Mendez & Sanchez, APC
MENDEZ Attorneys at Law
5440 E. Beverly Bivd.
SANCHEZ CITY OF RIALTO Los Angeles, CA 90022
T: (323) 838-1444 F: (323) 838-1226
2015 MAY 15 PM12: 02 www.mendezsanchezlaw.com
RECEIVED
CITY CLERK
May 12, 2025
VIA CERTIFIED MAIL Certified No: 7022 3330 0000 7126 5421
RIALTO UNIFIED SCHOOL DISTRICT
182 E. Walnut Ave.,
Rialto, CA 92376
Rialto City Clerk's Office Certified No: 7022 3330 0000 7126 5438 150 S. Palm Ave.,
Rialto, CA 92376
RE: Application to File Late Gov. Claim for Damages; Gov. Code §§911.4 & 911.6 Client:
To the aforementioned agencies:
Attached please find Minor Claim for damages against the City of Rialto and/or Rialto Unified School District. This is an application to file a late government claim for damages, but still within the required one year statutory period.
This claim arises from a serious automobile versus bus collision that occurred on August 27, 2024. The collision was thought to be solely caused by Georgina Jovita Ordaz Alonso, the driver of the white, Honda Accord, who made an unsafe U-turn in front of Amalia Silva's bus.
However, it was not until we received the police report on or about April 8, 2025 that we learned that video surveillance exists depicting bus driver Amalia Silva traveling at 51 MPH within a 45 MPH zone. Due to a conflict on the bus, driver Amalia Silva was distracted immediately prior to the collision. (See Exhibit "A", Police report, pg. 23.).
Government Code § 911.4 allows a claimant to present an application to file a late claim, provided that the claim is presented within one year of the date of incident.
In pertinent part, Government Code § 911.6(b) expressly states that "[the board shall grant the application where one or more of the following is applicable:
(1) The failure to present the claim was made through mistake, inadvertence, surprise or excusable negligent and the public entity was not prejudiced in its detense of the claim...
(2) The person who sustained the alleged injury, damage, or loss was a minor during all of the time specified in Section 911.2 for the presentation of the claim"
Los Angeles Pasadena Orange County Las Vegas
Under the law, a "surprise" under Government Code § 911.6(b) exists when party/ claimant is placed in an injurious legal situation, through no fault of their own, that ordinary prudence wouldn't have guarded against.
Here, this instant circumstance is the exact reason that Government Code § 911.6(b) was implemented by the Legislature. Despite multiple requests, counsel was unable to obtain the police report until on or about April 8, 2025. It was only upon receiving this report that we learned for the first time—that liability was likely to be imposed on City of Rialto and/or Rialto Unified School District due to the fact that the bus driver was speeding at the time of the collision. Until that point, there was no factual basis to assert a viable governmental claim. The delay in obtaining this critical information was outside of claimant's control and could not have been avoided through the exercise of reasonable diligence. Minor has made request for such report since September 4, 2024. This constitutes a classic case of "surprise" under the statute and supports the granting of relief under Government Code § 911.6(b). No reasonable diligence on part of Minor (the claimant herein) could have discovered these facts.
Further, the claimant is a minor during all of the time specified in Section 911.2 for the presentation of the claim.
Further, there is absolutely zero prejudice to the government entity because a claim was already filed regarding the same incident by Deceased Freddy Arizpe (San Bernardino Case No. CIVSB2429872). It is also still well-within the required 1-year period to present this instant late claim. Minor claim form is also attached hereto as Exhibit "B".
However, should this late application not be granted, Minor legal injuries will suffer severe prejudice.
Minor therefore applies to present a late claim to City of Rialto and/or Rialto Unified School District. Again, this application is made well-within the one-year requirement of the Government Code. Should the City of Rialto and/or Rialto Unified School District deny this application, Minor intends to move the Court for an application to present a late claim. We are confident the Court would grant this motion and encourage the City of Rialto and/or Rialto Unified School District to accept this application for a late claim.
Please send any correspondences and/or documentation regarding this claim to:
MENDEZ & SANCHEZ
5440 E. BEVERLY BLVD
LOS ANGELES, CA 90022
[email protected]
[email protected]
Thank you, and we appreciate your notification within the required statutory period.
Very yours truly,
Britten foras
Brittany Farias, Esq.
Attorney at Law
BAF/ec
Encl
EXHIBIT "A"
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC CRASH REPORT Pago 1 of 33
CHP 555 Page 1 (Rev. 2-22) OPI 060
SPECIAL CONDITIONS CITY JUDICIAL DISTRICT | LOCAL REPORT NUMBER DUURED
FATAL RIALTO SAN BERNARDINO SUPERIOR COURT RANCHO 9860-2024-02558 14 CUCAMONGA COURTROUSE
Public School Bus 1 (44)
HUMBER COUNTY REPORTING DISTRICT BEAT BAY OF WEEK TTOWANAY
EIDEMKANOR
SAN BERNARDINO 901 S MOW TF S XVES •NO
CRASH OCCURRED ON CRASH AT AR CRASH TIME (2400) NOTIF. TIME (3400) NCICE OFFICER ID 0812772024 1500 18/27/202: 1510 9860 019429
LOCUST AVENUE
AT INTERSECTION WITH
XOR: 770 FEET NORTH of MIRO WAY •YES X] NO DINO E20240214-860 SP& COORDINATES POR LOCATION (LOC.) AND AREAS OF IMPACT NOD. NOT LAT. CRAME AS LOCATION LONG. Го ст. не томат соно LOC. 34.127283 -117.409785
LONG. LONG. ADDL AO DI
LONG. ACT LAT.
13 LAT.
STATE CLASS AIR BAO [SAFETY EQLIP. VEH YEAR MAKEMODELICOLOR LICENSE NUMBER STATE
PARTY DRIVER'S LICENSE NUMBER
CA M G 2019 HOND ACCORD WHI 8GTE653 CA
DRIVER NAME (FIRST, ABOOLE, LAST)
GEORGINA JOVITA ORDAZ ALONSO OWNER'S NAME ] SAME AS DRIV
STREET ADDRESS HUGO RODRIGUEZ HERNANDE
TRIAN
1529 VIRGINIA DRIVE CANER'S ADDRESS EX SAME AS DRIVER
PATRED CITY/STATE/P
VEHICLE
COLTON CA 92324 DISPOSITION OF VEHICLE ON ORDERS OF: [X] OFFICER DRIVER •OTHER BICY- SEX THAIR EYES TWEIGHT STATEWIDE TOWING - (951)682-9336 GUST PRIOR MECHANICAL DEFECTS:
F l BRN BRN 5'0" X NONE APPARENT REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: 1HGCV1F14KA010291
UNKNOWN VEHICLE TYPE DESCRIBE VEHICLE DAMAGE
POUCY NUMBER LUNK. NONE MINOR
INSURANCE CARRIER
ATOR 01
NONE NONE X MAJOR • ROLL-OVER
DIR OF TON STREET OR HIGHWAY LANE TOTAL I SPEED
TRAVE LANES CA DOT-
N LOCUST AVENUE 1 45 CALT TOPIPSC.
PARTY DRIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY ECLAP. VEH. YEAR MAKE/MODEUCOLOR LICENSE NUMBER STATE 2 CA B M G 2020 THOB SCHOOL BUS YEL 1573102 CA
DRIVER NAME (FIRST, MIDDLE, LAST)
AMALIA SILVA OWNER'S NAME SAME AS DRIVER
STREET ADDRESS RIALTO UNIFIED SCHOOL DISTRICT
TRIAN
525 SOUTH WILLOW AVENUE OWNER'S ADDRESS SAME AS DRIVER
PARKED CITY/STATE/ZIP 182 EAST WALNUT AVENUE RIALTO CA 92376
VEMICLE
RIALTO CA 92376 DISPOSITION OF VEHICLE ON ORDERS OF: •OFFICER [X DRIVER OTHER BICY. BEX HAIR EYES THEIGHT WEIGHT STATEWIDE TOWING - (951)682-9336 BRN BRN 5'3" PRIOR MECHANICAL DEFECTS: X NONE APPARENT REFER TO NARRATIVE F
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
NONE VEHICLE TYPE DESCRIBE VEHICLE DAMAGE BUR - TOP
OPER- POLICY NUMBER •UNK NONE | MINOR
INSURANCE CARRIER
SELF-INSURED SELF-INSURED 13 [MOR DO ROLL-OVER
DIR OF ON STREET OR MEGHWAY LANE TRU TOTAL SPEER 62952
LANES DOT.
TRAVEL
LOCUST AVENUE CALT - MCMX
PARTY ORIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY EQUIP. VEH. YEAR MAKEMODEL/COLOR LICENSE NUMBER STATE 3 DRIVER NAME (ARST, MIDDLE, LAST)
OWNER'S NAME •SAME AS DRIVER
PEDES STREET ADDRESS
OWNER'S ADDRESS I SAME AS DRIVER
PASSKED CITY/STATE/S
VELAGLE DISPOSITION OF VEHICLE ON ORDERS OF:
OFFICER DRIVER MOTHER
BICY. SEX THAIR EYES HEIGHT (WEIGHT RACE
PRIOR MECHANICAL DEFECTS: NONE APPARENT REFER TO MARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
VEHICLE TYPE DESCRIBE VEHICLE DAMAGE
OPER. INSURANCE CARRIER POLICY NUMBER •UNK CONONE OMINOR ATOR •AOD. MANOR ] ROLL-OVER
DIR OF ON STREET OR HIGHWAY LANE THRI TOTAL SPEED
pOT.
TRAVEL LANE: LANES
- MONIX
PREPARER'S NAME DISPATCH NOTIFIED REVIEWER'S NAME DATE REVIEWED S. C HODDER 01/30/2025
JASON M GARBER, 019429 ] NO • NA
An Internationally Accredited Agency Destroy Previous Editions
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC CRASH CODING Page2 of 33
CHP 555 Page 2 (Rev. 2-22) OP: 060
CRASH DATE (MO. DAY YEAR) CRASH TIME (2400) NCIC # OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
PROPERTY TOWNER'S NAME OWNER'S ADDRESS
DAMAGE
PERSON NOTIFIED SAME AS OWNER TELEPHONE NUMBER METHOD OF NOTIFICATIOI (MARK ALL, THAT APPLY) [LOG/ INCIDENT NUMBER N PERSON PHONE DISPATCH CHP 422
DESCRIPTION OF DAMAGE
SEATING POSITION SAFETY EQUIPMENT AIR BAG INATTENTION CODES OCCUPANTS CHILD RESTRAINI B- UNKNOWN • CELLPHONE HANDHE
A - NONE IN VEHICLE ) - IN VEHICLE USED -M AIR BAG NOT DEPLOYED CELLPHONE HANDSFF 1 TO 9 - STANDARD SEATING B- UNKNOWN - IN VEHICLE NOT USED C-RADIO/ONG EQUIPMENT
POSITION C - LAP BELT USED S - IN VEHICLE USE UNKNOWN N- OTHER
D - LAP BELT NOT USED P- NOT REQUIRED
T - IN VEHICLE IMPROPER USE - SMOKING
10 - REAR OCC. TRK, VAN, E - SHOULDER HARNESS USED U - NONE IN VEHICLE 1 2 3 EJECTED FROM VEHICLE - - EATING
STATION WAGON, ETC.* F. SHOULDER HARNESS NOT USED
4 5 6 G - LAP/SHOULDER HARNESS USED BLIC BICYCLE- HELMET 0- NOT EJECTED G- CHILDREN H- LAP/SHOULDER HARNESS NOT USED 1 - FULLY EJECTED H- ANIMALS 789 11 - POSITION UNKNOWN" DRIVER PASSENGER 1- PERSONAL HYGIENE J- PASSIVE RESTRAINT USED V-NO x-NO 3 - PAKHOMY EJECTED J- READING 10 0- OTHER* K - PASSIVE RESTRAINT NOT USED W-YES y - YES
P- NOT REQUIRED (- OTHER
ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK (*) SHOULD BE EXPLAINED IN THE NARRATIVE.
PRIMARY CRASH FACTOR TRAFFIC CONTROL DEVICES 1 2 3 VEHICLE AUTOMATION LEVEL 12 3 MOVEMENT PRECEDING CRASH
LIST NUMBER (E) OF PARTY AT FAULT
CITED A CONTROLS FUNGTIONING X A SAE LEVEL - 0 A STOPPED 1 A VC 21801(a) YES B PROCEEDING STRAIGHT
B CONTROLS NOT FUNCTIONING* X B SAE LEVEL - 1
B OTHER IMPROPER DRIVING: C CONTROLS OBSCURED C. SAE LEVEL -2 C RAN OFF ROAD X D NO CONTROLS PRESENT / FACTOR* D SAE LEVEL - 3 D MAKING RIGHT TURN C OTHER THAN DRIVER* TYPE OF CRASH E SAE LEVEL -4 E MAKING LEFT TURN D UNKNOWN* A HEAD-ON F SAE LEVEL - 5 IF MAKING U TURN
B SIDE SWIPE G UNKNOWN* G BACKING
C REAR ENO H SLOWNG/STOPPING
2 VEHICLE AUTOMATION ENGAGED
WEATHER (MARK 1 TO 2 ITEMS) X D BROADSIDE PASSING OTHER VEHICLE
X A CLEAR E HIT OBJECT IX A NO AUTOMATION L CHANGING LANES
B CLOUDY F OVERTURNED B DRIVER ASSISTANCE K PARKING MANEUVER
C RAINING G VEHICLE / PEDESTRIAN C PARTIAL AUTOMATION L ENTERING TRAFFIC D SNOWING H OTHER*: D CONDITIONAL AUTOMATION MOTHER UNSAFE TURNING E FOG /VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH E HIGH AUTOMATION IN XING INTO OPPOSING LANE F OTHER*: (MARK 1 TO 2 ITEMS) F FULL AUTOMATION O PARKED G MND A NONCOLLISION G UNKNOWN* P MERGING
LIGHTING B PEDESTRIAN Q TRAVELING WRONG WAY
X A DAYLIGHT X C OTHER MOTOR VEHICLE OTHER ASSOCIATED FACTOR/S R OTHER':
2 (MARK 1 TO ZITEMS)
B DUSK - DAWN D MOTOR VEHICLE ON OTHER ROADWAY S LANE SPLITTING
C DARK - STREET LIGHTS E PARKED MOTOR VEHICLE CIC SECTION VIOLATKR CITED
A YES SOBRIETY - DRUG - PHYSICAL
F TRAIN Eva (MARK ALL THAT APPLY
D DARK - NO STREET LIGHTS
E DARK - STREET LIGHTS NOT G BICYCLE CVC SECTROW VIOLATIONE CITED YES X X A HAD NOT BEEN DRINKING FUNCTIONING® H ANIMAL: I'NO B HBD - UNDER INFLUENCE
ROADWAY SURFACE /FIXED OBJECT: C CHO SECTION VIOLATION: C HBD- NOT UNDER INFLUENCE* X A DRY •INO D HBD - IMPAIRMENT UNKNOWN'
B WET. J OTHER OBJECT: E UNDER DRUG INFLUENCE*:
C SNOWY - ICY E VISION OBSCUREMENT: DRE EXAM. CONDUCTED D SLIPPERY (MUDDY, OILY, ETC.) K ADDITIONAL OBJECTS STRUCK E INATTENTION®: STIMULANT
ROADWAY CONDITION(S) PEDESTRIAN'S ACTIONS G STOP & GO TRAFFIC HALLUCINOGEN (MARK 1 TO 2 ITEMS) X A NO PEDESTRIANS INVOLVED H ENTERING / LEAVING RAMP DISSOCIATIVE ANESTHETICS
A HOLES, DEEP RUT B CROSSING IN CROSSWALK PREVIOUS CRASH NARCOTIC ANALGESIC B LOOSE MATERIAL ON ROADWAY* AT INTERSECTION INHALANT
C OBSTRUCTION ON ROADWAY• CAT INTERSECTOSSWALK NOT CANNABIS
D CONSTRUCTION - REPAIR ZONE DEPRESSANT
LE REDUCED ROADWAY WIDTH L UNINVOLVED VEHICLE F IMPAIRMENT - PHYSICAL• F FLOODED• MOTHER:: G IMPAIRMENT NOT KNOWN
G OTHER*: F NOT IN ROAD x /x IN NONE APPARENT H NOT APPLICABLE
SKETCHO UNUSUAL CONDOTONS G APPROACHING / LEAVING SCHOOL BUS LO RUNAWAY VEHICLE I SLEEPY / FATIGUED
MISCELLANEOUS
1 2 3 SPECIAL INFORMATION
REFER TO SKETCH PAGE(S) A HAZARDOUS MATERIAL
INDICATE NORTH B CELL PHONE HANDHELDIN USE
C CEL PHONE HANDSFREE N
X ID CELL PHONE NOT IN USE
E CELL PHONE USE UNKNOWN
F SCHOOL BUS RELATED
1 3 BIKEWAY FACILITY
A SHARED ROADWAY
B CLASS I - BIKE PATH'
C CLASS II - BIKE LANE'
D CLASS III - BIKE ROUTE:
•REFER TO NARRATIVE FOR ADDITONAL INFORMATION E GREWAY- SEPARATED An internationally Accredited Agency
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED / WITNESS / PASSENGERS Page 3 of 33
CHP 555 Page 3 (Rev. 2-22) OP 060
NCIC & OFFICER D NUMBER
CRASH DATE (MO. DAY YEAR) CRASH TIME (2400)
082182024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY (*X" ONE) INJURED WAS (*"ONE) PARTY BEAT AIR SAFETY EJECTED WITNES& PABBENGER AGE 8BX NUMBER POS. BAG EQUIP.
ONLY ONLY FATAL SUSPECTED SERIOUS SUSPECTED MINOR POSSIBLE DRIVER PASS. PED. BICYCLIST OTHER OPER.
INJURY NJURY INJURY
18 M X 1 6 L
TELEPHONE
NAME / D. O. B. / ADDRESS
FREDY ARIZPE UNKNOWN/UNKNOWN
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
RIALTO FIRE DEPARTMENT ARROWHEAD REGIONAL MEDICAL CENTER BLUNT FORCE TRAUMA TO HEAD AND TORSO RESULTING IN FATAL INJURIES. PRONOUNCED DECEASED BY DOCTOR REBECCA HOUSTON ON AUGUST 29, 2024, AT 1617 HOURS, SAN BERNARDINO COUNTY DEPUTY CORONER INVESTIGATOR K. WOOD, IS F6930. CORONER CASE NUMBER 702405964.
VICTIM OF VIOLENT CRIME NOTIFIED
1 IM G
42 F
TELEPHONE
NAME / D. O. B, / ADDRESS
GEORGINA JOVITA ORDAZ ALONSO
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
ARROWHEAD REGIONAL MEDICAL CENTER
RIALTO FIRE DEPARTMENT
DESCRIBE INJURIES
BRAIN BLEED, BRAIN BRUISING
•* 19
NAME / D. O. B. / ADDRESS
DAISY RODRIGUEZ-ROMERO,
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
ARROWHEAD REGIONAL MEDICAL CENTER
RIALTO FIRE DEPARTMENT
DESCRIBE INJURIES
BRAIN RLEED AND BRAIN BRITISING
11 M X
NAME /0,0,B./ ADDRESS
TIAN KAING
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
CITY OF RIALTO FIRE KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
ABRASION TO RIGHT COLLAR BONE AND PAIN TO RIGHT ARM
13 F
NAME /D. O, B, /ADDRESS
DARIANY SANTOS MALDON ..............
(INJURED ONLY) TRANSPORTED BY: TAKEN TO:
ES RUN NUMBER: KAISER PERMANENTE FONTANA
CITY OF RIALTO FIRE
DESCRIBE INURIES
SCRATCHES TO LEFT SHIN, NAUSEA, AND PAIN TO HEAD
22 F 0
NAME / D. O, B. /ADDRESS
AMALIA SILVA...
(INURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
NOT TRANSPORTED WILL SEEK OWN AID
DESCRIBE INJURIES
PAIN TO BACK
VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME ID NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
STATE OF CALIFORNIA
JEPARTMENT OF CALIFORNIA HIGHWAY PATROI
INJURED / WITNESS / PASSENGERS Page 4 or 33
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (NO. DAY YEAR) CRASH TIME (2400) NCIC B OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
WITNESS PASSENGER EXTENT OF INJURY ("X"ONE) INJURED WAS ("X" ONE) SAFETY EJECTED ONLY AGE SEX NUMBER POS.
ONLY FATAL
DRIVER PASS. BICYCLIST OTHER
INJURY
" M
NAME / D. O. B. / ADDRESS TELEPHONE
KING FELLOWS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
CITY OF RIALTO FIRE KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
PAIN TO NOSE. HEAD. CHESL.AND LEFT SIDE OF WAIST
13 NAME / D. O.B./ ADDRESS
SKY KAING
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
CITY OF RIALTO FIRE KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
PAIN TO BACK, STOMACH, AND HEAD
NAME/D.O. 8./ADDRESS
JACOB WILLIAMS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
CITY OF RIALTO FIRE KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
PAIN TO HEAD, NECK, AND LOWER BACK
11. NAME /D.O. B./ADDRES$
HANNAH URIOSTIGUE
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO.
SANDRA AMAYA KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
PAIN TO HEAD
11 F
NAME /D. O,8. /ADDRESS
SADIE PEACE /
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER; TAKEN TO.
CITY OF RIALTO FIRE LOMA LINDA UNIVERSITY MED CENTER
DESCRIBE INJURIES
PAIN TO NECK AND LOWER BACK
7* 13 F
NAME/D. O. B./ADDRESS
ARMANI STEWART
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
CITY OF RIALTO FIRE KAISER PERMANENTE FONTANA
DESCRIBE INJURIES
PAIN TO HEAD
VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME ED NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED / WITNESS / PASSENGERS Page 5 of 33
CHP 555 Page 3 (Rev. 2-22) OPI 080
CRABH DATE (MO. DAY YEAR) CRASH TIME (2400) NCIC * OFFICER D NUMBER 08272024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY ("X" ONE) INJURED WAS ("X" ONE) PARTY BEAT
WITNESS PASSENGER AIR
AGE SEX NUMBER POS. BAG
ONLY ONLY PATAL • POBIBLE DRIVER PASS, PED. BICYCLIST OTHER OPER.
SUSPECTED SERIOUS SUSPECTED MINOR
CURY INJURY
14 F X [x) 2 0
TELEPHONE
NAME / D. O. B. / ADDRESS
CHLOE MAGANA
(UNLURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
NOT TRANSPORTED WILL SEEK OWN AID
DESCRIBE INJURIES
PAIN TO HEAD AND NAUSEA
11 NAME / D. O. B. / ADDRESS
MADISON MAGANA
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
NOT TRANSPORTED WILL SEEK OWN AID
DESCRIBE INJURIES
POSSIBLE CONCUSSION
NAME /D. O. B./ ADDRESS
SOPHIA MAGANA
(INURED ONLY) TRANSPORTED BY: TAKEN TO:
EMS RUN NUMBER:
WILL SEEK OWN AID
NOT TRANSPORTED
DESCRIBE INJURIES
PAIN TO RIGHT BOREARM
•* 11 F
NAME /D. O.B. / ADDRESS
OLIVIA ANAYA
(NJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO.
DESCRIBE DURIES
VICTIM OF VIOLENT CRIME NOTIFIED
To loo old LI.
NAME / D. O, B. / ADDRESS
DELILAH ARCOS ABUNDES
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
X 11 M
NAME /D. O. B. /ADDRESS
ISAIAH BOJORQUEZ UNKNOWN/NONE
(INLURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE IURIES
• VICTIM OF VICLENT CRIME NOTIFIED
PREPARER'S NAME ID NUMBER NO. DAY YEAR REVIEWER'B NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
STATE OF CALIFORNIA
JEPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED / WITNESS / PASSENGERS Page 6 of 33
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (MO. DAY YEAR) CRASH TIME (3400) NGIC B OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY ("X" ONE)
WITNESS PASSENGER
AGE SEX
ONLY ONLY FATAL SUSPECTED SERIOUS SUSPECTED NINOR POSSIBLE
INJURY INJURY INJURY
#
12 F
NAME /D.O. B./ADDRESS
SADIE CAMACHO-SILVA
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
* 13 M
NAME ID, O, B. / ADDRESS
NATHAN CAMPOS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
11 M
NAME /D. O. B. /ADDRESS
EMMANUEL CASTELLANOS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
12 NAME /D. O. 8. I ADDRESS TELEPHONE
ANGEL CASTILLO (12/31/2011)
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
•• I
NAME /D. O. B./ADDRESS
DANNY CASTRO
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE (NJURIES
•* 11
NAME /D. O. 8, / ADDRESS
NIKAISHIA CORTEZ IBARRA,...............
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
• VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME I NUMBER NO. DAY YEAR REVIEWER'S NAME NO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
TE OF CALIFOR
ARTMENT OF CALIFORNIA HIGHWAY PATR
INJURED / WITNESS / PASSENGERS Page 7 of 33
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (NO. CRASH TIME (2600) INCE B OFFICER ID NUMBER
DAY YEAR
08/27/2024 1500 986Đ 019429 9860-2024-02558
EXTENT OF INJURY ("X" ONE) INJURED WAS (*X" ONE) PARTY BEAT AIR SAFETY EJECTED
WITNESS PASSENGER
ONLY AGE SEX NUMBER POS. BAG EQUIP.
ONLY FATAL POSSIBLE OPER.
DRIVER PASS, PED. BICYCLIST OTHER
ENLFURY INJURY INJURY
•* 11 F 2 P B 0
TELEPHONE
NAME / D. O. B./ADDRESS
WENDY FERNANDEZ
(INURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
13 MI
LAME / D. O, B. / ADDRES!
DANIEL GALAN (
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE LURIS
RAUL GARCIA
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
•*
NAME / D. O. B. / ADDRESS
ASTRID GONZALES HERN.
(RJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
• x
NAME / D. O. B. / ADDRESS
NEVAEH JUAREZ
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER TAKEN TO:
DESCRIBE INUURIES
13 M • 10l0l0l0000 c
NAME / D. O, B. / ADDRESS
DAMIAN LARA
(LURED ONLY) TRANSPORTED BY: EMB RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
• VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME ID NUMBER NO DEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An internationally Accredited Agency
STATE OF CALFORNIA
EPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED / WITNESS / PASSENGERS
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (MO. DAY YEAR) CRABH TIME (2400) OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
WITNESS PASSENGER EXTENT OF INJURY (**" ONE) SAFETY EJECTED
ONLY ONLY AGE BEX
FATAL SUSPECTED SERIOUS SUSPECTED MINOR
INJURY INJURY
11 F
NAME / D. O. B. / ADDRESS
ARLENE LOPEZ
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
13 M
NAME /D. O. B. /ADDRESS
MASON LOPEZ
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INDIRIES
X 12 F
101010060001 t
NAME / D, O, BIADDRESS
JANELLA MACKEY
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE JURIES
12 M
NAME /D. O, B, / ADDRESS
JOHNNY MEDINA ENCISO
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE URIES
•*
NAME / D. O. B. / ADDRESS
NATALIE MEJA GOMEZ
(LURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: T TAKEN TO
DESCRIBE INJURIES
•* 13 F
NAME /D.O. B. /ADDRESS
JOSSELIN OSTORGA SORIA
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
• VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME • NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. CHODDER 01/30/2025
An Intornationally Accredited Agency
ALFORNIA HIGHWAY PATROI
INJURED / WITNESS / PASSENGERS Page 9 of 33
CHP 555 Page 3 (Rev. 2-22) OP| 060
CRASH DATE (MO. DAY YEAR) CRASH TIME (2400) OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY ("X" ONE) INJURED WAS ("*" ONE) PARTY SEAT SAFETY CUECTED WITNES PAGBENGER AGE SEX NUMBER POS.
ONLY ONLY POSSIBLE
DRIVER PASS. PED. BICYCLIST OTHER OPER
INJURY INJURY
11 M 2 P B 0
TELEPHONE
NAME /D. O. B. / ADDRESS
ALEXANDER PENATE.
INJURED ONLY TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO.
DESCRIBE INJURIES
12 F
NAME /D. O. 8./ ADDRESS
NEVAEH ROBINSON ....
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
1B"MO1010101000000E1
NAME /0.0. 8/ADDRESS
LUIS SALAS....
(INLURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO.
DESCRIBE INJURIES
TAKEN TO:
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTUFIED
• 000000020
JAMAIR SMITH I
(INJURED ONLY) TRANSPORTED BY: TAKEN TO:
DESCRIBE INJURIES
L* 12
NAME /D. O. B. / ADDRESS
ANAYA SOLIZ..
(MURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
• VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME ID NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 S. CHODDER 01/30/2025
An Internationally Accredited Agency
TATE OF CALIFORNI
PARTMENT OF CALFORNIA HIGHWAY PATRO
INJURED / WITNESS / PASSENGERS Page 10 or 33
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (NO. DAY YEAR CRASH TIME (2400) NCIC & OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY ("X" ONE) INJURED WAS ("X" ONE)
WITNESS PASSENGER PARTY BEAT SAFETY EJECTED
SEX NUMBER POS. EQUIP.
ONLY ONLY FATAL SUSPECTED SERIOUS SUSPECTED MINOR POSSIBLE
ENJURY BURY INSURY INJURY
• 066006:...
12 F
NAME / D. O. B. / ADDRESS
ANDREA SOLIZ,
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
NAME / D. O. B. / ADDRESS
URIEL SORIANO
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
13 NAME /0. 0, B,/ ADDRESS
LESLY TABAREZ-RAMIR
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
X 12 M
NAME /D. O. B./ ADDRESS
KEMONTAY WILLIAMS.
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER:
DESCRIBE INJURIES
NAME /D. O. B. / ADDRESS
SCARLET VARGAS..
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
13 M l
NAME / D. O. B./ ADDRESS
JOHN VARGAS (04/12/2011)
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE LURIES
VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME ID NUMBER SO DAY YEAR REVIEWER'S NAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
CALIFORNIA HIGHWAY PATRO!
INJURED / WITNESS / PASSENGERS Page 11 of 33
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (NO. DAY YEAR CRASH TIME (2400) NCIC S OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
EXTENT OF INJURY (**X" ONE) INJURED WAS ("X" ONE) SAFETY EUECTED
WITNESS PASSENGER SEX
ONLY AGE EQUIP.
ONLY FATAL POSSIBLE
INJURY INJURY
x* 1 35 M
NAME /D.O.B. /ADDRESS TELEPHONE
KEVIN SANCHEZ.
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
NAME / D. O. B. / ADDRESS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER:
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
e 010 10 00000
(JURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
•*
NAME /D. O.8/ADDRESS
(ILURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
•*
NAME / D. O. B./ ADDRESS TELEPHONE
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO.
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
NAME / D. O.B./ADDRESS TELEPHONE
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO:
DESCRIBE INJURIES
• VICTIM OF VIOLENT CRIME NOTIFIED
PREPARER'S NAME MO. DAY REVIEWER'S MAME MO. DAY YEAR
JASON M GARBER 08/27/2024 S. C HODDER 01/30/2025
An Internationally Accredited Agency
DEPARTMENT CAL ORNA HICHMAY PATROL
SKETCH DIAGRAM
CHP 555 Page 4 (Rev. 2-22) OPI 060 Page 12 of33
CRASHDATE (MO, DAY YEAR) CRASH TIME (2400) NGIC • OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED (SCALE = ) Locust
• E
Avenue
S
Southbound Southbound Northbound Northbound
:
....
Vehicle #2
Vehicle #1
Vehicle #1
:
: •
•
:
-
-
Miro Way
A. Concrete Curbs
C: Raled Double Yellow Ceramic Lanters
-20 ft.- 901262124,0 -20 ft.—
PREPARED BY ID NUMBER NO. DAY YEAR REVIEWERS MANE NO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 An Internationally Accredited Agency
DEPARTMENT OF CALFORAIA HIGHWAY PATROL
FACTUAL DIAGRAM
CHP 555 Page 4 (Rev. 2-22) OPI 060 Page 13 of33
CRASH DATE (NO. DAY YEAR) CRASH TIME (2400) OFFICER ID NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED (SCALE = Locust
• E
Avenue
S
Southbound Southbound Norbid Northbound
• •
•
Mire Way
Aspahlt Roadway Surface
-20 ft.- 2712(t-7712(t.+ -20 ft.
PREPARED BY ID NUMBER NO. DAY YEAR REVISWERS HAME MO. DAY YEAR JASON M GARBER 019429 08/27/2024 S. CHODDER 01/30/2025
An Internationally Accredited Agency
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 14 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 FACTUAL DIAGRAM LEGEND:
2 3 VEHICLE POINTS OF REST:
VEHICLE WHEEL FEET DIRECTION REFERENCE FEET DIRECTION SECOND
POINT REFERENCE
POINT
1 Left 595 North North roadway 2 East West roadway
Front edge edge of Locust
prolongation line Avenue
of Miro Way
1 Left 586 North North roadway 6 East West roadway
Front edge edge of Locust
prolongation line Avenue
of Miro Way
2 Left 596 North North roadway 17 East West roadway
Front edge edge of Locust
prolongation line Avenue
of Miro Way
2 Left 619 North North roadway 15 East West roadway
Front edge edge of Locust
prolongation line Avenue
of Miro Way
4 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 •
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 15 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE:
1. Vehicle 1's Rear Window (Center) 11. Middle Tire Friction Mark #3 21. Start Tire Friction Mark
2. Vehicle 2's Front Grille Plate (Center) 12. End Tire Friction Mark #3 22. Middle Tire Friction Mark #5
3. Start Tire Friction Mark #1 13. Start Tire Friction Mark #4 23. End Tire Friction Mark #5
4. Middle Tire Friction Mark #1 14. Start Gouge Mark #1 24. Start Tire Friction Mark #6
5. End Tire Friction Mark #1 15. End Gouge Mark #1 25. Middle Tire Friction Mark #6
6. Start Tire Friction Mark #2 16. End Tire Friction Mark #4 26. End Tire Friction Mark #6
7. Middle Tire Friction Mark #2 17. Start Curb Scuff #1 27. Start Tire Friction Mark #7/ Gouge Mark #2
8. End Tire Friction Mark #2 18. End Curb Scuff #1 28. Middle Tire Friction Mark #7/ Gouge Mark #2
9. Start Tire Friction Mark #3 19. Start Curb Scuff #2 29. End Tire Friction Mark #7/ Gouge Mark #2
10. Middle Tire Friction Mark #3 20. End Curb Scuff
2 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 16 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE LOCATION:
# Feet Direction First Reference Feet Direction Second Reference Point Point
1 732 North North roadway 24 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
2 645 North North roadway 12 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
3 770 North North roadway 26 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
4 759 North North roadway 25 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
5 742 North North roadway 24 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
6 768 North North roadway 20 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
7 731 North North roadway 13 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
8 692 North North roadway 6 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
9 758 North North roadway 28 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
10 742 North North roadway 24 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
2 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 17 OF 33
DATE OF INCIDENT NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE LOCATION (continued):
11 695 North North roadway 6 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
12 674 North North roadway On Vest roadway edg
edge prolongation f Locust Avenu
line of Miro Way
13 757 North North roadway 19 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
14 755 North North roadway 18 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
15 752 North North roadway 17 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
16 695 North North roadway On West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
17 692 North North roadway On West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
18 670 North North roadway On West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
19 655 North North roadway On West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
20 645 North North roadway On West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
2 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 18 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE LOCATION (continued)
21 632 North | North roadway 3 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
22 608 North North roadway 7 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
23 595 North North roadway 2 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
24 629 North North roadway 5 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
25 605 North North roadway 4 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
26 600 North North roadway 3 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
27 640 North North roadway 4 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
28 613 North North roadway 16 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
29 586 North North roadway 6 East West roadway edge
edge prolongation of Locust Avenue
line of Miro Way
2 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 19 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 All times, speeds, and measurements throughout this report are approximate. Measurements 2 were obtained using visual estimation and GPS unless otherwise stated. All opinions and 3 conclusions were based on evidence and/or statements. 4 5 FACTS:
6 7 SCENE DESCRIPTION:
8 9 This crash occurred on Locust Avenue, north of Miro Way, within the city limits of Rialto. At this 10 location, Locust Avenue is a designated north/south, relatively flat, asphalt paved roadway, which 11 is maintained by the city of Rialto. There is one 12-foot-wide lane and one 20-foot-wide lane for 12 northbound traffic, which are delineated by raised white ceramic lane delineators. There is one 13 12-foot-wide lane and one 20-foot-wide lane for southbound traffic, which are delineated by raised 14 white ceramic lane delineators. The northbound and southbound lanes are separated by a set of 15 raised yellow ceramic lane delineators. The roadway is bordered to the east and west by concrete 16 curbs. The posted speed limit at the location of this crash is 45 miles per hour. 17 18 This crash occurred during daylight hours. The roadway was dry and there were no roadway 19 defects or visual obstructions observed or claimed.
20 21
22 23
24 25
26 27
28 29
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 20 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER ID. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 SCENE DESCRIPTION (continued):
2 3 The following weather observations were recorded for August 27, 2024, and were sourced from 4 www.wunderground.com. The following observations were recorded for the area of Rialto, CA 5 92376. The recorded data is consistent with my observations at the scene. 7 Date: August 27, 2024
8 Time: 12:51 PM Pacific Standard Time
9 Temperature: 91 Degrees Fahrenheit
10 Dew Point: 46 Degrees Fahrenheit
11 Humidity: 21%
12 Wind Speed: 5 miles per hour
13 Wind Direction: West-Southwest
14 15 Refer to the Factual Diagram and the Factual Diagram Legend for further roadway depiction. 16 17 PARTIES:
18 19 Party #1 (Georgina Jovita Ordaz Alonso) was transported to Arrowhead Regional Medical 20 Center prior to my arrival. On August 27, 2024, at 1600 hours, Officer D. Gates, ID 22316, 21 responded to Arrowhead Regional Medical Center and located Party #1. Party #1 was positively 22 identified as Georgina Jovita Ordaz Alonso by her valid California driver license. Party #1 was 23 established as the driver of Vehicle #1 (Honda Accord) at the time of the crash by the following:
24 25 - Injuries sustained by Party #1 correspond with this crash. 26 - Party #1 was located by the Rialto Fire Department unconscious in the driver seat of 27 Vehicle #1.
28 - Party #1 shares the same address as the registered owner of Vehicle #1. 29 PREPARED BY T.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 21 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PARTIES (continued):
2 3 Vehicle #1 (Honda Accord) came to rest on its wheels, facing in a northwesterly direction, 4 blocking the southbound #2 lane of Locust Avenue, against the right front side of Vehicle #2. 5 Vehicle #1 sustained major damage, including, but not limited to: The right fender was crumpled, 6 the right side doors were crumpled, the right "A" pillar, right "B" pillar, and right "C" pillar were 7 buckled, the roof was crumpled, the right quarter panel was crumpled, the right rear wheel was 8 displaced, the rear bumper cover was displaced, the trunk was displaced, the right rear light 9 fixture was broken, the left rear tire was off the bead, the windshield was shattered, the rear 10 window was shattered, the right side windows were shattered, and the right-side skirt airbag 11 deployed. No prior mechanical defects were noted or claimed. The driver position seatbelt, the 12 right front passenger seatbelt and the right rear passenger seatbelt in Vehicle #1 were visually 13 inspected and appeared to be in proper working order. 14 15 Party #2 (Amalia Silva) was contacted on scene standing next to Vehicle #2 (Thomas) upon my 16 arrival. Party #2 was identified by her valid California driver license. Party #2 was established as 17 the driver at the time of the crash by the following:
18 19 - Party #2 admitted to driving Vehicle #2.
20 - Party #2 had specific knowledge of the crash.
21 - Party #2 is employed by the registered owner of Vehicle #2 22 23 Vehicle #2 (Thomas) came to rest on its wheels, facing in a southerly direction, blocking the 24 southbound #2 lane of Locust Avenue, against the right side of Vehicle #1. Vehicle #2 sustained 25 minor damage, including, but not limited to: The left fender was crumpled, the front bumper was 26 crumpled, the headlight panel was scraped, and the left front side was dented and bent, the front 27 grille plate was detached, and the front license plate was bent. No prior mechanical defects were 28 noted or claimed. The seatbelts in Vehicle #2 were visually inspected and appeared to be in 29 proper working order.
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S.CHODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 22 OF 33
DATE OF INCIDENT NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE:
2 3 Refer to the Factual Diagram Legend and the Factual Diagram for points of rest and physical 4 evidence.
5 6 PHOTOGRAPHS:
7 8 There were 538 digital color photographs taken of the crash scene, involved vehicles, and 9 physical evidence by Sergeant J. Sauceda, ID 20596. These photographs were downloaded onto 10 two non-rewriteable compact discs. One disc was booked into the San Bemardino Area evidence 11 locker, booking number E2024-0214-860. The second disc will be maintained in the San 12 Bernardino Area digital media file.
13 14 l obtained a video of the crash from the Monster Distribution Center, located at an address of 15 1405 North Locust Avenue, Rialto, California 92377. The video depicts Vehicle #2 traveling 16 southbound on Locust Avenue, in the #1 lane. Vehicle #1 enters the video traveling northbound 17 on Locust Avenue, in the #1 lane. Vehicle #1 then proceeds to make a U-turn directly in front of 18 Vehicle #2. Vehicle #2 then crashes into the right side of Vehicle #1. The video was downloaded 19 onto two non-rewriteable compact discs. One disc was booked into the San Bernardino Area 20 evidence locker, under booking number E2024-0214-860. The second disc will be maintained in 21 the San Bernardino Area digital media file.
22 23
24 25
26 28
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/2712024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 23 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 PHYSICAL EVIDENCE (continued):
2 3 I obtained a video from the interior of Vehicle #2 at the time of the crash from the Rialto Unified 4 School District. The video depicts Vehicle #2 traveling southbound on Locust Avenue, in the #1 5 lane, at 51 miles per hour. Party #2 glances at the rear-view mirror, looks forward and makes a 6 facial expression. Party #2 applies the brakes, slows to 44 miles per hour, and then you hear a 7 crash. Vehicle #1 appears in the video to the right of Vehicle #2. You can see Vehicle #1 through 8 the glass of the passenger entry. The video was downloaded onto two non-rewriteable compact 9 discs. One disc was booked into the San Bernardino Area evidence locker, under booking 10 number E2024-0214-860. The second disc will be maintained in the San Bernardino Area digital 11 media file.
12 13
14 15
16 17
18 20
21 22
23 24
25 26
27 28
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 24 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 OTHER FACTUAL INFORMATION:
2 3 Pre-Crash Profile for Party #1: Refer to Officer G. Lomenick's, ID 18972, attached supplemental. 4 5 Party #1 was unable to produce proof of insurance and there was no proof of insurance located in 6 Vehicle #1, a violation of California Vehicle Code section 16028(a). 8 The following personnel responded to the crash scene:
9 10 California Highway Patrol San Bernardino Area
11 2211 Western Avenue, San Bernardino, CA 92411
12 (909) 383-4247
13 14 Unit 75-S3, Sergeant J. Sauceda, ID 20596 - Supervisor / Photographs 15 Unit 75-S8, Acting Sergeant J. Wheatley, ID 20626 - Supervisor / Photographs 16 Unit A75-214, Officer J. Garber, ID 19429 - Investigating Officer 17 Unit A75-202, Officer D. Peterson, ID 16590 - Measurements / Sketch / Factual Diagram 18 Unit 75-D6, Officer K. Fadgen ID 19251 - Vehicle impound 19 Unit 75-D10, Officer D. Gates ID 22316 - Responded to Arrowhead Regional Medical Center to 20 obtain Party #1's, Passenger Arizpe's, and Passenger Rodriguez-Romero's identifying information 21 and extent of injuries
22 Unit A75-R1, Officer A. Lujan, ID 22539 - Obtained Vehicle #2's passenger information 23 25
26 27
28 29
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 25 OF 33
DATE OF INCIDENT NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 OTHER FACTUAL INFORMATION (continued):
3 Rialto Police Department
4 128 North Willow Avenue, Rialto, CA 92376
5 (909) 820-2550
6 7 The following Rialto Police Department personnel responded to the scene initially because the 8 crash occurred in the city of Rialto.
9 10 Lieutenant J. Mills, ID 00916
11 Sergeant K. Stephens, ID 01504
12 Sergeant D. Smith, ID 02320
13 Corporal M. Martinez, ID 01324
14 Officer G. Tolino, ID 02396
15 Officer R. Baxter, ID 02334
16 Officer F. Arroyo, ID 01813
17 Officer D. Couto, ID 02055
18 Law Enforcement Technician T. Disney, ID 02235
19 20
21 22
23 24
25 26
27 28
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 26 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 OTHER FACTUAL INFORMATION (continued):
3 Rialto Fire Department:
4 131 South Willow Avenue, Rialto, CA 92376
5 (909) 820-2501
6 7 The following Rialto Fire Department personnel responded to the scene. Due to the severity of 8 the crash and the number of patients requiring care, Rialto Fire Department personnel ID numbers 9 and positions were not obtained.
10 11 Medic Engine 202
12 Gardner, Patient Care
13 Flanders, Patient Care
14 Cowling, Patient Care
15 Medic Truck 203
16 Valdez, Patient Care
17 Terveen, Patient Care
18 Klien, Patient Care
19 Voyce, Patient Care
20 21 Medic Ambulance 201
22 Delgado, Patient Care
23 Melton, Patient Care
24 25 Medic Ambulance 202
26 Ryser, Patient Care
27 Tucker, Patient Care
28 29
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 27 OF 33
DATE OF INCIDENT NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 OTHER FACTUAL INFORMATION (continued):
3 Medic Ambulance 205
4 Vigil, Patient Care
5 Shipman, Patient Care
6 7 San Bernardino County Coroner
8 Coroner's Report #702405964
9 175 South Lena Road, San Bernardino, CA 92415
10 (909) 387-2978
11 Investigator K. Wood, ID F6930
12 13 The Inland Communications Center, Incident Detail Report, number 240827IN0541, contained a 14 list of one reporting party (Kevin) that called 9-1-1 to report he heard the crash. Witness #1 (Kevin 15 Sanchez) was contacted on October 19, 2024, at 0945 hours, and a statement was obtained. 16 19
20 21
22 23
24 25
26 27
28 29
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 28 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 STATEMENTS:
2 3 Statements are written in summary format and are not verbatim. Statements were read 4 back to the parties for verification.
5 6 Party #1 (Georgina Jovita Ordaz Alonso): Refer to Officer Lomenick's attached supplemental. 8 Party #2 (Amalia Silva) was contacted on scene and related she was driving Vehicle #2 9 (Thomas) southbound on Locust Avenue, in the #1 lane, at approximately 45 miles per hour. 10 Party #2 observed Vehicle #1 ahead, northbound on Locust Avenue, at approximately 45 miles 11 per hour. As Party #2 proceeded southbound, she checked her rear-view mirror and noticed one 12 student (Andrea was messing with another student (Tatiana). Party #2 told Andrea if she did not 13 knock it off, she would have to come to the front. This interaction took approximately one second. 14 Party #2 looked forward and noticed Vehicle #1 was now partially in the #1 lane of southbound 15 Locust Avenue, facing in a northwesterly direction, at approximately 15 miles per hour, directly in 16 front of her. Party #2 applied Vehicle #2's brakes to avoid a crash but was unable to, and the left 17 front of Vehicle #2 crashed into the right side of Vehicle #1. Vehicle #1 slid across the front of 18 Vehicle #2. After the crash, Party #2 opened Vehicle #2's emergency door, and helped all the 19 students out of Vehicle #2.
20 21 Witness #1 (Kevin Sanchez) was contacted on October 19, 2024, at 0945 hours and related he 22 was standing on the sidewalk in front of the Monster Distribution Center waiting for Uber Eats to 23 deliver his food. While waiting for his food, Vehicle #1 passed him northbound on Locust Avenue, 24 in the #1 lane, at 50-55 miles per hour. Witness #1 said, "The car swerved to the left into the 25 oncoming traffic. The bus didn't have a chance to react." 26 27
28 29
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 29 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 OPINIONS AND CONCLUSIONS:
2 3 AREA OF IMPACT:
4 5 Area of Impact #1 (Vehicle #1 versus Vehicle #2) was located approximately 28 feet east of the 6 west roadway edge of Locust Avenue and 770 feet north of the north roadway edge prolongation 7 line of Miro Way.
8 9 Area of Impact #2 (Vehicle #1 versus Concrete Curb) was located on the west roadway edge of 10 Locust Avenue and 695 feet north of the north roadway edge prolongation line of Miro Way. 11 12
13 14
15 16
17 18
19 20
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
NARRATIVEISUPPLEMENTAL PAGE 30 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 SUMMARY/CAUSE:
2 3 This crash occurred on Locust Avenue, north of Miro Way. Party #1 (Georgina Jovita Ordaz 4 Alonso) was driving Vehicle #1 (Honda Accord) northbound on Locust Avenue, in the #1 lane, 5 at 45 miles per hour, approaching Vehicle #2 (Thomas). Party #2 (Amalia Silva) was driving 6 Vehicle #2 southbound on Locust Avenue, in the #1 lane, at 51 miles per hour, approaching 7 Vehicle #1. As Party #1 proceeded northbound, she slowed to 10-15 miles per hour and began to 8 make a U-turn, directly in front of Vehicle #2's path of travel (California Vehicle Code section 9 21801(a)). Party #2 applied Vehicle#t 2's brakes to avoid a crash but was unable to and the left 10 front of Vehicle #2 crashed into the right side of Vehicle #1 (Area of Impact #1). The impact 11 caused Vehicle #1 and Vehicle #2 to travel out of control in a southwesterly direction. Vehicle #1 12 also rotated in a clockwise direction against the front of Vehicle #2 and was pushed into the 13 concrete curb (Area of Impact #2) on the west roadway edge of Locust Avenue. After the crash, 14 Vehicle #1 came to rest on its wheels, facing in a northwesterly direction, blocking the southbound 15 #2 lane of Locust Avenue, against the right front side of Vehicle #2. Party #1 remained 16 unconscious in the driver seat of Vehicle #1 and was transported to Arrowhead Regional Medical 17 Center for treatment of her injuries. Vehicle #2 came to rest on its wheels, facing in a southerly 18 direction, blocking the southbound #2 lane of Locust Avenue, against the right side of Vehicle #1. 19 Party #2 exited through the emergency exit of Vehicle #2 and waited on scene for California 20 Highway Patrol and medical assistance to arrive.
21 22
23 24
25 26
27 28
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025 •
STATE OF CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 31 OF 33
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
08/27/2024 1500 9860 019429 9860-2024-02558
1 RECOMMENDATIONS:
2 3 I recommend a copy of this report be forwarded to the San Bernardino County District Attorney's 4 office for review and consideration of prosecuting Party #1 (Georgina Jovita Ordaz Alonso) for 5 the following charges:
7 192(c)(2) California Penal Code - Misdemeanor vehicular manslaughter without gross 8 negligence: Driving a vehicle in the commission of an unlawful act, not amounting to a felony, 9 but without gross negligence; or driving a vehicle in the commission of a lawful act which might 10 produce death, in an unlawful manner, but without gross negligence. 11 12 16028(a) California Vehicle Code - No proof of insurance: Every person who drives a motor 13 vehicle upon a highway shall provide evidence of financial responsibility for the vehicle that is in 14 effect at the time the demand is made.
15 16
17 18
19 20
21 22
23 24
25 26
27 28
29 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
JASON M GARBER 019429 08/27/2024 S. C HODDER 01/30/2025
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRUCK / BUS CRASH SUPPLEMENTAL REPORT PARTY NUMBER
CHP 555D (Rev. 4-24) OP| 062 2
CRASH DATE CRASH TIME (2400) NCIC # OFFICER ID [LOCAL REPORT NUMBER 08/27/2024 019429 9860-2024-02558
GENERAL INSTRUCTIONS - COMPLETE THIS FORM FOR EACH QUALIFYING VEHICLE IF THE CRASH MEETS CRITERIA ON BACK OF THIS FORM.
QUALIFYING INFORMATION
THIS FORM IS BEING COMPLETED BECAUSE THIS VEHICLE IS:
L A truck or truck combination with a gross vehicle weight rating (GVWR) or gross combination weight rating (GCWR) greater than 10,000 pounds [X A bus with seats for 9 or more persons, including driver • A vehicle of any type displaying hazardous materials (HM) placards (includes auto, light truck, van, 10,000 Ibs. or less) TOTAL INVOLVED VEHICLES IN THE CRASH AT THE TIME OF THE CRASH, THIS VEHICLE WAS:
2 X Operating on a trafficway open to the public (in-transport)
NUMBER OF PERSONS SUSTAINING FATAL INJURIES
• Parked on or off the trafficway
1 NUMBER OF INJURED PERSONS TRANSPORTED FOR IMMEDIATE MEDICAL TREATMENT COMMERCIAL DRIVER LICENSE (CDL:
10 X YES •NO
NUMBER OF VEHICLES TOWED FROM SCENE DUE TO DISABLING DAMAGE COL CLASS (Check only one):
• Class A X Class B • Class • Classo D Class M
2 VEHICLE INFORMATION
VEHICLE CONFIGURATION (Enter one code from below). CARGO BODY TYPE (Enter one code from below) 4 2
1 - Passenger Car (only if vehicle has Hazardous Materials Placard) 0 - Not Applicable / No Cargo Body 2 - Light Truck (orly if vehicle has Hazardous Materials Placard) 1 - Bus (seals for 9-15 people. including driver) 3 - Bus (seats for 9-15 people, including driver) 2- Bus. (seats for 16 people or more, including driver) 4 - Bus (seats for 16 people or more, including driver) 3 - Van / Enclosed Box 5 - Single-Unit Truck (2 axles, 6 tires) 4 - Cargo Tank 6 - Single-Unit Truck (3 or more axles) 5 - Flatbed
7 - Truck / Traier(s) (Single-Unit Truck with Trailers)) 6 - Dump 8- Truck:/ Tractor (without trailer, bobtail, or saddlemount) T - Concrete Mixer 9 - Tractor / Semi-Trailer (one trailer) 8 - Auto Transporter 10 - Tractor / Doubles (two trailers) 9 - Garbage / Refuse 11 - Tractor / Triples (three trailers) 10 - Grain, Chips, Gravel 99 - Other Truck > 10,000 Ibs. (not listed above) 11 - Pole GVWR / GWR (Enter one code from below, Use GWR for truck combinations) 12 - Vehicle Towing Another Motor Vehicle 13 - Intermodal Chassis
14 - Logging
2 98 - Other Cargo Body (not fisted above)
1-10,000 Ibs. cr Less HAZARDOUS MATERIALS INVOLVEMENT (Excluding vehicle fuel system) 2-10.001 - 26,000 Ibs.
WAS THE VEHICLE DISPLAYING HM PLACARDS?
3 - Greater than 26,000 bs.
Bus Use (Enter one code from below) •YES X NO
IF YES, INCLUDE THE FOLLOWING INFORMATION FROM ONE OF THE PLACARDS; 0 - Not a Bus 3 - Intercity 4-Digit UN/NA identification number or placard name, if none:
1- School (Public or Private) 4 - Charter
Hazard Class or Division from bottom of placard:
2 - Transit 5- Other
Was HM released from this vehicle's cargo? •YES IX NO
MOTOR CARRIER INFORMATION
CARRIER TYPE (Check only one):
• Interstate • Intrastate • Non-commerce - goverment X Non-commerce - other trucks > 10,000 Ibs. GVWR / GWR
CARRIER NAME PHONE NUMBER
RIALTO UNIFIED SCHOOL DISTRICT (909) 873-4300
CARRIER ADDRESS (NUMBER AND STREET/P.O. BOX) CITY STATE ZIP CODE 182 EAST WALNUT AVENUE RIALTO CA 92376
CARRIER IDENTIFICATION NUMBERS USDOT MG / MX CA
• None 62952
SEQUENCE OF EVENTS
NOTE: FOR THIS VEHICLE, LIST UP TO FOUR EVENTS
Event 1: 13 Event 2: C Event 3: [ Event 4: C
NON-COLLISIONS COLLISION INVOLVING / WITH (continued)
Ran Off Road 15 Train
16 Pedalcycle
2 Jacknife Overturn (Rollover)
4 Downhill Runaway 19 Work Zone Maintenance Equipment
Cargo Loss or Shif COLLISION INVOLVING / WITH
: Explosion or Fire 12 Pedestrian 20 Other Moveable Object Separation of Unite 13 Motor Vehicle In-Transport 98 Other (Describe):
8 Cross Median / Centerline 14. Parked Motor Vehicle
PREPARED BY REVIEWED BY TDATE
JASON M GARBER, 019429 S. C HODDER 01/30/2025
Destroy Previous Editions Chp555D_0424.pdf
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL PARTY NUMBER
SCHOOL BUS CRASH SUPPLEMENTAL REPORT
CHP 555E (Rev. 12-17) OPI 061 2
DATE OF CRASH (MONTH, DAY, YEAR) TIME (2400) INCIC NUMBER OFFICER ID NUMBER REPORT NUMBER 08/27/2024 1500 9860 019429 9860-2024-02558
DRIVER INFORMATION
CALIFORNIA SPECIAL DRIVERS CERTIFICATE (DL-45) ICHP AREA NUMBER • No 1X Yes 9860
VEHICLE TYPE
| RESTRICTIONS (CHECK ALL THAT APPLY)
[X School Bus •SPAB • Youth Bus
•GPPV • 0 01 02 03 Ds 6D7 DA
MEDICAL CERTIFICATE (DL-S1A) IF YES
(VALID FOR 2 VEARS FROM DATE OF EXAM EXAM DATE EXPIRATION DATE • No 02/16/2023 02/16/2025
FIRST AID CERTIFICATE (VALID FOR 2 YEARS FROM ISSUE DATE - ONLY REQUIRED FOR IF YES DRIVERS WITH A 6 RESTRICTION ON THEIR SPECIAL DRIVERS CERTIFICATE ISSUE DATE /EXPIRATION DATE • No Ixi Yes 03/30/2023 03/30/2025
VEHICLE INFORMATION
INSPECTION APPROVAL CERTIFICATE (CHP 292)
INSPECTED BY (NAME AND ID NUMBER) LAST INSPECTION DATE | CHP AREA NUMBER [RATED PASSENGER CAPACITY Brian Pike, A17817 12/06/2023 9860 79
PASSENGER INFORMATION
NUMBER OF PASSENGERS ONBOARD
44 Place the number assigned to the passenger in the corresponding seating position on the chart below.
Place an "X" on the row(s) that do not apply.
6 10 11 21 12 30 42 34 13 35 45 A
2 22 14 7 33 28 15 43 44 19 16
15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 — Row
9 5 31 4 23 40 37 38 D
E
20 26 27 41 29 3 25 36 32 24 18 39 8 17 F
PREPARED BY REVIEWED BY DATE
JASON M GARBER, 019429 S. C HODDER 01/30/2025
REVIEWED BY SBOIC 1.D. NUMBER TDATE
D. M, CHAVEZ 021980 01/30/2025
Chp555E_1217.pdf
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
SUPPLEMENTAL REPORT
1 SUPPLEMENTAL REPORT
2 3 DATE/ TIME OF INCIDENT: August 27, 2024, at 1500 hours 4 INCIDENT LOCATION: Locust Avenue, North of Miro Way
5 CHP REPORT NUMBER: 9860-2024-02558
AGENCY: California Highway Patrol, Felony Investigations Office OFFICER/INVESTIGATOR: G. Lomenick, ID 18972
8 FOLLOW-UP: October 23, 2024
9 10
Purpose
12 13 To document the investigative steps taken by Officer Lomenick, 18972. 14 15
16 Summary
17 18 On October 22, 2024, I was requested to assist Officer Garber, ID 19429, with obtaining 19 statements from Party #1 and Passenger Romero. Also, I was able to obtain information from 20 the San Bernardino County Coroner's Office.
21 22 On October 23, 2024, I contacted Party #1. Party #1 related she only spoke Spanish. I had 23 Officer L. Gonzalez, ID 21638, who is certified bilingual in English and Spanish. Officer 24 Gonzalez interviewed Party #1. She related she was still in the hospital being treated for her 25 injuries she sustained in the crash. Party #1 related she did not remember much from the crash 26 and suffered major injuries. A significant portion of her memory prior to the crash was missing. 27 She remembered getting up at 0730 hours and taking her children to school. She did not 28 remember anything else from the day of the crash or the previous day. She related she did not 29 have any adverse medical history that would have impaired her driving capabilities. She was 30 not taking any prescribed medication, no illegal drugs and does not drink alcohol. She related 31 her typical daily routine consisted of going to bed around 2300 hours, waking up at 0730 hours, 32 and taking her kids to school. When she returns home, she does typical home upkeep such as 33 cleaning, laundry, and preparing food until she goes to pick up her children from school. Party:
34 #1 was able to provide the phone number for Passenger Romero's father. 35 36 On October 23, 2024, I contacted Passenger Romero's father at . Passenger 37 Romero only spoke Spanish. Officer Gonzalez was able to obtain a statement from Passenger 38 Romero. Passenger Romero also suffered significant memory loss and had no recollection of 39 how the crash occurred.
40 41 On October 23, 2024, I contacted the San Bernardino County Coroner's office. The coroner's 42 case number was 702405964. San Bernardino County Deputy Coroner Investigator K. Wood, 43 ID F6930, determined the cause of death for Passenger Fredy Arizpe to be 'blunt force trauma 44 to head and torso."
Prepared by: Officer Lomenick, ID 18972 Reviewed by: Page of Date: 10/23/2024 Date:
EXHIBIT "B"
•
CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2025 MAY 15 PMI2: 13
TO PERSON OR PROPERTY
MECEIVED
CITY CLERK
1. Claims for death, injury to person, or to personal property must be filed not later than six 6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be 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:
ARMANI STEWART
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TÉLEPHONE NO.
MENDEZ & SANCHEZ, APC, 5440 E. BEVERLY BLVD, L.A., CA 90022 ( 323) 723-2323
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE MENDEZ & SANCHEZ, APC
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if diffe ent fr m home ad rees pr vided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 8/27/2024 I _TIME: 3:10 ПАМ ПРМ
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.
Accident location: Locust Avenue & Miro Way, Rialto, CA
3. HOW DID DAMAGE OR INJURY OCCUR?
Claimainst was a student aboard bus owned & operated by RIALTO UNIFIED SCHOOL DISTRICT, when an automobile accident occurred causing injuries to all parties involved
4. WERE POLICE AT THE SCENE? •YES• 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.
Violation of California Vehicle Code, including but not limited to section § 22350
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Falck Ambulance 1,579.25
Item/Date: Amount: $
Loma Linda University Medical Medical Amount: & Pending Item/Date:
Cedar Pointe Chiropractic Amount: Amount s1938:08
Inland Empire Spine & Injury
L.A. Neurosciences, Inc. Amount $2,500.00
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 5,837.25 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Unascertain at this time, still under medical treatment Amount: $ Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $1,000,000.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary)
KEVIN SANCHEZ
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: L TELEPHONE: ( ).
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: MEDICAL SPECIALS WILL BE PROVIDED NAME:
ADDRESS: UPON FINAL DISCHARGE
ADDRESS:
TELEPHONE: |) TELEPHONE: ()
DATE: TIME: • AM • PM DATE: TIME: • AM • 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 corners.
If a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the → NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
7 SIDEWALK
HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS T HOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRU I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Brittany fores
SIGNATURE OF CLAIMANT OR AGENT
BRITTANY A. FARIAS, ESQ. 5/12/2025
TYPE OR PRINT NAME DATE
ATTORNEY FOR CLAIMAINT, ARMANI STEWART
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
CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2025 MAY 15 PM12: 13
TO PERSON OR PROPERTY
RECEIVEL
CITY CLERA
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be 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:
ARMANI STEWART
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
MENDEZ & SANCHEZ, APC, 5440 E. BEVERLY BLVD, L.A., CA 90022 ( 323) 723-2323
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE MENDEZ & SANCHEZ, APC
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if diffe ent fr m home ad rees pr vided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 8/27/2024 I _TIME: 3:10 ПАМГРМ
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.
Accident location: Locust Avenue & Miro Way, Rialto, CA
3. HOW DID DAMAGE OR INJURY OCCUR?
Claimainst was a student aboard bus owned & operated by RIALTO UNIFIED SCHOOL DISTRICT, when an automobile accident occurred causing injuries to all parties involved
4. WERE POLICE AT THE SCENE? •YES• 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.
Violation of California Vehicle Code, including but not limited to section § 22350
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Falck Ambulance 1,579.25
Amount: $.
Loma Linda University Medical Medical Amount: $ Pending Item/Date:
Cedar Pointe Chiropractic Amount: Amount si 938:08
Inland Empire Spine & Injury
L.A. Neurosciences, Inc. Amount $2,500.00
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $5,837.25 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Unascertain at this time, still under medical treatment Amount: $.
Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $1,000,000.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary)
KEVIN SANCHEZ
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: L TELEPHONE: | )
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: MEDICAL SPECIALS WILL BE PROVIDED NAME:
ADDRESS: UPON FINAL DISCHARGE ADDRESS:
TELEPHONE: TELEPHONE: | )
DATE: TIME: •AM • PM DATE: TIME: • AM • 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 corners.
If a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of the → NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
SIDEWALK
I HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS TO THOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE.
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. critten fores
SIGNATURE OF CLAIMANT OR AGENT
BRITTANY A. FARIAS, ESQ. 5/12/2025
TYPE OR PRINT NAME DATE
ATTORNEY FOR CLAIMAINT, ARMANI STEWART
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
CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2025 MAY 15 PM12:13
TO PERSON OR PROPERTY
RECEIVEO
CITY CLER+
1. Claims for death, injury to person, or to personal property must be filed not later than six (6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be 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:
ARMANI STEWART
FULL NAME DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TÉLEPHONE NO.
MENDEZ & SANCHEZ, APC, 5440 E. BEVERLY BLVD, L.A., CA 90022 ( 323) 723-2323 BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE MENDEZ & SANCHEZ, APC
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if diffe ent fr m home ad rees pr vided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 8/27/2024 I _TIME: 3:10 ПАМ ПРМ
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.
Accident location: Locust Avenue & Miro Way, Rialto, CA
3. HOW DID DAMAGE OR INJURY OCCUR?
Claimainst was a student aboard bus owned & operated by RIALTO UNIFIED SCHOOL DISTRICT, when an automobile accident occurred causing injuries to all parties involved
4. WERE POLICE AT THE SCENE? •YES• 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.
Violation of California Vehicle Code, including but not limited to section § 22350
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
1,579.25
Item/Date: Falck Ambulance Amount: $_
Loma Linda University Medical Medical Amount: sPending
Item/Date:
Cedar Pointe Chiropractic Amount: Amount sr.938.08
Inland Empire Spine & Injury
L.A. Neurosciences, Inc. Amount $2,500.00
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $ 5,837.25 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Unascertain at this time, still under medical treatment Amount: $ item/Date: Amount:$
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $1,000,000.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary)
KEVIN SANCHEZ
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: ) TELEPHONE: |)
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTOR(S) OR HOSPITAL(S) VISITED:
NAME: MEDICAL SPECIALS WILL BE PROVIDED NAME:
UPON FINAL DISCHARGE
ADDRESS: ADDRESS:
TELEPHONE: |) TELEPHONE: | 1
DATE: TIME: • АМ П PM DATE: TIME: • АМ •РМ
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 corners. 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
I HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS TO THOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE.
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Buttu fores
SIGNATURE OF CLAIMANT OR AGENT
BRITTANY A. FARIAS, ESQ. 5/12/2025
TYPE OR PRINT NAME DATE
ATTORNEY FOR CLAIMAINT, ARMANI STEWART
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
MENDEZ & SANCHEZ
5440 E. Beverly Bivd
Los Angeles, CA 90022 CITY OF RIALTO
7022 3330 0000 7126 5438
2025 MAY 15 PM 12: 08
CITY CLEAR
RIALTO CITY CLERKS OFFICE
150 S. Palm Avenue
Rialto, CA 92376