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Home My WebLink AboutMINUTES - 02111997 - C22-C23 D CLAIM hl� aa 4q BOARD OF SUPERVISORS OF CONTRA COSTA COUNTr7i�L��LWNiiu February 11, 1997 Claim Against the County, or District governed by) COUNTY COU;VSELMARTINEZCAllIF. BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailek to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Martin J. Everson ATTORNEY: Date received ADDRESS: 17 Hunters Terrace BY DELIVERY TO CLERK ON January 23, 1997 Danville, CA 94526 BY MAIL POSTMARKED: Hand Delivered via: Risk Mpmt. 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: January 23, 1997 ��IL �p�IyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ()() This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS 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: % BY: LeL1-LGC. lu 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 (X) 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: FEB 111997 PHIL BATCHELOR, Clerk, �y—��c '� �iS a � , 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 MAILING 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 oabove. 1 O Dated: FEB 1m BY: PHIL BATCHELOR by��/c`" �� 'Deputy Clerk CC: County Counsel County Administrator k-z) d RECEIVED Martin J. Everson `t:, _ ;� 1996, DEC 2 6 199-0Lucille Everson 17 Hunters Terrace COUNTYCOuN9EL Danville, CA 94526 TOWN OF DANVILL.G MARTINEZ CALIF. (510) 943-6383 November 27, 1996 RECEIVED Intake Division .1M123 office for Civil Rights U.S . Department of Health and Human Services ESC SOA� WOFSUPOW OAS 50 United Nations Plaza, Room 322 San Francisco, California 94102 Re : Complaint of Discrimination Under Section 504 of the Rehabilitation Act and Title II of the Americans With Disabilities Act of 1990 Dear Sir or Madam: This is a complaint of discrimination on the basis of a disability in violation of Section 504 of the Rehabilitation Act, 29 U.S.C. §794 , and Title II of the Americans with Disabilities Act, 42 U.S.C. §12101. The complainant is Andrew Everson, a 14-year old (DOB: 9/12/82) , mentally retarded boy diagnosed with Down Syndrome. The undersigned is the father of Andrew Everson and I make this complaint on his behalf . This complaint is brought against the San Ramon Valley School District, the Contra Costa SELPA, the Danville Police Department, Mr. Duff Danilovich (Principal of Los Cerros Middle School/Employee San Ramon Valley School District) , Elizabeth Anderson (Teacher/Employee Contra Costa SELPA) , and Jeffrey Hebel (Police Officer/Employee Danville Police Department) . This claim involves the wrongful application of a W&I 5150 commitment of Andrew Everson to a locked psychiatric facility in violation of his civil rights under the statutes referred to above. Further, the involuntary commitment of this 14-year old mentally retarded youth constituted a wrongful arrest and false imprisonment. The complainant requests that the Office of Civil Rights promptly investigate this complaint and take all necessary actions to prevent any further violations -of Andrew' s federally protected rights. Andrew Everson has been a student in the Special Education class at Los Cerros Middle School since September 12, 1995 . Andrew has never been diagnosed with a mental illness or mental disorder. Andrew is severely mentally retarded and functions at the cognitive and emotional level of a 3-year old. His speech is severely limited. He is not aggressive or hostile and his behavior has Intake Division Office of Civil Rights U.S. Department of Health and Human Services Re: Complaint of Discrimination Under Section 504 of the Rehabilitation Act and Title II of the Americans With Disabilities Act of 1990 November 27, 1996 Page 2 always been merely a manifestation of his mental retardation. Andrew' s Individual Education Program (IEP) requires that he be attended at all times at school by a one-on-one aide trained in behavior management . In addition, his IEP requires the teacher and his aide to manage his behavior according to a written behavior intervention plan which is required to be kept in the classroom. There are approximately 15 students in Andrew' s Special Education class. Up until three weeks ago, there was a teacher and two full time aides . One of the aides was the one-to-one aide assigned to Andrew. All of the students have serious developmental delays and some have demanding physical handicaps . Although another full time aide was added within the last three weeks, the classroom contained too many students and the staffing remained inadequate with the result that Andrew' s aide was- not working one-on-one with him, he was largely ignored by the teacher and his IEP Plan was not being implemented. Further, Andrew' s mother would visit the classroom on a regular basis and recently has noticed a hostile attitude from Andrew' s aide, Amanda Savage, when the aide was asked about the activities -she had been undertaking with Andrew and the amount of time she had been spending with him. It was Mrs. Everson' s impression that Ms . Savage no longer considered herself to be Andrew' s aide. When confronted with these same questions, the classroom teacher, Elizabeth Anderson, has been evasive. On November 22: 1996, Andrew engaged in disruptive behavior is the classroom which was mishandled by the teacher. The teacher' s mishandling of the situation caused the behavior to escalate. At the request of the teacher and principal, Andrew was taken into custody by a police officer on a W&I 5150 72-hour detention on the basis that he was mentally ill and was a danger to others . He was confined in the locked psychiatric ward at the county hospital . No one from his school bothered to go with him to the hospital . He was likely extremely frightened. A copy of the 5150 form is attached. A copy of the Police Report is also attached. Prior to placing the 5150, the school principal (Duff Danilovich) attempted to contact my wife and me to pick Andrew up at the school . My wife was at the supermarket and I was in Fresno on business. Because he was not able to locate us, the principal called the police department . The responding officer then placed the 5150 . Andrew was taken into custody in leather restraints and Intake Division office of Civil Rights U.S. Department of Health and Human Services Re : Complaint of Discrimination Under Section 504 of the Rehabilitation Act and Title II of the Americans With Disabilities Act of 1990 November 27, 1996 Page 3 committed to the locked psychiatric unit at Merrithew Memorial Hospital in Martinez . Andrew was taken into custody at 1 :47 p.m. , 43 minutes prior to the end of the normal school day. He was taken into custody, despite the fact that the teacher was aware that Andrew' s mother would be home shortly in order to be available to take him off the school bus. Shortly after being committed to the locked psychiatric unit, Andrew was released to the custody of his mother by the evaluating psychiatrist who found no evidence of mental illness or mental disorder and found no evidence that he was a threat to anyone. In fact, Andrew did not have a mental disorder when he was taken into custody, but rather was exhibiting reactive behavior of the type which would be exhibited by a 3-year old, consistent with his mental retardation. Further, had the teacher and principal utilized the management techniques called for in Andrew' s Behavior Management Plan, the situation would not have escalated. Andrew' s behavior was inappropriately handled by the teacher and the principal and he was wrongfully taken into custody on a 115150" because his parents were not immediately available to take him home. Less drastic alternatives, such as taking Andrew to a separate room or taking him to the principal ' s office, were not considered. The application of a 5150 hold in this instance was a violation of Andrew s civil rights, a violation of the Americans With Disabilities Act, and constituted a false imprisonment/false arrest of an innocent, mentally retarded 14-year old boy. The Police Report of this incident contains repeated references to Andrew being mentally ill and having a mental disorder, which descriptions are absolutely false. Nowhere in the Report is it mentioned that he is mentally retarded and nowhere is it mentioned that he has Down Syndrome, which would be obvious to the police officer. Further, the police officer' s description of the events as reported to him by the witnesses takes no account of the fact that his behavior was influenced by his mental retardation. The Police Report makes reference to a statement by Andrew' s teacher that his behavior had deteriorated dramatically over the preceding months and that the teacher could no longer control him. At no time prior to November 22, 1996, had the principal, teacher, aide, or any other person involved in Andrew' s educational program advised either of his parents, orally or in writing, that there was a problem with his behavior. If that were true, Andrew' s Intake Division office of Civil Rights U.S . Department of Health and Human Services Re: Complaint of Discrimination Under Section 504 of the Rehabilitation Act and Title 11 of the Americans With Disabilities Act of 1990 November 21, 1996 Page 4 behavioral consultant would have been contacted to assess the situation and to take steps to correct any problems that existed. Andrew was subsequently suspended from school . A copy of the Suspension Notice is enclosed. Please note that the CCSELPA stated as grounds for suspension: " . . .Andrew pushed teacher to floor and urinated on her. " In fact, the teacher' s mishandling of Andrew' s behavior precipitated reactive behavior on his part. Andrew was likely confused and scared. During the encounter, he urinated in his pants most likely because he was afraid. He does not have the mental capacity to urinate on anyone. He is not aggressive or hostile by nature. The teacher chose to describe this as "urinating on her. " This is a deliberate exaggeration by the teacher and CCSELPA in an attempt to cover up their inept and outrageous conduct . The principal, teacher and police officer involved violated their obligation to protect Andrew who, because of his disability, is unable to protect himself. Although Andrew Everson is severely mentally retarded, he has the same rights as other citizens of this country to be treated with respect and- dignity and to live in a non-threatening environment. In this instance, those members of society who were most intimately charged with the responsibility of caring for him totally failed their obligations and discriminated against him because of his disability. I am in the process of obtaining medical records from . the psychiatric unit of the hospital which can be forwarded to you along with any additional information that would be of help in your review of this incident . Very truly yours, MARTIN J. EVERSON MJE:ar Enclosures (W&I 5150 form, Suspension Notice, Police Report) CC: Fpdnces Horzempa, Caseworker, Regional Center of 'East Bay ,6anville City Manager Dana Sassone, San Ramon Valley School District CCSELPA (g(Face Page CONTE. :OSTA COUNTY SHERIFF'S DEPARTMEZ PA0070000 Beat Conunuatiion P.O. Box 391, Martinez,California 94553-0039 ppitananital ❑HRD ❑Arrest ❑` . t.OR No. City Cod 3.Crime/Classification 4.Detail 1 __ Q S,More 9 6-3 y` 7 33 _ c r SL - cam-rrC- T 2. Persons 6.Day/Date/Time of Oc urren+ce ��( 7.Date/Time Re ted 8.Employee No, p aAy (- -Z`4 6 t Zd It'ZZ-RG f3 25 1{b 7 L� 9.Reclassi. 10.Address/Location of Occurrence 6caaon CSM 12o DA 11440 ❑ 11. PRI ❑VIC ❑WIT nmsp ❑RUN ❑SUS QLEAD 0Outer 12.Noma(L,F.M) 13.Race Sex Age 14.008 15.Driver License No. C O CH Jit^ . I HOWS14 16.Address I (7(p Code) 17.Home Phone 9(000 &415:A169 4 :We ( a K 18.Employed By or School 19.Work Phone Acct URIFx45p Schcoc zv ss2- "Zo 20.Hair 21.Eyes 22.HL 23.WL 24.AKA/Maitlen Name 25.Social SecurityNo. NIA NIA 26.Further Description(Stars,Tattoos,Mannerisms,Clothing,Etc.) 27.Booking o C; No. wINCIMI, a cetzaas SCNQac N 28. ❑PRI ❑VIC WIT ❑MSP ❑RUN ❑SUS ❑LEAD ❑Other 29.Name{L.F.M) 30.Racef Sex 1 Age 31.D08 32.Driver License No. el e4l 10-29- 071?'x+93 33.Address (Zf,Cotle} 34.Home Phone ACA /W6 ROAD, h/vzcCX!Z' ( ) N 35_Employed By or School 36.Work Phone 10,161,4T" 60STA '33 _ VY 37,Hair 38.Eyes 39.Ht40.Wt 41.ARA/Maiden Name - 42.Social Security No. Is9m I 69N 15fS`r tis NIA vN!C 43.Further Description(Scars.Tattoos.Mannerisms,Clothing,Etc.) H ♦ f 44.Booking or CNo. 45. ❑PRI ❑Vic WiT 'L ❑MSP RUN ❑SUS ❑LEAD ❑Other 46.Name(L,F.M) 1 47.Race!Sex 1 Age 48.DOB 49.Driver License No. QCl N T CFFN ZZ - -Y3 5070 114YZ 30.Address (Nip Code) 51.Home Phone `PDI &C-714116R =At} AI ICC(S c /y/A 52.Employed B w School 53.Work Phone Crjm;A Ca H Q%JKT'i OFFr c, '51Z-37- 39'" 54.Hair 55.Eyes 56.Ht 57.Wt $8.AKA/Maiden Name 59-Social Security No. uhtK umic 60.Further Description(Scars,Tattoos.Mannerisms.Clothing.Etc) 61.Booking or Ci .No. 62.Veh!Ves 63.Uc,No.(State) 64.Year 65.Make fib.Model 67.Body Style 63,Col.,Top ❑S ❑Vict Bottom 69.Status 70.Registered Owner 71.R.O.Address ❑Left ❑lmipound 72.Towed to or Released to 73.Who has keys? Stored 74.Evid. ❑Yes 75.FtP ❑Yes 76.Oispo of Evidence IF 77.E Missing 78.S Damaged No o N 71 Brill of Incident (1) 1110SVOILT CoNc6 NS 7RC-7 /tit 6714MOCK 4 z'cC COAAA KtACHT 140 (2) t 5-6 N N c YF6zSoN N ANQ (3) 6CZ0 N F2F TN SUCet�0 v tNttT ,q ! t`tSS ACTI�RCA- (4) ISM tM �u6resQN- (5) (6) (7) 80.Distribution 81,Additional Routing ❑e ❑C �DA ODE ❑L ❑o ❑SR ❑V ❑investigation [;Vice ❑Narcotics ❑Juv ❑Coroner 82.Reposing Depuy(Print) 83.Date/Time Wri en844..Dispoo. ❑Property Ck V)ACS ❑Intell. ❑R.O. ❑SHC S5(�j, { !,-�, � {� Ucod - ❑Patrol Captain!"�Compl.Ofc./❑Marine Patrol 85.Approving Supe(Pring 86.Sup¢No. 67.Date 88.Page q Outer .4:-7-. FAQ✓ C 11 .�r b.l ,f(I.`//./�! {'h�l.-i2j ric'OL✓ ,�'/7/fix? //L-Z?o ff.=-ot- RM A (Rev.1/89) 0Face Page CONTF. OSTA COUNTY SHERIFF'S DEPARTMEq A0070000 Beat.,.._ OW�w who t P.O. Box 391,Martinez, California 94553-0039 ❑HRP ❑Anes1 ❑S 1.OR No. 2y.Qty G e 3.Crime/Classification f.� 4.Detail 1 M S.More V 33 t �Cy C( Cd/-'vn-ITA`LtIyT 2. Persons 8.Day/Date/Time of Occurrence Z Date/Time Reported 8,Employee No. I$ 9.Reclassi. 10.Address/Location of Occurrence 9cation 11. ❑PRI ❑VIC WIT ❑MSP ❑RUN ❑SUS ❑Lher 12.Name(L,F.M) 13.Race Sex/Age 14.DOB 15.Drivel License No. NOA - Y! S--V SS .37;?/794 16.Address (Xip Cod¢I 17.Home Phone ism 64 20A C1^NvI(y-<r i ) 18.Employed By or School 19.Work Phone e ctavP9 c&Jrcrf OIPr �466- 837- V?Y9 26.Hair 21.1 22.H4 23.WL 24.AKA/Maiden Name 25.Social Secunty No. 1-I u Fti� 26.Further Description(Scars,Tattoos.Mannerisms,Clothing,Etc.) ^ 27.Booking or Cit No. 28. ❑PRI ❑VIC WIT ❑MSP I RUN ❑SUS ❑LEAD Other 29.Name(L.F,M) 36.Race Sex Age 31.DOB 32.Driver License No. Y"p-WAK-C it =c sz -9-9fY I (Cott (qr So 33.Address jzil5 Code) 34.Home Phone L'3 C RM 160 (213-AP A V-TCC ( 35.Employed By or School 36,Work Phone AH e ON ACCc�Y =� - cllob �is3$-t8Y6 37 Hair 38.Ey¢sr Ht 4Q.Wt 4i.AKA l Maiden Name 42.Social Security No. UNC is 43.Further Description(Scars.Tattoos.Mannensms,Clothing,Etc) 44.Bookin or ite No. 45. ❑PRI ❑VIC LYWIT 415 O MSP 0 RUN ❑SUS O LEAP ❑Other 46.Name(L.F,M) 47,Race Sex 1 ge 48,008 49,Driver License No. zC'14A v el e6 -r3-7 Cd 13Y 8 13 60.Address (Zi Code) 51,Home Phone 52.Employed BY or School 53.Work Phone CAN MOh jAtCF� (JN-Tr-V40 ftOQC D1s71�rT ( SSZ - cbzb 54.Heir SS.Eyes 56.Nt 57.Wt 58.AKA/Maiden Name 59.Social Security No. 0 NIC Li mv- 6fL Further Description(Scars.Tattoos.Mannerisms,Clothing,Etc.) A 61.Booking or 9te No. N /} 62.Veh/Vas 63.Lic.No.(State) 64.Year 65.Make 66.Model 67.Body Style 63.Color Top ❑S ❑Vict Bottom 69.Status 70.Registered Owner t1.R.O.Atldress ❑Leh ❑Impound 72.Towed to or Released to 73.Who has keys? Stored 74.Evkf. ❑Yes 75.F/P ❑Yds 76.Dispel of Evidence T7.$Missing 78,S Damaged No No 79.Brief Synopsis of Incident (1) (2) (31 (4) (5) (6) (7) 80.Distribution 81.Additional Routing ❑S ❑C ODA ODE ❑L []O ❑SR OV ❑Ireestigation ❑Vice ❑Narcotics ❑Juv ❑Coroner 82.Reporting Deputy(Print) 83.Date/Time Wnn n 84.Dispo. QProperty Ck. ❑Acs ❑lniell. ❑R.D. ❑SHC Il-Z3-46C)70fl CCt7dK ❑Pr atol Captain ❑Compl.Olc. n Marine Patrol 85.Appr i gLSupv.(Print) 86.Sup¢No. 67.Date 88.Page of� FORM A (Rev.1/89) ❑Face Pape CONTF,�.OSTA COUNTY SHERIFF'S DEPARTMEci, .CA0070000 Beat..,_�_(_ .X❑Con6upW tion P.O. Box 391, Martinez,California 94553-0039 ❑HRa ❑Arrest 1.DR No. {t 2.City Cod 3.Crime/Classification T 4.Detail 1 �;Sp 5.More IRC - t 1 s {� .i. M1/K TTM 41�/4r 2. Persons 6.Day/Data/Time of Occurrence T.Date f Time Reported 8.Employee No. ❑ 9.Reclassi- 10.Address/Location of Occurrence fication 11. ❑PRI ❑VIC ❑WIT 0 MSP ❑RUN ❑SUS Q LEAD Cher 12.Name(L,F.M) 13.Ra e/Bec/Age 14.DOB 15.Driver Lice a No. v6(zSoN NVOS MS t6 ill-a-137-1N 16.Address (Zip Code) 17.Home Phone ! 1t{Tf& MVV ( ) ?%( - 3 t? 18.Employed By or School 19.Work Phone 'ZQS CifMM5 IKntOW4!t ( 1 --- 20.Mair 21.Eyes 22.HL f1 23.Wt 24.AKA/Maiden Name 25.Social Security No. aH 'AtK $ O 133 1 r''" Sb - 99_ 6/Sri 26.Further Description(Scars.Tattoos,Mannerisms.Clothing.Etc.) 27.Booking or Cite o. NIAM 28. ❑PRI ❑VIC ❑WIT ❑MSP ❑RUN ❑SUS ❑LEAD Other 29.Name{L.F.M) 30.Race J Sex 1 Age 31.0611 32.Driver License No. 33.Address (Zip Code) 34.Home Phone S ) 35.Employed By or School 36.Work Phone 37,Hair 38.Eyes 1 39.Ht 60.Wt 41.AKA/Maiden Name 42.Social Security No. 43.Further Description iScars.Tattoos.Mannerisms.Clothing,Etc.) 44.Booking or Cite No. 45. ❑PRI ❑VIC ❑WIT ❑MSP ❑RUN ❑SUS ❑LEAD ❑Other 46.Name(L.F,M) 47.Race f Sex f Age 48.DOB 69.Driver License No. 50.Address {Zip Code) 51.Home Phone ( 1 52.Employed By or School 53.Work Phone ( 1 54,Hair 65.Eyes S6.Ht 57.WL 58.AKA 1 Maiden Name 59.Social Security No. 60-Further Description(Scars.Tattoos,Mannerisms.Clothing,Etc.) 61.Booking or Cite No. SZ Veh/We SI Lic.No.(State) 64.Year 65.Make 66.Model 67.Body Style 63,Color Top ❑S ❑Vict Bottom 69.Status 70.Registered Owner 71.R.O.Address ❑Len []unpound 72.Towed to or Released to 73.Who has keys? Stored 74.Evid. p Yes 75.F/P ❑Yes 76.Dispo of Evidence 7T.S Missing 78.5 Damaged No No _ 79.866 Synopsis of mcident 111 (2) (3) (4) (5) (6) m 80.Distribution 61.Additional Routing ❑9 ❑C ODA ODE ❑L ❑0 ❑SR ❑V ❑mves6gation ❑Vice ❑Narcotics ❑3uv ❑Coroner 82.Reporting Deputy(Print) 83.Date/Time Win84.Dispo. ❑Property Ck ❑Acs ❑mets. ❑R.O. ❑SHC ,�rH� /-23-46 CM ❑Patrol Captain ❑Compl.Ofc. ❑Madne Patrol 85.Approving Supv.(Print) 86.Supe No. 87.Date 88.Page Other FORMA (Rev.1/89) 'OContinuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENIPA0070000 seat 6 O. Box 391, Martinez, California 945534r-+3 n HRO E3 Arrest 0 Supplemental � C]; 1.OR No. 2,City C e 3.CnmelCtasnhcatpn <.Oend 1 / 5.Reclau- acu1v s 1A6NT C(VvWTTA-k Nf 2 a d.Vicom mi, AM F,M) 7.Date Ong,Report B.Employee No. 9.Add r Putt Locatioa of Occurence 16.Susoecrs Name(L.F.M) 11.Property Dearnpbon: Impounded.Recovered,Found,Lost Stolen-Item Number,Ankle,Ouandry.Brand/Make7ManulacWie*s Mode(Number,Serial Number.Miscellaneous DescMt+on,Lp I,On wrwe Tsker1.Valve.Include Total Lou-UST IN FOLLOWING ORDER:A)Currency,Now 8)Jewelry{C)Clothing,Furs:D)Vehicles:E)(Mice Equipment.F)A'd'o.TVs,etc; G)Firoam t;M Household Goods.I)Misc. 12,Recolared Property S t7.Narradve 1 Statements pp AlAtf 1 JZ5 ?Iles Z It, O TAzosD ITocos. c6ims vqTtsgleuximm scf4cor- Foe 4 .r 14) 154=8 THAT IWQ SWt i6CPT 1Q- IL4Q S9B3-6YT 5) 0OWN A 4tO TkATHAD VAi TkaA99QCM la) m UPOm M`i V COW f-D pek c cN W#J - Atioletg ON (a) St4 iqZ - AN IF vq:0 WAq- if.It- OSH ex Nt4 1 -ST.C\(A I (9) 6744E'iZ -�=v N N FSfZF' RRSa 4�'tG ZW-t so .S (1p) STA IN 2 i{ ITN MH S CG AMO &IC 1 ZS (III S ANQ IAIF C,dr4S WOM WAS IN OI :msmS O M F1o02 021 (1a) 1 COKTACT6Z - A NLt4mam a KHQvq -- cm D FvxavS 0e CraTS T 6;- 0466 GIF 1141F MISHTA4( t•(ACCe -NM 051 sTg0&-qS 0S C m Sek CC. 51t4, TOtQ A A& 't H.61' Iola) is N 861aAH THAVIZWMS AONNO IKF 41836Nt 0T) ri tY T2YF a9) WtteN FV S D TeGTN' &4 ANPEeLON tem F GXAIWOAtt P TMtr -ITUw4 f'0 (21) R S A pjFMAc4S- S t3DISNT ZN A f646CC x7Z. &!Q ArW?- Tso it s7ezC6 TbtF DtrNCvqXw `t'ktrKao- CX1:a0u 'swis- Q3) xe) N ?SON !�WtSZGKtY XbWC-Q M 0120tiz To Pm e c* R5) P6MAC6 S'iv0tV4TS4467 6(2ABa(-O -V695-01+S . AWA Arco05- H`S�- te.Distribution 15.Adddtonat Routing [IS CIC []DA C]DE ❑L 00 []SR OV C]kwanpaeon Ovice QNarcotics c3Jur ❑e«oner ❑Property Ck. ❑ACS ❑Imetl. []FLO. C]SHC 16.Repopprting Oepnury�(Pnnq t7.Date I Time Minti,i 188..Dem. C]Pavol Caotem ❑Comptoic ❑Mame Pavol �ti7r �irC4. «� 07 GCF ❑dollar 19.APWo/v/lnp�Supv.lPrinp - 2p.Supv.No. 21.Darn 22.Pae �a �9t t FORM 8 (A" I leg) �Contlnwbon CONTRA COSTA COUNTY SHERIFF'S DEPARTMEI ZCA0070000 Beat_f L _ .4. Sox 391, Martinez.California 94553-C ,3 C Supplemental '•.- ❑HPO C A"est Co g 1.DR No. 2.City Cost 13 Crune/Ciasa,ficaiwn A.DOW st sit b- X65 33 CN 3CC COMAIZ7MF)It z S R;:tet d Victim mi, a(L F.M} 7,Date Ong.Report 6.Employee No. U 9 AOGeaal Location of Occurence 10.Suspxls Name(L.F.M) it Property Desi peon: Impounded.Recovmeo.Found.lost Stolen-Item Number,Mtcle.Ouantity,Brand/Make/Manufactuter's Model Number.Serial Number,Miscellaneous Description,L8ea4on Whwa Take.Value,Include Tout Loss•UST IN FOLLOWING ORDER:A)Currency.Notes;8)Jewelry.C)Clothing.Fun.D)Vehicles:E)Office Ecuipment.F)Radio.TVs,ac: G)Fkprms:H)Household Goods.b Mise 12.ilacormed Propar,y$ 13.Narrative/Statements Tu K p{ XJ X Sell IS J41 f5) OILtZsaN AMQ FIfF M f o FdCF Tl14S 2M': (61 FA t?tOTN R.o�lstn LcuF12SON h N T7Crl'KPl` m in C09CM KqM OWN. - PQ(Ceo 6R.COtY ls� (9I \IMO; (9) (tg) OTREIZ 9rApp Mf Ae gre ` o'MPz-rtab AmQ i2 NONO To til) Arzocmi AmWQH, Q;- PAMMGVZCM AS -MPa lr CACCey (12) DAMVVlr .D e (13) no oN /( $ ANT 'F Lom&vgam a P Wi(` (,7) MD Cs` Nz_ tel . Gt-tTACT(SD 11x1 ct t�1ZSaN req f 6 lU FO Ci 4 tYY (19) \( 'XS0H A.S A DAMrR *TQ A S A eiSUXT Or (201 PMRC TO Cert c v t H% (SH S 121) rtsv ss (22) 2 Cf)iMM:ZTfQ BQ6KS,4ty I MP6R V4 X S(S;O }ktt WAS PAYSEb (23) IN �is1*{C� (Z 5,1 N �y I V Tr C (24} .}+c656J S S(50 ry i25} 14.Dntrnludon 15.Additional Routing 08 CC CDA ODE CL CO CSR CV Cirtveatigadon CVice CNarcotics CJuv CC«ohm C PmPeny Ctc C ACS C small. CRO. C SHC r 16.Reporting Deputy(Pnnt) 17.Date/Tuna CPavot Caotam C]Compl-olc CManne Patrol sQ� qC-{„ If—Z3,47d o ❑ottw 19.Appy no Supe.(Pring 20.Suer.No. 21.Date 22.Page L .5701 FORM B (Rev 1/89) Condrluaeon CONTRA-COSTA COUNTY SHERiFF'S DEPARTMEOZ CA0070000 EbatcoJ .0. Box 391. Martinez,California 94553-Q, J ❑SVOPlementaf . . ❑HRO ❑A+*est OS .1. No. 2.Gy C e 3 Cnme/C4ss.hsatron A.Dena t. / p 3.Reclasy,. fk$SAM133i IMEWAV-1 VC CO&WnWHE 2 fico" 6 Victim IN, a It. F.Mj 7,Data Ong.Report 8,Employee No. 9.Addrees/ Location of Occurence 10.SuaPocts Nama(L.F.M) 11 Propottr oasa,ption: ImpoundW,Recwwed.Found,Lost.Stolen-Item Number,AA cIe,QVanItty,grana/Make/Manutacturef 3 Modet Numb6(,Serial Numtmt.Miscellaneous Description,Location where Taean.Vali,,,.include Towl Loan-UST IN FOLLOVANG ORDER:A)Cunency,Notal:e)Jewelry;C)Clothing.Furs:01 Vanities:Q OKce Equipment.F)Radio.TVs wr. GI Finwimit:N Household Goods.11 Misc 12,Racovwed Property S 13.Narrat"/Smtementa (1j Z S aK.. TO THIF R if a TR Ot (2) Ft�S —KF 6 fz SQ&WVaiRhES GIP Tit' rL 51i!4 N S t3! iaF f''-Z f el WieQAtf Vn/1 X N�-IK1SS COM e/ K zsrtu F ' tC C Q Qm s-g rl S (6jNjoMgGH ' evil-msS . <-O 'VH,4rT E'2SdH 5PAdatO m M oM99MA At-6Tt Q TO S ftlk NOW50 SU S ej HV-A BRA0134M POP(J SkWFPZ f91 of3=Atl ACS-0 \MIAIC hG TO s�-- OF2S4N (11) QI war/leG0%t / r/'iT3U to X1`13400 Hep dt*Lce, (12 Rt'e" PV �4 N. (13) nal 2DRN A&CO-1 AN06RSON .. H i4eQ A1 tNARt>TS nal TO Cot-og( 1t 2Sd &f<,, WiSMT TO TRE 06640t ANO e0qW7ft ne) C.V 4 �casF #d•L14t 4F i-!E p S7�f2f3 C n6, F - AS 65-5-5� l Ci-IgSSad w AT K a9j qlkACC or, fs O-ASMI ell fagmelo 5090^ri-s Amy At 5s.Z4N op NTS <S of -114T NCW. (21) (2Z) J'7 A N ea A-r (a5i, CeWkS (23) c WS5 C(LASSOXW1 (15' tea) (} (.l.0 ieuoAMID u H S 0F test Co"rOr Lr MAgipffACC V-(FHT 'P7" e"(SH Atj7i?R JW- O O A 04 14,Davibutlon 1a.Additional Routing OB OC ODA ODE OL 00 OSR OV Olrweatigation oViee ONuddtlCS OJUV ODagnw O Property Ck. O ACS O Intall, O FLO. O SHC 16.Reporting Deputy(Pnnt) 17.D(atte/Time Kyld 18.Oapo. O Paud Capon O C,ompi.Ott O Manna Pavoi i ' O `�iQ OOUcmip- +w 19.ApprO,Hyn�g/Supe.(Pring 20.Supv.No. .Dam 22.Page 4 FOAMS (Rev.1/89) Continuation CONTRA-COSTA COUNTY SHER}FF'S DEPARTMEtjZCA0070000 Beat -_ O. Box 391, Martinez.Caiiiornia 94553-G, ,9 ❑suoa(emen(a( p tiRO ❑Anest (is + D+t+�i t.OR No. 2.City C e m 3.CnuCtannlicaoon 1. S($Z1 3.flecuss�- _31 S 3 �T C T �n 2. 6cs,en 6 Victim Na a(L F.M) 7.Data Ong.Report 8.Employee No. cl 9.AddyNs/ Locata.on o Occurence 10.Suspacrs Name(L.F.M) 11 P(Opwly Description: Impounded,Recovered,Found,Lost Stolen-Rem Numoes,AnKie.Quantity,&and/MakelMtsmIlwtuer's Model Number,Sahel Number,Miacetlanepus Desaiption,Lotstnm WfMn Taken Value,Include Total Lou-UST IN FOLLOWING ORDER.A)Currency,Notes;0)Jawelry,C)Clothing.Fun:0)Vanities:E)Office Equipment,F)Radio.TVs.nc.: G)Firearms:H)Household Goods:l)Misc 12.R"Wed Properly$ 13.NanAt"/Statements ) N >1 2oaxr . µE' 200M s t4qxt -TQ tee n i s 0 Cc a arZ nN 13) CAS,; Ir+OFOM Ksa.pfi TPf atPom ARS-MCC COJGD lar .• Sht N t2Ci0M ISi 61 /uA CC_ Cavtio CRC esar+ " PENN o °( CTANS t- PoorC m CiF V(ztesa GFF-t-C6 IY . f-N ANDNRSEM ^NQ rol C-\14srscm f=ccc 'TO k 6 RC3J Acc6*S vc r9) K PRR k'SNAC !� SeS. CV✓1 n0) (III tc5,4�hCC EtdT t26�tr{ �-XTCJ rC f1 0 T� NS (12) C C �` �21BR 4 PJCC +7 ,Y M OFF (1a) ALWtiRSIGH AND EA- -T Q0 k-TM. Z H QUC F SS RYlERS+o ria) S 1111rC1C MA2S4le"KC :�N 'T lk!4 ` C DQ - ZTN HSS - 84 n51 "AOWA4 04MCA-MW A6PTCAC T ?- C) (16) (rn t 61-� ISI ASQrt ZM C&MV4T vc+tzS4N. fi (1e) W 40A S No 5-tijaco0w fif-rww {19) ISVMON IQ CA lS' \J9 (- V SAN-. t20) 'L F (21) az) Vt T --i S4=M CtrlAf5bQbO n3) C. o :Pf (xa) Lk 0 SS1S1-6CYA. K as) (ZfiStYt!}I DsvegsotgS AMD e-M& *t1NTTC ZVN> M.Dnwbution 15,Addldonal Routing [i8 0 ❑DA 0D ❑L ❑O 0S ❑V ❑Inve tigason ❑Vice {Narcotics ❑Jur ❑Coroner ❑Praperty Ck ❑ACS ❑1melL ❑R.O. ❑SHC 16.ReP.M119 Deputy(PI nq 17. )D)au I Timk Y tmw 18.Dam, ❑PevisCaptain ❑Compl.Olc. ❑Manna Pavot -9k ♦f"4-S-i 090 ^t fir 1 JC ❑OOW 19.Approving Sup,(Prif 20.SUP,No, 21,Dam 22T L fy 4 FORM 8 (Rev.1/89) Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat to i { 1.0. Box 391, Martinez.California 94553- t3 C]Supplemental � ❑HRO ❑Ar*esi C]� t.OR No. Cren</Classification t 4ead tRecuar- 4 S 33 !Yt T C TGC t zTcrrr 2. 6daaon 6.victim N, a(L F.M) T.Date Ong.Report a. Employee No. O 9.Addrwe/ Location ot Occurence 1g.Suspects Name(L.F,M) 11 Propeny Desuipoon: dnpownced,Recovered.Found-Last Stolen-dem Numbef.Article.Quantity.Brand/Make/Manvtacturees Model Number.Serial Number-Mi4caltanaous Desuigaon,Location Where Taken.Value.Include Tout Lou-LIST IN FOLLOWING ORDER:Al Currency.Notm B)Jewel(y;C)Clothing.Furs:0)Vehicles;E)Office Equipment F)Rata,TVs.etc, G)Firearms:Ht Household Goods:p Misc. 12.Recd,ared Property S 13.Nartae,e/$ulem his litS C - SICV z Tk vS OraaXto " (z, 040tliz C AAA S H TO 'tB IF 431 OeE4KC i t00 "j MOIZIS- l J�S 0L COMT Gil LC l N r (4) 13 s^ V� cc Tr 6' (6) ~% KA:Z (6/ m AMM(-T? 0 7FM S (6) ncp T CQJQN AMQ r-aer-a w44 it"AAK&WA4 (9, sxc SSZS I`tif4 ct �S xht>•I�' -v a gt N o j4xm u wr4ZT'(�o a2 srcv rztd mo nn (13) Njuiil C,4H06ZSptj) - t'+06rCS-dH ^PQ(-Q 114 CCO tC- (141 Ctl4`�CCU hf O 7RJ�Y (16) Ctl�Tl fS 13E *t�MS ,r9 RA I Ct (17) G i:Cz S o i IH TS AebQNQ not llkc7 CCAS.WOMISM Nklmn2w& OCCASZONS, QvC, 0 t4:ES (19) Ca A NO tr H`t Ct1 6v"1$ MQ N QWNOT �t1NlT(�G (20) (21) t221 SegH 6cc.o Taco 1-wkr S. eeo ouleztultr (23) F C R OM C S. o (24) G TIQH Pro M Se G,4T C QlmK t2s) VA /,A6P:[CAe -I rT7V rrLGH e 14.Qsetby " 15.Additional Routing ❑B ❑C ODA ODE ❑L ❑o ❑SR ❑V ❑Mvestigaeon QViq ❑Nucotics ❑Juv ❑Coroner ❑Property Ck- ❑ACS ❑Intell. ❑R.O. ❑SHC 16.Reporting Deputy(Pont) 1).Data/Trow Nri (ryy 16fr.'D♦npo, ❑Patrol Capam ❑Compl.Ofc. ❑Manna Patrol c.as ��Z Q l 4 ❑Other 19.Aper n Sup,.(Pring 20.sup,No. 21.Data 22.Pa e FORMS (Re,. 1/69) I lontinud9on CONTRA.COSTA COUNTY SHERWPS DEPARTMENX,CA0070000 seat `P 1A. Box 391, Martinez, California 94553-1� Supplemental O HRO ❑Arrest t.OR No, 2.City C e 3.Cnme/Ctasai(itahOn 4.Detail 1. S 3.RBUassry C16- IYBS 0m, 3 cCU"ww -rMe'%t 2 6taaon 6 Victim Ni- a(L F,M) 7.Date Ong.Report 8.Employee No. 9 Address/ Location ot Occurence 10.S,apect's Name(L.F.M) I P(opany Oasu,pnon: Impounded.Racovared-Found.Lost Stolen-kam Number.MiCle.Ouantity.&anotMakttMamutatiurer s Model Number.Sana!Number.Misceaanepus Oaetripegn.Location What*Taken.Value.include Total Loss-LIST IN FOLLOWING ORDER A)CurrenCy,Notes;B)Jewelry,C)Clothing.Fun.D)Vehicles;E)Office Equipment.F)Radio.Ns.an, GI Firaamu:H}Household Goods.It Misc. 12.Recp wsd Property 1 13,Narrati..vye�/Statements ` { ACMPir5 JG CT (2) Q 4t () CdczVHSVeaz-s FvC (3, (#0 YRS, C-\t dnS aTiLto K(` ScKaac 14) Ta1469 AHQ ADY-14HC7 -tHC;LD a (5) qcc Nrt eATTcr/,^PTS T fe eiarc14 RM Ail v5(3r4 Hra 16, r a 70 c0 T oN µn m w r o (6) (91 94 1AS k' S ore 'TO C-v amS perrwre ^mn (10) -W 4 ErAC-MG N S TAliiC N. n1) (121 S51. CFt�¢TKo D (131 Ota) (151 {t6) {tT) t=aa 1:sn {tor tzt> (22) (23) 124) (25) 14.pw,Wtion 15.Additional Routing OB OC ODA ODE OL 00 DSR OV ❑It idi akon Ovvte ONarcotitn Ojuv UC000ner O Propany Ck. O ACS O ImNI. ORO. O SHC 16.Raoorkng DePuy(Pnnt) 17.Data/Time Wrlgan 16,Oaoo. OPiootCAPtain Ocompl-otc, OMannaPstot 5 f ? 093 1 ((&AVC D Omar 19.AciVovin� 1.nQ 20.Sup..No. 21.Dara 122.Pyg d -'Y-of_1 FORME (Rev.1/891 APPLICATION FOR 72-HOUR DETF TION " DETAINMENT ADVISEMENT FOR EVALUATION AND TREATME. I - �.;' �I `4 �� n My ame is Confidential ClientlPatient Information ! am a (Peace Officer, eta) with (Name Of Agency). Sea California W 8 you I Coda Section 5328 You are not under criminal arrest, but 1 em laking you MN 302 (7190) for examination by mental health professionals at (Name of Facility). W & f Code, Section 5157, requires that each person when first You will be told your rights by the mental health staff, detained for psychiatric evaluation be giver, certain specific information It taken into custody at his or her residence, the pe, orally, and a record be kept of the advisement by the evaluating facility. son shall also be told the following information in substantially the following form: E3 Advisement Complete Advisement Incomplete You may bring a few personal items with you which I wilt have to approve. You can make a phone Call Good Cause for incomplete t)dvisament and/or leave a note to tell your friends endlor family where you have been taken. Advisement Completed Syl Position Date To Application is hereby made for the admission of— residing f I`4'` � �`` ` _i.. '` ` :•t `f t(.. , ' tom residing a ` � `• , California, for 72-hour treatment and evaluation pursuant to Section 5150, (adult) at seq. or Section 5585 at seq. (minor), of the Welfare and institutions Code. If a minor, to the best of my knowledge, the legally responsible party appears to be/is: (Circle one) Parent; Legal Guardian; Juvenile Court as a WIC 300; Juvenile Court as a WIC 601/602; Conservator. If known, provide names, address and telephone number: The above person's condition was called to my attention under the following circumstances: (See reverse side for definitions) '�.': < , i C, .d �'Y it C. % F �, <..C.' i�L i2 T i^ y \i l: ': . _..:>�:`al 1• I n.0(^` �-! tl�l_ "f �• i`.i ii\;;�L a ,_ t�<'i:1 fC"' tjrlr.f/'.J The following information has been established: (Please give sufficiently detailed information to support the belief that the person for whom evaluation and treatment is sought is in fact a danger to others, a danger to himselftherself and/or gravely disabled.) L.: '1i � •{ '( ij[cN (fir "'C j<7: r 't .1 t� >(. -Tl r,. r.. Ai-- /-A +C r iii l�C'-t 11. it-If-t(' r-( r tel, '�. ,_, 14 rzk:t ` x-::.;•t , ;�;- E t� _ is f\ �� K':-:� ��_.�r�.,,�- +rF ,} f ' 't1z'� t.x, � {iC°-zF 3� f C. ? �/'ic�� f..t l;C�l;� •.x;Ct ;; i�- Ij Vit' F it l C �{ 1.fC_ C ' it1" (� (jtiJ{ �' C)G�V/!C trot.•}ti` , i.. Based upon the above information it appears that there is probable cause to believe that said person is, as a result of mental disorder: 0 A danger to himself/herself. A danger to others. C3 Gravely disabled adult. F-1 Gravely disabled minor. Signature Idle add hadgJ.J'cumber of pea f oiffcer.member of attending staff of evaluation facility Date J J f'f,-r _ Phone r or parson designated/W,/ oumy. i r a Time J (1 Name of Law Enforce am Agency or Evaluation FaCifitylPerson Address of Law Enforcement Agency of Evafuafon Filonlywerson Q Weapon was confiscated and detained person notified of procedure for return of weapon pursuant to W Is I Code Section 8102. (officertunit d phone 4) NOTIFICATIONS TO BE PROVIDED TO LAW ENFORCEMENT AGENCY NOTIFICATION OF PERSON'S RELEASE FROM AN EVALUATION AND TREATMENT FACILITY IS REOUESTED BY THE REFERRING PEACE OFFICER BECAUSE: O Person has been referred under circumstances in which criminal charges might be filed pursuant to W d I Code Sections 5152.1 and 5152.2. Notify(offieerlunit a phone #) a Weapon was confiscated pursuant to W 8 I Code Section 8102. Notify(officer tunic 8 phone A) MR SEE REVERSE SIDE FOR INSTRUCTIONS REFERRING AGENCY CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY'! CALIPOR IA"February 1997 CCUNTv COUNSEL Claim Against the County, or District governed by) MARTINEZ GAUP. BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document maile4Lto you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph 1V below), given pursuant to Government Code Amount: $293.87 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Minda P. Guting ATTORNEY: Date received ADDRESS: 2264 Oak Hills Dr. BY DELIVERY TO CLERK ON January 21, 1997 Pittsburg, CA 94565 BY MAIL POSTMARKED: January 17, 1997 1. FROM: Clerk of the Board of Supervisors TO: County Counsel / Attached is a copy of the above-noted claim. January 23' BY1997 Pe BATCiiELDR, Clerk�p DATED: : Deputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and ve 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: l�Z7 �� BY: eputy County Counsel Ill. 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 (X) 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: FEB 11 IN? PHIL BATCHELOR, Clerk, By�ii L LA�jL� `� , 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 MAILING 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: FEB 13 10407 BY: PHIL BATCHELOR byi � Deputy Clerk CC: County Counsel County Administrator FOSTER PAU :9GE APPENDIX B 4EPLACES ACTION: 54-105 J� 2 1 �qqT SECTION: 4-1 5 I PAGE NO. i PAGE NO. 1 ISSUED/REVISED: - - S EFFECTIVE DATE: 09-MM C ERKCONTR00DA COSTA CO CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented w o not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be n presented not later than one year after the accrual of the cause D of action. (Sec. 911.2, Govt. Code) z n m m In B. Claims must be filed with the Clerk of the Board of Supervisors 0,o at its office in Room 106, County Administration Building, 651 Pine n Street, Martinez, CA 94553 (or mail to P.O. Box 911, Martinez, .CA) . rt o Ga C. If claim is against a district governed by the Board of Supervisors, d rather than the County, the name of the District should be filled in. (D (31 D. If the claim is against more than one public entity, separate claims w must be filed against each public entity. hi o E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end N of--tRis form. 2@IIS4@t0ltS!l45SSAtSf ttllAlft4fff/�ffftl/ff�ltffff�t/elft/efftfff�fffRkR*• C rt RE: Clam by )Reserved for Clerk's filing stamps �We MINDA P . GUTING o r• � Against the COUNTY OF CONTRA COSTA) (D ro d w orsocIAL SERVICE DEPT . DISTRICT) m v (Filln name ) w n w The undersigned claimant hereby makes claim against the County of Contra N Costa or the above-named District in the sum of $�o� �7 and in support of this claim represents as follows! rt o I. M*Fen dId the damage or-Injury occui? ZGive exact date and hour] N The damage occured on October 28 , 1996 . p a f'tfieie did-tFe-damage or Injury occur? ZIncIude clay and countyj- - ��` The damage haooened at 2264 Oakhills Drive , Pitt$ • Ca . 94565 . ------ How did the damage oz Injury occur? ZGiv'e�ulI-detalI's, use extra sheets if required) The car keys were stolen inside my purse , which I have placed it at the maindoor floor of my house . While I went back to pick up some foodstuffs in which I 've left them behinds few metters away from II-�9_pr These incidents can be substantiated by a- oice reports i: at particular act oz Dials"slop on the part ot-county or dis"tricel -- officers, servants or employees caused the injury or damage? The culprit is a Foster child under the sup . of the Soca S -We Dept Contra Costa County (DMCL f86-71) Issued/Revised: i12-�T - Social Service Dept. Manual Distribution: A-1 ,B-15, FOSTER PARENTS LIABILITY COVERAGE APPENDIX B REPLACES SECTION: 54-105 SECTION: 54-105 PAGE N0. 2 1 PAGE NO. 2 D R D: 11-0 F _ BOARD OR SUPERVISORS OF CONTRA COSTA COUNTY in-tructions to Claimant (cont'd) 5. What are the tastes of county or district officers, secvantaror sWoyees causing the damage or injury? Social service dept . - -- ------- - -- ---- - --- - -- - a:--liThat damage or�njur es do you claim iesuIted7r7Give of injuries injuries or damages claimed. Attach two estimates for auto damage) COMPLETE CHANGE OF THE DOORKEYS OF THE CAR BOTH THE LUCK AND THE IGNITION KEY , RECIEPT IS HEREBY ATTACHED AS PART OF THEI ----HE------------------ - ---------- -"- ------r----r- 7. How was the amount cIaimea-"above computed? 72nclude the estimataed--- amount of any prospective injury or damage.) CLAIM . It is computed based on the spart parts and the labor . ----- -- ------- - --------- -------_ ----------------- + Ti.- Names ani add=eases of witnesses, doctors and hospitals. not applicable T T r r r T List tFie expenditures you made on account of this accident or injury: DATE ClITEM a tg } AMOUNT -ftt!}!!f}!}ttftttttttf t}tf ttf tt tff*fff tf tf alt�ff It}t}}t}}!}}ttffliffitf*+k Govt. Code Sec. 910.2 provides: •The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of AttorneyCf Cla nts i ature 6 ^i4„el Telephone No. Telephone No. ffflfff!lffffffffflfffftt}ff•tttffflf tf ffffffft!!f!f}fffffffffffff}ffff lf! 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, #&ccount, voucher, or writing, is guilty of a felony." Contra Costa County (DMCL 186-77) Issued/Revised: 12-02-86 Social Service Dept. Manual Distribution: A-1,B-15, TOYOTA VJQ11111,11 COMCWRD T0YiQ#T4q 1090 CONCORD AVE. CONCORD, CA 94520 (510) 682-7131 DATE CDT�;RFD YOUR ORDER NO DATE SHi--FnOISE is rJE'C RL Ila Tc= DATE E S ACCOUNT NO2 1S rACE I OF I o H L 1) CASH RETATL T T 0 O. SUP VA SIESM SIL NO, TERMS F.O.E.POINT 1 22 CASH CONCIORD, (,A QUANTDY ORD SPOP B.0. PART NUMBER DESCRIPTION LIST NET 6 9 0(1:'a 16610 ir;"'LINTJIFR 1;., 115 83 11"1 2 11 is in T i� W V P 4: i4 P **AT TENT ION ! ATTrNT TON 1 3PEN MONDAY—THURSDAY 800AM (i '00 111 PARTS )PEN FRIDAY 8' 00AM 6 :30 PH SUBLET )PEN SATURDAY F"00 AM — 1 *. 3() Pis FREIGHT C. )HOLFSALELIFlE S'> 7�jSALES TAX GUSTO S. 7 X 911111?A - 4 1 1,n , r"11 JOTtGE: All prices are subject to change without notice. 20% handling charge on all returned merchandise. Parts not returnable after 0 days. No refunds on Carburetor parts or smog parts. No refunds on electrical parts. No refunds on special order parts. All claims or aturned goods must be accompanied by this bill, (g Printed on recycled paper to protect the environment. ?4 � :0 c � ?a cn 7� y � ti > 7Z s Igg?��,nu v �w e . a?a AMENDED CLAIM ! JAN 2 31997 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTy�,Cp1.�,OJ� ELFebruary 11, 1997 MARTINEZ CALIF. Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document maile4 to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Trudie Rogers ATTORNEY: Date received ADDRESS: P.O. Box 4001 BY DELIVERY TO CLERK ON .January 23. 1997 Antioch, CA 94509 BY MAIL POSTMARKED: via: Fax I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: January 23, 2997 PIL RAepuTTCVELOR, Clem„� y. II. FROM: County Counsel TO: Clerk of the Bard of Supervisors This claim complies substantially with Sections 910 and 910.2. 4Lfft f Y11.:`G m ( ) This claim FAILS to comply substantially with Sections 91C and 910.2, and we are so notifying &4�fG . claimant. The Bard 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). jp�i..Lt�'�cc,�,e�( . Dated: k 7 h 7 BY:�7l frx ,tl Deputy County Counsei 111. 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 (X) 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,FEBDated: B 11 1997 PHIL BATCHELOR, Clerk, Byiu r c Vii{ u 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 MAILING 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 Bard Order and Notice to Claimant, addressed to the claimant as shown above. Dated: FEB 13 1997 BY: PHIL BATCHELOR by,`r/ Deputy clerk CC: County Counsel County Administrator : - - miss trudie rogers P(7 Box 4001 • Antkvch CA 94504 RECEIVED JAN 2 31997 January 19. 1997 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. AMENDED Cl.AAf AGAINST THF. ('0UA'TY 01 CONTIL1 COSTA Per Govt. Cantle §§ 900. 9105; 906; 910 910.2 ; -.6 ; 911.2 ; 91.5. (a) (1) - (C) ti XGL101 Chief k, „r t ..n£ t3SM(;OmItV �'11le street Room Vo. 106 '.1 i;lm ;a CA 94553 r) tA(t-2371/75 �,'.ir-335-1913 (fax) Dar(h. erk Nlaglio; This amended£:calm cute the Claim is partof the Claim dated September 01, 19W This AmArided Claim consists of two (2)pages. The entire Claim consists of five (5)pages. I have continued to suffer greviously since the dates of my original claim and continue to do so. I am homeless and include the dates of my loss as"and on-going' t,)extend to the time in the future when and until I am no longer homeless. I have been, and continue to be horribly wronged. I have experienced a living nightmare at the hands of the Concord Homeless,Shelter and its staff, as well as others who seem to be involved in mmming this 'program' or setting Its poi i:y. During my 50-day residency, I accomplished absolutely nothing, as I had been promised, toward my obtaining my own permanent housing. Instead. I've become a nervous wreck,can't sleep,suffer nightmares, am sick from coughing and congestion and illness from the rain and cold. I am not used to being,nor have I ever been, a habitually sick pemon.Yet nothing I experienced on the streets, no trauma, matches the sadistic cruelty which 1, Now Go, �?flL1` ritc it bcfalc them in a table, enA note it in¢Book tiiM it nw, h-. or'he time ii:coma VIBLE Forovcrmidc%n - L1NG9 523H CLA1,14 January 19, 1447 Page two of two and others (apparently routinely),experienced at the 'shelter,' As 1 have emerged from isolation and depressive withdrawal recently, I've met three persons within three days who were also residents{`clients,' as we were always called;) of the shelter during my stay. Two `graduated,' one quit in disgust, frustration and fear. All,are homeless! Needless to say, seeing them .•• speaking with them, prompts me.to pursue this unfinished matter. I cannot help but note that all of us are persons of color; three of African heritage. I have a stack of taxes and letters I've written,meetings attended-at1 to no avail, After i filed a claim against the" unty,denied by the Board in October'96,the maliciousnss toward me by the staff grew even worse, Other t:,Ily ,neidents occurred; what must be the worst follows, While at the 'shelter,'I have most recently suffered what I know to be a retaliatory and a constructive eviction i; .:re cold and windy, and dark evening of Monday September 30, 1996. After I had come in from work,I was it t',-mpg t',,at I had been "disqualified from the program." I was given no paper or written notice, so I refused to sheriffs came out and removed me from the premisis. After my much insistence, and my wondering alou4 e responsible if I were to be knocked in the head on this dark stretch of road,one of the deputes drov, mt R7Station, ase people obviously believe that they are above the law, Standard Landlord - Tenant principles W not seem to apply because they give the fraudulent illusion that they want to seem not to be"offering their property for hire ." They did however require us to work in order to remain on the premisis. I had just cleaned 6.o wvmcrr's restroom, toilets,sinks,showers,mopped the floor-on my last day there,as I had been required to do on previous occasions, I don't mind work; my mother was a maid ••. but my time and my labor also have value! This was, in essence, like being charged 'rant.' The place is run like a cross between an animal shelter and a prison,only animals have advocates,whereas homelessness in America is apparently considered a crime. I do not drink or smoke. I work every day. 1 am homeless because I do not have $1600 cash deposits to move into my own apartment. I am not an animal. I am not a criminal, as I was treated at the 'shelter.' I am not drunk or drugged,not lazy or crazy. I am homeless. Please note that the Sheriff's Department has been added to my Complaint, as Weil as other agencies and individuals whose actions have caused me personal injury. The Complaint shall be filed upon the Board's denial of my Amended Clalm,per Govetrmnent Code Serzion 910.6. 1 have been advised to file in the Federal District Court. 1 declare under penalty of perjury that the foregoing is true and correct to the best of my know!edge and belief under the laws of the state of California. J Rated January 19, 1997 and signed at Antioch California by trudle ragers fs Taxer! : Wednesday January 22, 1997 �l %J ' C, 23 TO: BOARD OF SUPERVISORS Contra FROM: Phil Batchelor, County Administrator Costa County DATE: „S?t �'♦ February 11, 1997 SUBJECT: Final Settlement of Workers ' Compensation Claim - Constance Farnsworth vs. Contra Costa County WEAR Na_ WCK 0031308 SPECIFIC REOUEST(S)OR RECOMMENOATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Receive this report concerning subject final settlement and payment in the total amount of $30,000 from the Workers ' Compensation Trust Fund. REASONS FOR RECOMMENDATIONJBACKGROUND: Richard M. Jacobsmeyer, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the workers ' compensation claim of Constance Farnsworth vs . Contra Costa County. This Board's November 5, 1996 closed session vote was: Supervisors DeSaulnier, Rogers, Bishop and Torlakson, yes; Supervisor Smith, absent. This action is being taken so that terms of this final settlement and the earlier November 5, 1996 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: .YES SIGNATURE: r _RECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENOATtON OF BOA MMITTEE —APPROVE .OTHER StONATURE S: ACTION OF BOARD ON APPROVED AS RECOMMENDED _,._.._ OTHER _.._ VOTE qF SUPERVISORS ,/! 1 HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT } AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED`a... /' "Q" � f/, / �97 Contact: Tony Schleder - 335-1411 PHIL BATCHELOR,CLERK OF THE BOARD OF CC: CAO Risk Management SUPERVISORS AND COUNTY ADMINISTRATOR Auditor-Controller Laughlin, Falba, Levy & �0- Moresi (via Risk Management) BY E DEPUTY