIVELY. X X 0 0 0 0 0 0 0 0 0 MAURICE ZEITLIN PSYCHIATRIST 450000 0 31625 0 0 0 9219 0 0 0 490844 0 0 0 PHENG BAKHENG CMO 380000 0 4425 0 0 0 0 0 0 0 384425 0 0 0 CEASAR VALLE PEDIATRICIAN 272950 0 30475 0 0 0 6211 0 0 0 309636 0 0 0 JAVIER QUESADA PHYSICIAN 280009 0 600 0 0 0 11153 0 8713 0 300475 0 0 0 SOMPIA PAIGNE CEO 244633 0 0 0 0 0 125 0 3217 0 247975 0 0 0 LYNN JASMINE OPTOMETRIST 212871 0 4700 0 0 0 8663 0 930 0 227164 0 0 0 SOMPIA PAIGNE OFFICER MEDICAL PRACTICE PURCHASE. X 825000 242500 0 1 1 242500 PART II LOAN TO/FROM INTEREST PERSON ON APRIL 1, 2020, THE ORGANIZATION ENTERED INTO A PURCHASE AGREEMENT FOR A MEDICAL PRACTICE OWNED BY KITTYA PAIGNE, A FAMILY MEMBER OF THE ORGANIZATION'S CEO, SOMPIA PAIGNE. KITTYA PAIGNE IS ALSO A HIGHLY COMPENSATED EMPLOYEE OF THE ORGANIZATION. THE $825,000 PURCHASE PRICE WAS BASED ON AN INDEPENDENT VALUATION BY A THIRD PARTY. PURSUANT TO THE AGREEMENT, THE APRIL 1, 2020 LOAN BALANCE OF $692,500 WILL BE PAID IN MONTHLY INSTALLMENTS OF $12,500 UNTIL PAID IN FULL. FORM 990, PART VI, SECTION A, LINE 2 SOMPIA PAIGNE CEO, KITTYA PAIGNE PHYSICIAN, BOZA PHENG COO, AND BAKHENG PHENG CMO ARE ALL SIBLINGS. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE FORM 990 IS COMPLETED, A COPY IS DELIVERED TO MEMBERS OF THE BOARD. THE BOARD REVIEWS THE RETURN AND IF ANY CHANGES ARE NEEDED, THE PREPARER IS NOTIFIED. FORM 990, PART VI, SECTION B, LINE 12C EACH EMPLOYEE OR AGENT ENGAGED IN THE SELECTION, AWARD, AND ADMINISTRATION OF CONTRACTS, AND EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ARE REQUIRED TO ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS CMWC USA IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. DUTY TO DISCLOSE. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION, ARRANGEMENT, OR CONTRACT. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE LEAVES THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS DECIDE IF A CONFLICT OF INTEREST EXISTS. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE GOVERNING BOARD OR COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE LEAVES THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION, ARRANGEMENT OR CONTRACT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE AN ALTERNATIVE TO THE PROPOSED TRANSACTION, ARRANGEMENT OR CONTRACT. AFTER EXERCISING DUE DILIGENCE, THE GOVERNING BOARD OR COMMITTEE DETERMINES WHETHER THE ORGANIZATION CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION, ARRANGEMENT OR CONTRACT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION, ARRANGEMENT OR CONTRACT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE DETERMINES BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION, ARRANGEMENT OR CONTRACT IS IN CMWC USA'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY. IF THE GOVERNING BOARD OR COMMITTEE HAS A REASONABLE CAUSE TO BELIEVE AN INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT INFORMS THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED 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 GOVERNING BOARD OR COMMITTEE DETERMINES THE INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION UP TO AND INCLUDING IMMEDIATE TERMINATION. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION PACKAGE IS REVIEWED ON THE PERFORMANCE AND CAPABILITIES OF THE CEO, AND APPROVED IN ADVANCE BY THE GOVERNING BOARD MEMBERS WHO DO NOT RECEIVE ANY COMPENSATION. THE COMPARABILITY DATA UTILIZED IS GALLAGHER SURVEYS AND THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) COMPENSATION AND BENEFITS SURVEY. THE SURVEYS PROVIDE DETAILED INFORMATION ON EXECUTIVE, CLINICAL AND ADMINISTRATIVE PERSONNEL WORKING IN PRIMARY CARE COMMUNITY HEALTH CENTERS. THE ORGANIZATION CONTEMPORANEOUSLY SUBSTANTIATES THE DELIBERATION AND DECISION PROCESS OF THE GOVERNING BOARD IN THE BOARD MINUTES, INCLUDING A DESCRIPTION OF THE COMPARABLE DATA AND HOW IT WAS OBTAINED, THE DATE APPROVED, A DESCRIPTION OF THE TRANSACTION, AND WHO WAS PRESENT. THE PROCESS FOR DETERMINING THE COMPENSATION PACKAGES FOR OTHER OFFICERS AND KEY EMPLOYEES IS THE SAME PROCESS AS FOR THE CEO. FORM 990, PART VI, SECTION C, LINE 19 TAX RETURN AND FINANCIAL STATEMENT ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND ON ANOTHER WEBSITE (GUIDESTAR). FORM 990, PART IX, LINE 11G PROVIDER SERVICES: PROGRAM SERVICE EXPENSES 2,339,507. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,339,507. PAYROLL FEES: PROGRAM SERVICE EXPENSES 35,836. MANAGEMENT AND GENERAL EXPENSES 13,957. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 49,793. PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 63,516. MANAGEMENT AND GENERAL EXPENSES 24,737. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,253.