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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
ARROYO VISTA FAMILY HEALTH FOUNDATION
 
Employer identification number

95-3514918
Return Reference Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: MADE FOR THE COMMUNITY, BY THE COMMUNITY, ARROYO VISTA FAMILY HEALTH CENTER IS A NON-PROFIT COMMUNITY HEALTH CENTER GOVERNED BY A CONSUMER BOARD OF DIRECTORS WITH A TRUSTED TEAM OF HEALTHCARE PROFESSIONALS SERVING THE GREATER NORTHEAST LOS ANGELES SINCE 1981. WE ARE LICENSED BY THE STATE OF CALIFORNIA DEPARTMENT OF HEALTH SERVICES. AS A FEDERALLY QUALIFIED HEALTH CENTER, FUNDING IS PROVIDED THROUGH PUBLIC HEALTH SERVICES ACT, SECTION 330, WITH ADDITIONAL FUNDING FROM LOS ANGELES COUNTY AND PRIVATE SOURCES. WE ARE ACCREDITED BY THE JOINT COMMISSION, WHICH MEANS THAT ARROYO VISTA HAS BEEN RIGOROUSLY INSPECTED, TESTED AND EVALUATED. WE ARE NATIONALLY RECOGNIZED FOR THE HIGHEST LEVEL OF PATIENT SAFETY AND QUALITY OF CARE. AS A CERTIFIED PRIMARY CARE MEDICAL HOME BY THE JOINT COMMISSION, WE FOLLOW CARE COORDINATION AND INTERDISCIPLINARY TEAM CARE MODEL FOR THE PROVISION OF SERVICES. FROM OUR HUMBLE BEGINNING IN 1981 AS A SMALL STOREFRONT CLINIC, WE HAVE GROWN TO A NETWORK OF FOUR HEALTH CENTERS AND A MOBILE CLINIC SERVING EVERY MEMBER OF THE COMMUNITY, WITH OVER 79,000 PATIENT VISITS IN 2020. ARROYO VISTA PROVIDES A COMPREHENSIVE RANGE OF MEDICAL, DENTAL, OPTOMETRY, BEHAVIORAL HEALTH, IMAGING, AND PHARMACEUTICAL SERVICES. OUR SERVICES ARE DESIGNED FOR ALL AGES, FROM INFANTS AND CHILDREN, TO TEENS, ADULTS, AND THE ELDERLY. MANY SERVICES ARE PROVIDED AT NO COST, INCLUDING HEALTH EDUCATION, ANNUAL FLU VACCINE CLINICS, IMMUNIZATIONS FOR CHILDREN, AND ANNUAL HEALTH FAIR SCREENINGS. WE ALSO PROVIDE TRANSPORTATION ASSISTANCE AND APPLICATION SUPPORT FOR MEDI-CAL, MEDICARE, MHLA AND COVERED CA. SERVICES ARE PROVIDED TO OUR VALUED PATIENTS REGARDLESS OF ABILITY TO PAY. PATIENTS WITH OR WITHOUT INSURANCE, MEDI-CAL AND MEDICARE... EVERYONE IS WELCOME AT ARROYO VISTA. OUR SERVICES ARE PROVIDED IN A CULTURALLY SENSITIVE, LINGUISTICALLY APPROPRIATE AND COMPASSIONATE MANNER. MANY OF OUR DOCTORS, NURSES, AND ADMINISTRATIVE STAFF COME FROM THE LOCAL COMMUNITY, AND MANY OF US INCLUDING OUR BOARD MEMBERS ARE ALSO PATIENTS OF ARROYO VISTA.
FORM 990, PART VI, SECTION B, LINE 11B EXPLANATION: THE INFORMATIONAL RETURN IS PREPARED BY AN OUTSIDE ACCOUNTANT. IT IS THEN REVIEWED BY THE CFO. ONCE APPROVED, THE RETURN IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS E-FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION: ARROYO VISTA BOARD MEMBERS SHALL COMPLETE A DIRECTOR QUESTIONNAIRE ANNUALLY CONFIRMING THEIR INDEPENDENT STATUS AND COMPLIANCE WITH THE AGENCY'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15 EXPLANATION: ARROYO VISTA'S PERSONNEL COMMITTEE HAS RESPONSIBILITY FOR THE REVIEW OF PERSONNEL POLICIES AND PROCEDURES INCLUDING COMPENSATION AND BENEFIT PROGRAMS. ARROYO VISTA EXECUTIVE COMMITTEE'S RESPONSIBILITIES INCLUDE YEARLY EVALUATION OF THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND COMPENSATION, WHICH IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS FOR FINAL REVIEW AND APPROVAL. OTHER OFFICERS AND KEY EMPLOYEES UNDERGO AN ANNUAL APPRAISAL REVIEW TO DETERMINE PROMOTION TO A HIGHER PAY LEVEL OR FOR MERIT INCREASES. THE CEO WILL MAKE THE DECISION ON MERIT INCREASES BASED ON THE SUPERVISOR'S AND/OR EXECUTIVE'S RECOMMENDATION AND EMPLOYEE PERFORMANCE AT THE TIME OF THE APPRAISAL REVIEW.
FORM 990, PART VI, SECTION C, LINE 19 EXPLANATION: ARROYO VISTA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST, AND TO INDEPENDENT AUDITORS DURING THEIR ANNUAL INDEPENDENT FINANCIAL AUDIT.
FORM 990, PART X, LINE 15, OTHER ASSETS AT MARCH 31, 2018, THE FOUNDATION HAD A RECEIVABLE THAT REPRESENTED UNCONDITIONAL PROMISES TO USE THE FACILITY LOCATED AT 6000 NORTH FIGUEROA STREET, LOS ANGELES, CA 90042, FROM THE CITY OF LOS ANGELES, DEPARTMENT OF GENERAL SERVICES (THE "CITY"). THE INITIAL TERM OF THE AGREEMENT WAS FOR THE RENT-FREE USE OF THE BUILDING FOR 20 YEARS STARTING IN JUNE 1987. THE AGREEMENT WAS AMENDED IN OCTOBER 2014, AND THE LEASE WAS RENEWED FOR ANOTHER 15 YEARS AT A NOMINAL RENT OF $1 PER YEAR. THE FOUNDATION USES THE PREMISES FOR THE PRIMARY OBJECTIVE OF PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY. AS OF MARCH 31, 2021, THE BALANCE FOR THE RECEIVABLE IS $4,019,194.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


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