On June 02, 2021 a
Summons
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 O
“' T
’ATTORNEY OR PARTY. WITHOUT ATTORNEY (Name, State Bar number, and address):
FOR CORT: UE @YD
SUPERIOR COURT OF CALIFORNI,
Randall S. Schlavone SBN148021 COUNTY 0F SAN BERNARDINC T‘
Po Box 1061 FON rANA uh. [$33359
San Bernardino Ca 92402
FAX
NOV 2 2 2021
TELEPHONE N0; 909—885—1522 No.(0ptronau.-
E—MAIL ADDRESS
ATTORNEY F0R(Name):
(Optional):
SUPERIOR COURT 0F CALIFORNIA COUNTY 0F San
Plaintiff
Bernardmo
Raul Saldana, Eric Saldana
‘
BY
4
624 I
'
A
.
m,
29'
h
W
fl,
H—WA PR'E TO. nFP!
,
h
l7“
g
STREET ADDRESS: 247 Thlrd Street
MAILING ADDRESS:
cmr AND ZIP cons: San Bernardino 924 1 5
BRANCH NAME: Civil
CASE NUMBER:
PLAINTIFF/PETITIONER; Raul Saldana, Eric Saldana
.
CIVSB 2115525
.
DEFENDANT/RESPONDENT; D1gn1ty Health et a1, Does 1—100
Ref. No. or File No.:
PROOF 0F SERVICE OF SUMMONS
(Separate proof of service is required for each party served.)
age and not a party to this action.
1. At the time of service I was at least 18 years of
2. l served copies of:
a- summons
b. complaint
c.
d.
E Alternative Dispute Resolution
Civil Case Cover Sheet (served in complex cases
(ADR) package
only)
e. E cross-complaint
other (specify documents): otice of Trial Settin Conference Certificate of Assignment ’
Tngai *Hdus ’a“£¢.~,vu smhwwui'
f.
Comp?!
3. a.
fiméwufi
Party serveg (specify
11> ”4,1
,
name of party as shown on documents served):
lm’ {M
Omar Saleh, MD.
not a person
behalf of an entity or as an authorized agent (and
b. E] Person (other than the party in item 3a) sewed on to the party named in item 3a):
name and relatio nship
under item 5b on whom substituted service was made)
(speci fy
4. Address where the party was served:
12339 Rodeo Drive, Rancho Cucamonga Ca 9173
9
5. | sewed the party (check proper box)
item 2 to the party or person authorized to
personally delivered the documents listed
in
a by personal service. |
1-21—21 (2) at (time): 1:15 pm
receive service of process for the party (1) on (date):
1
left the documents listed in item 2 with or
service. On at (time): I
b. [:1 by substituted (date):
item
(name and title or relationship to person indicated in 3):
in the presence of
(1) E (business) a person at least 18 years of
of the person to be served. informed him
age apparently in charge at the office or usual place
or her of the general nature of the papers
I
.
of business
(2) E (home) a competent member of the househ
place of abode of the party. informed him
old (at least 18 years of age) at the dwelling house
or her of the genera
l
l nature of the papers .
or usual
at least 18 years of age apparently in
charge at the usual mailing
(3) E: (physical address unknown) a person informed
a United States Postal Servic e post office box. I
address of the person to be served, other than
him or her of the general nature of the papers.
(4) D |
at the place where the copies were
e
thereafter mailed (by first-class, postag prepai
d) copies of the documents to the person
left (Code Civ. Proc., § 415.20 mailed the docum ents
to be
on
a declaration of mailing is attached.
. I
sewed
from or
E (date): (city):
.
actions taken first to attempt personal service
(5) l attach a declaration of diligence stating Page 1 of2
Code ofCivi) Procedure. §417.10
Form Adopted for Mandatory Use PROOF 0F SERVICE OF SUMMONS
Judicial Council of Califomia
POS—01 0 [Rev. January 1, 2007]
PLAINTIFF/PETITIONER: Raul Saldana, Eric Saldana CASE NUMBER:
BEFENDANT/RESPONDENT: Dignity Health
CIVSB 21 15525
et a1, Does 1-100
5_ C. E by mail and acknowledgment of receipt of service.
address shown in item 4, by first-class mail, postage prepaid,
I mailed the documents listed in item 2 to the party, to the
(1) on (date): from
(3) E with
(2) (city):
two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed
(4) a to
to
me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., 415.30.)
an address outside California with return receipt requested. (Code Civ. Proc.. § 415.40.)
§
d. E 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.
a.
b-
C-
E
E as the person sued under the fictitious name of (specify):
d- D as occupant.
0n behalf of (specify):
under the following Code of Civil Procedure section:
D
416.10 (corporation) E 415.95 (business organization, form unknown)
E
416.20 (defunct corporation) E 416.60 (minor)
E
416.30 (joint stock company/association) E 416.70 (ward or conservatee)
416.40 (association or partnership) E 416.90 (authorized person)
E 416.50 (public entity) E 415.46 (occupant)
7. Person who served papers
E other:
a. Name: JAMES COOK
Address: PO 2781, SAN BERNARDINO CA 92406
Telephone number: 909—562- 1 871
5°99?"
The fee for service was: $ 59.50
l am:
(1) not a registered California process server.
(2) exempt from registration under Business and Professions Code section 22350(b)'.
V
(3)
(i)
(ii)
E
a registered California process server:
owner
Registration No.:
D employee
1604
independent contractor.
(iii) County: SAN BERNARDINO
8. declare under penalty of perjury under the laws of the State of California that the foregoing
I
is true and correct.
or
9. E I am a California sheriff or marshal and I certify that the foregoing is true and correct.
Date: 1 1—22-2021
JAMES COOK
(NAME 0F PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL)
}
/vamv14/404 r(S|GNATURE )
P0801“ ‘ReV' “““a'mm Page 2 of 2
PROOF 0F SERVICE 0F SUMMONS
Document Filed Date
November 22, 2021
Case Filing Date
June 02, 2021
Category
Medical Malpractice Unlimited
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POS-01 O “' T ’ATTORNEY OR PARTY. WITHOUT ATTORNEY (Name, State Bar number, and address): FOR CORT: UE @YD SUPERIOR COURT OF CALIFORNI, Randall S. Schlavone SBN148021 COUNTY 0F SAN BERNARDINC T‘ Po Box 1061 FON rANA uh. [$33359 San Bernardino Ca 92402 FAX NOV 2 2 2021 TELEPHONE N0; 909—885—1522 No.(0ptronau.- E—MAIL ADDRESS ATTORNEY F0R(Name): (Optional): SUPERIOR COURT 0F CALIFORNIA COUNTY 0F San Plaintiff Bernardmo Raul Saldana, Eric Saldana ‘ BY 4 624 I ' A . m, 29' h W fl, H—WA PR'E TO. nFP! , h l7“ g STREET ADDRESS: 247 Thlrd Street MAILING ADDRESS: cmr AND ZIP cons: San Bernardino 924 1 5 BRANCH NAME: Civil CASE NUMBER: PLAINTIFF/PETITIONER; Raul Saldana, Eric Saldana . CIVSB 2115525 . DEFENDANT/RESPONDENT; D1gn1ty Health et a1, Does 1—100 Ref. No. or File No.: PROOF 0F SERVICE OF SUMMONS (Separate proof of service is required for each party served.) age and not a party to this action. 1. At the time of service I was at least 18 years of 2. l served copies of: a- summons b. complaint c. d. E Alternative Dispute Resolution Civil Case Cover Sheet (served in complex cases (ADR) package only) e. E cross-complaint other (specify documents): otice of Trial Settin Conference Certificate of Assignment ’ Tngai *Hdus ’a“£¢.~,vu smhwwui' f. Comp?! 3. a. fiméwufi Party serveg (specify 11> ”4,1 , name of party as shown on documents served): lm’ {M Omar Saleh, MD. not a person behalf of an entity or as an authorized agent (and b. E] Person (other than the party in item 3a) sewed on to the party named in item 3a): name and relatio nship under item 5b on whom substituted service was made) (speci fy 4. Address where the party was served: 12339 Rodeo Drive, Rancho Cucamonga Ca 9173 9 5. | sewed the party (check proper box) item 2 to the party or person authorized to personally delivered the documents listed in a by personal service. | 1-21—21 (2) at (time): 1:15 pm receive service of process for the party (1) on (date): 1 left the documents listed in item 2 with or service. On at (time): I b. [:1 by substituted (date): item (name and title or relationship to person indicated in 3): in the presence of (1) E (business) a person at least 18 years of of the person to be served. informed him age apparently in charge at the office or usual place or her of the general nature of the papers I . of business (2) E (home) a competent member of the househ place of abode of the party. informed him old (at least 18 years of age) at the dwelling house or her of the genera l l nature of the papers . or usual at least 18 years of age apparently in charge at the usual mailing (3) E: (physical address unknown) a person informed a United States Postal Servic e post office box. I address of the person to be served, other than him or her of the general nature of the papers. (4) D | at the place where the copies were e thereafter mailed (by first-class, postag prepai d) copies of the documents to the person left (Code Civ. Proc., § 415.20 mailed the docum ents to be on a declaration of mailing is attached. . I sewed from or E (date): (city): . actions taken first to attempt personal service (5) l attach a declaration of diligence stating Page 1 of2 Code ofCivi) Procedure. §417.10 Form Adopted for Mandatory Use PROOF 0F SERVICE OF SUMMONS Judicial Council of Califomia POS—01 0 [Rev. January 1, 2007] PLAINTIFF/PETITIONER: Raul Saldana, Eric Saldana CASE NUMBER: BEFENDANT/RESPONDENT: Dignity Health CIVSB 21 15525 et a1, Does 1-100 5_ C. E by mail and acknowledgment of receipt of service. address shown in item 4, by first-class mail, postage prepaid, I mailed the documents listed in item 2 to the party, to the (1) on (date): from (3) E with (2) (city): two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed (4) a to to me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., 415.30.) an address outside California with return receipt requested. (Code Civ. Proc.. § 415.40.) § d. E 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. a. b- C- E E as the person sued under the fictitious name of (specify): d- D as occupant. 0n behalf of (specify): under the following Code of Civil Procedure section: D 416.10 (corporation) E 415.95 (business organization, form unknown) E 416.20 (defunct corporation) E 416.60 (minor) E 416.30 (joint stock company/association) E 416.70 (ward or conservatee) 416.40 (association or partnership) E 416.90 (authorized person) E 416.50 (public entity) E 415.46 (occupant) 7. Person who served papers E other: a. Name: JAMES COOK Address: PO 2781, SAN BERNARDINO CA 92406 Telephone number: 909—562- 1 871 5°99?" The fee for service was: $ 59.50 l am: (1) not a registered California process server. (2) exempt from registration under Business and Professions Code section 22350(b)'. V (3) (i) (ii) E a registered California process server: owner Registration No.: D employee 1604 independent contractor. (iii) County: SAN BERNARDINO 8. declare under penalty of perjury under the laws of the State of California that the foregoing I is true and correct. or 9. E I am a California sheriff or marshal and I certify that the foregoing is true and correct. Date: 1 1—22-2021 JAMES COOK (NAME 0F PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL) } /vamv14/404 r(S|GNATURE ) P0801“ ‘ReV' “““a'mm Page 2 of 2 PROOF 0F SERVICE 0F SUMMONS