Request Restraining OrderCal. Super. - 6th Dist.February 17, 2021Petition for workplace Violence Clerk stamps date here when form is filed.WV'1 00 Restraining Orders Read How Dr) l Gel an ()rder to Prohibit l'Vorkplace Violence (form WV-lOO-INFO) before completing this form. NOTE: Petitioner must I L Ebe an employer with standing t0 bring this action under Code of Civil Procedure section 527.8. Also fill out Confidential CLETS Information (form CLETS-OOI) with as much information as you know. FEB 1 7 2021 ® Petitioner (Employer) CI k the Cou’fi NGUYEN.Cl a. Name: R. Catholic Welfare Corp. ofSJ. dba St. Lucy Sch! 3mm“ “g:°§ CW?” °' ngpfiv IS a E corporation D 5016 proprietorShip Fill in court name land street address: D (speci/jz): Superior Court of California, County of d' rl‘ th‘ 't b h 1f fth I 'd t‘r d‘ 't ® sama Claraan ls 1mg ls su1 0n e a o eemp oyeel en I 1e m 1 em . 19' N. Firststreet b. Lawyer for Petitioner (ifanyfor this case) San Jose‘ California 951 13 Name: Stephanie Davin State Bar No.2 3079] l Firm Name: Rankin Stock Heaberlin Oneal Court fills in case number when form is filed. Petitioner’s Address (Ifthe petitioner has a lawyer. give the lawyer 's Case Nu : information.) "21 c H 00 9 8 6 5 C. Address: 96 North 3rd St. Suite 500 City: San Jose State: CA Zip: 95112 Telephone: (408)293-0463 Fax: (408)293-9514 E-Mail Address: stephanie@rankinstock.com ® Employee in Need of Protection FullName: Susan Grover Sex: D M E F Age: ® Respondent (Person From Whom Protection ls Sought) FullName: SumatiPanchala.k.a.Rose Age: 60- Address (ifknown): Sidewalk on Industrial Street next t0 76 Kennedy Ave. City: Campbell State: CA Zip: 95008 ® Additional Protected Persons a. Are you asking for protection for any family or household members ofthe employee or for any other employees at the employee‘s workplace or at other workplaces of the petitioner? D Yes E No (Ifyes, listthem): FullName fi Agg Household Member? Relationshipto Employee D Yes D No D Yes D No D Yes D No D Additional protected persons are listed in Attachment 43. This is not a Court Order. J“°‘°a'c°”"°'°‘ca'“°'“'a‘ WWW ”“5589“ Petition for Workplace Violence Restraining Orders WV'1°°’ P3991 °f6Revused January 1, 2018. Mandatory Form Code ofCMI Procedure, §§5278ana 5279 (workplace Violence Prevention) a Case Number: 91pun99365h‘VVVV ® b. Why do these people need protection? (Explain):E Response is stated in Attachment 4b. Relationship of Employee and Respondent a. How does the employee know the respondent? (Describe): D Response is stated in Attachment 5a. Respondent has resided on Industrial Avenue near St. Lucy Parish School for approximately 4-5 months. b. Respondent D is E is not a current employee of petitioner. (Explain any decision m retain. terminate. or otherwise discipline the respondent): D Response is stated in Attachment 5b. Respondent has never been an employee of Petitioner. Venue Why are you filing in this county? (Check all that apply): a, E The respondent lives in this county. b. E The respondent has caused physical or emotional injury to the petitioner‘s employee in this county. c. D Other (specify): Other Court Cases a. Has the employee or any of the persons named in@been involved in another court case with the respondent? D N0 E Yes lfyes. check each kind Ql'case and indicate where and when each wasfiled: Kind ofCase Filed in {(‘ounm/Stute) Year Filed Case Number (ifknown) (1) D Workplace Violence (2) D Civil Harassment (3) D Domestic Violence (4) D Divorce. Nullity. Legal Separation (5) D Paternity. Parentage. Child Suppon (6) U Eviction (7) D Guardianship (8) D Small Claims (9) D Postsecondary School Violence (10) D Criminal (H) D Other (specify): b. Are any restraining orders or criminal protective orders now in effect relating to the employee or any of the persons in® and the respondent? [j N0 C Yes ([f'st. attach a copy Ifyou have one.) This is not a Court Order. Petition for Workplace Violence Restraining Orders wv'wov P3962 °‘6 (Workplace Violence Prevention) 9 Rawsed January 1‘ 201B CaseNumfiei: c H 00 98 6 5 Description of Respondent's Conduct a. Respondent has (check one 0r more): (1) D Assaulted. battered. or stalked the employee (2) E Made a credible threat 0f violence against the employee by making knowing or willful statements or engaging in a course of conduct that would place a reasonable person in fear for his or her safety or the safety of his or her immediate family. b. One or more of these acts (check either or both): (1) E Took place at the employee’s workplace (2) E Can reasonably be construed to be carried out in the future at the employee’s workplace Address of workplace: 76 Kennedy Ave.. Campbell. CA 95008 c. Describe what happened. (Provide details; include the dates ofall incidents beginning with (he most recent; tell who did what t0 whom: identifi' any witnesses): D Response is stated in Attachment 8c. Petitioner hereby makes reference t0 the Declaration of Susan Grover which includes a detailed account of the events surrounding this petition. In essence. Respondent has resided on the sidewalk on Industrial Avenue in Campbell California. directly adjacent to St. Lucy Parish School. During the time of her residence. Respondent has created a health and safety risk to the students and employees by keeping perishable foods near her camp for prolonged periods of time. and entenaining guests near her camp who not only use the public street by the school as a restroom. but who also refuse t0 comply with State and local guidelines and mandates. Respondent herself does not wear a mask and does not socially distance herself not only from her guests. but also from the staff, the students, and their families. d. Was the employee harmed or injured? E Yes D N0 (lnyS. describe harm or injuries): E Response is stated in Attachment 8d. Petitioner hereby makes reference lo the Declaration of Susan Grover which includes a detailed account of the events surrounding this petition. e. Did the respondent use or threaten to use a gun or any other weapon? D Yes E No (Ifyes. describe): D Response is stated in Attachment 8e. This is not a Court Order. Petition for Workplace Violence Restraining Orders wv"°°' page 3 °‘6 (Workplace Violence Prevention) 9 Rewsea January 1‘ 2018 .f. Case Number: 216H009865 For any of the incidents described above. did the police come? E Yes D No D l don't know [f yes. did the employee or the respondent receive an Emergency Protective Order? D Yes E No D ldon‘t know If yes. the order protects (check all that apply): D the employee D the respondent D one or more of the persons in @. (Attach u copy ()fthe order ifyou have one.) Check the orders you want E <9 E Personal Conduct Orders I ask the court to order the respondent not to do any of the following things to the employee or to any person to be protected listed in @2 a. b. C d. roam E Harass. intimidate, molest. attack. strike. stalk, threaten, assault (sexually or otherwise). hit, abuse, destroy personal property of, or disturb the peace 0f the person. D Commit acts 0f unlawful violence on or make threats ofviolence to the person. D Follow or stalk the person during work hours or to or from the place of work. D Contact the person. either directly or indirectly. by any means. including, but not limited to, in person, by telephone. in writing. by public or private mail. by interoffice mail. by e-mail. by text message, by fax, or by other electronic means. E Enter the person’s workplace. E Other (speczfv): D As stated in Attachment 9f. Maintain a residence within 1000 feet of St. Lucy Parish School. engage in behavior in violation of State and Local guidelines and mandates. keep perishables near her camp in such quantities as would attract rodents, entertain guests who refuse to comply with State and Local guidelines and mandates relating to the Covid-l9 pandemic as well as health and safety measures e.g. utilizing proper facilities Io eliminate. The respondent will be ordered n0! to take any action t0 get the addresses 0r locations ofany protectedperson unless the courlfinds good cause no! 10 make the order. a. Sta -Awa Ordery y 3 oo l ask the court to order the respondent to stay at least W yards away from (check all that apply): (l) E The employee. (8) D The employee‘s vehicle. (2) D The other persons listed in @ . (9) E Other (specify): Rewsed January 1‘ 2018 St. Lucy Parish School, located at 76 Kennedy Ave., Campbell. California 95008 (3) E The employee’s workplace. (4) D The employee’s home' St. Lucy Church. located at 2350 S. Winchester (5) E The employee’s school. Blvd., Campbell. California 95008 (6) D The school ofthe employee‘s children. (7) D The place of child care ofthe employee’s children. This is not a Court Order. Petition for Workplace Violence Restraining Orders wv"°°v P3994 °‘5 (Workplace Violence Prevention) 9 Case Number: 210H009865 b. If the court orders the respondent Io stay away from all the places listed above. will he or she still be able t0 get to his or her home. school. orjob? D Yes E No (lfno. explain): D Response is stated on Attachment 10b. Respondent is homeless and her current residence is on the sidewalk near 76 Kennedy Ave., Campbell, California 95008. ® Guns or Other Firearms and Ammunition ® Rewsed January 1. 2018 Does the respondent own or possess any guns or other fireanns? D Yes D N0 E l don’t know Iflhejudge grants a protective order. (he respondent will be prohibitedfiom owning, possessing, purchasing, receiving, 0r attempting t0 purchase or receive a gun, otherfirearm. and ammunition while the protective order is in eflect. The respondent will also be ordered t0 turn in m law enforcement. 0r sell to 0r store with a licensed gun dealer, any guns orfirearms within his 0r her immediate possession or control. E Temporary Restraining Order l request that a Temporary Restraining Order (TRO) be issued against the Respondent to last until the hearing. l am presenting form WV-l 10, Temporary Restraining Order. for the court’s signature together with this Petition. Has the Respondent been told that you were going to go I0 court to seek a TRO against him/her? E Yes D No (Ifyou answered n0. explain why below): D Reasons are stated in Attachment 12. Petitioner hereby makes reference to the Declaration of Susan Grover which includes a detailed account of the events surrounding this petition. Petitioner requests a TRO to prevent Respondent from engaging in behavior in violation ofState and Local guidelines and mandates. keeping perishables near her camp in such quantities as would attract rodents. and entertaining guests who refuse t0 comply with State and Localiuidelines and mandates relating to the Covid-19 pandemic as well as health and safety measures e.g. utilizing proper facilities to eliminate. D Request for Less Than Five Days' Notice of Hearing You mus! have your papers personally served 0n the respondent a! leastfive days before the hearing. unless the court orders a shorter timefbr service. (Form WV-200-INFO explains what is proofofpersonal service. Form WV-200, Proof of Personal Service. may be used Io show (he court (hat the papers have been served.) If you want there to be fewer than five days between service and the hearing, explain why: D Reasons are stated in Attachment 13. D No Fee for Filing l ask that there be no filing fee because the respondent has threatened violence against the employee, or stalked the employee. or acted or spoken in a manner that has placed Ihc employee in reasonable fear ofviolence. This is not a Court Order. Petition for Workplace Violence Restraining Orders WV'1°°’ Page 5 °f6 (Workplace Violence Prevention) 9 Cale Numbir: 2 CH009865 D No Fee to Serve Orders I ask the court to order the sherifl‘ or marshal no serve the respondent with the others for free because this request for orders is based on a credib|e threat of violence or stalking. U Court Cass I ask the court to order the respondent to pay my court costs. CI Additional Orders Requested I ask the court to make the following additional orders (specifi): D Additional orders requesttd are stated in Attachment l7. I‘ Number of pages attached to this form, ifany: 1-- Date: 2 I '2‘ I 2“ Stephanie Davin f. g Lawyer 's name (ifany) ’Zawfer 's signature I declare under penalty of peljury under the laws of the Stale of California that the information above and on all attachments is true and conect. Date: l4. I] . Z! R. Catholic Welfare Corp. of SJ. dba St. Lucy Schl Name ofpetitioner Si ature Susan Grover, Principal Title This is not a Court Order. Petiu'on for Workplace Violence Restraining Orders WV"°°' "9‘6“ (Workplace Violence Prevention) rPrlnt this form I I Save thh form l mRudelnmyLZO‘la SHORT TITLE: R. Catholic Welfare Corp. of SJ. dba St. Lucy Schl. CASE "UMBER - v. Sumati Panchal a.k.a. "Rose" 210H009865 1O 11 12 13 14 15 16 17 18 19 20 21 23 24 25 26 27 The individual indentified in Section 3, Sumati Panchal a.k.a. "Rose" has caused great annoyance. harassment. and substantial emotional distress t0 not only the administration and faculty at St. Lucy School. but also to its grade school students. Ms. Panchal has resided next to the fence at St. Lucy's for approximately 4 months. Despite repeated requests to leave. she refuses to do so. ln fact. she has continuously increased the size of her "camp," and increased the distribution of perishable food t0 unknown persons. Additionally. there have been times when the unknown persons who come to receive food. take the unpleasant liberty of using the bathroom in the middle ot‘the street and in plain view ofthe School's students. Needless to say. such behavior is both seriously disturbing and continuously conceming. There is literally no way to know who will show up t0 visit Rose. what they will bring, or what they will do in front of the School's students. The safety of the children is of paramount importance to the Parish and School. ln being allowed to reopen. the Parish and School have very specific and mandated State and local guidelines regarding social distancing. masks. etc.. which they must comply with. Rose and her guests have been witnessed many times not observing any guidelines. including. but not limited to: refusing to wear a mask and socially distance from her guests and on occasion the students. I(Anachmem 4b) l (Required for verified pleading) The items on this page stated on Information and belief are (specify item numbers, not line This page may be used with any Judicial Councal form or any other paper filed with the court. Pm. numbers) Form Approved by me ADDITIONAL PAGEMW 00ml“WM Attach to Judicial Council Form or Other Court Paper CRC 201 50‘MC-OZOlNaw Jmuuy 1 1987] SHORT TITLE: R. Catholic Welfare Corp. ofSJ. dba St. Lucy Schl. CASE NUMBER -v. Sumati Panchal a.k.a. "Rose" 2 1 C H 00 98 6 5 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 The individual indentified in Section 3. Sumati Panchal a.k.a. "Rose" has caused great annoyance. harassment. and substantial emotional distress to not only the administration and faculty at St. Lucy School, but also to its grade school students. Ms. Panchal has resided next to the fence at St. Lucy's for approximately 4 months. Despite repeated requests to leave. she refuses to do so. ln fact. she has continuously increased the size of her "camp," and increased the distribution of perishable food to unknown persons. Additionally. there have been times when the unknown persons who come to receive food. take the unpleasant liberty of using the bathroom in the middle of the street and in plain view of the School's students. Needless to say. such behavior is both seriously disturbing and continuously concerning. There is literally no way to know who will show up to visit Rose. what they will bring, or what they will do in front 0f the School's students. The safety of the children is of paramount importance to the Parish and School. In being allowed to reopen. the Parish and School have very specific and mandated State and local guidelines regarding social distancing. masks. etc.. which they must comply with. Rose and her guests have been witnessed many times not observing any guidelines. including. but not limited to: refusing to wear a mask and socially distance from her guests and on occasion the students. (Attachment 8d) (Required for verified pleading) The items on this page stated on Information and belief are (specify item numbers. not line numbers) Thus page may be used with any Judidal Councnl form or any other paper filed w1th the court. Page Form Approved a, mo ADDITIONAL PAGEMW Cm‘ °'Wm“ Attach to Judicial Council Form or Other Court Paper CRC 20‘ 501 M0020 [New Jmuay 1. 1967]