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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2017
Open to Public
Inspection
Name of the organization
STANFORD HEALTH CARE
 
Employer identification number
94-6174066
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) ASIAN AMERICANS FOR COMMUNITY INVOLVEMENT
2400 MOORPARK AVE
SAN JOSE,CA95128 		94-2292491 501(c)(3) 27,500       SUPPORT COMMUNITY CLINIC
(2) VMC FOUNDATION
2400 MOORPARK 207
SAN JOSE,CA95128 		77-0187890 501(C)(3) 10,000       INFECTIOUS DISEASE SUPPORT/EDUCATION
(3) LATINAS CONTRA COSTA
255 NO MARKET ST
SAN JOSE,CA95110 		56-2412069 501(C)(3) 10,000       CANCER SUPPORT/EDUCATION
(4) ST JAMES COMMUNITY FOUNDATION
PO BOX 995
SAN MATEO,CA94403 		46-3224440 501(c)(3) 10,000       CANCER SUPPORT/EDUCATION
(5) MAYVIEW COMMUNITY HEALTH CENTER INC
270 GRANT AVE
PALO ALTO,CA94306 		94-2239648 501(C)(3) 70,000 50,000 EMPLOYEE SALARY IN-KIND 0.5 FTE SOCI SUPPORT COMMUNITY CLINIC
(6) HEALTHCARE FOUNDATION OF NORTHERN & CENTRAL CALIFO
1215 K ST
STE 730
SACRAMENTO,CA95814 		86-1174825 501(C)(3) 82,140       MEDICAL RESPITE PROGRAM
(7) PENINSULA HEALTHCARE CONNECTION
33 ENCINA AVE
103
PALO ALTO,CA94301 		20-2886131 501(C)(3) 50,000       HEALTHCARE FOR HOMELESS
(8) SOUTH COUNTY COMMUNITY HEALTH CENTER INC
1885 BAY RD
PALO ALTO,CA94303 		94-3372130 501(C)(3) 75,000 50,000 EMPLOYEE SALARY IN-KIND 0.5 FTE SOCI SUPPORT COMMUNITY CLINIC
(9) SAMARITAN HOUSE
4031 PACIFIC BLVD
SAN MATEO,CA94403 		23-7416272 501(C)(3) 125,000       SUPPORT COMMUNITY CLINIC
(10) COMMUNITY HEALTH PARTNERSHIP INC
1401 PARKMOOR AVE
STE 200
SAN JOSE,CA95111 		77-0352645 501(C)(3) 27,500       COMMUNITY MAMMOGRAPHY ACCESS PROJECT
(11) COMMUNITY INITIATIVES - SF HEP B FREE PROJECT
101 GROVE ST
406
SAN FRANCISCO,CA94102 		94-3255070 501(C)(3) 15,000       INFECTIOUS DISEASE SUPPORT/EDUCATION
(12) AVENIDAS
450 BRYANT STREET
PALO ALTO,CA94301 		94-1480548 501(C)(3) 100,000       COMMUNITY BASED HOME HEATH HOME PROGRAM
(13) KARA
457 KINGSLEY AVENUE
PALO ALTO,CA94301 		94-2431483 501(C)(3) 12,000       CLINICAL THERAPY PROGRAM
(14) MENTAL HEALTH AMERICA OF NORTH CALIFORNIA
9719 LINCOLN VILLAGE DR
SACRMENTO,CA95827 		94-1476949 501(C)(3) 95,905       BEHAVIOURAL HEATH SUPPORT
(15) AMBULATORY SURGERY ACCESS COALITION
1119 MARKET STREET
SUITE 400
SAN FRANCISCO,CA94103 		94-3180356 501(C)(3) 10,000       CANCER SUPPORT
(16) SANTA CLARA VALLEY MEDICAL CENTER
PO BOX 398414
SAN FRANCISCO,CA94139 		94-6000533 GOVT 90,000       INFECTIOUS DISEASE SUPPORT/EDUCATION & MED RESPITE VEHICLE
(17) VOLUNTEERS FOR INTER-AMERICAN DEVELOPMENT ASSISTAN
1519 63RD STREET
EMERYVILLE,CA94608 		68-0249466 501(C)(3)   416,637 FAIR MARKET VALUE PE MEDICAL SUPPLY AND M MEDICAL SUPPLY AND EQUIPMENT DONATION
(18) GO COPIA PBC
1160 E BATTERY ST
STE 100
SAN FRANCISCO,CA94111 		47-1068807 170(E)   253,908 FAIR MARKET VALUE FO FOOD DONATION FOOD DONATION
(19) THE BOARD OF TRUSTEES OF STANFORD UNIVERSITY
3145 PORTER DRIVE
PALO ALTO,CA94304 		94-1156365 501(C)(3) 64,374,850 69,291 HOSPITAL COSTS INCUR IN-KIND LABORATORY ACCESS TO CARE AND RESEARCH SUPPORT
(20) NAMI SANTA CLARA COUNTY
1150 S BASCOM AVE
STE 24
SAN JOSE,CA95128 		94-2430956 501(c)(3) 23,050       COMMUNITY PEER MENTOR PROGRAM
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
19
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2017
Page 2

Schedule I (Form 990) 2017
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PROCEDURES FOR MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 WHEN A GRANT IS APPROVED, SOMEONE WITH SIGNATURE AUTHORITY FROM THE GRANTEE ORGANIZATION SIGNS THE GRANT AGREEMENT, WHICH INCLUDES A RECEIPT OF FUNDS STATEMENT (WHEN AND HOW MUCH WAS RECEIVED) AND THE PURPOSE FOR WHICH THE FUNDS MUST BE USED. A GRANTS MANAGER MAINTAINS CONTACT THROUGHOUT THE GRANT PERIOD FOR USE OF FUNDS AND PROGRESS ON STATED GOALS AND OBJECTIVES. AT THE END OF THE GRANT PERIOD, FINAL GRANT REPORTS ARE REVIEWED BY THE GRANT MANAGER. COPIES OF ALL DOCUMENTS ARE KEPT IN HARD FILES AND ELECTRONICALLY BY THE GOVERNMENT AND COMMUNITY RELATIONS DEPARTMENT.
Schedule I (Form 990) 2017



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