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Home My WebLink AboutMINUTES - 09262000 - C9-C11 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C.9 Adopted this Order on SEPTEMBER.26 2000 by the following vote: AYES: SUPERVISORS GIOIA, UILKEMA, DESAULNIER, CANCIAMILLA AND GERBER NOES: NONE ABSENT: NONE ABSTAIN; NONE Subject: CONTINUANCE OF CONSIDERATION OF CLAIM OF T. CLAUSEN, K. CLAUSEN AND B. CLAUSEN IT IS BY THE BOARD ORDERED that consideration of approval of the claim for T. Clausen, K. Clausen, and B. Clausen is CONTINUED for thirty (30) days until Board Agenda date of October 24, 2000. i hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED, ,� ' Q z, PHIL BATCHELOR, Clerk of the Board ' Of Superv` ors and County Administrator By:: Deputy .1111 C4 a CLAIM t "BQARD OF SU-PEMSORS OF CONMA COSIA C'(}= CALWoEXiA BOARD- a SEPTBffiER 261 2000 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document railed to you is your California Government Codes. ► notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV belowl, given pursuant to Government"Warnings".Section 913 and r� 915.4. Please note all Warnings . AMOUNT: $3,5000.00 AIDC 2 N: 2900 CLAIMANT: ROGER E. WALL MARTINEZ CA41F- ATTORNEY: DATE RECEIVED: August 28, 2000 ADDRESS: 1355 Mt. Pisgah Rd, #4 BY DELIVERY TO CLERK ON: r Angust 28; Qj Walnut Creek CA 94596 Transmittal BY MAIL POSTMARKED: L FROM: Clerk of the Board of Supervisors M. County Counsel Attached is a copy of the above-noted claim. August 28, 2000 PHIL BA LOR, Cler Dated: By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisipi ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim PAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ) Other: - � Dated: B' y � It Deputy County Counsel III. FROM: Clerk of the Board TO. County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: la This Claim is rejected in full. Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated PHIL BATCHELOR, Clerk, By / , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NLARJNG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated By: PHIL BATCHELOR By , Deputy Clerk ,CC: County Counsel County Administrator Maim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Maims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100`s day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or grooving crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,651 Pine Street,Martinez,CA 94553. C. If Claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity,separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec.72 at the end of this form. RE: Claim by ) Reserved for Clerk's Filing Stamp c Against the County of Contra Costa > or - s District) (Fill in Name) The undersigned claimant hereby snakes claim against the County of Contra Costa or the above named District in the sum of S ' + and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) ---------------------------------------------------------- 2. __________________ _ 2. Where did the damage or injury occur? (include city and county) t -------- ---i---------- ----- ------ `�-_-`_�-�- = ;- -----A --F� . 3. How did the damage or injury occur? (Give ttdi detain;use extra paper if required) r ....�'�_ t,r—w+►.��.. � tZ..�{�� rF•ir" ;�."..E+... �"'� (.'.y�.�"1. 1 11`� s�..y��. �1r... ��.r ""'1 "T�t a 4.t✓�t�f w, 4_ �*+ .t r� yy�� W< eti cvL - 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? (Over) 5. 'what are the names of county or district officers,servants,or employees causing the damage or injury? ----- w ------------------------------------------------ ------------------ b. What damages or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.} �� `�4'�J�� ,'� -`-�+�....__ Y��f1,.P�S 'S�tr�.ti.:��l-.sa I Y-`�C.•--� ` -co I-Q—T(-,, "� cJ-.)k"�Jtr`"t7 c�1 7. - How was the above claimed amount computed" (include the estimated amount of any prospective injury or damage.) ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses;doctors,and hospitals. Oct- 9. 4 List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT If Gov. Code Sec.910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney - a -� (Claimant's Signature) Lim (Address) Telephone No. Telephone No �'L "7 NOTICE Section 72 of the Penal Code provides: "Every person who,with intent to defraud,presents for allowance or for payment to any state board or officer,or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim,bill, account,voucher,or writing,is punishable either by imprisonment in the county jail for a period of not ,,more than one year, by a fine of not exceeding one thousand dollars ($1,000 ),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars ($10,000), or by both such imprisonment and fine. ATivNT NAM�;";CDRESS PHONE I SSN DATE TIMERE.G. FIC PAT.ACCTNO. P/T Y BIRTHDATE AGE SEX MIS PIC MED,REC.NO, JOHN MUIR MEDICAL CENTER WOUND CARE {CUT'S, ABRASIONS, BURNS, ETC, WALNUT CREEK,CALIFORNIA _7 KEEP THE DRESSING CLEAN AND DRY. USEFUL MEDICAL CENTER TELEPHONE NUMBERS: ❑ ELEVATE THE WOUND TO HELP RELIEVE SORENESS AND HELP SPEED WOUND HEALING. EMERGENCY DEPARTMENT 939-580{5 PHYSICIANS REFERRAL SERVICES 947-5380 ❑ DESPITE THE GREATEST CARE, ANY WOUND CAN BE ED 932-6100 INFECTED. IF YOUR WOUND BECOMES RED, SWOLLEN TEL-MED , OUTPATIENT BILLING 932-2400 SHOWS PUS OR RED STREAKS, OR FEELS MORE SORE INSTEAD OF LESS SORE AS DAYS GO BY YOU MUST REPORT TO YOUR DOCTOR OR RETURN TO THE EMERGENCY DEPARTMENT RIGHT AWAY. V+ GENERAL INSTRUCTIONS(NOTE ALL BOXES CHECKED APPLY TO YOU) Cl SUTURE REMOVAL DAYS. YOU HAVE RECEIVED EMERGENCY TREATMENT ONLY. THIS TREATMENT IS NOT INTENDED, AS A SUBSTITUTE OR REPLACEMENT FOR CONTINUING MEDICAL CARE.FOR YOUR PROTECTION, PLEASE FOLLOW THE INSTRUCTIONS CHECKED FOR YOU BELOW. IF NO SPRAIN,FRACTURE, SEVERE BRUISES IMPROVEMENT. CALL YOUR DOCTOR OR RETURN TO THE EMERGENCY DEPARTMENT. ❑ ELEVATE INJURED PART HIGHER THAN THE LEVEL OF THE HEART TO LESSEN SWELLING. A COPY OF YOUR BILL WILL BE SENT TO YOU WITHIN THE NEXT FEW DAYS. ❑ USE ICE PACKS FOR FIRST 24-48 HOURS(15-20 MINUTES BECAUSE OF THE SOPHISTICATION AND 24 HOUR AVAILABILITY OF THE 5 TO 6 TIMES PER DAY). STAFFING,EQUIPMENT AND SUPPORT SERVICES INVOLVED IN EMERGENCY HEAT TO INJURED AREA AFTER 48 HOURS, AS CARE.FEES ARE UNDERSTANDABLY HIGHER THAN FOR SIMILAR TREATMENT E] COMFORTABLE. IN A DOCTOR'S OFFICE,PRIVATE PHYSICIANS OR CONSULTANTS WILL BILL YOU SEPARATELY. FOR ANY QUESTIONS REGARDING YOUR BILL, PLEASE. ❑ KEEP CAST OR SPLINT DRY. CONTACT THE OUTPATIENT BILLING DEPARTMENT AT 958-2400. ❑ CHECK FINGERS OR TOES IN CASTED EXTREMITY FOR CIRCULATION AND IF FINGERS OR TOES GET COLD,WHITE PHYSICIAN REFERRAL NUMB OR SWOLLEN, OR IF PAIN INCREASES MARKEDLY YOU HAVE BEEN REFERRED TO ONE OF OUR MEDICAL STAFF CALL THE DOCTOR OR RETURN. PHYSICIANS FOR FOLLOWUP CARE, SOME INSURANCE PLANS REQUIRE ❑ USE CRUTCHES AS DIRECTED. PRIOR AUTHORIZATION TO ENSURE PAYMENT FOR SUCH CARE.IF YOU HAVE ' QUESTIONS IN THIS REGARD, WE SUGGEST YOU CONSULT YOUR NO DRIVING INSURANCE PLAN OR YOUR PRIMARY CARE PHYSICIAN UNDER YOUR PLAN. YOU MAY ALSO OBTAIN ASSISTANCE FROM OUR PHYSICIAN REFERRAL YOU HAVE A CONDITION OR HAVE RECEIVED MEDICATION SERVICE AT 947-5380._ ® THAT MAY INHIBIT YOUR ABILITY TO DRIVE OR OPERATE X-RAYS DANGEROUS MACHINERY. THE INTERPRETATION OF YOUR X-RAYS BY THE PHYSICIAN IN THE HEAD INJURY INSTRUCTIONS EMERGENCY DEPARTMENT IS ONLY A PRELIMINARY REPORT,THE HOSPITAL RADIOLOGIST WILL ALSO REVIEW THESE X-RAYS AND YOU WILL BE REPORT TO YOUR DOCTOR IMMEDIATELY IF ANYTHING NOTIFIED IF THERE IS A SIGNIFICANT DIFFERENCE IN THE INTERPRETATION. LISTED OCCURS(EVEN WITHIN SEVERAL MONTHS). YOU WILL RECEIVE A SEPARATE BILL FROM DIABLO RADIOLOGY GROUP FOR INTERPRETATION OF YOUR X-RAYS.IF YOU ARE REFERRED FOR FOLLOW-UP_ ❑ PERSISTENT VOMITING, STIFF NECK, FEVER OR SEVERE PLEASE CALL 947-5320,TO MAKE ARRANGEMENTS TO PICK UP YOUR FILMS HEADACHE. PRiOR TO YOUR APPOINTMENT. ❑ UNEQUAL EYE PUPILS LONE PUPIL LARGE,ONE SMALL) , LABORATORY TEST ❑ CONFUSION OR UNUSUAL DROWSINESS. A BACTERIAL CULTURE OR SPECIAL LAB TESTS WERE OBTAINED TO AID ❑ CONVULSIONS OR UNCONSCIOUSNESS. IN THE DIAGNOSIS AND/OR TREATMENT OF YOUR PROBLEM.IN MOST CASES THE RESULT SHOULD BE BACK IN 3 DAYS.PLEASE CALL 939-5800 FOR THE ❑ STAGGERING GAIT OR OTHER PROBLEM WITH NORMAL RESULTS AND FURTHER INSTRUCTIONS. USE OF ARMS OR LEGS. NOTE:WAKE PATIENT EVERY-HRS TETANUS A BOOSTER INJECTION OF{ )DIPTHERIA TETANUS-DT,( )TETANUS WORK/SCHOOL EXCUSE TOXOID-TT WAS GIVEN AND SHOULD LAST FOR 5-10 YEARS IF YOU ARE INJURED DURING THAT TIME. ❑ TETANUS IMMUNE GLOBULIN WAS GIVEN SINCE THERE HAD BEEN NO Cl NO WORK FOR-DAYS DUE TO PREVIOUS IMMUNIZATIONS OR AN INADEQUATE IMMUNIZATION IN PAST. MAY RETURN TO WORK AFTER THE END OF THIS PERIOD. IF NOT WE ALSO BEGAN A TETANUS SERIES TODAY. YOU SHOULD HAVE FREE OF SYMPTOMS BY THIS DATE, PLEASE FOLLOW UP WITH ❑ ANOTHER BOOSTER IN 4-6 WEEKS FROM YOUR DOCTOR OR HEALTH REFERRAL DOCTOR. DEPARTMENT ❑ LIGHT WORK ONLY(AVOID HEAVY LIFTING OR EXTREME,STRENUOUS WORK). ❑ NO PHYSICAL EDUCATION UNTIL PA7IENT•J _%TRUCTIONS r" _ a INSTRUCTIONS GIVEN ' 0 SPRAIN/SEVERE BRUISE ❑NO DRIVING 0 HEAD INJURY 0 TETANUS13 WOUND CA RE y L]LAB RESULTS SIGNATURE IWAVA YtAD AND UNDERSTAND THE ABOVE INSTRUCTIONS 0 WORK EXCUSE OF PATIENT xM.D. 0 X-RAY MEDICAL RECORDS _�� ' I�HN�111U1R MEti#CAL CANT R F1�RGAF��INSTRUCTIONS EMERGENCY DEPT CLINICAL RECORD 7PYP7_'7 DRV 71/Oh '� -fAln,k"11-m-11 1-rrn r.a„• e+., 1 w.. TO: BOARD OF SUPERVISORS FROM: Phil Batchelor, County Administrator ` ontril . . DATE: September 2$, 2000 ,l.�-'��-�� '� '» sta SUBJECT: Final Settlement of Claim Shelley Bradburn vs. Contra Costa County uounty SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Deceive this report concerning the final settlement of Shelley Bradburn and authorize payment from the Workers' Compensation Trust fund in the amount of$90,000. BACKGROUNDIREASONS FOR RECOMMENDATION: Robert J. Cavallero, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the workers' compensation claim of Shelley Bradburn vs. Contra Costa County. This Board's August 8, 2000 closed session vote was: Supervisors Gioia, Uilkema, Gerber, Canciamilla and DeSaulnier, yes. This action is taken so that terms of this final settlement and the earlier August S, 2000 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: YES SIGNATURE: , k,"R-ECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE t --APPROVE OTHER -SIGNATURE(S): w ACTION OF BOAR SEPTEMBER 269 2000 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD UNANIMOUS (ABSENT NONEAND SUPERVISORS ON THE DATE SHOWN, AYES: NOES: ABSENT: ABSTAIN: ATTESTED _ SEPTEMBER 26, 2000 PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact: Tony Schleder—335-1411 cc: CAO Risk Management Auditor-Controller BYZ;)67 % � ��` 'DEPUTY a TO: BOARD OF SUPERVISORS G � . FROM: Phil Batchelor, County Administrator - Contra . w. . DATE: September 26, 2000Cotila, ; ,. SUBJECT: Final Settlement of Claim Judith Day vs. Contra Costa County County SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Receive this report concerning the final settlement of Judith lay and authorize payment from the Workers" Compensation Trust fund in the amount of$25,0001. BACKGROUND/REASONS FOR RECOMMENDATION: Keith A. Epstein, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the workers' compensation claim of Judith day vs. Contra Costa County. This Board's September 12, 2000 closed session vote was: Supervisors Gioia, Uilkema, Canciamilla and DeSaulnier, yes Gerber, absent. This action is taken so that terms of this final settlement and the earlier September 12, 20010 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: YES SIGNATURE: . ,,-12ECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE 41--"APPROVE OTHER SIGNATURES: 044; ACTION OF BOAR SEI TE'MSER 26, 2000 APPROVED AS RECOMMENDED X _ OTHER VOTE OF SUPERVISORS i HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD UNANIMOUS (ABSENT X NONE OF SUPERVISORS ON THE DATE SHOWN} AYES: NOES: ABSENT: ABSTAIN: - — ATTESTED SEPTEMBER 26, 20W PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact:Tony Schleder®335-1411 cc: CAO Risk Management Auditor-Controller BY =, DEPUTY c