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RECEIVED FOR SCANNING
VENTURA SUPERIOR COURT
18 202
PLD-PI-001
ATTORNEY OR PARTY WITHOUT ATTORNEY a
[David A. Richard, SBN 128348 / Nichole L. Bartlet, SBN 307221 FOR COURT USE OMY
RICHARD BARTLETT LAWYERS
1591 Spinnaker Drive, Suite 205
Ventura, CA 93001
TELEPHONENO: (805) 644-0808 FAX NO. (Optonen: (805) 644-0848
E-maiL ADDRESS (opera). nbartlett@richardinjurylaw.com
attorney ror ware) Plaintiff{s), ANN REBENTISCH
‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA.
street aooress 800 South Victoria Avenue
‘MAILING ADDRESS
aryanozpcooe Ventura, CA 93009
erancrname Hal! of Justice
PLAINTIFF: ANN REBENTISCH
OeFeNDANT: BEAUCHAMP FAMILY LLC, etal.
and
(4 ooes11o 30.
COMPLAINT—Personal Injury, Property Damage, Wrongful Death
(7) AMENDED (Number):
Type (check all that apply):
(3 MOTOR VEHICLE OTHER (specify): Premesis Liability
Property Damage [__] Wrongful Death
Personal Injury [) Other Damages (specify):
Jurisdiction (check all that apply): (CASE NUMBER:
(5) ACTION IS A LIMITED CIVIL CASE
Amount demanded [_} does not exceed $10,000
[—) exceeds $10,000, but does not exceed $26,000
(1) ACTION Is AN UNLIMITED CIVIL CASE (exceeds $26,000)
[__] ACTION IS RECLASSIFIED by this amended complaint
CJ from iimited to unlimited
[1 from untimited to limited
1. Plaintiff (name or names): ANN REBENTISCH
alleges causes of action against defendant (name or names):
BEAUCHAMP FAMILY, LLC; BEAUCHAMP FAMILY 2, LLC; and DOES | TO 30.
2. This pleading, including attachments and exhibits, consists of the following number of pages: 4
3. Each plaintiff named above is a competent adult
a. (7) except plaintiff (name):
(1) [2] a corporation qualified to do business in Califomia
(2) (] an unincorporated entity (describe):
(3) [-) a public entity (describe):
(4) [2] aminor (7) an adult
(a) [) for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
(b) [) other (specify):
(5) (2) other (specify):
b. (_) except plaintiff (name):
(1) (_) a corporation qualified to do business in California
(2) [_] an unincorporated entity (describe):
(3) [_] 2 public entity (describe):
(4) (J aminor (——) an adult
(a) (_} for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
(o) (J other (specity):
(5) (J other (specify):
TJ information about additional plaintiffs who are not competent adults is shown in Attachment 3. Page tot 3
Form Approved fo Optra! ve COMPLAINT—Personal Injury, Property Cae rete cae
PLO-P1001 (Rev. January 1, 2007] Damage, Wrongful Death
ayPLD-PI-001
SHORT TITLE: (CASE NUMBER:
REBENRISCH v. BEAUCHAMP FAMILY, LLC et al.
4. (7) Plaintiff (name):
is doing business under the fictitious name (specify):
and has complied with the fictitious business name laws.
5. Each defendant named above is a natural person
a except defendant (name): Beachamp Family c. [J except defendant (name):
(1) [2 a business organization, form unknown (1) (2) a business organization, form unknown
(2) (2) a corporation (2) (2) a corporation
(3) [£2] an unincorporated entity (describe): (3) [[-] an unincorporated entity (describe):
(4) () a public entity (describe): (4) 2) a public entity (describe):
(5) [2 other (specify): (5) (2) other (specify):
LLC
b. (7) except defendant (name): Beauchamp Family 2. (7) except defendant (name):
(1) (2) a business organization, form unknown (1) (2) a business organization, form unknown
(2) (<_] a corporation (2) [_) a corporation
(3) ([) an unincorporated entity (describe): (3) ([] an unincorporated entity (describe).
(4) (J a pubic entity (describe): (4) (J a public entity (describe):
6) other (specify): (5) [) other (specify):
LLC
[) Information about additional defendants who are not natural persons is contained in Attachment 5.
6. The true names of defendants sued as Does are unknown to plaintiff.
a Doe defendants (specify Doe numbers): to 5 were the agents or employees of other
named defendants and acted within the scope of that agency or employment.
b. Doe defendants (specify Doe numbers): 6 to 10 are persons whose capacities are unknown to
plaintiff.
7. [2] Defendants who are joined under Code of C.vil Procedure section 382 are (names):
8. This court is the proper court because
a. [] at least one defendant now resides in its jurisdictional area.
b. [_] the principal place of business of a defendant corporation or unincorporated association is in its jurisdictional area.
c. injury to person or damage to personal property occurred in its jurisdictional erea.
d. (_] other (specify):
9. [[) Plaintiff is required to comply with a claims statute, and
a. [_] has complied with applicable claims statutes, or
b. [_] is excused from complying because (specify):
PLO-PH-001 (Rev January 1. 2007) COMPLAINT—Personat Injury, Property Page 203
Damage, Wrongful DeathPLD-PI-001
SHORT TITLE: ‘CASE NUMBER
REBENRISCH v. BEAUCHAMP FAMILY, LLC et al.
10. The following causes of action are attached and the statements above apply to each (each complaint must have one or more
causes of action attached):
a. (_] Motor Veb'cle
b. [J General Negligence
. (2) intentional Tort
. ] Products Liability
2) Premises Liability
‘ (2) Other (specify:
-~eao
11. Plaintiff has suffered ‘
a. (7) wage loss
b, (] loss of use of property
c. [7] hospital and medical expenses
d. (7) general damage
e. (-_] property damage
f. (7) loss of earning capacity
9. [-) other damage (specify):
12. [[-) The damages claimed for wrongful death and the relationships of plaintiff to the deceased are
a. (_] listed in Attachment 12.
b. () as follows:
13. The relief sought in this complaint is within the jurisdiction of this court.
14. Plaintiff prays for judgment for costs of suit; for such relief as is fair, just, and equitable; and for
a. (1) (J compensatory damages
(2) (_] punitive damages
The amount of damages 's (in cases for personal injury or wrongful death, you must check (1)):
according to proof
(2) [J in the amount of: $
15. [[_] The paragraphs of this complaint alleged on information and belief are as follows (specify paragraph numbers):
a
Date: October 10, 2022 ( (x Y
David A. Richard, Esq. CD
(TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY)
PLO-PI-O01 [Rev January 1 2007] COMPLAINT—Personal Injury, Property Page ots
Damage, Wrongful DeathPLD-PI-001(4)
SHORT TITLE: CASE NUMBER
REBENRISCH v. BEAUCHAMP FAMILY, LLC et al.
FIRST CAUSE OF ACTION—Premises Liability Page 4
(number)
ATTACHMENT TO [¥] Complaint [_] Cross - Complaint
(Use 8 separate cause of action form for each cause of action.)
Prem.L-1, Plaintiff (name): ANN REBENTISCH
alleges the acts of defendants were the legal (proximate) cause of damages to plaintiff.
‘On (date): 10/30/2020 plaintiff was injured on the following premises in the following
fashion (description of premises and circumstances of injury):
At approx. 7:10pm Plaintiff was walking her dog to her car in the parking lot behind Pet Food
Express and Home Goods located at Conejo Valley Plaza, 1330 North Moorpark Road in
Thousand Oaks, CA. She stepped on a cover to a water shut off valve which broke and gave
way under her 142 Ib weight, and her left foot sunk into the 18" hole. She sustained injuries in
the resulting fall.
Prem.t-2, [Z) Count One—Negligence The defendants who negligently owned, maintained, managed and
operated the described premises were (names):
BEAUCHAMP FAMILY, LLC; BEAUCHAMP FAMILY 2, LLC
TZ) does 1 to 5
Prem.L-3 Count Two—Willful Failure to Warn (Civil Code section 846] The defendant owners who willfully
or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were
(names):
TO does 6 sto 10
Plaintiff, a recreational user, was [J aninvited guest [1 a paying guest.
Prem.L-4: (Z) Count Three—Dangerous Condition of Public Property The defendants who owned pub‘ic property
‘on which a dangerous condition existed were (names):
[2does 11 to 15
a. 7] The defendant public entity had oo actual (_] constructive notice of the existence of the
dangerous cond:tion in sufficient time prior to the injury to have corrected it.
b. (J The condition was created by employees of the defendant public entity.
Allegations about Other Defendants The defendants who were the agents and employees of the
other defendants and acted within the scope of the agency were (names):
Prem.L-5. a.
C4 does 16 sto 300
b. C] The defendants who are liable to plaintiffs for other reasons and the reasons for their liability are
(J described in attachment Prem.L-5.b [-_] as follows (names):
Page oft
eee CAUSE OF ACTION—Premises Liability Code ot Co Proce, § 425 12
PLOLPL-O01 4) (Rev January 1 2007]
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RECEIVED FOR SCANNING VENTURA SUPERIOR COURT 18 202 PLD-PI-001 ATTORNEY OR PARTY WITHOUT ATTORNEY a [David A. Richard, SBN 128348 / Nichole L. Bartlet, SBN 307221 FOR COURT USE OMY RICHARD BARTLETT LAWYERS 1591 Spinnaker Drive, Suite 205 Ventura, CA 93001 TELEPHONENO: (805) 644-0808 FAX NO. (Optonen: (805) 644-0848 E-maiL ADDRESS (opera). nbartlett@richardinjurylaw.com attorney ror ware) Plaintiff{s), ANN REBENTISCH ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA. street aooress 800 South Victoria Avenue ‘MAILING ADDRESS aryanozpcooe Ventura, CA 93009 erancrname Hal! of Justice PLAINTIFF: ANN REBENTISCH OeFeNDANT: BEAUCHAMP FAMILY LLC, etal. and (4 ooes11o 30. COMPLAINT—Personal Injury, Property Damage, Wrongful Death (7) AMENDED (Number): Type (check all that apply): (3 MOTOR VEHICLE OTHER (specify): Premesis Liability Property Damage [__] Wrongful Death Personal Injury [) Other Damages (specify): Jurisdiction (check all that apply): (CASE NUMBER: (5) ACTION IS A LIMITED CIVIL CASE Amount demanded [_} does not exceed $10,000 [—) exceeds $10,000, but does not exceed $26,000 (1) ACTION Is AN UNLIMITED CIVIL CASE (exceeds $26,000) [__] ACTION IS RECLASSIFIED by this amended complaint CJ from iimited to unlimited [1 from untimited to limited 1. Plaintiff (name or names): ANN REBENTISCH alleges causes of action against defendant (name or names): BEAUCHAMP FAMILY, LLC; BEAUCHAMP FAMILY 2, LLC; and DOES | TO 30. 2. This pleading, including attachments and exhibits, consists of the following number of pages: 4 3. Each plaintiff named above is a competent adult a. (7) except plaintiff (name): (1) [2] a corporation qualified to do business in Califomia (2) (] an unincorporated entity (describe): (3) [-) a public entity (describe): (4) [2] aminor (7) an adult (a) [) for whom a guardian or conservator of the estate or a guardian ad litem has been appointed (b) [) other (specify): (5) (2) other (specify): b. (_) except plaintiff (name): (1) (_) a corporation qualified to do business in California (2) [_] an unincorporated entity (describe): (3) [_] 2 public entity (describe): (4) (J aminor (——) an adult (a) (_} for whom a guardian or conservator of the estate or a guardian ad litem has been appointed (o) (J other (specity): (5) (J other (specify): TJ information about additional plaintiffs who are not competent adults is shown in Attachment 3. Page tot 3 Form Approved fo Optra! ve COMPLAINT—Personal Injury, Property Cae rete cae PLO-P1001 (Rev. January 1, 2007] Damage, Wrongful Death ayPLD-PI-001 SHORT TITLE: (CASE NUMBER: REBENRISCH v. BEAUCHAMP FAMILY, LLC et al. 4. (7) Plaintiff (name): is doing business under the fictitious name (specify): and has complied with the fictitious business name laws. 5. Each defendant named above is a natural person a except defendant (name): Beachamp Family c. [J except defendant (name): (1) [2 a business organization, form unknown (1) (2) a business organization, form unknown (2) (2) a corporation (2) (2) a corporation (3) [£2] an unincorporated entity (describe): (3) [[-] an unincorporated entity (describe): (4) () a public entity (describe): (4) 2) a public entity (describe): (5) [2 other (specify): (5) (2) other (specify): LLC b. (7) except defendant (name): Beauchamp Family 2. (7) except defendant (name): (1) (2) a business organization, form unknown (1) (2) a business organization, form unknown (2) (<_] a corporation (2) [_) a corporation (3) ([) an unincorporated entity (describe): (3) ([] an unincorporated entity (describe). (4) (J a pubic entity (describe): (4) (J a public entity (describe): 6) other (specify): (5) [) other (specify): LLC [) Information about additional defendants who are not natural persons is contained in Attachment 5. 6. The true names of defendants sued as Does are unknown to plaintiff. a Doe defendants (specify Doe numbers): to 5 were the agents or employees of other named defendants and acted within the scope of that agency or employment. b. Doe defendants (specify Doe numbers): 6 to 10 are persons whose capacities are unknown to plaintiff. 7. [2] Defendants who are joined under Code of C.vil Procedure section 382 are (names): 8. This court is the proper court because a. [] at least one defendant now resides in its jurisdictional area. b. [_] the principal place of business of a defendant corporation or unincorporated association is in its jurisdictional area. c. injury to person or damage to personal property occurred in its jurisdictional erea. d. (_] other (specify): 9. [[) Plaintiff is required to comply with a claims statute, and a. [_] has complied with applicable claims statutes, or b. [_] is excused from complying because (specify): PLO-PH-001 (Rev January 1. 2007) COMPLAINT—Personat Injury, Property Page 203 Damage, Wrongful DeathPLD-PI-001 SHORT TITLE: ‘CASE NUMBER REBENRISCH v. BEAUCHAMP FAMILY, LLC et al. 10. The following causes of action are attached and the statements above apply to each (each complaint must have one or more causes of action attached): a. (_] Motor Veb'cle b. [J General Negligence . (2) intentional Tort . ] Products Liability 2) Premises Liability ‘ (2) Other (specify: -~eao 11. Plaintiff has suffered ‘ a. (7) wage loss b, (] loss of use of property c. [7] hospital and medical expenses d. (7) general damage e. (-_] property damage f. (7) loss of earning capacity 9. [-) other damage (specify): 12. [[-) The damages claimed for wrongful death and the relationships of plaintiff to the deceased are a. (_] listed in Attachment 12. b. () as follows: 13. The relief sought in this complaint is within the jurisdiction of this court. 14. Plaintiff prays for judgment for costs of suit; for such relief as is fair, just, and equitable; and for a. (1) (J compensatory damages (2) (_] punitive damages The amount of damages 's (in cases for personal injury or wrongful death, you must check (1)): according to proof (2) [J in the amount of: $ 15. [[_] The paragraphs of this complaint alleged on information and belief are as follows (specify paragraph numbers): a Date: October 10, 2022 ( (x Y David A. Richard, Esq. CD (TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY) PLO-PI-O01 [Rev January 1 2007] COMPLAINT—Personal Injury, Property Page ots Damage, Wrongful DeathPLD-PI-001(4) SHORT TITLE: CASE NUMBER REBENRISCH v. BEAUCHAMP FAMILY, LLC et al. FIRST CAUSE OF ACTION—Premises Liability Page 4 (number) ATTACHMENT TO [¥] Complaint [_] Cross - Complaint (Use 8 separate cause of action form for each cause of action.) Prem.L-1, Plaintiff (name): ANN REBENTISCH alleges the acts of defendants were the legal (proximate) cause of damages to plaintiff. ‘On (date): 10/30/2020 plaintiff was injured on the following premises in the following fashion (description of premises and circumstances of injury): At approx. 7:10pm Plaintiff was walking her dog to her car in the parking lot behind Pet Food Express and Home Goods located at Conejo Valley Plaza, 1330 North Moorpark Road in Thousand Oaks, CA. She stepped on a cover to a water shut off valve which broke and gave way under her 142 Ib weight, and her left foot sunk into the 18" hole. She sustained injuries in the resulting fall. Prem.t-2, [Z) Count One—Negligence The defendants who negligently owned, maintained, managed and operated the described premises were (names): BEAUCHAMP FAMILY, LLC; BEAUCHAMP FAMILY 2, LLC TZ) does 1 to 5 Prem.L-3 Count Two—Willful Failure to Warn (Civil Code section 846] The defendant owners who willfully or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were (names): TO does 6 sto 10 Plaintiff, a recreational user, was [J aninvited guest [1 a paying guest. Prem.L-4: (Z) Count Three—Dangerous Condition of Public Property The defendants who owned pub‘ic property ‘on which a dangerous condition existed were (names): [2does 11 to 15 a. 7] The defendant public entity had oo actual (_] constructive notice of the existence of the dangerous cond:tion in sufficient time prior to the injury to have corrected it. b. (J The condition was created by employees of the defendant public entity. Allegations about Other Defendants The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were (names): Prem.L-5. a. C4 does 16 sto 300 b. C] The defendants who are liable to plaintiffs for other reasons and the reasons for their liability are (J described in attachment Prem.L-5.b [-_] as follows (names): Page oft eee CAUSE OF ACTION—Premises Liability Code ot Co Proce, § 425 12 PLOLPL-O01 4) (Rev January 1 2007]