Annual Utilization Report of Specialty Clinics
Facility Name:PSYCHOLOGICAL SERVICES CENTER
OSHPD ID:306013688Report Status:Submitted
License Category:PsychologyReport Year:2002
Table of Contents
Click on any of the links listed below to view the corresponding section.
Section 1 - General Information
Section 2 - Facility Description
Section 3 - Patients and Encounters
Section 4 - Income Statement
Section 5 - Major Capital Expenditures
Errors and Warnings
Section 1 - General Information

1.Facility Name:PSYCHOLOGICAL SERVICES CENTER
2.OSHPD ID Number:306013688
3.Street Address:1730 FRANKLIN STREET SUITE 212
4.City:OAKLAND
5.Zip:94612
6.Facility Phone No.:(510) 628 - 9065 ext. 231
7.Administrator Name:Janet Jackson
8.Administrator E-mail Address:jjackson@alliant.edu
9.Was this clinic in operation at any time during the year?Yes
10.Operation Open From:01/01/2002
11.Operation Open To:12/31/2002
12.Name of Parent Corporation:Alliant International University
13.Corporate Business Address:2728 Hyde Street, Suite 100
14.City:San Francisco
15.State:CA
16.Zip:94109 -
17.Person Completing Report:Janet Jackson
18.Report Preparer's Phone No.:510-628-9065
19.Fax No.:510-628-9068
20.E-mail Address:jjackson@alliant.edu
30.Submitted by:306013688
31.Submitted Date and Time:10/27/2003 11:40:00 AM


Section 2 - Facility Description
LICENSE CATEGORY (TYPE)
Line
No.		(1)
1.License CategoryPsychology
LICENSEE TYPE OF CONTROL
Line
No.		(1)
5.Select the category that best describes the licensee type of control of your clinic from drop down list:Non-profit Corporation


Section 3 - Patients and Encounters
PATIENTS AND ENCOUNTERS IN THE CALENDAR YEAR (ALL CLINICS)
Please report the total number of individual, unduplicated patients served and the total number of encounters for these patients. Please refer to the instructions for further details.
Line
No.		(1)
Unduplicated Patients		(2)
Encounters
1.Total, all locations under this license (Main, Mobile, Satellite, etc.)3284,150
SURGICAL CLINICS ONLY
Line
No.		(1)
Number
5.Number of surgical operating rooms on December 310
6.Total number of surgical operations performed during the calendar year0
7.If you provided abortion services directly at your clinic, provide the total number of abortions performed0
PSYCHOLOGY CLINICS ONLY
Line
No.		Service Type(1)
Encounters
11.General Medical0
12.Substance Abuse (alcohol and drug)0
13.Mental Health Counseling3,550
14.All Other600
15.Total4,150


Section 4 - Income Statement
INCOME STATEMENT
Line
No.		(1)
Total
1.Gross Patient Revenue$220,000
WRITE-OFFS AND ADJUSTMENTS:
2.Charity0
3.Contractual Adjustments0
4.Bad Debts$3,173
8.Other Adjustments0
9.Total Write-Offs and Adjustments (line 2-8)$3,173
10.Net Patient Revenue (line 1 minus 9)$216,827
Other Operating Revenue:
11.Grants - Public0
12.Grants - Private0
13.Donations / Contributions0
19.Other$303,426
20.Total Other Operating Revenue (sum lines 11 - 19)$303,426
25.Total Operating Revenue (line 10 + Line 20)$520,253
Operating Expenses:
30.Salaries, Wages and Employee Benefits$449,122
31.Contract Services - Professional$74,022
32.Supplies$4,086
33.Rent / Depreciation / Mortgage Interest$53,165
34.Utilities$0
35.Professional Liability Insurance$68,029
36.Other Insurances$4,505
44.All Other Expenses$52,726
45.Total Operating Expenses (sum lines 30 - 44)$705,655
50.Net From Operations (line 25 minus Line 45)-$185,402

The Clinic's License Fee Will Be Based Upon The Completion Of This Income Statement And Will Be Calculated Accordingly.

Section 5 - Major Capital Expenditures

Section 127285(3) of the Health and Safety Code requires each clinic to report "acquisitions of diagnostic or therapeutic equipment during the reporting period with a value in excess of five hundred thousand dollars ($500,000)."

Diagnostic and Therapeutic Equipment Acquired During The Report Period
1.Did your clinic acquire any diagnostic or therapeutic equipment that had a value of $500,000 or more? (If 'Yes', fill out lines 2 through 11 below.)No

Diagnostic and Therapeutic Equipment Detail
Line
No.		(1)
Description of Equipment		(2)
Value		(3)
Date of Aquisition
MM/DD/YYYY		(4)
Means of Acquisition
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
11.0

Building Projects Commenced During Report Period Costing Over $1,000,000

Section 127285(4) of the Health and Safety Code requires each clinic to report the "commencement of projects during the reporting period that require a capital expenditure for the facility or clinic in excess of one million dollars ($1,000,000)."
25.Did your clinic commence any building projects during the report period which will require an aggregate capital expenditure exceeding $1,000,000? (If 'Yes', fill out lines 26 through 30 below.)No

Detail of Capital Expenditures
Line
No.		(1)
Description of Project		(2)
Projected Total Capital Expenditure		(3)
OSHPD Project No.
(if applicable)
26.0
27.0
28.0
390
30.0

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