CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2023 NOV - 8 AMI: 21
TO PERSON OR PROPERTY RECE.Vet.
CITY CLENA
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months afer the ocumence (Gov. Code §911.2).
2. Claims for damages to real property must he filed not later than one (1) year after the occurrence (Gov. Code §911.2). RETURN TO:
3.READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Michael-Nolhan X. Morales
FULL NAME DATE OF BIRTH
Los Angeles, CA 90012
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: May 16, 2023 TIME: 11:45 DAM PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks.
Sidewalk. Riverside Avenue, South of Merril Ave. Please see attached sheet.
3. HOW DID DAMAGE OR INJURY OCCUR?
Please see attached sheet. Slip and fall due to gravel on easement, landing into street in potholes that were the subject of the repair and associated construction work from recent rains at the time.
4. WERE POLICE AT THE SCENE? • YES IM NO WERE PARAMEDICS AT THE SCENE? • YES NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
City of Rialto, Arthur Cervantes, Denying Injury and Treatment, Further Complicating Injuries
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 60,964.80 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Loss of Wages at $39.02 + $3615.20 OT/Week (@12 Wks) Amount: $60,964.80 Item/Date: Medical Expenses, Excluding Transportation Amount: $ 7325.53 TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 68,290.33 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Reimbursed Via Railroad Disablity Pre Tax Amount: $-2610/Total (6 Wks) Item/Date: Continued Treatment and Missed Work Amount: $ 312/Day TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: = SEE ATTACHMENT
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have Information (attach additional pages, if necessary) NAME: Ernie Vasquez NAME:
ADDRESS: ADDRESS:
TELEPHONE: TELEPHONE: (
B. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: Keck Hospital of USC NAME: DUNTOWN URGENT CARE
ADDRESS: :1500 San Pablo St, Los Angeles, CA 90033 ADDRESS: 269 SAN PEORO SIREET LOS ANGELES, CA 90012
TELEPHONE: (800)872-2273 TELEPHONE: ( )
DATE: MULTIPLE TIME: MULTIPL DAMOPM DATE: 2023-05-16 _ TIME: 16:03 • AM I PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X" and by showing house numbers or distances to street comers. accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
SIDEWALK
ICEDEFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
Michael-Nolhan X. Morales 10-03-2023
TYPE OR PRINT NAME DATE
Self
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 May 16, 2023
Rialto, CA
First: Michael-Nolhan, Middle: Xavier, Last: Morales
11:30
Attempted to visit Arco
• Traveled West on Merrill Ave.
• Directed to go North on Riverside
• U Turn just on the other side of the railroad tracks. • Signs indicating businesses are open during construction, driveways are accessible at this area by Rally's.
• Traveled South on Riverside, unable to enter Arco via Riverside. Told I could only go RIGHT or SOUTH, but not enter the Arco. I had stopped to ask about getting to the Arco. • Traveled South beyond Merrill Ave.
• Made a right turn into the Walgreens parking lot which was coned off to allow traffic to pass through. Went towards the Bloomington Ave exit until realizing there was no way to access ARCO from this side either.
• Exited Walgreens parking lot via Riverside Avenue, Traveled South. • Traveled WEST after making a right turn onto Arul Street. • Traveled North after making a right turn onto Bloomington Ave.
Car stopped just before the corner of Bloominginton and Riverside, this was just prior to the area where construction was active, but it was blocking some traffic for a moment as I was not far enough over to allow traffic through. Despite this traffic easily could have gone through the Walgreens parking lot entrance that provided the exact same access. Directed by construction, l pulled forward as far as possible into the Westmost lane of Riverside avenue where there was no traffic. Coming around the corner my car made one last push then stopped as it was out of fuel. The construction crew at this point wanted to help and did have a gas can but no way to dispense it.
11:40
I remained in the car during this time, and looked at options to refuel or otherwise get going again. I exited the car to go towards the Arco and get a gas can, walking behind my car in the street, and then up on the sidewalk. I crossed the street and upon getting to the other side on the sidewalk was told I needed to move my car and hurry up and my car was going to be towed 1 of 6
May 16, 2023
Rialto, CA
(despite having just been told to enter this area as they knew my car was at this point disabled-and even assisted pushing it there.). I went back to my car to get a different form of payment, walking only on the sidewalk until I was right beside my car.
Stepping off the curb into the street, my right foot slipped as my left went forward. Having slipped, and now unstable attempting to avoid a full on fall into the street, I was able to catch myself and fell down barely able to arrest my fall before striking the pavement face first, but injured my foot in the process as it went into a pothole. I immediately attempted to get out of the street as I could hardly stand. I sat in my car right away and knew something was wrong. As I sat in pain, I was unable to do anything at all, and removing my shoe saw there was obviously a more severe injury associated with this pain, and something was extruding from the side of my foot.
Still in the car, a street sweeper went immediately beside me, almost taking off my mirror which I had to fold in as it passed. My window had been open, and barely closed in time to avoid particulates and debris from flying into my face as the sweeper was no less than 6" from me, with only about 3" of clearance from the outermost of my now folded mirror. The sweeper made a slow, precarious pass, then immediately went behind me.
A couple members of the construction crew approached and wanted to push the car mto move, at which point I explained | had just fallen there, to assist I awkwardly turned near backwards with my right foot pushing as much as possible as I steered and entered the Walgreens parking lot. As soon as I was in the clear more construction vehicles passed through the area I had previously been parked/stopped.
I remained in the car trying to mentally organize myself as to what I needed to do first, as far as being able to get medical treatment, and to get home, to a dog that had been alone since 1:45.
Familiar with the process of such incidents from work. As I realized this was a more serious injury, I wanted to properly document it, and called the Rialto Civic Center for further information on who the lead construction crew was as I was unable to read the writing on the trucks from where I sat, and there also seemed to be sub-contractors involved as well, or at least some different or alternate branding on site.
11:51
Calling the Civic Center, on a call that lasted 20m 40s, I briefly explained what happened, and where I was, and asked to get the contractors business information so | could contact them to report the injury. I was directed around quickly, and spoke to a woman from Maintenance and Engineering, and told someone would be sent out, and should arrive within 10-15 minutes.
An unknown city official arrived roughly 10 minutes later, pulling up beside me on the right side in a white Engineering truck from the City of Rialto, with the truck ID E0522-E. I saw the individual exit his truck, but did not see where he went, and thought maybe he had to get something else from his truck first. I continued to try and figure out how I would be able to get myself home, or if I could call a Lyft or Uber driver, and pay them to go get a gas can and fill it 2 of 6
May 16, 2023
Rialto, CA
up as there was no way I could make it across the street at this point. (I later ended up doing this).
Unknown to me, when I turned around I had this individual lurking behind me silently, and having been watching me for an unknown time as he never made his presence known or even ever introduced himself, or presented any identification to myself of the contracting construction crew as | later discovered. Upon my own investigation at a later time, this individual was determined to be Rialto Civil Engineer Arthur Cervantes, and someone who appears to bounce from city to city work wise.
The first thing Mr. Cervantes said, was not hello, but rather, "YOU CALLED THE CITY", as he remained behind me in a defensive position. Automatically anticipating some details would have to be given, I gave him my ID, and he also took my license plate down for some reason. At no point did he ever come to the front of me, or even to the side of me, but instead stood behind my rear driver's side door to where | had to turn to move myself so | was sideways in order to even see him. He was so far back that when he dropped my ID, it fell near the rear driver's side tire. He had no words, and I began to explain what happened, and what I wanted to get from him. In a very defensive attitude he began asking why I needed this information, and "what does this have to do with you?" He continued this, and I again restated what I had prior.
As I continued to be harassed by Mr. Cervantes and belittled, as he asked "what are you trying to do", to which I explained I was trying to get the contracting companies information, so I could then focus on moving my car, that was now stuck, but the matter of being out of gas was not really the issue at this very moment.
He immediately went off in an even more aggressive attitude and verbal assault near yelling, "that does matter, this whole thing started because you ran out of gas, that is your fault!"...why do you need this information"... "this has nothing to do with the city", and then stopped talking.
I then and now for the second time explained that working for the railroad, and Amtrak/Metrolink specifically, I was well aware there had to be some process that must be done in order to properly document this, especially given that this injury would result in personal expenses and time out of work given in typically walking no less than 6 miles a day but average around 8-11 for work alone, most of which is on a moving train up and down stairs, or in rocks.
I again for the third time explained why I needed this information, and that working for Metrolink I knew there was some sort of process that needed to be done to properly document this, and I wanted to make sure this was done the right way, as this is on a public sidewalk.
With a slightly less, but still aggressive and argumentative tone, he again instead of addressing the actual situation tried to shift blame by stating, "you stepped off the sidewalk into the street"..."it's your fault, you stepped into the street". I explained again how it happened, and was still confused as to what he was trying to prove or why he would not help me to get medical treatment sooner. This unusual blame rant went on for a few more minutes, as Mr. Cervantes 3 of 6
May 16, 2023
Rialto, CA
then claimed I was able to walk to the gas station and back with no problem, as if he had not listened to anything I had said having given him information of what happened now 4 times over the past 20-25 minutes during his interrogation. I clarified again, that this happened on the way back to the car, stepping off the sidewalk, and that it was the sidewalk where I slipped, and he again pressed on, stating the obvious, that I had to step into the street to get to my car, ultimately going on to say that I should know this whole area for multiple block is a construction zone, and therefore it is my fault, and "you didn't call ambulance"..."there is nothing wrong here" as my foot at this point was at a 45 degree angle and swollen to where I could not put my shoe on, I then explained I was able to move out of the street Mr. Cervantes continued his interrogation asking, "can you drive", to which I stated, "with one foot", and his response was, "that's all you need", "there is nothing wrong here", "you fell, and this has nothing to do with the city", dismissing what I had just said entirely, I again reminded him, I can drive, and use cruise control, but I am more than likely going to be out of work, and I need to get this documented. This infuriated Mr. Cervantes as he became even more angered with yet a more aggressive tone asking, "why do you want this information.... this has nothing to do with the city", "THIS IS YOUR FAULT"!
Finally, worn out from behind harassed, and realizing that Mr. Cervantes was not at all receptive to any information, I stated, "I don't know what else you want me to tell you, or what you are looking for, or what other information you need from me" ", to which he stated, "I THINK I UNDERSTAND'", at which point he then made threats to have me arrested, stating, "why don't we just call the police and let them deal with you for making false claims"...'let me get your license plate" (again)...and then took off without saying anything further. After this point Mr.
Cervantes disappeared and appeared to be talking to someone from the construction crew briefly before getting in his work vehicle and departing around 12:45, never once giving any ID as to who he was to myself or the construction crew.
12:36
Mr. Arthur Cervantes Walks away, a phone call is made to Rialto Civic Center regarding this encounter, the call lasted 10 minutes 38s. A photo of his work vehicle was taken at 12:39, capturing the only identification that I had to confirm identity. ~12:45
Mr. Cervantes departs without any notice.
In the time I was dealing with Mr. Cervantes, the street where the incident took place had been swept again, and the area repaved. Initially the lane nearest to the sidewalk had been closed off, and it was where I was instructed to stop, but when I finally was able to depart and go get medical attention, now 2 lanes were open for traffic to pass through, and the construction had completed for the day.
During this time Mr. Cervantes made no effort to gain information, and had no such plans to document anything either as he stood in his very imposing and threatening pose, and it was 40f6
May 16, 2023
Rialto, CA
obvious that nothing but time and energy was being wasted and Mr. Cervantes was a problem more than an aid, and was obstructing me from getting information so I could move on and address the warning issue with my foot. It should also be known that it was very clear I was not lying about this either as I was in near full uniform, and had my work boots that I took off when I left work beside me on the floor of the passenger's seat, with my backpack, Amtrak crew tags, and Metrolink branded conductor hat sitting on the passenger's seat next to me. Mr. Cervantes did nothing but cause harm, escalate the situation, try to have me arrested, and deter me from seeking medical attention, inciting fear in his threats, and wasting valuable time. It is also unknown what he told the construction crew as far as character goes, but it did appear that even the construction crew was thrown off back the lack of professionalism demonstrated by Mr.
Cervantes.
12:53
Ernie Vasquez, Safety Manager at Matich Corporation came to take the statement for his incident report. This took roughly 10 minutes, and was professionally done. 13:31
Once this was completed I finally was able to deal with the car citation, called an Uber to assist with getting across the street and filling up a container of fuel, and refuel my car. 14:05
A followup call is made to Rialto Civic Center in attempts to find out who this unknown representative was. The call lasts 20 minutes, 56s.
16:03
Finally getting back to Los Angeles, someone is waiting for me when I return and is able to assist me getting to urgent care and take care of my dog for the evening. At this time I am checked in. I utilize Urgent Med. 269 S. San Pedro Street, Los Angeles, CA 90012. I have used their facility before and know they take my insurance, and also can do imaging. 16:26
Incoming Call (909) 421-7229
At this time I speak with Tim Sullivan, the call lasts 12 min 24s, / give him details, and city truck ID. I am waiting at Urgent Care at this point, imaging has not yet been completed. 16:44
Outgoing Call (909) 421-7229
I spoke to Tim Sullivan again as I had to go in for imaging prior. Shortly after this call I received results from imaging to confirm it was a fracture.
Due to the time of things and scheduling limitations, I am not able to be seen by orthopedics until 2 days later after the initial injury on Thursday at 10 AM at the Verdugo Hills location of USC Medical Center.
5 of 6
May 16, 2023
Rialto, CA
As a direct result of this injury I was placed out of work from my full time job as a railroad conductor for 3 months, which was the maximum allowable time I could take off while not risking my job being lost. As of October 2023, I still continue to have permanent injury that makes certain tasks both at home and at work more challenging. When consulting the insurance team behind the construction crew, the construction team outright lied and denied everything, even saying they never had any interactions with me. They have since denied all attempts of contact after giving their final statement.
6 of 6
Associated Damages Rialto Incident May 16, 2023
Type Service date Member Provider or facity name Prescriptionname Provider billed Ax cost Plan Paid You May Owe Your Cost Totals Medical 2023-08-07 Michael-Nolhan (Self, Michasl Chiu 30 14,09 1.83 16.32 Medical 2023-08-07 Michael-Nothan (Self) Kack Hospital of USC 1081.75- 28.48 35 1145.23 Medical 2023-08-07 Michael-Nothan (Self Brian Hong 400 196.39 596.39
Medical 2023-07-05 Michael-Nolhan (Solf Eric White 30 14.69 1.69 48.32 : Modicel 2023-07-06 Michael-Nolhan (Seff Brian Hang 400 196.39 0. 596.39 2023-07-06 Michaet Nolhan (Solf) Kock Hospital of USC 1081,75 28.48 35 1145.23 Medicat
2023-08-08 Michael-Nolhan (Self) Brian Hong 400 230.17 35 665.17 • Model 2023-06-08 Michad Nathan (Self. USC Care Medical Group, Inc. 117 75.73 182.73 2023-05-18 Michaet-Nolhan (Sell). Brian Hong 6CO 308.35 35 843.35 Medical 2023-05-18 Michac-Nolhan (Self Maurice Yu 117 68.16 7.57 182.73 Medical 2023-05-18 Michae-No/han (Sett) Brian Hong. 600 540 60 1200
2023-05-18 Michael-Nolhan (Self, Orthokinetix 69.29 59.88 129.17 2023-05-16 Michael-Nolhan (Self, Anaheim Urgent Care Inc 298 100.5 25 426.5 Totats 5224.79 1805.03 295.71 7325.53
Associated Wages Rialto Incident May 16, 2023
: туро Total Per Week Total Per Month
Wages (Baso) $6252.80
Wages (Overtime) $3517.20 $14088.90 $42206.40
$5080.40 $20321.60 $60964.80
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