Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOHN'S WELL CHILD & FAMILY CENTER
Employer identification number
95-4067758
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
6,942,873
8,083,836
7,584,194
11,208,647
12,063,315
45,882,865
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
6,942,873
8,083,836
7,584,194
11,208,647
12,063,315
45,882,865
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
933,337
6
Public Support. Subtract line 5 from line 4.
44,949,528
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
6,942,873
8,083,836
7,584,194
11,208,647
12,063,315
45,882,865
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
4,508
30,228
34,736
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
2,200
2,200
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
45,919,801
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
31,527,443
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
97.887 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
97.281 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
ST JOHN'S WELL CHILD & FAMILY CENTER
Employer identification number
95-4067758
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990, PART I, LINE 1
THE MISSION OF ST. JOHN'S WELL CHILD AND FAMILY CENTER IS TO ELIMINATE HEALTH DISPARITIES AND FOSTER COMMUNITY WELL-BEING BY PROVIDING AND PROMOTING THE HIGHEST QUALITY CARE IN SOUTH LOS ANGELES. THE VISION OF ST. JOHN'S WELL CHILD AND FAMILY CENTER IS TO DELIVER HIGH-QUALITY PRIMARY AND PREVENTIVE MEDICAL, DENTAL AND MENTAL HEALTH SERVICES THAT GO BEYOND THE BORDERS OF TRADITION TO UNINSURED, UNDERSERVED AND ECONOMICALLY DISADVANTAGED PERSONS IN LOS ANGELES. WE ARE DEVOTED TO INSTILLING THE VALUE OF WELL-BEING TO OUR COMMUNITIES, RESULTING IN SELF-ADVOCACY, SELF ESTEEM AND SELF SUSTENANCE, THROUGH INNOVATIVE AND DEVELOPMENTAL PROGRAMS AND COLLABORATIVE ENDEAVORS. STARTING AS A SMALL VOLUNTEER CLINIC IN THE BACK BUILDING OF ST. JOHN'S EPISCOPAL CHURCH, ST. JOHN'S CLINIC HAS GROWN TO BECOME A MAJOR NONPROFIT NETWORK OF FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) AND SCHOOL BASED CLINICS THROUGHOUT DOWNTOWN, SOUTH AND NORTHEAST LOS ANGELES. ST. JOHN'S WELL CHILD AND FAMILY CENTER PROVIDES MEDICAL, DENTAL, MENTAL HEALTH SERVICES, CASE MANAGEMENT, HEALTH EDUCATION AND SOCIAL SUPPORT TO MORE THAN 100,000 PATIENT VISITS IN SOUTH LOS ANGELES. WE OPERATE ELEVEN SITES - INCLUDING FIVE COMPREHENSIVE COMMUNITY HEALTH CENTERS AND SIX SCHOOL BASED CLINICS SPANNING THE BREADTH OF DOWNTOWN AND SOUTH CENTRAL LOS ANGELES AND COMPTON. IN ADDITION, ST. JOHN'S OPERATES MANY COMMUNITY HEALTH, SOCIAL SERVICE AND SCHOOL READINESS PROGRAMS. THESE PROGRAMS ARE DESIGNED TO IMPROVE BIRTH OUTCOMES AND REDUCE HIGH-RISK PREGNANCIES AND IMPROVE READINESS FOR SCHOOL AMONG PRE-SCHOOL CHILDREN AND THEIR FAMILIES. WE ALSO PROVIDE CHILD CARE AND EARLY CHILDHOOD DEVELOPMENT SERVICES, PARENTING WORKSHOPS, WORKFORCE READINESS TRAININGS AND PARENT/CHILD LITERACY PROJECTS.
OTHER PROGRAM SERVICES
FORM 990, PART III, LINE 4D
IN SUPPORT OF THE MEDICAL, DENTAL, AND MENTAL HEALTH SERVICES, THE ORGANIZATION OFFERS THE FOLLOWING SERVICES: INSURANCE BENEFITS COUNSELING AND ENROLLMENT, CASE MANAGEMENT AND HEALTH EDUCATION, YOUTH DEVELOPMENT PROGRAMS, SCHOOL READINESS PROGRAMS, PARENT WORKSHOPS, LEGAL SERVICES AND COUNSELING, AND COMMUNITY RESOURCE SERVICES. OTHER ENABLING SERVICES HAD 33,505 PATIENT VISITS DURING 2010. FAMILY RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 CEO, MR. MANGIA, AND HIGHEST COMPENSATED EMPLOYEE, MR. BAHARHONA, HAVE A FAMILY RELATIONSHIP. FORM 990 REVIEW POLICY FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE ORGANIZATION'S TOP MANAGEMENT WILL REVIEW THE 990 AND A FINAL DRAFT WILL BE PROVIDED TO THE BOARD OF DIRECTORS.
CONFLICT OF INTEREST POLICY
FORM 990, PART VI, SECTION B, LINE 12C
ST. JOHN'S WELL CHILD AND FAMILY CENTER DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS SHALL NOT PROFIT PERSONALLY FROM THEIR POSITION WITH ST. JOHN'S WELL CHILD AND FAMILY CENTER, AND SHALL NOT BRING THEIR INTERESTS INTO CONFLICT OR COMPETITION WITH THE INTERESTS OF THE ORGANIZATION. CONFLICTS OF INTEREST SHALL INCLUDE ALL ACTUAL, APPARENT AND POTENTIAL CONFLICTS. EACH YEAR, ALL ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBERS SHALL SUBMIT A STATEMENT TO THE BOARD DISCLOSING ALL ORGANIZATIONS, FIRMS, ORGANIZATIONS OR ENTERPRISES WHICH COULD BE CONSTRUED AS RELATED TO THE INTEREST OF ST. JOHN'S WELL CHILD AND FAMILY CENTER, IN WHICH THE ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBERS, OR PERSONS CLOSE TO HIM/HER, HAS A MATERIAL FINANCIAL INTEREST OR IN WHICH HE/SHE SERVES AS A DIRECTOR, OFFICER OR ADVISOR. ANY ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER AWARE OF ANY TRANSACTION OR CONTRACT BEING CONSIDERED BY ST. JOHN'S WELL CHILD AND FAMILY CENTER WHICH PUTS HIS/HER INTEREST IN POSSIBLE CONFLICT WITH THE ORGANIZATION'S INTERESTS SHALL NOTIFY THE BOARD OF DIRECTORS, COMMITTEE, OR OTHER DECISION MAKERS, OF THE POSSIBLE CONFLICT. THE MATERIAL FACTS AS TO THE TRANSACTION AND THE ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER'S INTEREST SHALL BE FULLY DISCLOSED, AND SHALL BE PROMPTLY RECORDED IN THE BOARD OR COMMITTEE MINUTES. ANY ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER WITH A POSSIBLE CONFLICT OF INTEREST SHALL ABSTAIN FROM VOTING ON THAT MATTER. THE MINUTES OF THE MEETING SHALL REFLECT THE EXISTENCE OF ANY SUCH CONFLICT AND THAT THE ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER DID NOT VOTE OR PARTICIPATE IN THE MATTER IN QUESTION. UPON BEING INFORMED OF A POSSIBLE CONFLICT OF ANY ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER, NO OTHER ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER SHALL APPROVE ANY TRANSACTION UNLESS THAT ST. JOHN'S WELL CHILD AND FAMILY CENTER BOARD MEMBER BELIEVES, IN GOOD FAITH, THAT THE TRANSACTION IS JUST, REASONABLE AND FAVORABLE TO ST. JOHN'S WELL CHILD AND FAMILY CENTER. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST.
COMPENSATION REVIEW
FORM 990, PART VI, SECTION B, LINE 15A
THE COMPENSATION OF THE CEO WAS REVIEWED IN 2010 BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. COMPENSATION WAS DETERMINED BY CONSULTING SURVEYS OF INDUSTRY STANDARDS FOR EMPLOYEE POSITIONS, INCLUDING THE COMPENSATION AND BENEFITS SURVEY OF THE CENTER FOR NONPROFIT MANAGEMENT AND THE COMPENSATION AND BENEFITS SURVEY FOR THE CALIFORNIA PRIMARY CARE ASSOCIATION. IN ADDITION, RESEARCH WAS CONDUCTED ON SALARY RANGES AND PAY SCALES AT OTHER COMPARABLE COMMUNITY CLINIC OPERATIONS IN LOS ANGELES THROUGH FORM 990S AND INTERVIEWS. THE REVIEW WAS DOCUMENTED IN THE BOARD MINUTES OF THE EXECUTIVE SESSION.
DOCUMENT DISCLOSURE
FORM 990, PART VI, SECTION C, LINE 19
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST TO BE VIEWED AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE OR VIA MAIL.
RECONCILIATION OF NET ASSETS
FORM 990, PART XI, LINE 5
($ 139,833) CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 28,700 COMMUNITY SUPPORT PROVIDED THROUGH THE CARE FOR OTHERS ----------- FUND (RECORDED THROUGH BALANCE SHEET ENTRIES) (111,133)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.