Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
ST JOSEPH HEALTH SYSTEM FOUNDATION
 
Employer identification number
33-0143024
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) COVENANT MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
82-2913146 501(C)(3) 30,530,055 0     SPONSORSHIP
(2) ST JOSEPH HEALTH NORTHERN CALIFORNIA LLC
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
81-4791043 501(C)(3) 7,264,991 0     SPONSORSHIP
(3) MISSION HOSPITAL REGIONAL MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-1643360 501(C)(3) 2,129,675 0     SPONSORSHIP
(4) ST JOSEPH HOSPITAL OF ORANGE
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-1643359 501(C)(3) 1,476,683 0     SPONSORSHIP
(5) ST MARY MEDICAL CENTER
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-1914489 501(C)(3) 1,358,671 0     SPONSORSHIP
(6) ST JUDE HOSPITAL INC
1801 LIND AVE SW ATTN TAX DEPT
RENTON,WA98057
95-1643325 501(C)(3) 1,225,395 0     SPONSORSHIP
(7) CHARITABLE VENTURES OF ORANGE COUNTY INC
1505 E 17TH ST STE 101
SANTA ANA,CA92705
20-8756660 501(C)(3) 167,500 0     SPONSORSHIP
(8) CAL STATE FULLERTON PHILANTROPIC
2600 NUTWOOD AVE 850
FULLERTON,CA92831
33-0567945 501(C)(3) 150,000 0     SPONSORSHIP
(9) OC UNITED TOGETHER MINISTRIES
418 W COMMONWEALTH AVE
FULLERTON,CA92832
46-3761517 501(C)(3) 150,000 0     SPONSORSHIP
(10) CATHOLIC CHARITIES USA
2050 BALLENGER AVE
ALEXANDRIA,VA22314
53-0196620 501(C)(3) 120,000 0     OPERATIONAL SUPPORT
(11) EL SOL NEIGHBORHOOD EDUCATIONAL CENTER
PO BOX 449
SAN BERNARDINO,CA92404
33-0552297 501(C)(3) 117,500 0     SPONSORSHIP
(12) WILLIAM D RUCKELSHAUS CENTER FOUNDATION
901 5TH AVE STE 2900
SEATTLE,WA98164
20-4490085 501(C)(3) 100,000 0     OPERATIONAL SUPPORT
(13) HIGH DESERT SECOND CHANCE
16666 SMOKE TREE ST BLDG B4
HESPERIA,CA92345
46-4690286 501(C)(3) 95,000 0     SPONSORSHIP
(14) THE RELEVANT YOU
625 NORTH BACON DRIVE
BOISE,ID83712
84-2866167   76,000 0     OPERATIONAL SUPPORT
(15) ORANGE COUNTY ASIAN PACIFIC ISLANDER COMMUNITY ALLIANCE - OCAPICA
12912 BROOKHURST ST STE 410
GARDEN GROVE,CA92840
91-2047245 501(C)(3) 75,000 0     SPONSORSHIP
(16) CATHOLIC CHARITIES DIOCESE OF LUBBOCK
102 AVE J
LUBBOCK,TX79401
75-1966688 501(C)(3) 75,000 0     SPONSORSHIP
(17) HUMBOLDT STATE UNIVERSITY SPONSORED PROGRAMS FOUNDATION
PO BOX 1185
ARCATA,CA95518
94-6050071 501(C)(3) 75,000 0     SPONSORSHIP
(18) CENTER FOR INTERCULTURAL ORGANIZING
1390 SE 122ND AVE
PORTLAND,OR97233
74-3098100 501(C)(3) 75,000 0     SPONSORSHIP
(19) COVENANT HOUSE ALASKA
755 A STREET
ANCHORAGE,AK99501
13-3419755 501(C)(3) 75,000 0     SPONSORSHIP
(20) THE POVERELLO CENTER INC
1110 W BROADWAY ST
MISSOULA,MT59802
23-7439391 501(C)(3) 75,000 0     SPONSORSHIP
(21) BETTER HEALTH TOGETHER
PO BOX 271
SPOKANE,WA99210
90-0997482 501(C)(3) 75,000 0     SPONSORSHIP
(22) TIDES CENTER
PO BOX 399385
SAN FRANCISCO,CA94139
94-3213100 501(C)(3) 75,000 0     SPONSORSHIP
(23) COMMUNITIES IN SCHOOLS OF RENTON- TUKWILA
1055 S GRADY WAY
RENTON,WA98057
91-1689158 501(C)(3) 75,000 0     SPONSORSHIP
(24) BAY AREA COMMUNITY RESOURCES
171 CARLOS DRIVER
SAN RAFAEL,CA94903
94-2346815 501(C)(3) 75,000 0     SPONSORSHIP
(25) VALLEY CARE COMMUNITY CONSORTIUM
7515 VAN NUYS BLVD
VAN NUYS,CA91405
20-5569606 501(C)(3) 75,000 0     SPONSORSHIP
(26) ORANGE COUNTY CONGREGATION
310 W BROADWAY
ANAHEIM,CA92805
95-3196836 501(C)(3) 70,000 0     SPONSORSHIP
(27) BETTY KWAN CHINN HOMELESS FOUNDATION
PO BOX 736
EUREKA,CA95502
46-1413135 501(C)(3) 55,000 0     SPONSORSHIP
(28) CATHOLIC RELIEF SERVICES
228 W LEXINGTON ST
BALTIMORE,MD21201
13-5563422 501(C)(3) 50,000 0     OPERATIONAL SUPPORT
(29) CATHOLIC CHARITIES OF OREGON
2740 SE POWELL BLVD 2
PORTLAND,OR97202
93-0386801 501(C)(3) 50,000 0     OPERATIONAL SUPPORT
(30) CENTER FOR DISASTER PHILANTHROPY
ONE THOMAS CIRCLE NW STE 700
WASHINGTON,DC20005
45-5257937 501(C)(3) 50,000 0     OPERATIONAL SUPPORT
(31) COMMUNITY ACTION OF NAPA VALLEY
2310 LAUREL ST
NAPA,CA94559
94-1610851 501(C)(3) 40,000 0     SPONSORSHIP
(32) CATHOLIC CHARITIES OF THE DIOCESE OF SANTA ROSA
PO BOX 4900 / 987 AIRWAY COURT
SANTA ROSA,CA95402
94-2479393 501(C)(3) 40,000 0     SPONSORSHIP
(33) FAMILY ASSISTANCE MINISTRIES
1030 CALLE NEGOCIO
SAN CLEMENTE,CA92673
33-0864870 501(C)(3) 37,500 0     SPONSORSHIP
(34) COMMUNITY HEALTH INITIATIVE
2140 JEFFERSON ST STE D
NAPA,CA94559
25-1924934 501(C)(3) 35,000 0     SPONSORSHIP
(35) LA LUZ CENTER
17560 GREGER ST
SONOMA,CA95476
68-0228235 501(C)(3) 35,000 0     SPONSORSHIP
(36) CHARLES DREW UNIVERSITY OF MEDICINE & SCIENCE
1731 E 120TH ST
LOS ANGELES,CA90059
95-6151774 501(C)(3) 35,000 0     SPONSORSHIP
(37) ALASKA PACIFIC UNIVERSITY
4101 UNIVERSITY DR
ANCHORAGE,AK99508
92-0023588 501(C)(3) 35,000 0     SPONSORSHIP
(38) UNIDOS SOUTH OC INC
PO BOX 1874
SAN JUAN CAPISTRANO,CA92693
82-3510252 501(C)(3) 35,000 0     SPONSORSHIP
(39) ALASKA NATIVE HERITAGE CENTER
8800 HERITAGE CENTER DR
ANCHORAGE,AK99504
92-0127531 501(C)(3) 35,000 0     SPONSORSHIP
(40) HUMBOLDT SENIOR RESOURCE CENTER
1910 CALIFORNIA ST
EUREKA,CA95501
94-2261434 501(C)(3) 20,000 0     SPONSORSHIP
(41) ARCATA HOUSE INC
1005 11TH ST
ARCATA,CA95521
94-3163269 501(C)(3) 20,000 0     SPONSORSHIP
(42) WOMENS TRANSITIONAL LIVING CENTER INC
PO BOX 916
FULLERTON,CA92836
51-0201813 501(C)(3) 20,000 0     SPONSORSHIP
(43) SECOND HARVEST FOOD BANK
8014 MARINE WAY
IRVINE,CA92618
32-0362611 501(C)(3) 20,000 0     SPONSORSHIP
(44) VICTOR VALLEY DOMESTIC VIOLENCE INC
PO BOX 2825
VICTORVILLE,CA92393
93-1067826 501(C)(3) 20,000 0     SPONSORSHIP
(45) CATHOLIC CHARITIES SAN BERNARDINO
1450 N D ST
SAN BERNARDINO,CA92405
95-3293901 501(C)(3) 20,000 0     SPONSORSHIP
(46) THOMAS HOUSE TEMPORARY SHELTER
PO BOX 2737
GARDEN GROVE,CA92842
33-0204757 501(C)(3) 20,000 0     SPONSORSHIP
(47) CASA TERESA INC
123 W MAPLE AVE
ORANGE,CA92855
95-3251986 501(C)(3) 20,000 0     SPONSORSHIP
(48) REDWOOD COMMUNITY ACTION AGENCY
904 G ST
EUREKA,CA95501
94-2646370 501(C)(3) 20,000 0     SPONSORSHIP
(49) ON THE MOVE
780 LINCOLN AVENUE
NAPA,CA94558
75-3149095 501(C)(3) 20,000 0     SPONSORSHIP
(50) COMMUNITY ACTION PARTNERSHIP OF ORANGE COUNTY
11870 MONARCH ST
GARDEN GROVE,CA92841
95-2452787 501(C)(3) 20,000 0     SPONSORSHIP
(51) ST VINCENT DE PAUL
PO BOX 1386
EUREKA,CA95502
94-1573587 501(C)(3) 20,000 0     SPONSORSHIP
(52) REDWOOD TEEN CHALLENGE
2212 2ND ST
EUREKA,CA95501
68-0358004 501(C)(3) 20,000 0     SPONSORSHIP
(53) FOOD FOR PEOPLE INC
307 WEST 14TH STREET
EUREKA,CA95501
94-2772549 501(C)(3) 20,000 0     SPONSORSHIP
(54) UPVALLEY FAMILY CENTER OF NAPA COUNTY
1440 SPRING ST
ST HELENA,CA94574
80-0023012 501(C)(3) 20,000 0     SPONSORSHIP
(55) REDWOOD EMPIRE FOOD BANK
3990 BRICKWAY BLVD
SANTA ROSA,CA95403
68-0121855 501(C)(3) 20,000 0     SPONSORSHIP
(56) MERCY HOUSE
PO BOX 1905
SANTA ANA,CA92702
33-0315864 501(C)(3) 20,000 0     SPONSORSHIP
(57) INSTITUTE FOR HEALTHCARE ADVANCEMENT
501 S IDAHO ST STE 300
LA HABRA,CA90631
33-0483197 501(C)(3) 20,000 0     SPONSORSHIP
(58) FAMILY ASSISTANCE PROGRAM
15075 SEVENTH ST
VICTORVILLE,CA92395
33-0107971 501(C)(3) 20,000 0     SPONSORSHIP
(59) FRIENDSHIP SHELTER INC
PO BOX 4252
LAGUNA BEACH,CA92652
33-0219404 501(C)(3) 20,000 0     SPONSORSHIP
(60) PATHWAYS OF HOPE
514 W AMERIGE AVE
FULLERTON,CA92832
33-0147739 501(C)(3) 20,000 0     SPONSORSHIP
(61) ORANGE COUNTY RESCUE MISSION
ONE HOPE DRIVE
TUSTIN,CA92782
95-2479552 501(C)(3) 20,000 0     SPONSORSHIP
(62) HIGH DESERT HOMELESS SERVICES INC
14049 AMARGOSA RD
VICTORVILLE,CA92392
33-0459227 501(C)(3) 20,000 0     SPONSORSHIP
(63) GRANDMAS HOUSE OF HOPE
174 W LINCOLN AVE STE 541
ANAHEIM,CA92805
26-0391438 501(C)(3) 20,000 0     SPONSORSHIP
(64) THE SALVATION ARMY
10200 PIONEER RD
TUSTIN,CA92782
94-1156347 501(C)(3) 20,000 0     SPONSORSHIP
(65) WEST COUNTY COMMUNITY SERVICES
16390 MAIN ST
GUERNEVILLE,CA95446
94-2277740 501(C)(3) 20,000 0     SPONSORSHIP
(66) COMMUNITY ACTION PARTNERSHIP OF SAN BERNARDINO COUNTY
696 S TIPPECANOE AVE
SAN BERNARDINO,CA92408
95-2376882 501(C)(3) 20,000 0     SPONSORSHIP
(67) SOUTH COUNTY OUTREACH
7 WHATNEY STE B
IRVINE,CA92618
33-0330233 501(C)(3) 20,000 0     SPONSORSHIP
(68) YWCA SONOMA COUNTY
PO BOX 3506
SANTA ROSA,CA95402
94-2347428 501(C)(3) 20,000 0     SPONSORSHIP
(69) THE LIVING ROOM CENTER INC
1207 CLEVELAND AVE
SANTA ROSA,CA95401
58-2675876 501(C)(3) 20,000 0     SPONSORSHIP
(70) FOOD FORWARDING INC
7412 FULTON AVE UNIT 3
NORTH HOLLYWOOD,CA91605
90-0678872 501(C)(3) 20,000 0     SPONSORSHIP
(71) GIVING CHILDREN HOPE
8332 COMMONWEALTH AVE
BUENA PARK,CA90621
95-3464287 501(C)(3) 20,000 0     SPONSORSHIP
(72) LAGUNA FOOD PANTRY
20652 LAGUNA CANYON RD
LAGUNA BEACH,CA92651
33-0593551 501(C)(3) 20,000 0     SPONSORSHIP
(73) WAYMAKERS
1221 E DYER RD SE 120
SANTA ANA,CA92705
95-3167866 501(C)(3) 20,000 0     SPONSORSHIP
(74) CASA YOUTH SHELTER
10911 REAGAN ST
LOS ALAMITOS,CA90720
95-3218061 501(C)(3) 20,000 0     SPONSORSHIP
(75) BUILD FUTURES
18822 BEACH BLVD STE 211
HUNTINGTON BEACH,CA92648
90-0629740 501(C)(3) 20,000 0     SPONSORSHIP
(76) WOMENS RECOVERY SERVICES A UNIQUE PLACE
PO BOX 1356
SANTA ROSA,CA95402
51-0178620 501(C)(3) 20,000 0     SPONSORSHIP
(77) ORANGE COUNTY FAMILY JUSTICE CENTER FOUNDATION
150 W VERMONT AVE
ANAHEIM,CA92805
20-4088652 501(C)(3) 20,000 0     SPONSORSHIP
(78) RESCUE MISSION ALLIANCE
315 NORTH A ST
OXNARD,CA93030
23-7278002 501(C)(3) 17,500 0     SPONSORSHIP
(79) ASIAN COUNSELING AND REFERRAL SERVICE
639 MARTIN LUTHER KING JR WAY S
SEATTLE,WA98144
91-0916176 501(C)(3) 17,500 0     SPONSORSHIP
(80) LIFELONG-HEALTH FOR ALL
210 S LUCILE ST
SEATTLE,WA98108
91-1215715 501(C)(3) 17,500 0     SPONSORSHIP
(81) FRIENDS OF ZENGER FARM
11741 SE FOSTER RD
PORTLAND,OR97266
93-1269630 501(C)(3) 15,000 0     SPONSORSHIP
(82) THE NATIVE AMERICAN REHABILITATION ASSOC OF THE NORTHWEST INC
1776 SW MADISON ST
PORTLAND,OR97205
23-7098400 501(C)(3) 15,000 0     SPONSORSHIP
(83) SHARE OUR STRENGTH
1030 15TH ST NW STE 1100W
WASHINGTON,DC20005
52-1367538 501(C)(3) 15,000 0     SPONSORSHIP
(84) AFGHAN LITERACY FOUNDATION
27 LOOKING GLASS
IRVINE,CA92620
80-0376335 501(C)(3) 15,000 0     SPONSORSHIP
(85) ACCESS CALIFORNIA SERVICES
631 S BROOKHURST ST STE 107
ANAHEIM,CA92804
33-0826205 501(C)(3) 15,000 0     SPONSORSHIP
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Graphic Arrow
84
3
Enter total number of other organizations listed in the line 1 table ........................ . Graphic Arrow
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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
PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION.
Schedule I (Form 990) 2021



Additional Data


Software ID:  
Software Version: