On June 02, 2021 a
Complaint,Petition
was filed
involving a dispute between
Raul Saldana And Eric Saldana,
and
Brett Clement, Do,
Dignity Health,
Dignity Health - St. Bernardine Medical Center,
Does 4 To100,
Omar Saleh, M.D.,
Saldana, Jason,
Saldana, Jessica,
Saldana, Kady,
Simpledeep Kaur Banipal,
for Medical Malpractice Unlimited
in the District Court of San Bernardino County.
Preview
.
POS-01 0
ATTORNEY 0R PARTY WITHOUT ATTORNEY (Name. Slatemumber, and address) \ FOR couRT USE ONLY 1‘
’
_ Randall S. Schlavone SBN: 148021 |
Kampf, Schiavone & Associates, A.P.C.
P.O. Box 1061 San Bernardino, CA 92402 SUPER.ORFCOIUlR-T§FCDAL|FORN|A
TELEPHONE NO.. (909) 885 _ 1522| FAX NO.
_
E _ MAIL ADDRESS
.
(Optional).
_ COUNTY OF SAN BERNARDINO
.
|
SAN BERNARDINO DISTRICT
ATTORNEY FOR (Name): I
San Bernardino County Superior Court DEC 1 2 2022
STREET ADDRESS: 247 West Third Street
I
MAILING ADDRESS:247 West Third Street
CITY AND ZIP CODE: San Bernardino, CA 9241 5 W I
_
BRANCH NAMEzJustice Center
M 335A ”EHEZ, DEPUW
CASE NuMBER:
PLAINTIFF: Raul Saldana and Eric Saldana
CIVSBZ1 15525
DEFENDANT: Dignity Health - St. Bernardine Medical Center, et al.
Ref- N°- °'F”e NW
PROOF 0F SERVICE 0F SUMMONs
(Separate proof of service is required for each party served.)
_k
. At the time of service | was at least 18 years of age and not a party to this action.
2. I served copies of:
S
E;
Summons
Complaint
Alternative Dispute Resolution (ADR) package
Elm
Civil Case Cover Sheet (served in complex cases only)
Si:
Cross-complaint
other (specify documents): Certificate of Assignment; AMENDMENT TO COMPLAINT; Notice of Trial Setting Conference
and Notice of Case Assignment; Intitial Trial Setting Conference Statement
3. a. Party served (specify name ofparty as shown on documents served):
Simpledeep Kaur Banipal as DOE 2
b- D Person (other than the party in item 3a) sewed on behalf of an entity or as an authorized agent (and not a person under
item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a):
4. Address where the party was served: 19400 Turtle Ridge Lane
Porter Ranch, CA 91326
5. | served the party (check proper box)
a. by personal service. | personally delivered the documents listed in item 2 to the party or person authorized to
receive service of process for the party (1) on (date): (2) at (time):
b- g by substituted service. On (date): 10/26/2022 at (time): 5:30 PM | leftthe documents listed in item 2 with or
in the presence of (name and title or relationship to person indicated in item 3b):
Farida Banipal - Co-occupant
Age: 60 Race: Middle Eastern Sex: Female Height: 5'5" Weight: 17o Hair: Brown
(1) El (business) a person at least 18 years of age apparently in charge at the office or usual place of business of the
person to be sewed. informed him of her of the general nature of the papers.
l
(2) fl (home) a competent member of the household (at least 18 years of age) at the dwelling house or usual place
abode of the party. informed him or her of the general nature of the papers.
I
of
E] (physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing address
(3)
of the person to be served, other than a United States Postal Service post office box. informed him of her of the |
,
general nature of the papers.
(4) E Ithereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be served at the
place where the copies were left (Code Civ. Proc., §415.20). mailed the documents on |
(date): 10/26/2022 from (City): Porter Ranch Or a declaration of mailing is attached_ D
(5) m | attach a declaration of diligence stating actions taken first to attempt personal service.
Page 1 of 2
Form Approved for Mandatory Use Code of Civil Procedure, § 41 7.1 0
#331535§?S25f'faffiaa'g°{"goon
PROOF OF SERVICE OF SUMMONS Poso1o-1/A32250
PETITIONER: Raul Saldana and
4x
Erlc Saldana
V ’
CASE NUMBER:
CIVSBZ1 15525
RESPONDENT: Dignity Health - St. Bernardlne Medical Center, e: aI.
c. D by mail and acknowledgment of receipt of service.
shown in item 4, by first-class mail, postage prepaid,
I mailed the documents listed in item 2 to the party, to the address
(1) on (date): (2) from (city):
with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed to me.
(3) E]
(Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 415.30.)
(4) D to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.)
d. D by other means (specify means of service and authorizing code section):
E] Additional page describing service is attached.
6. The "Notice to the Person Served" (on the summons) was completed as follows:
as an individual defendant.
as the person sued under the fictitious name of (specify):
EDES
as occupant.
On behalf of (specify):
under the following Code of Civil Procedure section:
D 416.10 (corporation) 415.95 (business organization, form unknown)
D 416.20 (defunct corporation) 416.60 (minor)
D 41 6.30 (joint stock company/association) 41 6.70 (ward or conservatee)
D 416.40 (association or partnership)
DDDDDD
416.90 (authorized person)
D 416.50 (public entity) 41 5.46 (occupant)
other:
7. Person who sewed papers
a. Name: Julio Ascorra - Amstar Express, Inc
b. Address: 509 Marin Street, # 237 Thousand Oaks, CA 91 360
c. Telephone number: (888) 778-2711
d. The fee for service was: $ 89.00
e. lam:
(1) D not a registered California process server.
(2) exempt from registration under Business and Professions Code section 22350(b).
(3) g re istered California
owner
process server:
employee é
independent contractor.
(i) ,
(ii) 6310
Registration No.1
(iii) County: Los Angeles
[V3 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
s. l
or
9, E] I am a California sheriff or marshal and I certify that the foregoing is true and correct.
Date: 10/28/2022
* Amstar Express, Inc
509 Marin Street, # 237
Thousand Oaks, CA 91360
(888) 778-2711
www.AmstarExpress.com
Julio Ascorra F
WHO SERVED PAPERS/SHERIFF OR MARSHAL) (SIGNATURE)
(NAME 0F PERSON
V
Page 2 of 2
POS-010 [Rev January 1, 2007]
PROOF OF SERVICE OF SUMMONS POS-O10IA32250
Document Filed Date
December 12, 2022
Case Filing Date
June 02, 2021
Category
Medical Malpractice Unlimited
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Preview
. POS-01 0 ATTORNEY 0R PARTY WITHOUT ATTORNEY (Name. Slatemumber, and address) \ FOR couRT USE ONLY 1‘ ’ _ Randall S. Schlavone SBN: 148021 | Kampf, Schiavone & Associates, A.P.C. P.O. Box 1061 San Bernardino, CA 92402 SUPER.ORFCOIUlR-T§FCDAL|FORN|A TELEPHONE NO.. (909) 885 _ 1522| FAX NO. _ E _ MAIL ADDRESS . (Optional). _ COUNTY OF SAN BERNARDINO . | SAN BERNARDINO DISTRICT ATTORNEY FOR (Name): I San Bernardino County Superior Court DEC 1 2 2022 STREET ADDRESS: 247 West Third Street I MAILING ADDRESS:247 West Third Street CITY AND ZIP CODE: San Bernardino, CA 9241 5 W I _ BRANCH NAMEzJustice Center M 335A ”EHEZ, DEPUW CASE NuMBER: PLAINTIFF: Raul Saldana and Eric Saldana CIVSBZ1 15525 DEFENDANT: Dignity Health - St. Bernardine Medical Center, et al. Ref- N°- °'F”e NW PROOF 0F SERVICE 0F SUMMONs (Separate proof of service is required for each party served.) _k . At the time of service | was at least 18 years of age and not a party to this action. 2. I served copies of: S E; Summons Complaint Alternative Dispute Resolution (ADR) package Elm Civil Case Cover Sheet (served in complex cases only) Si: Cross-complaint other (specify documents): Certificate of Assignment; AMENDMENT TO COMPLAINT; Notice of Trial Setting Conference and Notice of Case Assignment; Intitial Trial Setting Conference Statement 3. a. Party served (specify name ofparty as shown on documents served): Simpledeep Kaur Banipal as DOE 2 b- D Person (other than the party in item 3a) sewed on behalf of an entity or as an authorized agent (and not a person under item 5b on whom substituted service was made) (specify name and relationship to the party named in item 3a): 4. Address where the party was served: 19400 Turtle Ridge Lane Porter Ranch, CA 91326 5. | served the party (check proper box) a. by personal service. | personally delivered the documents listed in item 2 to the party or person authorized to receive service of process for the party (1) on (date): (2) at (time): b- g by substituted service. On (date): 10/26/2022 at (time): 5:30 PM | leftthe documents listed in item 2 with or in the presence of (name and title or relationship to person indicated in item 3b): Farida Banipal - Co-occupant Age: 60 Race: Middle Eastern Sex: Female Height: 5'5" Weight: 17o Hair: Brown (1) El (business) a person at least 18 years of age apparently in charge at the office or usual place of business of the person to be sewed. informed him of her of the general nature of the papers. l (2) fl (home) a competent member of the household (at least 18 years of age) at the dwelling house or usual place abode of the party. informed him or her of the general nature of the papers. I of E] (physical address unknown) a person at least 18 years of age apparently in charge at the usual mailing address (3) of the person to be served, other than a United States Postal Service post office box. informed him of her of the | , general nature of the papers. (4) E Ithereafter mailed (by first-class, postage prepaid) copies of the documents to the person to be served at the place where the copies were left (Code Civ. Proc., §415.20). mailed the documents on | (date): 10/26/2022 from (City): Porter Ranch Or a declaration of mailing is attached_ D (5) m | attach a declaration of diligence stating actions taken first to attempt personal service. Page 1 of 2 Form Approved for Mandatory Use Code of Civil Procedure, § 41 7.1 0 #331535§?S25f'faffiaa'g°{"goon PROOF OF SERVICE OF SUMMONS Poso1o-1/A32250 PETITIONER: Raul Saldana and 4x Erlc Saldana V ’ CASE NUMBER: CIVSBZ1 15525 RESPONDENT: Dignity Health - St. Bernardlne Medical Center, e: aI. c. D by mail and acknowledgment of receipt of service. shown in item 4, by first-class mail, postage prepaid, I mailed the documents listed in item 2 to the party, to the address (1) on (date): (2) from (city): with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed to me. (3) E] (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 415.30.) (4) D to an address outside California with return receipt requested. (Code Civ. Proc., § 415.40.) d. D by other means (specify means of service and authorizing code section): E] Additional page describing service is attached. 6. The "Notice to the Person Served" (on the summons) was completed as follows: as an individual defendant. as the person sued under the fictitious name of (specify): EDES as occupant. On behalf of (specify): under the following Code of Civil Procedure section: D 416.10 (corporation) 415.95 (business organization, form unknown) D 416.20 (defunct corporation) 416.60 (minor) D 41 6.30 (joint stock company/association) 41 6.70 (ward or conservatee) D 416.40 (association or partnership) DDDDDD 416.90 (authorized person) D 416.50 (public entity) 41 5.46 (occupant) other: 7. Person who sewed papers a. Name: Julio Ascorra - Amstar Express, Inc b. Address: 509 Marin Street, # 237 Thousand Oaks, CA 91 360 c. Telephone number: (888) 778-2711 d. The fee for service was: $ 89.00 e. lam: (1) D not a registered California process server. (2) exempt from registration under Business and Professions Code section 22350(b). (3) g re istered California owner process server: employee é independent contractor. (i) , (ii) 6310 Registration No.1 (iii) County: Los Angeles [V3 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. s. l or 9, E] I am a California sheriff or marshal and I certify that the foregoing is true and correct. Date: 10/28/2022 * Amstar Express, Inc 509 Marin Street, # 237 Thousand Oaks, CA 91360 (888) 778-2711 www.AmstarExpress.com Julio Ascorra F WHO SERVED PAPERS/SHERIFF OR MARSHAL) (SIGNATURE) (NAME 0F PERSON V Page 2 of 2 POS-010 [Rev January 1, 2007] PROOF OF SERVICE OF SUMMONS POS-O10IA32250