15-2 Exhibits To FAC

Case 1:07-cv-00026-OWW-TAG Document 15 Filed 01/08/2007 Page 1 of 75
1 Eugene Lee, SBN 178988

LAW OFFICE OF EUGENE LEE
2 555 West Fifth St, Suite 3100
Los Angeles, CA 90013
3 Telephone: (213) 992-3299
Facsimile: (213) 596-0487
4 Email: elee@LOEL.com
5 Attorney for Plaintiff

David F. Jadwin, D.O.
6 UNITED STATES DISTRICT COURT
7 EASTERN DISTRICT OF CALIFORNIA
8
DAVID F. JADWIN, D.O. Case No. 1:07-cv-26
9
Plaintiff Exhibits to First Amended Complaint
vs.
10
COUNTY OF KERN, et al Complaint Filed: January 5, 2007
11 Trial Date: None.
Defendants.
12
LIST OF EXHIBITS
13
1. Second employment contract dated 10/5/02.
14
2. Tort Claims Act complaint dated 7/3/06.
15
3. Letter from the Office of the County Counsel for the County of Kern to Plaintiff’s counsel
16
dated 9/15/06
17
4. California Department of Fair Employment and Housing Complaint dated 8/3/06 &
18
Amended Complaint dated 11/14/06.
19
5. Notice of Intent to Sue from Plaintiff to the California Labor and Workforce Development
20
Agency dated 1/5/07.
21
Dated: January 8, 2007
22
By: ___________________________________
Eugene Lee
23 Attorney for Plaintiff
24
JADWIN v. COUNTY OF KERN: EXHIBITS TO FIRST AMENDED COMPLAINT 1

EXHIBIT 1
Second employment contract dated 10/5/02

Case 00:
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50 FAX Document 15 Filed 01/08/2007 Page 3 of 75l4J001
\.......... I
, Kern County
Kern County
r' ....\ .
_ Ii \. '
--"--
2. 0 2C( . AGREEMENT FOR
AGREEMENT PROFESSIONALSERVICES
FORPROFESSIONAL SERVICES
CONTRACT EMPLOYEE
CONTRACT EMPLOYEE
ofKern
(Countyof
(County Kern- David-F.Jadwin,
DavidF. D.O.)
Jadwin,D.O.)
. L.. '" .
This Agreement
This made and
Agreement isis made and entered
entered into
into this
this f:"-{
IZ-C day of
" ~ day d a v g ~ a,c,2002,
of N~-JGA16llt. ~
2002,
between theCounty
betweenthe Countyof
ofKern,
Kern,aa political
politicalsubdivision
subdivisionofofthe
theState
Stateofof California
California (hereinafter
(hereinafter
"County"), which
"County"), owns and
which owns and operates
operates KernKern Medical
Medical Center
Center (hereinafter "KMC"), and
(hereinafter "KMC"), and
David F. Jadwin. D.O. (hereinafter "Core Physician"), a contract employee.
David F. Jadwin, D.O. (hereinafter "Core Physician"), a contract employee.
RECITALS
RECITALS
WHEREAS:
WHEREAS:
A, County
A. County isis authorized, pursuant to
authorized, pursuant to Government
Government Code
Code section
section 31000, to
31000, to
contract with
contract with specially
specially trained
trained persons,
persons, and
and further authorizes the
further authorizes the payment
payment ofof
compensation for the services rendered;
compensation for the services rendered; and and
B. County
B. County requires assistance inin the
requires assistance performance of
the pertormance professional medical
of professional medical
services at KMC as such services are unavailable from County resources;
services at KMC as such services are unavailable from County resources; and and
C. Core
C. Core Physician
Physician has
has special
special training,
training, knowledge
knowledge and
and experience
experience and
and isis
licensed by the State of California to practice medicine and is qualified to
licensed by the State of California to practice medicine and is qualified to renderrender
medicalservices.
medical services.
THEREFORE, itit isis agreed

NOW, THEREFORE,
NOW, agreed between
between County and Core
County and Core Physician
Physician as
as
follows:
follows:
ArticleI.I.
Article
TERMAND
TERM CONDITIONS
ANDCONDITIONS
1.1. TERM
TERM
The existing
The Agreement for
existing Agreement for Professional
Professional Services
Services between
between County and Core
County and Core
Physician (Kern County Agt. #1012-2000, dated October 24, 2000) is terminated
Physician (Kern County Agt. #1012-2000, dated October 24,2000) is terminated
effectiveOctober
effective 5,2002.
October5,2002.
ThisAgreement
This shall be
Agreementshall beeffective
effectiveon October5,5, 2002,
onOctober 2002, and
andshall remaininineffect
shallremain effect
throughOctober
through 4, 2007.
October4,2007.
2.2. SERVICES
SERVICES
CorePhysician
Core Physicianshall
shallrender
renderservices
servicesas
asset forthininExhibit
setforth "A," which
Exhibit"A," whichisisattached
attached
and made a part of this Agreement.
and made a part of this Agreement.
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ArticleII.II.
Article
COMPENSATION
COMPENSATION
1.1. SALARY(BASE)
SALARY (BASE)
CorePhysician
Core Physicianshall beentitled
shallbe to the
entitledto the following
followingbase
base compensation
compensation(as defined
(as defined
in Article II, Section 3):
in Article II, Section 3):
A.
A. Physicianwill
Core Physician
Core will work
work full-time
full-time (i.e.,
(i.e., according
accordingto to AMA
AMA survey
surveydata
data forfor
specialty but no less than forty 1401 hours per week) and will
specialty but no less than forty [40] hours per week) and will be compensated be compensated
with cash and
with cash and other
other value
value as follows: Core
as follows: Core Physician
Physician willwill be paid Eleven
be paid Eleven
Thousand Twenty-One Dollars and Eight Cents ($1 1.021
Thousand Twenty-One Dollars and Eight Cents ($11,021.08) biweekly not -08) biweekly not toto
exceed Two Hundred Eighty-Seven Thousand
exceed Two Hundred Eighty-Seven Thousand Five Hundred Twenty-NineFive Hundred Twenty-Nine
Dollars($287,529)
Dollars annually. The
($287,529) annually. maximumpayable
Themaximum underthis
payableunder thisAgreement
Agreement shall
shall
notexceed
not exceedOne OneMillion
MillionFour
FourHundred Thirty-SevenThousand
HundredThirty-Seven ThousandSix SixHundred
HundredForty-
Forty-
Five Dollars ($1,437,645) per the five-year term of the Agreement.
Five Dollars ($1,437,645) per the five-year term of the Agreement. County will County will
withhold, from said daily compensation of Core Physician, all applicable
withhold, from said daily compensation of Core Physician, all applicable federal, federal,
state and
state local payroll
and local payroll taxes.
taxes. County will pay
County will pay the
the Employer's
Employel's portion
portion of the
of the
hospital insurance portion of Social Security ("FICA
hospital insurance portion of Social Security ("FICA 2"). 2").
B. Core
B. CorePhysician
Physicianwill
willbe paidbiweekly
bepaid biweeklyononthe
thesame
sameschedule
scheduleas
asregular
regularfull-
full-
time County employees. The exact date of said biweekly payments will be
time County employees. The exact date of said biweekly payments will be at the at the
solediscretion
sale discretionof
ofCounty.
County,asasisisreasonable
reasonableand
andconvenient
convenientfor
forCounty.
County.
C.
C. adjustment inin compensation
No adjustment
No compensation will
will be effective without
be effective without aa written
written
amendment to this Agreement.
amendment to this Agreement.
2.2. OVERALLCOMPENSAnON
OVERALL COMPENSATIONSTRUCTURE
STRUCTURE
A.
A. The purpose
The purpose of this compensation
of this compensation plan
plan isis to
to provide
provide market-based.
market-based,
performance-driven compensation that recognizes a Core Physician's
performance-driven compensation that recognizes a Core Physician's efforts effortsand
and
contributionstoward
contributions towardpromoting
promotingthethemission andvalues
missionand valuesof ofKMC. CorePhysicians
KMC. Core Physicians
will be identified as such in their contracts with KMC.
will be identified as such in their contracts with KMC.
B. Total
B. Totalcompensation
compensationforforCore will be
Physicianswill
CorePhysicians becomposed
composedof ofaabase
basesalary
salary
paid by the County, professional fee payments from third-party
paid by the County, professional fee payments from third-party payors, and payors, and
potential other income generated due to the individual's status as
potential other income generated due to the individual's status as a physician. a physician.
These three
These sources of
three sources income shall
of income shall be referred to
be referred to inin this
this Agreement
Agreement as as total
total
Core Physician compensation.
Core Physician compensation. The structure for determining
The structure for determining total Core total Core
Physician compensation
Physician compensation shall
shall be referred to
be referred to inin this Agreement as
this Agreement the
as the
compensationplan.
compensation plan.
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14J003
C.
C. AAKern KernCounty
Countyclearing
clearingaccount
accountand andaaKMC
KMCcompensation
compensationbudget unitwill
budgetunit will
be established to account for all funds generated and received to pay total Core
be established to account for all funds generated and received to pay total Core
Physician compensation
Physician compensation and and to to pay
pay all
all expenses associated with
expenses associated with this
this
compensationplan.
compensation plan. These willact
Thesewill act as trustaccounts
astrust accountsand
andwill
will be solelyused
besolely for
usedfor
this
thispurpose.
purpose.
D.
D. AA Plan
Plan Administrator
Administrator will be retained
will be retained by KMC to
by KMC to administer this
administer this
compensationplan
compensation planand willreport
andwill tothe
reportto theFaculty
FacultyPractice
PracticeBoard.
Board.
E.E. AABoard Directorswill

BoardofofDirectors willbebeestablished
establishedtotooversee
overseethe
thecompensation
compensationplan
plan
and
andthe
the Plan
PlanAdministrator
Administrator of of the
the compensation
compensationplan. This Board
plan. This Board of
of Directors
Directors
shall bereferred
shallbe referredtotoininthis
thisAgreement
Agreementas theFaculty
asthe FacultyPractice
PracticeBoard. The Faculty
Board. The Faculty
PracticeBoard
Practice willestablish
Boardwill establishbylaws
bylawsincluding
includingpowers, dutiesand
powers,duties responsibilities
andresponsibilities
totobe
beapproved
approvedboth
bothby byaasimple
simplemajority
majorityof
ofthe
the Faculty
FacultyPractice
PracticeBoard
Boardand
and the
the
CEO of KMC.
CEOofKMC.
F.F. An assessment
An assessmentfor
for administrative
administrativeexpenses
expenses shall be made
shall be made on
on total
total Core
Core
Physician compensation to support the administrative expenses
Physician compensation to support the administrative expenses of the of the
compensationplan.
compensation plan.
(1)
(I) The
Theamount
amountororpercentage
percentageofofthe
theassessment
assessmentshall
shall be
bedetermined
determined
annuallyby
annually bythe
theFaculty
FacultyPractice
PracticeBoard.
Board.
(2) Administrative expenses

(2) Administrative expenses shall
shall include
include the salary and
the salary benefits for
and benefits for
the Plan
the PlanAdministrator
Administrator and
and any staff hired
any staff by KMC
hired by KMC toto support
support the
the Plan
Plan
Administrator, expenses of
Administrator, expenses of the
the Kern
Kern County
County Pension
Pension Plan
Plan for
for Physician
Physician
Employees, and
Employees, and other
other business
business expenses
expenses as as determined
determined by the Plan
by the Plan
Administratorand
Administrator theFaculty
andthe PracticeBoard.
FacultyPractice Board.
(3)
(3) TheTheamount
amountor orpercentage
percentageof ofthe
theassessment
assessmentshall
shall not
notexceed
exceedone one
percentof
percent of Core
Core Physician's
Physician'stotal
total compensation
compensation(as defined inin Article
(as defined Article II,II,
Section2,2,paragraph
Section paragraphB) duringthe
6)during thefirst
firsttwo
twoyears
yearsof thisAgreement.
ofthis Agreement.
G.G. CountyCountywillwillcover allprofessional

coverall professionalservices
servicesrendered
renderedby byCore
CorePhysicians
Physiciansat at
KMCand
KMC andatatsites
sitesdesignated
designatedby theCEO
bythe andPlan
CEOand PlanAdministrator
AdministratorunderunderCounty's
County's
liability and
liability and malpractice
malpractice coverage
coverage program.
program. SuchSuch liability
liability and
and malpractice
malpractice
coverageprogram
coverage programsnail shallnot
notextend anyconduct,
extendtotoany conduct, actions
actionsor activities,which
oractivities, whichdo do
notarise
not arisedirectly
directlyfrom the performance
fromthe performanceof ofthis
this Agreement.
Agreement. As As aa matter
matterof law,
of law,
Countyshall
County shalldefend
defendand and indemnify
indemnifyCore'Physician
Core(Physicianto to the same extent
the same extentasas would
would
be affordedtotoaaregular
beafforded regularfull-time
full-timeCounty
Countyemployee.
employee.
3
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3.3. BASESALARY
BASE (ITEMSINCLUDED
SALARY(ITEMS INCLUDEDAND
AND METHOD OFPAYMENT)
METHODOF PAYMENT)
A.
A. Base salaryisiscompensation
Basesalary compensationpaid paidto.
to.Core
CorePhysician
Physicianby bythe
theCounty
Countyfor:for: (1)
(1)
patientcare
patient carefor
for Medically
MedicallyIndigent
IndigentAdults
Adults (MIA),
(MIA), as defined by
as defined byCalifornia
CaliforniaWelfare
Welfare
and Institutions Code
and Institutions Code section 17000 et
section 17000 et seq., and adults
seq., and adults andand juveniles
juveniles
incarcerated and detained in County facilities; (2) as a safety-net provider.
incarcerated and detained in County facilities; (2) as a safety-net provider. partial partial
compensation for
compensation for under-compensated
under-compensated and uninsured patients;
and uninsured (3) teaching;
patients; (3) teaching; (4)(4)
administrative duties; and (5) other activities approved by the
administrative duties; and (5) other activities approved by the CEO of KMC and CEO of KMC and
PracticeBoard.
FacultyPractice
the Faculty
the Board. County shallfund
Countyshall fund the
the clearing
clearingaccount
account unit
unitbiweekly
biweekly
with an
with an amount
amount equal
equal to Core Physician's
to Core Physician's biweekly
biweekly base
base salary.
salary. The The base
base
salary, less the assessment for administrative expenses,
salary, less the assessment for administrative expenses, will be reported aswill be reported as
wages and subject to all appropriate federal and state taxes.
wages and subject to all appropriate federal and state taxes. The base salary The base salary
will be
will be considered
considered the minimum compensation
the minimum compensation that that aa Core
Core Physician
Physician shall
shall
receive under this compensation
receive under this compensation plan. plan.
B. The
B. base salary
The base salarywill
will be basedon
be based on aa benchmark
benchmarksalary
salaryininproportion
proportionto
to the
the
CorePhysician's
Core Physician'sfull-effort
full-effortcommitment.
commitment.
(1) The
(1) The structure
structure ofof benchmark
benchmark salaries
salaries isis based upon aa national
based upon national
standard with
standard with four
four salary
salary steps:
steps: "A", "C"and
"B", 41e"
"An,"B", "D."There
and "0." .arethree
There are three
criteria for step placement: level of clinical senrice,
criteria for step placement: level of clinical service, teaching, and teaching, and
administrative duties.
administrative duties. This
This benchmark
benchmark salarysalary structure
structure and
and criteria
criteria for
for
step placement
step placementare set forth
are set forth ininthe KMC Faculty
the KMC Faculty Practice
Practice Administrative
Administrative
Policiesand
Policies ProceduresManual.
andProcedures Manual.
(2) The
(2) The Faculty
FacultyPractice
PracticeBoard
Boardshall
shallestablish
establishthe
thecriteria
criteriafor
for measuring
measuring
the full-effort commitment. The Department Chairs, with
the full-effort commitment. The Department Chairs. with approval of approval of the
the
FacultyPractice
Faculty PracticeBoard,
Board,will
willestablish
establishthe expectedlevels
the expected levelsofof the
the criteria
criteriato
to
meet a full-effort commitment. The criteria for measurement
meet a full-effort commitment. The criteria for measurement of full-effort of full-effort
commitment isis set
commitment set forth
forth inin the KMC Faculty
the KMC Faculty Practice
Practice Administrative
Administrative
Policies andProcedures
Policiesand ProceduresManual.
Manual.
(3) Researchshall
(3) Research shallnot beconsidered
notbe consideredas aspart of aa Core
partof CorePhysician's
Physician'sfull-
full-
effortcommitment.
effort commitment. Research
Researchactivity
activity will
will be
be compensated
compensatedas set forth
as set forth inin
the KMC Faculty Practice Administrative Policies and Procedures
the KMC Faculty Practice Administrative Policies and Procedures Manual. Manual.
4.4. FEES
PROFESSIONALFEES
PROFESSIONAL
Professionalfees
Professional includeall
fees include all professional
professionalfee
fee collections
collectionsoror payments
paymentsassociated
associated
with direct
with direct patient
patient care
care by Core Physician.
by Core Physician. This
This shall be referred
shall be referred to to inin this
this
Agreement as
Agreement as professional
professional fees. Core Physician,
fees. Core Physician, oror inin cases
cases where
where CoreCore
Physician is part of a practice group entering into an agreement for services
Physician is part of a practice group entering into an agreement for services with with
the County,
the County, Core Physician's practice
Core Physician's practice group,
group, isis responsible
responsible forfor billing
billing and
and
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1"-./
collecting all
collecting all professional
professional fees for Core
fees for Core Physician's
Physician's services.
services. Each
Each Core
Core
Physician or practice group will have a separate tax identification number,
Physician or practice group will have a separate tax identification number.
Professional fees shall

Professionalfees shallbe collected and
becollected and dispersed
dispersed as
as follows:
follows:
A.
A. Professionalfee
Professional fee billing
billingbyby Core Physicianor
Core Physician or his
his or
or her
her practice
practice group
group shall
shall
be made
be made byby aa billing
billing service
service company,
company, approved
approved in in advance
advance by by the Faculty
the Faculty
Practice Board,
Practice Board, and
and based
based upon
upon minimum
minimum performance
performance standards
standards set set by the
by the
Faculty Practice Board. All professional fees collected by the billing
Faculty Practice Board. All professional fees collected by the billing service for service for
Core Physician
Core (i-e., gross
Physician (Le., professional fees
gross professional fees collected)
collected) shall
shall bebe paid
paid to the
to the
clearing account.
clearing account. TheThe billing
billing service
service will
will maintain
maintain individual and practice
individual and practice group
group
recordson
records on professional
professionalfee fee billing
billingand
and collections
collections and
and will
will account
account forfor such
suchto to the
the
PlanAdministrator.
Plan Administrator.
0.
B. The assessment
The assessment for
for administrative expenses will
administrative expenses will be
be deducted
deducted from
from gross
gross
professionalfees
professional fees collected.
collected.
C. Overhead
C. Overheadand and expenses
expensesfor for aa practice group or
practicegroup or aa Core
Core Physician who isis aa
Physician who
sole practitioner,
sole practitioner, asas determined
determined by an overhead
by an overhead distribution
distribution formula
formula established
established
by the Plan
bythe PlanAdministrator
Administrator andand the
the Faculty
Faculty Practice
PracticeBoard,
Board, will
will be deducted from
be deducted from
the gross professional fees collected and returned to the practice
the gross professional fees collected and returned to the practice group or Coregroup or Core
Physicianwho
Physician who isis aa sale
sole practitioner.
practitioner.
D.
D. Each Department
Each Departmentwithin KMC, at
within KMC, at its
its option,
option, may
may establish
establish aa Departmental
Departmental
Poolininwhich
Pool percentageof
which aa percentage of the
the remaining
remaininggross
gross professional
professionalfees collectedwill
fees collected will
distributed to
be distributed
be all Core
to all Core Physicians within that
Physicianswithin that Department
Department based
based upon
upon specific
specific
criteriaapproved
criteria approved by bythe
the Faculty
FacultyPractice
PracticeBoard.
Board.
E.
E. Gmss professional
Gross professionalfees
fees collected,
collected, less
less the
the assessment
assessment for for administrative
administrative
expenses, overhead, and an optional Departmental pool (i.e.,
expenses, overhead, and an optional Departmental pool (i.e., net professional net professional
fees collected)
fees collected) will
will be paid monthly
be paid monthly asas wages
wages and and will
will be subject to
be subject all
to all
appropriate federal
appropriate federal and
and state
state taxes;
taxes; however,
however, practice
practice groups (consistent with
groups (consistent with
their practice
their practice group
group agreements
agreements withwith the
the County), Core PhYSicians
County), Core Physicians who who are
are sale
sole
practitioners,or
practitioners, or Core Physiciansnot
Core Physicians notassociated
associatedwithwith aa practice
practice group
group may direct
may direct
the Plan Administrator
the Plan Administrator as to the
as to the distribution
distribution of
of net professional fees
net professional collected,
fees collected,
subjectto
subject to review
reviewby FacultyPractice
the Faculty
bythe PracticeBoard.
Board.
5.5. OTHERINCOME
OTHER INCOME
A.
A. Other income
Other income isis income
income generated
generated duedue to to the
the individual's
individual's status as aa
status as
physician, which
physician, which includes,
includes, but
but isis not
not limited
limited to.
to, royalties,
royalties, grants,
grants, speaker
speaker fees.
fees,
professionalwitness
professional fees, and
witnessfees, and other
other nonprofessional
nonprofessionalfees.fees.
5
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13. All
B. All other
other income
incomewillwill be paidtoto the
bepaid the Core Physicianinin accordance
CorePhysician accordancewith
with
instructions provided the clearing account by Core Physician or Core
instructions provided the clearing account by Core Physician or Core Physician's Physician's
practicegroup.
practice group. Expenses
Expensesproperly
properlyincurred
incurredbybythe CorePhysician
theCore Physicianiningenerating
generating
otherincome
other incomewill bereimbursed
willbe reimbursedtotothetheCore
CorePhysician
Physicianprior
priortotothe
thebalance being
balancebeing
channeledthrough
channeled throughthethe clearing
clearingaccount.
account. ThisThis remainder,
remainder, less lessassessment
assessmentforfor
administrative expenses,will
administrativeexpenses, willbebepaid
paidmonthly
monthlytotoCore
CorePhysician
Physicianas aswages.
wages. Other
Other
incomeshall
income shall be reported as
be reported as wages
wages and
and subject
subjecttoto all
all appropriate
appropriatefederal
federal and
and
statetaxes.
state taxes.
Incomegenerated
C. Income
C. generatedby byaaCore
CorePhysician thatisisdeposited
Physicianthat depositedtotothe
theCommunity
Community
Medical Education
Medical Education and
and Research
Research Foundation
Foundation ("CMERF")
("CMERF") for for department
department
educationaluse
educational shallnot
useshall notbe includedas
beincluded otherincome
asother incomeand andshall
shallnot
notbe subjecttoto
besubject
theassessment
the assessmentfor
foradministrative
administrativeexpenses.
expenses.
6.6. PRACTICE GROUPS

PRACTICEGROUPS
A.
A. All practice
All practicegroups
groupswill
will contract
contractwith
with KMC
KMCforforthe
the provision
provisionofof community
community
clinic services,
clinic which shall
services, which shall be
be integrated
integratedinto
intothe KMC teaching
the KMC teaching program.
program.TheThe
contract between
contract betweeneach group and
practicegroup
each practice and KMC
KMCwill definethe
will define the responsibilities
responsibilities
and funds
and funds flow,
flow, including
including professional
professional feefee distribution,
distribution, between
between eacheach
organization.
organization.
B.
B. Practice group
Practice group overhead
overheadand and business-related
business-relatedexpenses
expenses will
will be paid by
be paid by
the practice
the practice group
group inin accordance
accordance withwith predetermined
predetermined instructions.
instructions. Practice
Practice
groups will
groups will determine
determine the
the policy
policy for
for expense
expense limits
limits and
and reimbursable
reimbursable items.
items.
Countyisisnot
County notresponsible
responsibleforforthe
theamount
amountof ofgroup
groupoverhead
overheadand
andbusiness-related
business-related
expensesclaimed.
expenses claimed.
7.7. SOLEPRACTITIONERS
SOLE PRACTITIONERS
A.
A. Sole
Sole practitioners
practitionersareare Core
Core Physicians
Physicianswho
who areare sole
sole proprietors
proprietorsor have
or have
their own
their own professional
professionalcorporation.
corporation. Core Core Physicians
Physicianswhowho are
are sole
sole practitioners
practitioners
will be responsible
will be responsible for
for the
the cost
cost ofof professional
professionalfee
fee billing as negotiated
billing as negotiatedby the
by the
CorePhysician
Core withthe
Physicianwith thebilling
billingservice
servicecompany.
company. Sole
Solepractitioner
practitioneroverhead
overheadand and
business-related expenses will
business-related expenses will bebe paid
paid by
by the
the sale
sole practitioner.
practitioner. SoleSole
practitionerswill
practitioners will determine
determinethe the policy
policyfor expenselimits
for expense limitsand
andreimbursable
reimbursableitems.
items.
County isis not
County not responsible
responsible for for the
the amount
amount ofof overhead
overhead and and business-related
business-related
expensesclaimed.
expenses claimed.
B.
B, Any
Any other
other overhead
overheadamount
amount forfor use
use of
of space,
space, supplies
supplies and
and personnel
personnelat
at
KMC-ownedor
KMC-owned or-contracted
-contractedsites willbe
siteswill benegotiated
negotiatedwith
withthe
theCEO
CEOof of KMC.
KMC.
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05;30;2014 00:52 FAX
8.
8. CORE PHYSICIANS
OTHER CORE
OTHER PHYSICIANS
Core Physicians
Core Physicians who
who areare not
not part of aa practice
part of practice group and who
group and who are
are not
not sole
sole
practitioners and who
practitionersand who practice
practice exclusively
exclusively at
at KMC-owned
KMC-owned or or -contracted
-contracted sites will
sites will
responsible for
be responsible
be the cost
for the cost of
of professional
professional fee billing as
fee billing negotiated by
as negotiated the Core
by the Core
Physicianwith
Physician the billing
with the billingservice
service company.
company.
4
9.9, POOL
DEPARTMENTALPOOL
DEPARTMENTAL
Each Department
Each Department of of KMC.
KMC, by simple majority
by simple majority of of Core Physicians within
Core Physicians within that
that
Department,may
Department, may opt on aa yearly
opt on basis to
yearly basis to participate
participatein in aa departmental
departmental pool.
pool. The
The
departmental pool
departmental is aa group
pool is group incentive
incentive pool funded by
pool funded by net
net professional
professionalfees from
fees from
aa participating
participatingDepartment
DepartmentJo reward Core
.to reward Physicians within
Core Physicians within that
that Department
Department for
activities not
activities not recognized
recognized by by other
other parts
parts of this compensation
of this compensation plan. plan. Each
Each
Departmentparticipating
Department participating in in aa pool will establish
pool will establish criteria
criteria with
with the
the approval
approval ofof the
the
Faculty Practice
FaCUlty Practice Board
Board forfor pool
pool distribution.
distribution. The
The percentage
percentage of of net
net professional
professional
feesto
fees to be
be allocated
allocatedto to the
the departmental
departmental pool poolwill
will be
be determined
determined on on aa yearly
yearly basis
basis
by the
by Department with
the Department with the approval of
the approval of the
the Faculty
Faculty Practice Board. The
Practice Board. The
departmentalpool
departmental poolwill be distributed
will be distributed quarterly as wages
quarterly as wages and and will be subject
will be subject to
to all
all
appropriatefederal
appropriate federal and
and state taxes.
state taxes.
Article III.
Article Ill.
BENEFITS
BENEFITS
1.1. EFFECTIVEDATE
EFFECTIVE DATEOF BENEFITS
OF BENEFITS
The date
The date ofof employment
employment for for the purposeof
the purpose receiving and
of receiving and accruing
accruing benefits
benefits listed
listed
inthis
in this Article shall not
Article IIIIll shall not be
be affected
affected by by the
the date of this
date of this Agreement. but shall
Agreement, but shall bebe
the datethe
thedate the Core Physicianwas
Core Physician was first continuouslyemployed
first continuously employed by by KMC.
KMC.
2.
2. HEALTHINSURANCE
HEALTH INSURANCE
County shall
County shall provide
provide toto Core Physician and
Core Physician and eligible
eligible dependents medical, dental
dependents medical, dental
and vision
and vision insurance
insurance as as provided
provided to to other
other regular
regular County
County employees
employees of KMC.
of KMC.
Core Physicians
Core Physiciansfirst hired by
first hired the County
by the County ofof Kern after April
Kern after April 15.
15, 1997 must pay
1997 must pay
twenty (20) percent
twenty (20) percentofof the cost of
the cost of their
their health
health benefits.
benefits. County
County may change the
may change the
benefits provided
benefits provided under
under this
this insurance
insurance as such benefits
as such benefits shall
shall change
change for
for other
other
Countyemployees
County employees of of KMC. such change
Any such
KMC. Any change by County shall
by County shall not be a breach
not be breach of
Agreement.
this Agreement.
this
3.
3. LEAVEOF
PAID LEAVE
PAID ABSENCE
OF ABSENCE
Core Physician
Core Physician will receive paid
will receive paid leave
leave for
for holidays,
holidays, vacation,
vacation, sick
sick leave and
leave and
leave.
educationalleave.
educational
7
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141008
A.
A. Holidays:
Holidavs:
Core Physician
Core Physician shall
shall be
be entitled to such
entitled to such holidays
holidays as provided to
as provided to full-time
full-time County
County
employeesof
employees KMC. County
of KMC. may change
County may change the
the holidays
holidays provided
provided under
under this
this section
section
such holidays
as such
as holidayschange
change for
for other
other County
County employees
employees of KMC. Any
of KMC. Any such change
such change
by Countyshall
byCounty shall not be aa breach
not be breach of this Agreement.
of this Agreement.
6.
B. Vacation:
Vacation:
For each
For pay period
each pay of service,
period of service. CoreCore Physician
Physician shall be credited
shall be credited with
with aa vacation.
vacation
entitlement of 6.15
entitlement of 6.15 hours,
hours, for for aa maximum
maximum accrual
accrual of 160 hours
of 160 hours per
per year. Total
year. Total
unused
unused vacation
vacation accumulated
accumulated shall shall not exceed aa maximum
not exceed maximum of of 320
320 hours.
hours. No No
further vacation entitlement shall
further vacation entitlement shall be be credited
credited so long as
so long Core Physician
as Core Physician has
has the
the
maximumhours
maximum credited. IfIf Core
hours credited. Core Physician
Physicianis is presently
presently employed
employed by the County
by the County
of Kern,
of accrued vacation
Kern, accrued vacation entitlement
entitlement shall
shall bebe credited
credited to maximum of 320
to aa maximum 320
hours. Unused
hours. Unused vacation
vacation benefits
benefits will
will be credited to
be credited to Core
Core Physician
Physician to to a
maximumof
maximum 320 hours
of 320 hours ifif this
this Agreement
Agreement isis renewed.
renewed. CoreCore Physician
Physicianwill be paid
will be paid
for accrued
for and unused
accruedand unusedvacation
vacation hours
hours upon
upon termination
termination of employment.
of employment.
C.
C. SickLeave:
Sick Leave:
For each
For each paypay period
period ofof service,
service, Core Physician shall
Core Physician shall be credited with
be credited with sick
sick leave
leave
creditfor
credit for illness
illness or or accident
accident ofof 2.46 hours, for
2.46 hours, for aa maximum
maximum accrual
accrual of 64 hours per
64 hours per
year. After
year. five years
After five of employment,
years of employment, including
including full-time
full-time employment
employment prior prior to the
to the
effective date of this Agreement, Core Physician shall earn and
effective date of this Agreement, Core Physician shall earn and accrue sick leave accrue sick leave
credit for
credit· for illness
illness oror accident
accident at at the
the rate of 3.07
rate of 3.07 hours
hours forfor each
each pay pay period
period of
setvice for
service for an an annual
annual accrual
accrual of 80 hours
of 80 hours per
per year.
year. Total
Total unused
unused sick
sick leave
leave
accumulated shall
accumulated shall not exceed aa maximum
not exceed maximum of of 1152
1152 hours.
hours. No No further
fbrther sick
sick leave
leave
entitlementshall
entitlement shall be credited so
be credited long as
so long Core Physician
as Core Physician has the maximum
has the maximum hours
hours
credited. IfIfCore
credited. Physician isis presently
Core Physician presentlyemployed
employedby bythe
the County
County of Kern, accrued
Kern, accrued
sick leave
sick leaveshall
shall be to aa maximum
credited to
be credited maximum of of 1152
1152 hours.
hours. Unused
Unused sick sick leave
leave will
will
be credited
be credited to to Core
Core Physician
Physician to maximum of
to aa maximum 1152 hours
of 1152 hours ifif this
this Agreement
Agreement is is
renewed. Core
renewed. Core Physician
Physician will
will not
not be paid for
be paid for accrued
accrued and and unused sick leave
unused sick leave
upon termination
upon termination of of employment.
employment. County County policy
policy applicable
applicable to to other
other regular
regular
County employees
County employees of of KMC regarding use
KMC regarding use of of sick
sick leave
leave shall
shall apply
apply toto Core
Core
Physician.
Physician.
D.
D. EducationalLeave:
Educational Leave:
Core Physician
shall receive
receive 80 hours paid
80 hours paid education
education leave
leave annually.
annually. TheThe first
first
hours shall
80 hours
80 shall be
be credited on the
credited on the effective
effective date of the
date of the Core
Core Physician's
Physician's
employment contract.
employment On each
contract. On each successive anniversary date
successive anniversary of that
date of that contract.
contract, an
an
additional 80 hours shall accrue. Education leave must be used
additional 80 hours shall accrue. Education leave must be used within the within the year
that itit isis accrued
that accrued and unused education
and unused education leave
leave does not accrue
does not to the
accrue to the fol/owing
following
8
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contract year.
contract year. Unused
Unused education
education leave
leave will
will not
not be paid upon
be paid termination of
upon termination of
employment. All education l e a h must be approved in advance of
employment. All education leave must be approved in advance of use by the use by the
CorePhysician's
Core Physician'sDepartment
DepartmentChair
Chairand
and the
the Medical
MedicalDirector.
Director.
4.4. UNPAIDLEAVE
UNPAID LEAVEOF ABSENCE
OFABSENCE
County shall provide

County shall provide Core
Core Physician
Physician the
the right
right to
to unpaid
unpaid leave
leave of of absence
absence
to other
provided to
provided other regular
regular County
County employees
employees of KMC pursuant
of KMC pursuant toto County policy.
County policy.
County may change its policy regarding leave of absence, as its policy
County may change its policy regarding leave of absence, as its policy for leavefor leave
of absence
of absence shall change for
shallchange for other
other County
County employees
employeesof KMC. Any
of KMC. such change
Any such change
byCounty
by Countyshall
shallnot
notbebeaa breach
breachofofthis
this Agreement.
Agreement.
5.5. RETIREMENT PLAN

RETIREMENTPLAN
A.
A. Core Physician
Core Physician shallshall participate
participate inin the Kern County
the Kern County Pension
Pension PlanPlan and
and
Tnrst Agreement
Trust Agreement for for Physician
Physician Employees
Employees (the (the "Plan"),
"Plan"), aa qualified
qualified defined
defined
contribution pension
contribution pension plan,
plan, pursuant
pursuant toto the
the terms
terms ofof the
the instrument
instrument under
under which
which
the Plan has been established (the "Plan Document"),
the Plan has been established (the "Plan Document"), as from time-to-time as fmm time-to-time
amended. County
amended. Countyshall shallwithhold
withhold 3.1
3.1 percent
percent ofof Core
Core Physician's
Physician's biweekly
biweekly gross
gross
salary (that
salary (that is, before deductions
is, before deductions including
includingtaxes)
taxes) and pay such
and pay such amount
amount within
within aa
reasonable time
reasonable time asas the Core Physician's
the Core Physician's mandatory
mandatory employee
employee contribution
contribution
requiredunder
required underthe the Plan
PlanDocument.
Document. County shall contribute
County shall contribute anan additional
additional amount
amount
equal to
equal to 12.5
12.5 percent
percent of Core Physician's
of Core Physician's biweekly
biweekly gross
gross salary
salary (that
(that is, before
is, before
deductions including taxes) as County's required contribution
deductions including taxes) as County's required contribution under the Plan under the Plan
Document. Total
Document. Total contributions
contributions by Physicianand
Core Physician
byCore and County will not
County will not exceed
exceedthethe
yearly amount
yearly allowed by
amountallowed law; provided,
bylaw; provided, however.
however, ifif any
any amounts
amounts are are contributed
contributed
excess of
inin excess of such
such permissible
permissible amounts,
amounts, the excess contribution
the excess contribution shall
shall bebe
corrected as
corrected as provided the Plan
provided inin the Plan Document
Document or or under law. Any
under law. changes inin the
Any changes the
PlanDocument
Plan Documentwill will control
controlthe
the terms
termsofof this
this Agreement.
Agreement.
B. Subject
B. Subject toto the
the receipt
receiptofof aa favorable
favorable determination
determinationletter
letterfrom
from the
the Internal
Internal
Revenue Senrice, County
Revenue Service. County willwill amend
amend and and restate·
restate.the Plan Document
the Plan Document to to
substitute a fixed-dollar contribution by County and Core Physician
substitute a fixed-dollar contribution by County and Core Physician in lieu of the in lieu of the
contributions provided
contributions provided inin the
the immediately
immediately preceding
preceding paragraph
paragraph A. A. County
County and and
Core Physician
Core Physician contributions
contributions for each Plan
for each Plan year"
year (as(as defined
defined in in thethe Plan
Plan
Document)under
Document) underthe the amended
amended and and restated
restated Plan
Plan document
document shall be as
shall be as follows:
follows:
County shall contribute
County shall contributeasas County's
County's required
required contribution
contribution the
the sumsum ofof Seventeen
Seventeen
Thousand Five Hundred Dollars ($17,500) for the account of
Thousand Five Hundred Dollars ($17,500) for the account of Core Physician for Core Physician for
each complete Plan year of service (as defined in the Plan
each complete Plan year of service (as defined in the Plan Document) by Core Document) by Core
Physician. Core
Physician. Core Physician's
Physician's mandatory
mandatory employee
employee contributions
contributions required
required underunder
the amended and restated Plan Document shall
the amended and restated Plan Document shall be as fotlows: If Core be as follows: If Core
Physician's Compensation (as defined under the Plan
Physician's Compensation (as defined under the Plan Document) was One Document) was One
Hundred Fifty Thousand
Hundred Fifty Thousand Dollars
Dollars ($150,000)
($150,000) or or less
less during
during the immediately
the immediately
precedingPlan
preceding year, Core
Planyear, CorePhysician'S
Physician'smandatory
mandatoryemployee
employeecontribution
contribution required
required
9
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I4J 010
underthe
under the Plan
PlanDocument
Documentshall shallbe $4,000 for
be$4,000 for aa complete
complete Plan Plan yearyear of of service
service by by
CorePhysician.
Core Physician. IfIfCoreCore Physician's
Physician'sCompensation
Compensationwas more than
was more thanOne One Hundred
Hundred
and Fifty Thousand Dollars ($150.000) but less than
and Fifty Thousand Dollars ($150,000) but less than One Hundred and Seventy One Hundred and Seventy
Thousand Dollars
Thousand ($170,000), during
Dollars($170,000), duringthe the immediately
immediatelyprecedingprecedingPlan year, Core
Plan year, Core
Physician's mandatoryemployee
employeecontribution
contributionrequiredrequiredunderunderthe the Plan Document
PlanDocument
shall be
shall beNine
NineThousand
ThousandDollars Dollars($9,000).
($9,000). IfIfCore Core Physician's
Physician's Compensation
Compensationwas was
One Hundred Seventy Thousand Dollars ($170,000)
One Hundred Seventy Thousand Dollars ($170,000) or more but less than One or more but less than One
Hundred Eighty
Hundred EightyThousand
Thousand DollarsDollars ($180,000)
($180.000) during during the
the immediately
immediately preceding preceding
Plan year, Core Physician's mandatory employee contribution
Plan year, Core Physician's mandatory employee contribution required under required underthe the
Plan Document shall be Twelve Thousand Five Hundred Dollars ($12,500) for aa
Plan Document shall be Twelve Thousand Five Hundred Dollars ($12,500) for
complete Plan
complete Plan year
year of of services.
services. IfIf Core Core Physician's
Compensation was was One One
Hundred and Eighty Thousand ($180,000) or more
Hundred and Eighty Thousand ($180,000) or more but less than One Hundred but less than One Hundred
NinetyThousand
Ninety ThousandDollarsDollars($190,000)
($190,000) duringduringthe immediatelypreceding
the immediately precedingPlan Planyear,
year,
Core Physician's
Core Physician's mandatory
mandatory employeeemployee contribution
contribution required
required under under the Plan
the Plan
Document shalt
Document shall be Seventeen Thousand
be Seventeen Thousand Five Five Hundred
Hundred Dollars ($17,500) for
Dollars ($17.500) for aa
complete Plan
complete Planyear
year ofof services.
services. IfIf Core
Core Physician's
Compensationwas was at at least
least
One Hundred
One Hundred Ninety Ninety Thousand
Thousand Dollars Dollars ($190,000)
($190,000) during during the the immediately
immediately
precedingPlan
preceding Planyear,
year, Core
Core Physician's
Physician'smandatory
mandatoryemployeeemployee contribution
contributionrequired required
under the Plan Oocument shall be the maximum
under the Plan Document shall be the maximum amount permitted by Internal amount permitted by Internal
Revenue Code
Revenue Code section
section 415(c)(1)
415(c)(l) (which
(which isis currently
currently $40,000)
$40,000) reduced reduced by by the
the
County contribution
County contribution for for the
the account
account of Core Physician
of Core Physicianfor for the
the PlanPlan year. Core
year. Core
Physician's mandatoryemployee
employee contributions.
contributions shall shall be withheld by
bewithheld by County
County from from
Core Physician's biweekly salary in relatively equal amounts.
Core Physician's biweekly salary in relatively equal amounts. Total contributions Total contributions
byCore
by CorePhysician
Physicianand and County
Countywilt will not
not exceed
exceedthe the yearly
yearly amount
amount allowedallowed by by law;
law;
provided, however, if any amounts are contributed in excess
provided, however, if any amounts are contributed in excess of such permissible of such permissible
amounts, the
amounts, the excess
excess contribution
contribution shallshall be be corrected
corrected as as provided
provided in in the
the Plan
Plan
Document or
Document or under
under law.law. Any changes inin the
Any changes the Plan
Plan Document
Document will will control
control thethe
terms of this Agreement. County's required contribution
terms of this Agreement. County's required contribution for the account of Core for the account of Core
Physician and
Physician Core Physician's
and Core Physician's mandatory
mandatory employee employee contributions
contributions are are also
also
subjectto
subject to all
allof
of the
the transition
transitionrulesrulescontained
contained inin the the Plan
Planas as itit now
now exists
exists or or may
may
be hereafter amended which may reduce the
be hereafter amended which may reduce the amount of contribution. The amount of contribution. The
transition rules include, but are not limited to, those contained
transition rules include, but are not limited to, those contained in sections 3.3(b), in sections 3.3(b),
3.3(d), 3.5, and
3.3(d), 3.5, and 3.63.6 of of the
the amended
amended and and restated
restated PlanPlan Document.
Document, Core Core
Physician (together with all Plan participants) shall be responsible
Physician (together with all Plan participants) shall be responsible for a pro rata for a pro rata
shareof
share the annual
ofthe annualcostscostsof of administering
administeringthe the Plan.
Plan. DueDue to to the
the manner
mannerin which
inwhich
Planparticipant
Plan participantaccounts
accounts are are held
heldandand invested,
invested, most such costs
most such costs cannotcannot be be paid
paid
directly from Plan assets. To facilitate payment
directly from Plan assets. To facilitate payment of such costs, County shallof such costs, County shall
advance such
advance such costs
costs forfor so
so long
long asas County
County determines
determines such such an an arrangement
arrangement isis
necessaryor
necessary or desirable.
desirable. To Tooffset such costs,
offset such costs, County
County shall
shall reduce
reduceits its contribution
contribution
to the Plan for Core Physician by Core Physician's
to the Plan for Core Physician by Core Physician's pro rata share of such pro rata share of such costs
costs
asdetermined
as determinedunder underthe the Plan
PlanDocument.
Document.
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FAX Document 15 Filed 01/08/2007 Page 13 of l475
J 0011002
C. IfIfthe
. .C. thefixed contributionstructure
fixed contribution structuredescribed
describedininthe immediatelypreceding
the immediately preceding
paragraphBBresults,
paragraph results,or
orwould
wouldresult,
result,ininthe
the Internal
InternalRevenue
RevenueService
Servicenot
notissuing
issuing
favorabledetermination
aa favorable determination,letter
,letterfor
for the
the Plan
Planunder
underthe the amended
amendedand and restated
restated
PlanDocument,
Plan Document,the theCounty reservesthe
Countyreserves theright
righttotosubstitute
substituteanother
anothercontribution
contribution
structurewhich
structure whichwill bedesigned
willbe designedtotomaximize
maximizebenefit CorePhysician
benefittotoCore Physicianononaacost-
cost-
neutralbasis
neutral basistoto County,
County,and such substitute
andsuch substitutecontribution
contributionstructure
structureshall
shallcontrol
control
theterms
the termsofofthis
thisAgreement.
Agreement. County
Countywillwillconsult
consultwith
withthe
thePension
PensionCommittee,
Committee,as as
identified inin the
identified the Plan
Plan Document,
Document, withwith respect
respect toto such
such substitute
substitute contribution
contribution
structure.
structure.
D.
D. County's required
County's requiredcontribution
contributionandand all
all mandatory
mandatoryemployee
employeecontributions
contributions
will be
will be paid to such
paid to such financial
financial services
services firm(s)
firm($) as as determined
determined under
under thethe Plan
Plan
Document. If,If, pursuant
Document. pursuant toto thethe Plan
Plan Document,
Document, Plan Plan assets
assets are
are allocated
allocatedtoto
separateaccounts
separate accountsfor foreach
eachPlanPlanparticipant,
participant,such
suchfinancial
financialservices
servicesfirm(s}
firm(s)shall
shall
be solely
be solely responsible
responsiblefor for allocating
allocating Core
Core Physician's
Physician's contribution
contribution amount
amount and and
investmentexperience
investment experiencetotohis hisororher
heraccount.
account. If,If,pursuant
pursuantto thePlan
tothe PlanDocument,
Document,
Plan participants
Plan participants control
control thethe investment
investment of of their
their accounts
accounts atat such financial
such financial
servicesfirm(s),
services firm(s), the
the investment
investmentof of Core
Core Physician's
Physician'sPlan Planaccount
accountthrough such
through such
financialservices
financial servicesfirm
firm shall
shallbe determinedby
bedetermined byCore
CorePhysician.
Physician. County
Countyshallshallnot
not
beliable
be liablefor
forthe
theinvestment
investmentexperience
experienceof CorePhysician's
ofCore Physician'sPlan
Planaccount.
account.
E.
E. Core Physician
Core Physician isis not
not eligible
eligibletoto participate
participateinin any other retirement
any other retirementplanplan
establishedor
established orfunded bythe
fundedby Countyfor
theCounty forits
itsemployees,
employees,including
includingbut
butnot
notlimited
limitedtoto
the Kern
the Kern County
County Employees'
Employees'Retirement
RetirementAssociation,
Association, andand this
this Agreement
Agreementdoes does
notconfer
not confer upon
uponCore
Core Physician
Physicianany rightto
any right to claim
claimentitlement
entitlementto to benefits
benefitsunder
under
anysuch
any suchretirement
retirementplan(s).
plan(s).
6.
6. SOCIALSECURITY
SOCIAL ANDMEDICARE
SECURITYAND MEDICARETAXES
TAXES
Core Physician
Core Physician isis exempt
exempt from
from payment
payment of of Social
Social Security
Security taxes
taxes as the Kern
as the Kern
County
County Pension
Pension Plan
Plan for
for Physician Employees isis aa qualified
Physician Employees qualified alternative
alternativetoto the
the
insurance system
insurance system established
established by by the
the federal
federal Social
Social Security Act. Core
Security Act. Core
Physicians
Physiciansemployed
employedbefore
beforeMarch 31, 1986,will
March31,1986, willcontinue
continueto beexempt
to be exemptfrom
fromthethe
paymentof
payment ofMedicare
Medicaretaxes.
taxes.
7.7. DEFERREDCOMPENSATION
DEFERRED COMPENSATIONPLAN
PLAN
Core
Core Physician
Physician shall
shall be
be eligible
eligible to participate inin the
to participate the Kern
Kern County
County Deferred
Deferred
Compensation
Compensation PlanPlan II on
on the
the same
same basis
basis and to the
and to the same
same extent
extent as
as full-time
full-time
County
County employees.
employees. County
County may may change
change itsits Deferred
Deferred Compensation Planas
Compensation Plan as itit
shall
shall change
changefor
for other
other County
Countyemployees
employeesof of KMC.
KMC. Any such change
Any such changeby
byCounty
County
shallnot
shall beaabreach
notbe breachofofthis
thisAgreement.
Agreement.
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\....../
8.
8. KERN$FLEX PLAN
KERN$FLEX PLAN
Core Physician
shall be eligible to
be eligible participate in
to participate in the
the Kern$Flex
Kern$Flex Plan
Plan II on
on the
the
same
same basis
basis and
and to
to the
the same
same extent
extent as
as eligible
eligible County
County employees.
employees. County
County may
may
change its
change its Kern$Flex
Kern$Flex Plan, as its
Plan, as its policy
policy for Kern$Flex
Kern$Flex shall
shall change
change for other
other
County employees
County KMC. Any such
employees of KMC. change by
such change by County
County shall not be
shall not be aa breach
breach of
this Agreement.
this Agreement.
9.
9. EXPENSE REIMBURSEMENT
EXPENSE REIMBURSEMENT
A.
A. Core Physician
Core Physician will
will be reimbursed for approved
be reimbursed approved and
and necessary
necessary
expenditures related
expenditures related to
to continuing
continuing education
education including
including seminar fees,
fees, travel
travel and
and
study materials.
study materials. Reimbursement
Reimbursement for travel,
travel, lodging
lodging and
and meals
meals shall
shall be
be upon
upon the
the
same terms
same terms and rates
rates as
as allowed
allowed for County
County employees
employees of KMC.
KMC. Core
Core Physician
Physician
will be
will be reimbursed
reimbursed expenses
expenses and
and materials
materials not
not to
to exceed
exceed $2,500 per year.
$2,500 per year.
0.
B. Core Physician
Core Physician will
will be reimbursed for approved
be reimbursed approved and
and necessary
necessary
expenditures related
expenditures related toto education
education and
and training
training as
as directed
directed by
by KMC.
KMC.
Reimbursement for travel,
Reimbursement travel, lodging
lodging and
and meals
meals shall
shall be
be upon
upon the
the same
same terms
terms and
and
rates as
rates as allowed
allowed for
for County
County employees KMC.
employees of KMC.
C. County
C. County will
will pay
pay reasonable
reasonable moving
moving expenses
expenses (defined
(defined asas the
the moving
moving of
household goods
household goods and
and vehicles)
vehicles) for
for Core
Core Physician
Physician toto relocate
relocate from
from Philadelphia,
Philadelphia,
Pennsylvania,
Pennsylvania, toto Bakersfield, California, in
Bakersfield, California, in an
an amount
amount not not to
to exceed Twenty
exceed Twenty
Thousand
Thousand Dollars
Dollars ($20,000). Core Physician
($20,000). Core Physician shall
shall provide
provide three
three written
written bids
bids for
moving expenses and
moving expenses and County
County shall
shall reimburse
reimburse Core
Core Physician
Physician for the
the lowest
lowest of
the three
the three bids.
bids. In In order
order toto be
be reimbursed
reimbursed for said
said moving
moving expenses,
expenses, CoreCore
Physician
Physician shall
shall submit
submit the
the three
three written
written bids
bids along
along with
with the
the invoice(s)
invoice(s) for
for actual
actual
services performed by
services performed by the
the low
low bid
bid contractor(s).
contractor(s).
D.
D. Reimbursement
Reimbursement for expenses
expenses incurred
incurred in
in generating
generating professional
professional fees
fees will
will
be
be reimbursed
reimbursed as
as set
set forth
forth in
in Article
Article II,
II, Section
Section 4, above.
above.
E. Reimbursement
E. Reimbursement for expenses
expenses incurred
incurred in
in generating
generating other
other income will be
income will be
reimbursed
reimbursed as set forth
as set forth in
in Article
Article II,
II,Section
Section 5,
5, above.
above.
IV.
Article IV.
Article
TERMINATIONAND
TERMINATION CORRECTIVE ACTION
AND CORRECTIVE ACTION
1.
1. TERMINATION
TERMINATION OF
OF AGREEMENT
AGREEMENT
A.
A. Core Physician
Core Physician may
may terminate this Agreement,
terminate this Agreement. without cause, upon
without cause, upon ninety
ninety
(90)
(90) days'
days' prior
prior written
written notice
notice to
to County.
County.
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..
3.3. REVIEW ANDAPPEAL

REVIEWAND APPEALPROCESS
PROCESS
Review and appeal

Reviewand appealof the decision
of the decision to
to impose
impose corrective
correctiveaction
action or
or terminate
terminatefor
for
causeshall
cause shallfollow
followthetheprocess
processsetsetforth
forthininthe KMCFaculty
theKMC FacultyPractice
PracticeBoard
Boardpolicy
policy
and procedure,
and procedure,titled
titledCorrective
CorrectiveAction
Action andandTermination
TerminationReview
ReviewProcess,
Process,or
orthe
the
medical staffbylaws,
medicalstaff whicheverisisapplicable.
bylaws,whichever applicable.
Articlev.
Article V.
' GENERAL PROVISIONS
GENERALPROVISIONS
1_1. ASSIGNMENT
ASSIGNMENT
Core Physician
shall not
not assign
assign or
or transfer
transfer this
this Agreement
Agreement oror its obligations
its obligations
hereunder,or
hereunder, orany partthereof.
anypart thereof. Core
CorePhysician
Physicianshall
shallnot
notassign anymoney
assignany moneydue due
orwhich
or which becomes
becomesduedueto toCore
CorePhysician
Physicianunder
underthis
thisAgreement
Agreementwithout
withoutthetheprior
prior
writtenapproval
written approvalof County.
ofCounty.
2.2. ASSISTANCE INLITIGATION

ASSISTANCEIN LITIGATION
CorePhysician
Core Physicianagrees
agreesto beavailable
to be availabletotoCounty,
County, atat no costtoto County,
nocost testify
County,tototestify
as an
as anexpert
expertwitness or otherwise,
witness or otherwise, ininthe
the event
event of litigationunder
of litigation underany any cause
causeof of
action beingbrought
actionbeing broughtagainst
againstCounty
Countyor KMC,its
orKMC, itsdirectors,
directors,officers
officers or employees
oremployees
except where
except where the
the Core Physicianisis aa named
Core Physician named party.
party. KMCKMC will will credit
credit the time
the time
spent inin preparation
spent preparation and
and testimony
testimony asas administrative
administrative time time as defined inin the
as defined the
compensationplan.
compensation plan.
3.3. AUTHORITYTO
AUTHORITY BINDCOUNTY
TOBIND COUNTY
ItItisisunderstood
understoodthat
thatCore Physician,ininCore
CorePhysician, CorePhysician's
Physician'sperformance ofany
performanceof and
anyand
allduties
all. duties under this Agreement,
underthis hasno
Agreement, has noauthority
authorityto
to bind
bindCounty
Countyor KMCto
orKMC to any
any
agreementsor
agreements orundertakings.
undertakings.
4.4. CAPTIONSAND
CAPTIONS INTERPRETATION
ANDINTERPRETATION
Paragraphheadings
Paragraph headingsininthisthisAgreement
Agreementare areused
usedsolely
solelyfor convenience,and
forconvenience, andshall
shall
whollydisregarded
bewholly
be disregardedininthe theconstruction
constructionofofthis
thisAgreement.
Agreement. No Noprovision
provisionofofthis
this
Agreement shall
Agreement shall bebe interpreted
interpretedfor or against
for or against aa party
partybecause
becausethat
that party
partyor
or its
its
legal representative
legal such provision,
drafted such
representative drafted provision, and
and this
this Agreement
Agreement shall
shall bebe
construedas
construed asififjointly
jointlyprepared
preparedbybythe
theparties.
parties.
5.5. CHOICEOF
CHOICE LAWNENUE
OFLAWNENUE
Theparties
The partieshereto
heretoagree
agreethat
thatthe
the provisions
provisionsofofthis
thisAgreement
Agreementwill
willbe construed
beconstrued
pursuant tothe
pursuantto thelaws
lawsof
ofthe
theState
Stateof
ofCalifornia.
California. This
ThisAgreement
Agreementhas
hasbeen
beenentered
entered
14
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,
\ ...../ "-.,
into and
into and isisto
to be
be performed
performedin in the
the County
Countyof of Kern.
Kern. Accordingly,
Accordingly, the partiesagree
the parties agree
the venue
that the
that venue of of any
any action
action relating
relatingto this Agreement
to this Agreement shall
shall be
be in
in the
the County
County of
of
Kern.
Kern.
6.
6. CONFLICTOF
CONFLICT INTEREST
OF INTEREST
parties to
The parties
The to this
this Agreement
Agreement have have read
read and
and are
are aware
aware of of the
the provisions
provisions ofof
section 1090 et
section 1090 et seq.
seq. and
and section 87100 et
section 87100 et seq.
seq. of of the
the California
California Government
Government
Code relating
Code relating to
to conflict
conflict of
of interest
interestof public officers
of public officers and employees. All
and employees. All parties
parties
hereto agree that they are unaware of any financial or economic
hereto agree that they are unaware of any financial or economic interest of interest any
of any
public officer
public or employee
officer or employee of of County
County relating
relating toto this
this Agreement.
Agreement. ItIt isis further
further
understood and agreed that if such a financial interest does exist
understood and agreed that if such a financial interest does exist at the inceptionat the inception
of this
of this Agreement,
Agreement, County
County maymay immediately
immediatelyterminate
terminate thisthis Agreement
Agreement by by giving
giving
written notice thereof. Core Physician shall comply with
written notice thereof. Core Physician shall comply with the requirements ofthe requirements of
California Government
California Government Code Code section
section 87100
87100 et seq. during
et seq. the term
during the term ofof this
this
Agreement.
Agreement.
7.
7. COMPLIANCEWITH
COMPLIANCE WITH KMC AND COUNTY
KMCAND COUNTY POLICIES
POLlClES
Core Physician
Core Physician will
will comply
comply with
with all
all applicable
applicable KMCKMC and and County
County policies and
policies and
procedures. Core
procedures. Core physici~n
physician will
will keep daily time
keepdaily time sheets
sheets onon forms
forms supplied,
supplied, andand in
in
the manner
the manner specified,
specified, by KMC. Core
by KMC. Core Physician will conform
Physician will conform toto office
office policy
policy and
and
routine as
routine as established
established by the Department
by the Departmentof which Core
of which Core Physician
Physician is is aa member,
member,
including, but
including, but not
not limited
limited toto orientation,
orientation, attendance
attendance at case conferences,
at case conferences,
supervision, inin service
supervision, service education,
education, patients'
patients' rights
rights functions
functions and performance
and performance
improvement activities.
improvement activities. CoreCore Physician
Physician shall
shall submit
submit to to drug
drug testing,
testing, other
other
laboratory testing and physical examinations as may be required
laboratory testing and physical examinations as may be reqUired by County. by County.
8.8. COMPLIANCEWITH
COMPLIANCE WITH LAW
LAW
Core Physician
shall observe
observe and and comply with all
comply with all applicable
applicable County.
County, state
state and
and
federal laws,
federal laws, ordinances,
ordinances, rules
rules and
and regulations
regulations nownow in effect or
in effect or hereafter
hereafter
enacted, including
enacted, including but
but not
not limited
limited to JCAHO, Title
to JCAHO, Title 22,
22, California
California Code
Code ofof
Regulations, EMTALA,
Regulations, EMTALA, allall federal
federal and
and state
state billing
billing requirements
requirements including
including Medi-
Medi-
CallMedicaid and
Cal/Medicaid and Medicare
Medicare billing
billing regulations, EEOC, HIPAA,
regulations, EEOC. FEHA and
HIPAA, FEHA and Cal-
Cal-
Core Physician will at all times meet state and federal
OSHA. Core Physician wilt at all times meet state and federal licensure and
OSHA. licensure and
Countypersonnel
County personnel qualifications
qualificationsfor the practice
for the practiceof medicine.
of medicine.
9.9. COUNTERPARTS
COUNTERPARTS
This Agreement
This Agreement may be executed
may be executed simultaneously in any
simultaneously in any number of counterparts,
number of counterparts,
each of
each which shall
of which shall be deemed an
be deemed an original but all
original but of which
all of which together
together shall
shall
constituteone
constitute one and
andthe same instrument.
the same instrument.
15
- .. -.'----
,,
EMPLOYMENTSTATUS
10. EMPLOYMENT
10. STATUS
CorePhysician
Core Physicianshall
shallbe
beemployed
employedby bythe
theCounty
CountyofofKern
Kernpursuant
pursuanttotothe
theterms
termsof of
this Agreement
this Agreement and and the
the medical staff bylaws
medical staff bylaws ofof KMC.
KMC. CoreCore Physician
Physician
acknowledgesthat
acknowledges heor
that he or she
shewill
will not
notbe deemedaa classified
bedeemed classifiedemployee,
employee,or or have
have
any rights
any rights or
or protections
protections under the County's
under the County's Civil
Civil Service
Service Ordinance, rules or
Ordinance, rules or
regulations.
regulations.
11.
11. ENFORCEMENTOF
ENFORCEMENT REMEDIES
OFREMEDIES
Noright
No rightor remedyherein
orremedy hereinconferred
conferredon onororreserved
reservedtotoCounty
Countyisisexclusive
exclusiveof ofany
any
otherright
other rightor
or remedy
remedyherein
hereinoror byby law
laworor equity providedor
equityprovided or permitted,
permitted,but
buteach
each
shall be cumulative
shall be cumulative of every other
of every other right or remedy
right or remedy given hereunder or
given hereunder or now
now or
or
hereafter existing
hereafter existing by law or
by law or inin equity
equity or or by
by statute
statute or
or otherwise,
otherwise, and may be
and may be
enforcedconcurrently
enforced concurrentlyor fromtime
orfrom timeto totime.
time.
12.
12. MEDICAL RECORDS
MEDICALRECORDS
Any and all

Any and all patient
patient medical
medicalrecords
records andand charts
charts produced
produced as as aa result
resultof of either
either
party's performance
party's performanceunderunderthis
this Agreement
Agreement shallshall be
beand remainthe
and remain the property
propertyof of
County. During
County. Duringthe termof
theterm ofthis
thisAgreement,
Agreement,Core CorePhysician
Physicianshall
shallbe permittedtoto
bepermitted
inspect
inspect and/or
andlor duplicate any patient's
duplicate any medical record
patient's medical record oror chart
chart toto the extent
the extent
necessaryto
necessary to meet
meetprofessional
professionalresponsibilities
responsibilitiesto to such
suchpatient
patientand/or
andlorto toassist
assistinin
the defense
the defenseof of any
any malpractice
malpracticeor or similar
similarclaim
claimtotowhich
which such
such medical recordoror
medicalrecord
chart maybe
chartmay bepertinent,
pertinent, provided
providedsuchsuchinspection
inspectionand/or
andforduplication
duplicationisispermitted
permitted
andconducted
and conductedininaccordance
accordancewithwithapplicable
applicablelegal
legalrequirements
requirementsand pursuanttoto
andpursuant
commonlyaccepted
commonly acceptedstandards
standardsof of patient
patientconfidentiality.
confidentiality. Core
CorePhysician
Physicianshallshallbebe
solely responsible for
solely responsible for maintaining
maintaining patient
patient confidentiality
confidentiality with
with respect
respect to to any
any
informationobtained
information pursuantto
obtained pursuant to this
this paragraph
paragraphandand will
will comply
complywith allfederal
with all federal
andstate
and lawsand
statelaws regulationsregarding
andregulations regardingpatient
patientconfidentiality.
confidentiality.
13.
13. MEDICALS1AFF
MEDICAL STAFFMEMBERSHIP
MEMBERSHIP
Core
CorePhysician
Physicianwill
willat
atall
ailtimes
timesbebeaamember
memberiningood
goodstanding
standingof ofthe
themedical
medicalstaff
staff
of
ofKern
KernMedical
MedicalCenter
Centerand andgoverned
governedas assuch
suchbybythe
themedical
medicalstaff
staffbylaws.
bylaws. This
This
Agreement
Agreement may may be be immediately terminated ifif Core
immediately terminated Core Physician's
Physician's privileges/
privileges1
membership
membershipare aremodified
modifiedor orrestricted
restrictedpursuant
pursuanttotoaction
actionunder
underthe themedical
medicalstaff
staff
bylaws
bylawssuch
suchthat
that services
servicesperformed
performedby byCore
CorePhysician
Physicianare
are limited
limitedororrestricted.
restricted.
Prior toperforming
Priorto performingduties,
duties,Core
CorePhysician
Physicianwill
willcomplete
completethe
thefollowing:
following:
(a)
(a) Application
Applicationfor
formedical
medicalstaff
staffmembership;
membership;
(b)
(b) Provideproof
Provide proofof
ofcurrent
currentlicense fromMedical
licensefrom MedicalBoard ofCalifornia;
Boardof California;
(c)
(c) Provideproof
Provide proofof
ofcurrent DEAcertificate;
currentDEA certificate;and
and
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(d)
(d) Meetwith
Meet withthe medicalstaff
themedical staffoffice
officeto
toensure
ensureappropriate
appropriate
documentationisispresent
documentation presentfor
forcredentialing
credentialingof staff
medicalstaff
ofmedical
privileges.
privileges.
14.
14. MODIFICATIONS OFAGREEMENT
MODIFICATIONSOF AGREEMENT
ThisAgreement
This maybe
Agreementmay bemodified
modifiedininwriting
writingonly,
only, signed
signedby
bythe partiesinininterest
the parties interest
atthe
at timeof
thetime themodification.
ofthe modification.
15.
15. NON-APPROPRIATION
NON·APPROPRIATION
County reserves
County reserves the
the right
right to
to terminate this Agreement
terminate this Agreement inin the
the event insufficient
event insufficient
funds are
funds areappropriated
appropriatedor orbudgeted
budgetedforforthis
thisAgreement
Agreementininanyanyfiscal
fiscalyear
yeardue
duetoto
closing
closingof of aaclinical
clinicaldepartment
departmentor KMC. Upon
orKMC. Uponsuch
suchtermination,
termination, County
Countywillwillbe
be
released from
released from any
any further financial obligation
further financial obligation toto Core
Core Physician,
Physician, except
except forfor
services performed
services performed prior
prior to the date
to the of termination
date of or any
termination or any liability due toto any
liability due any
defaultexisting
default existingatatthe
thetime
timethis sectionisisexercised.
thissection exercised. Core
CorePhysician
Physicianwill begiven
willbe given
thirty (30) days'
thirty (30) days' written notice ininthe
written notice the event
event that
that such
such an action isis required
an action required by by
County.
County.
16.
16. NON-DISCRIMINATION
NON-DISCRIMINATION
The parties
The partiesmutually
mutuallyagree
agreetoto abide byall
abideby alllaws, federal, state
laws, federal. stateand
andlocal, andby
local,and by
all
allpolicies
policiesof
ofthe
theCounty
CountyofofKern
Kernrespecting
respectingdiscrimination.
discrimination. TheTheparties
partiesshall
shallnot
not
discriminate on
discriminate the basis
on the basis of
of race,
race, color,
color, national
national origin,
origin, age, religion, marital
age, religion, marital
statusor
status orsexual preference.
sexualpreference.
17.
17. NON-WAIVER
NON·WAIVER
Nocovenant
No covenantor orcondition
conditionof
ofthis
thisAgreement
Agreementcancanbebewaived exceptby
waivedexcept bythe
thewritten
written
consent
consent ofof County.
County. Forbearance
Forbearance or or indulgence
indulgence by County inin any
by County any regard
regard
whatsoever shall
whatsoever shall not constitute aa waiver
not constitute of the
waiver of the covenant
covenant or or condition
condition toto be
be
performedby
performed by Core
Core Physician.
Physician, County shall be
County shall be entitled
entitled toto invoke
invoke any
any remedy
remedy
available toto County
available County under
under this
this Agreement
Agreement or by law
or by or inin equity
law or equity despite
despite said
said
forbearanceor
forbearance orindulgence.
indulgence.
18.
18. NOTICES
NOTICES
Noticestotobe
Notices givenby
begiven byone partytotothe
oneparty theother
otherunder
underthis
thisAgreement
Agreementshall
shallbe
begiven
given
writing by
inin writing personal delivery,
by personal delivery, byby certified
certified mail,
mail, return
return receipt
receipt requested,
requested, or
or
express delivery
express delivery service
service at
at the
the addresses
addresses specified below. Notices
specified below. Notices delivered
delivered
personallyshall
personally bedeemed
shall be deemedreceived
receivedupon
uponreceipt:
receipt: mailed
mailedor expressednotices
orexpressed notices
shall be
shall bedeemed
deemed received
receivedfour
four (4) days after
(4)days deposit. AA party
afterdeposit. maychange
partymay changethethe
address to which notice is to be given by giving notice as provided above.
address to which notice is to be given by giving notice as provided above.
17
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Core Physician
Physician County
David
David F. Jadwin, D.O. Peter K. Bryan
Bryan
26900 Monet Lane Chief Executive
Executive Officer
Valencia, CA 91355
91355 Kern Medical Center
1830
1830 Flower Street
Bakersfield,
Bakersfield, CA 93305-4 197
93305-4197
19. PROFESSIONAL RESPONSIBILITIES

RESPONSIBILITIES
Core Physician perform the services and duties set forth in this Agreement in
Physician will perform
a diligent and conscientious
conscientious manner in accordance accepted professional
accordance with accepted professional
and ethical standards of the medical
medical profession
profession and the medical
medical staff bylaws
bylaws of
KMC.
20. RELATIONSHIP
RELATIONSHIP
County and Core Physician recognize that Core Physician

Physician recognize Physician is rendering
rendering
specialized, professional
specialized. professional services. The parties recognize
parties recognize that each possessed
each is possessed
legal knowledge
of legal knowledge and
and skill,
skill, and
and that this Agreement is fully understood
understood by the
and is the result
parties, and result of bargaining
bargaining between
between the parties.
parties. Each
Each party
acknowledges their opportunity to fUlly
acknowledges .and independently
fully .and independently review
review and
and consider
affirm complete
this Agreement and affirm complete understanding
understanding of the effect and
and operation
operation of
its
its terms prior to entering
entering into
into the same.
same.
21. SEVERABILITY
Should
Should any part,
part, term, portion
portion or provision
provision of this Agreement be be decided finally to
be
be in
in conflict
conflict with
with any law of the United
United States
States or the State of California,
California, or
otherwise be unenforceable
otherwise be unenforceable or ineffectual,
ineffectual, the validity of the remaining
remaining parts,
parts,
terms, portions,
portions, or provisions
provisions shall bebe deemed and shall
severable and
deemed severable shall not be
be
affected
affected thereby,
thereby, provided
provided such
such remaining
remaining portions
portions or provisions
provisions can
can be
be
construed
construed in in substance
substance to constitute
constitute the agreement
agreement which
which the parties
parties intended
intended to
enter into
into in
in the first instance.
instance.
22. SOLE AGREEMENT

SOLE AGREEMENT
This
This Agreement,
Agreement, including
including all
all attachments
attachments hereto,
hereto, contains
contains the
the entire
entire agreement
agreement
between
between the parties
parties relating
relating to the
the services,
services, rights, obligations and
rights, obligations and covenants
covenants
contained herein
contained herein and
and assumed
assumed by by the parties respectively.
the parties respectively. No
No inducements,
inducements,
representations
representations or promises
promises havehave been
been made,
made, other than
than those
those recited
recited in
in this
this
Agreement. No No oral
oral promise,
promise, modification,
modification, change
change or inducement
inducement shall
shall be
be
effective
effective or given
given any force
force or effect.
effect.
"
IN WITNESS TO THE FOREGOING, the parties have signed this Agreement
uponINtheWITNESS TO THE FOREGOING, the parties have signed this Agreement
dates indicated.
upon the dates indicated.
APPROVED AS TO CONTENT: COUNN KERN
APPROVED AS TO CONTENT: COUNTY OFOF
KERN
KERN MED)II~~~N+e-R,
B~e~~ai£O
Steve A. Perez, Chairman
Board ofof
Board Supervisors
Supervisors
KERN COUNTY PERSONNEL CONTRACT

CONTRACT EMPLOYEE
EMPLOYEE
BY~~
BY
Kay F. Madden, Director Va/d*sw
"../.1.,--
Kay F. Madden, Director
APPROVED AS TO FORM:
OFFICE OFAS
APPROVED TO FORM:
COUNTY COUNSEL
OFFICE OF COUNTY COUNSEL
By~g.~
BY -x.&Wfld&
Deputy
Deputy
Agreement.Jadwin.081202
19
Case 1:07-cv-00026-OWW-TAG Document 15 Filed 01/08/2007 Page 21 of 75@004!0_04_ _
05/30/2014 00:58 FAX
\
"-../
EXHIBIT"A"
EXHIBIT "A''
JOB D ESCRlPTlON
JOB DESCRIPTION
F. JADWIN,
DAVID F.
DAVID JADWIN, M.D.
M.D.
CHAIRMAN
PATHOLOGYCHAIRMAN
PATHOLOGY
The pathology
The pathologychairman
chairman shall
shall serve as the
serve as the medical
medical director
director for
for the anatomic pathology
the anatomic pathology
service and clinical laboratories at KMC. The pathology chairman will report
service and clinical laboratories at KMC. The pathology chairman will report to the to the KMC
KMC
Medical Director.
Medical This isis aa full-time
Director. This full-time position
position requiring 48 hours
requiring 48 hours ofof service,
service, on
on average,
average,
per week.
per week.
1.
1. Administrative responsibilities
Administrative responsibilities include:
include: TheThe pathology
pathology chairman,
chairman, together
together with
with
thelaboratory
the manager(s),will
laboratorymanager(s), will ensure
ensurethat the Department:
that the Department:
a. IsIs inin compliance

a. compliance withwith federal state regulations
and state
federal and regulations regarding
regarding clinical
clinical laboratory
laboratory
operation.
operation.
b. Meets
b. standards for
Meetsstandards for accreditation
accreditationby the College
by the College ofof American
American Pathologists
Pathologists (CAP)
(CAP)
andthe
and theAmerican
American Association
Associationof Banks (MBS).
BloodBanks
of Blood (AABB).
c.c, Operates
Operates within
within the
the policies
policies established
established by KMC and
by KMC and the
the medical
medical staff
staff bylaws.
bylaws,
rulesand
rules and regulations.
regulations.
d. Operates
d. effectively and
Operates effectively and smoothly,
smoothly, andand provides
provides timely
timely reports,
reports, provided
provided
adequate resources
adequate resources areare provided.
provided.
2.
2. Administrativeduties
Administrative duties include:
include:
a. a. Oversees the
Oversees the development,
development, implementation
implementation and maintenance of
and maintenance of
department policies and procedures for the clinical
department policies and procedures for the clinical laboratory and pathology laboratory and pathology
department,including
department, includingsurgical
surgical pathology,
pathology, cytopathology
cytopathologyand and autopsy
autopsy pathology.
pathology.
b,b. Operates and manages the pathology department
Operates and manages the pathology department quality assessmentquality assessment and and
improvementprogram.
improvement program.
c. c. Oversees
Oversees the the performance
performance of the clinical
of the clinical laboratory in the
laboratory in CAP laboratory
the CAP laboratory
proficiency surveyprogram.
proficiency survey program.
d. d. Ensures that performance
Ensures that performancedeficiencies
deficienciesare addressed in
are addressed in aa timely
timely manner.
manner.
e.e. Reviewsdepartment
Reviews department budgets
budgets and and major
major expenditures
expendituresfor for appropriateness.
appropriateness.
ff. . Monitors performance and prepares annual
Monitors performance and prepares annual evaluations for evaluations for staff
staff
pathologists and
pathologists andthethelaboratory
laboratorymanager.
manager.
g. g. Serves
Serves as
as aa member
member ofthe
of MedicalExecutive
the Medical ExecutiveCommittee,
Committee, the Chairmen's
the Chairmen's
Council, the Faculty Practice Board, the Quality Management
Council, the Faculty Practice Board, the Quality Management Committee, the Committee, the Blood
Blood
Usage Committee, and
UsageCommittee, and other
other committees
committeesthat may be
that may be assigned
assigned by the president
by the president of
of the
the
medical
medical staff.staff.
h.h. Through participation
Through participation inin the
the Blood
Blood Usage Committee, ensures
Usage Committee, adequate
ensures adequate
transfusion service and utilization.
transfusion service and utilization.
i.1. Coordinates and
Coordinates and monitors
monitors department
department faculty
faculty involvement
involvement in hospital
in hospital
committees.
committees.
20
-~-----~-~ ....._ - - - - - - - - - -
.... ~.
\. -
-'
J.j - Conducts
Conducts andand monitors
monitors regular
regular department
department meetings,
meetings, inin compliance
compliance with
with
medical staff
medical staff bylaws,
bylaws, andand provides
provides timely
timely department
department reports.
reports, including
including an
an annual
annual
department
departmentreportreportfor
forthe
the medical staff.
medicalstaff.
k.k. Coordinates medical
Coordinates medical student
student andand resident
resident training
training for
for students and
students and
residents
residentson on training
trainingrotation
rotationwithin
withinthe
the department.
department.
I.I. Meets
Meetswith
with the
the KMC
KMCmedical
medicaldirector
director at
at least
least monthly.
monthly.
m.m. Oversees the
Oversees the scheduling
scheduling and and effectiveness
effectiveness ofof pathology
pathology educational
educational
conferences for
conferences for outside
outside departments,
departments, including
including the oncology conference
the oncology conference andand the
the
oncology
oncologyclinic.
clinic.
n.n. Completesclinical
Completes clinical pathology
pathologyand and anatomic
anatomic pathology
pathology service
service work
work as
as may
may
berequired.
be required.
3.
3. Teachingduties
Teaching duties include:
include:
a.
a. Coordinates
Coordinates andand participates
participates in
in teaching
teaching conferences
conferences to to include
include weekly
weekly
gynecologyconference,
gynecology conference,oncology
oncologyconference,
conference,and and surgery
surgery conference.
conference.
b.
b. Prepares and presents
Preparesand presentsdidactic
didactic lectures.
lectures.
c.
c. Actively participates
Actively participatesin
in and
and presents departmental, interdepartmental,
presents departmental, interdepartmental, and
and
interdisciplinaryprograms
interdisciplinary programswithin KMC.
within KMC.
4.
4. Patientcare
Patient care duties
duties include:
include:
a.
a. Performs anatomic pathology
Performsanatomic pathologyservices
services as assigned.
as assigned.
b.
b. Documents care
Documents care provided
provided consistent
consistent with
with CMS
CMS requirements
requirements for
professionalfee
professional billing.
fee billing.
5.
5. Otherduties
Other duties as
as assigned bythe
assigned by the chief
chief executive
executive officer
officer or
or medical
medical director.
director.
6.
6. standard workweek
AA standard workweek will be48
will be 48 hours per week.
hours per week. Actual
Actual hours
hours may
may vary week-to-
vary week-to-
week according
week according to specific assignments;
to specific assignments; however,
however, the
the objective
objective is
is to
to achieve
achieve 2112
2112
worked hours
worked during aa twelve-month
hoursduring twelve-month period.
period.
21
I
Case 00:59
05/30/2014 1:07-cv-00026-OWW-TAG
f4J@J001/002
001/002
i.-
".-..- Kern County
Kern County
Apt r. / o 3 5 - - Z d d 4
AMENDMENT No.1
AMENDMENT No. 1
TO
TO
AGREEMENT FOR PROFESSIONAL SERVICES
AGREEMENT FOR PROFESSIONAL SERVICES
CONTRACT EMPLOYEE
CONTRACTEMPLOYEE
(County- David
(County -
F. Jadwin,
DavidF. D.O.)
Jadwin, D.O.)
This Amendment
This Amendment No. No. 11to
to the
the Agreement
Agreement forfor Professional
Servicesisis made
madeandand
entered into this /Z&h day of
entered into this 1'2.6. day of ..JDo/t.,l/8£~ 2002, by and between the County of Kern
d b d ~ 6 t 2002,
h by and between the County of Kern
("County"), aa political
("County"), political subdivision
subdivision ofof the State of
the State of California, which owns
California, which operates
and operates
owns and
Kern MedicalCenter
Kern Medical Center (hereinafter and David
"KMC"), and
(hereinafter"KMC"), David F. Jadwin, D.O.
F. Jadwin, D.O. (hereinafter
(hereinafter"Core
"Core
Physician"),aa contract
Physician"). employee.
contractemployee.
RECITALS
RECITALS
WHEREAS:
WHEREAS:
a.
a. Countyand
County andCore Physicianhave
Core Physician haveheretofore
heretoforeentered
enteredinto
into an
anAgreement for
Agreementfor
Professional (Kern County
Services (Kern Agt. #1012-2000,
County Agt. #I012-2000, dated
dated October 24, 2000)
October 24, 2000)
(hereinafter"Agreement"),
(hereinafter "Agreement"), to
to provide
providepathology
pathologyservices; and
setvices; and
b.
b. County and
County and Core
Core Physician
Physician desire
desire to
to extend the term
extend the term of
of thethe Interim
Interim
Agreement, attached
Agreement, as Exhibit
attached as " A to
Exhibit "A" the Agreement,
to the Agreement, through October 5,5 , 2002.
through October 2002, and
and
increasethe
increase maximumpayable
the maximum payabletoto allow
allowforfor the
theextended
extendedterm;
term; and
and
c.c. County further desires

County further desires to
to pay
pay Core
Core Physician
Physician an
an additional
additional$25,000,
$25,000, for
for aa
one-time biweekly payment
one-time biweekly payment of of $33,036.64,
$33,036.64, for the pay
for the periodbeginning
pay period beginningSeptember
September21, 21,
2002 to
2002 to compensate
compensate Core Core Physician
Physicianforfor the
the additional workload inin the
additional workload the Department
Department of of
~ a t h o l o & : ~ .".....
Pathology:-""
~
NOW, THEREFORE,
NOW, THEREFORE, the
the parties hereto agree
parties hereto to amend
agree to the Agreement
amend the as
Agreement as
follows:
follows:
1.1 . Exhibit "A," section

Exhibit"A," section1, TERM, shall
1,TERM, beamended
shallbe amendedas
asfollows:
follows:
"1.
"1. TERM
TERM
Performance
Performanceby byCore
CorePhysician
Physicianand
andCounty
Countyunder
underthe
theterms
termsofofthis
this interim
interim
agreement
agreementshall
shallcommence October24,2000,
commenceOctober andshall
24, 2000, and shallremain
remaininineffect through
effectthrough
5, 2002."
October5,
October 2002."
2.
2. Exhibit "A,"section
Exhibit"A," section3.
3, COMPENSATION
COMPENSATIONAND
AND BENEFITS,
BENEFITS,paragraph
paragraph3a,
3a, shall
shallbe
be
amended asfollows:
amendedas follows:
"3.
"3. COMPENSATION
COMPENSATIONAND BENEFITS
ANDBENEFITS
1
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05/30/2014 00:59 FAX
3a. Core
3a. Physicianwill
Core Physician work full-time
will work (i.e., according
full-time (Le., accordingto to AMA
AMA survey
survey data
data for
for
specialtybut
specialty noless
butno than forty
lessthan forty [40J hours per
[40]hours week) and
perweek) and will
will be compensatedwith
be compensated with cash
cash
other value
and other
and as follows:
value as Core Physician
follows: Core Physician willwill be
be paid
paid Eight Thousand Thirty-Six
Eight Thousand Thirty-Six
Dollars and Sixty-Four Cents ($8,036.64) biweekly not to exceed
Dollars and Sixty-Four Cents ($8,036.64) biweekly not to exceed Two Hundred Nine Two Hundred Nine
Thousand Six
Thousand Sixty-EightDollars
Hundred Sixty.Eight
Six Hundred Dollars ($209,668)
($209,668)annually.
annually. Core Core Physician
Physicianwill
will be
be
paid an
paid an additional
additional Twenty-Five
Twenty-Five Thousand Dollars ($25,OOO),
Thousand Dollars ($25,000), for aa one-time
for one-time biweekly
biweekly
paymentof
payment ThousandThirty-Six
Thirty-ThreeThousand
ofThirty-Three Thirty-Six Dollars
Dollarsand
andSixty-four Cents ($33.036.64),
Sixty-four Cents ($33.036.64),
for the pay period beginning September 21, 2002. The maximum
for the pay period beginning September 21, 2002. The maximum payable under payable under this
this
Agreementshall
Agreement shallnot exceed Four
not exceed HundredForty-Four
FourHundred Forty-Four Thousand
ThousandThree Three Hundred Thirty-
HundredThirty-
Six Dollars ($444,336) per the term of the Interim Agreement.
Six Dollars ($444,336) per the term of the Interim Agreement. County will withhold, County will withhold,
from said daily
from said daily compensation
compensationof of Core
Core Physician,
Physician, allall applicable
applicable federal.
federal, state and local
state and local
payroll taxes. County
payrolltaxes. will pay
Countywill theemployer's
paythe employer's portion
portionofof the hospitalinsurance
the hospital portionof
insuranceportion of
Social Security ("FICA
Social Security ("FICA 2")."27."
3.3. Except as
Except provided herein,
as provided herein, all
all other
other terms,
terms, conditions,
conditions, and covenants of
and covenants of the
the
Agreement shall remain in full force and effect.
Agreement shall remain in full force and effect.
IN WITNESS WHEREOF,
IN WITNESS WHEREOF, the parties have
the parties have executed this Amendment
executed this Amendment NO.1 to
No. 1 to
Agreementas
the Agreement
the of the
asof the day and year
dayand first written
year first written above.
above.
APPROVEDAS
APPROVED AS TO CONTENT:
TOCONTENT: COUNTY OF KERN
COUNTYOF KERN
KER~~.~~~~~~~
By ~I~.~
K.Bryan
PeterK.
Peter Bryan
B~~---L-Jl~'-L~1r
A. Perez, Chairman
SteveA.
Steve Perez, Chairman
~xecutiveOfficer
Chief Executive
Chief Officer Board of Supervisors
Board of Supervisors
COUNTYPERSONNEL
KERNCOUNlY
KERN PERSONNEL COREPHYSICIAN
CORE PHYSICIAN
BY~~'~
BY
Kay F. Madden f.rd
~A.-rn~~
B ~ 4r.
w i idd F.
F. Jadwin,
,-
Jadwin, 0.0.
0.0.
Kay F. Madden ""$ .f)~
-b- •
Director
APPROVEDAS
APPROVED AS TO FORM;
TO FORM;
COUNTYCOUNSEL
OFCOUNTY
OFFICEOF
OFFICE COUNSEL
By~g.~
Deputy
Amendm@nI1.DavldJadwin.091'02
2
EXHIBIT 2
Tort Claims Act complaint dated 7/3/06

KERN
CLAIM AGAINST THE COUNTY OF KERN
86 910,910.2 & 910.4)
Code §§
(Government Code
This claim must be filed with the Clerk of the Board of Supervisors, 1115 Truxtun
This Truxtun
th
A 6 Floor,
ve., 5
Ave., Floor, Bakersfield, California 93301. If it is a claim
Bakersfield, California claim for death.
death, injury
iniuw to
person, iniury to personal pro~erty
person. injury iniury to growins
property or injury within six
growing crops, it must be filed within
months after the the accident or event giving rise to the claim. If it is a claim for any
claim. If
other cause of action, fled within
action, it must be filed within one year after
afier the
the event(s)
evenf(s) giving rise
rise to the
claim. You
claim. You must complete
complete both sides and sign the the claim form
form for the
the claim
claim to be valid.
valid.
Complete information
Complete information must be provided. the space provided is inadequate,
provided. If the inadequate, please
use additional paper and identify information
use information by paragraph number.
number.
1.
1. name and mailing address of claimant:
State the name
David
D a v i d F.
F . Jadwin,
F. J a d w i n , D.O.,
Jadwin, D . O . , F.C.A.P.,
D.O., F . C . A . P . , 3184
F.C.A.P., 3 1 8 4 Beaudry
3184 B e a u d r y Terrace,
T e r r a c e , Glendale,
Terrace, G l e n d a l e , CA 91208-1745
Glendale, 91208-1745
2.
2. State the mailing address to which claimant desires notices from the County to
sent:
be sent:
Law Office
O f f i c e of
o f Eugene
E u g e n e Lee,
L e e , 445
Lee, 4 4 5 South
S o u t h Figueroa
F i g u e r o a Street,
S t r e e t , Suite
Street, S u i t e 2700,
2 7 0 0 , Los
2700, L o s Angeles,
A n g e l e s , CA 90071
Angeles, 90071
90071
3.
3. place and other circumstances of the accident or event(s)
State the date, place event(s) giving
giving
rise to the claim.
rise claim.
See attachment.
See attachment.
attachment.
4. Provide injury, damage or loss incurred

Provide a general description of the injury, incurred so far as it
be known:
may be known:
See attachment.
See attachment.
attachment.
1
PAGE 01/01
07/03/2006 10:54 18182499682
5.
5. provide
Provide the the name
name or namesnames of the public public employee or employees causing the
injury,
injury, damage
damage or loss,
loss, if known:
known:
Mr.
M r . Peter
Peter Bryan, Dr. D r . Irwin
I r w i n Harris
H a r r i s ,r Dr.
D r . Eugene Kercher,
Kercher, DDr. Ragland,
r . Scott Ragland,
PS. Jennife.
p~, J e n n i f e r abraham,
A&ih-m. Dr,
D r . William
W i l l iam Roy,
Rov. et~t ai.
al-
6.
6. Regardingthe
Regarding the amount claimed (including
amount claimed estimated amount of any prospective
(including estimated
injury,
injury, damage loss known
damage or loss as of the
known as the time
tims the claim
claim is filed):
IfIf less
less than
than ten
ten thousand dollars ($10,000),
thousand dollars ($10,000), state
state the amount: $
$, .
more than
IfIf more than ten dollars, would
thousand dollars,
ten thousand claim be
would the claim limited civil case (less
be a limited
than $25,000)?
than one)
(Circle one)
$25,ODO)? (Circle
7.
7. Please stale
Please state any
Yes
Ye6
any additional
additional information
information which
@
which may be helpful
helpful in
in considering
considering this
claim:
claim:
complainant
Complainant met
met with
w i t h Mr.
Mr. Bernard B&rffiann
Barmann with respect to the foregolng
foregoing on
february
e b r u a r v g,
9. 2006
2006.
must date
Claimant must
Claimant dale and sign below,
and sign below.
B.
8. Signedtthis
Signed his.3 ,3 day ~ u l v .ZOlj_
day of July, 20M-.,
r=!J~-~ ~ -p~,
I
SIGNATURE
CLAIMANT'S SIGNATURE
CLAIMANT'S
F
WARNING! IT
WARNING! IS A CRIMINAL
IT IS CRIMINAL OFFENSE
OFFENSE .-
TO FILE
TO FILE A FALSE
FALSE CLAIM (Penal Code §72)
(Penal Code $72)
(3103)
Do<> #g9f,SO
::t'·~il1m'Q1'mdOe
2
ATTACHMENT – CLAIM AGAINST THE COUNTY OF KERN
3. State the date, place and other circumstances of the accident or event(s)
giving rise to the claim.
A. Breach of Contract
Pursuant to an employment contract (“Contract”), Complainant was

formerly Chair of Pathology at Kern Medical Center (“KMC”). On
June 14, 2006, Mr. Peter Bryan (CEO of KMC) summarily informed
Complainant that he was being stripped of chairmanship effective
June 17, 2006, due to his taking excessive sick leaves. As of
June 14, 2006, Complainant had taken 12 weeks of CFRA sick leave
and approx. 3-4 weeks of County sick leave based on doctor’s
certifications which he submitted.
Prior to June 14, Mr. Bryan had not communicated to Complainant

his concerns regarding Complainant’s sick leaves. In fact, Mr.
Bryan had in at least two written communications told Complainant
that Complainant would have until June 16, 2006 to decide whether
to continue or resign his chair position. Ultimately, Mr. Bryan
failed to honor the June 16 deadline.
In addition, the Contract states that Complainant shall be
employed by the County of Kern “pursuant to the terms of
this Agreement and the medical staff bylaws of KMC”. Mr. Bryan
failed to comply with KMC bylaws in stripping Complainant of
chairmanship.
B. Wrongful Demotion/Termination in Violation of Cal. Bus. &
Prof. C. § 2056 & Conspiracy Relating Thereto
The above-referenced demotion of Complainant to a staff
pathologist also constituted a constructive termination. Mr.
Bryan’s email to Complainant of June 14, 2006, strongly intimated
that Complainant was no longer welcome at KMC. On June 26, 2006,
Mr. Bryan reinforced that sentiment when he abruptly informed
Complainant that he was no longer permitted to enter KMC grounds,
contact any KMC employee or faculty member or access any KMC
equipment or networks for any reason for the remainder of his
leave.
The demotion/termination constituted retaliation by Mr. Bryan

against Complainant for raising concerns relating to patient
health care. Previous to June 14, Complainant had apprised Mr.
Bryan and other medical staff leadership in emails and
communications too numerous to count of several crisis issues
which critically jeopardized patient health care at KMC:
i) need for follow-up on failure of a formerly-employed KMC

pathologist to detect cancer diagnoses in numerous
patient prostate biopsies;
ii) chronically incomplete or inaccurate KMC blood component
product chart copies, in violation of state regulations
and accreditation standards of JCAHO, CAP and AABB;
iii) chronically inadequate fine needle aspirations collected
by KMC radiologists leading to incomplete and/or
incorrect patient diagnoses and greatly increased expense

for KMC;
iv) need for KMC pathology dept. i) to review outsourced
pathology diagnoses prior to undergoing major therapy in
reliance on those diagnoses and ii) to approve
outsourcing of pathology to outside vendors; and
v) need for effective oversight of blood usage program by
pathology dept.
C. Per Se Libel / Ratification by KMC
In a letter dated October 17, 2005, Drs. Eugene Kercher

(President of KMC Medical Staff), Scott Ragland (President-elect
of KMC Medical Staff), Jennifer Abraham (Past President of KMC
Medical Staff) and Irwin Harris (KMC Chief Medical Officer)
informed Complainant that three letters written by Complainant’s
colleagues at KMC expressing “dissatisfaction” with Complainant
would be “entered into your medical staff file.” When
Complainant asked to see the three letters, he was refused. In
so reprimanding Complainant, Drs. Kercher, Ragland, Abraham and
Harris utterly failed to comply with KMC bylaws.
Finally on January 6, 2006, Complainant received a letter from
Ms. Karen Barnes (Deputy County Counsel for the County of Kern)
to which were attached the above-referenced three letters in
redacted form, one of which maliciously defamed Complainant’s
professional competence. Complainant was later able to determine
that Dr. William Roy was the author of the defamatory letter.
Dr. Roy did not respond to Complainant’s subsequent written
requests for explanation of his defamatory comments.
D. Related Causes of Action
Complainant also seeks to bring claims of intentional infliction

of emotional distress, negligent hiring, negligent supervision
and negligent retention in relation to the foregoing.
4. Provide a general description of the injury, damage or loss incurred so far

as it may be known:
With respect to the County of Kern and each KMC officer or staff
member as appropriate:
Pro rata loss or reduction of employment compensation of approx.
$400,000 per annum for the period from (i) on or about Dec. 2005
to Oct. 4, 2007 (end of current contract employment period) due
to demotion, sick leaves and vacation time, and (ii) from Oct.
2007 until such time as complainant is able to secure comparable
position with comparable pay after engaging in a diligent job
search. Complainant believes his career as a pathologist is
effectively at an end due to his age and the dearth of pathology
chair positions in the US.
Attorney’s fees (approx. $40,000 so far) and other costs.
Loss of reputation.
2
Severe emotional distress (and reimbursement of associated

medical expenses of approx. $30,000).
Punitive damages.
3
EXHIBIT 3
Letter from the Office of the County Counsel for the

County of Kern to Plaintiff’s counsel dated 9/15/06
Bernard C.
Bernard Barmann, Sr.
C. Barmann, Sr. OFFICE OF
OFFICE OF THE
THE Tom Newell
Tom Newell
County Counsel
County Counsel Sewice Representative
Service Representative
COUNTY COUNSEL
COUNTY COUNSEL Reply to
Reply (661) 8683867
to (661) 8683867
Stephen D.
Stephen D. Schuett Claim Service Unit
Claim Unit
Assistant COUnty
Assistant Cour.sel
County Cour.se! COUNTY OF
COUNTY KEFW
OF KEHN
Administrative Center
Administrative
1115 Truxtun
1115 Truxtun Avenue, 4th Floor
Avenue, 4th Floor
Bakersfield, CA
Bakersfield, CA 93301
93301
Telephone: (661)
Telephone: (661) 868-3801
8683801
Fax: (661)
Fax: (661) 868-3875
8683875
NOTICE OF
NOTICE OF ACTION
ACTION TAKEN
TAKEN ON
ON CLAIM
CLAIM
15, 2006
September 15, 2006
EUGENE LEE
EUGENE LEE
LAW OFFICE
LAW OFFICE OF
OF EUGENE
EUGENE LEE
LEE
445 SOUTH
445 SOUTH FIGUEROA
FIGUEROA ST
ST SUITE
SUITE 2700
2700
LOS ANGELES
LOS ANGELES CA
CA 90071
90071
Name of Claimant(s):
Name Claimant(s): David F. Jadwin,
David F. Jadwin, D.O.,
D.O., F.
F. C.
C. A.
A. P.
P.
Date of Incident:
Date Incident: 6-14-2006
6-14-2006
NOTICE IS
NOTICE IS HEREBY
HEREBY GIVEN
GIVEN that
that the
the claim
claim you
you submitted
submitted toto the
the Clerk
Clerk of the
the Kern
Kern County
County
Board of Supervisors
Board Supervisorsonon 7-5-2006
7-5-2006 was
was not
not acted
acted upon
upon by
by the
the Board.
Board. The
The claim
claim is
is deemed
deemed
rejected by
rejected by operation
operation of law
law forty-five
forty-five (45)
(45) days
days after
after the
the date
date the
the claim
claim was
was soso presented.
presented.
WARNING
WARNING
Subject to
Subject to certain
certain exceptions,
exceptions, youyou have
have only
only six
six (6)
(6) months
months from
from the
the date
date this
this notice
notice was
was
deposited in
deposited in the
the mail
mail to
to file
file aa court
court action
action on
on this
this claim.
claim. (See
(See Government
Government Code
Code I 945.6.)
945.6.)
You
You may
may seek
seek the
the advice
advice of an
an attorney
attorney of your
your choice
choice in
in connection
connection with
with this
this matter.
matter. IfIf
you desire
you desire to
to consult
consult an
an attorney,
attorney, you
you should
should do
do so
so immediately.
immediately.
Very truly
Very truly yours,
yours,
~~
,,
Tom Newell, Service Representative
Tom Newell, Service Representative
TN:tn
I:\Templates\General Liability\GL-NOA
PROOF OF
PROOF OF SERVICE MAIL
SERVICE BY MAIL
STATE OF
STATE OF CALIFORNIA
CALIFORNIA )
)) ss
ss
COUNTY OF
COUNTY OF KERN
KERN ))
II am
am employed
employed in in the
the County
County of Kern,
Kern, State
State of California.
California. II am
am over the
the age
age of
eighteen years
eighteen years and
and not
not a party
party to
to the
the within
within action.
action. My
My business
business address
address is 1I 15 Truxtun
is 1115 Truxtun
Avenue, Bakersfield,
Avenue, Bakersfield, CA 93301.
93301.
On 9-15-2006,
On 9-15-2006, I1 served
served the
the foregoing
foregoing document described
described as
as Notice
Notice of Action
Action
Taken on
Taken on Claim
Claim in
in this
this action
action by
by placing
placing a true copy
copy thereof enclosed
enclosed in
in a sealed
sealed envelope,
envelope,
addressed as
addressed as follows:
follows:
Eugene Lee
Eugene Lee
Law Office
Law Office of Eugene
Eugene Lee
Lee
So. Figueroa
445 So. Figueroa St.,
St., Suite
Suite 2700
2700
Los Angeles,
Los Angeles, CA.
CA. 90071
90071
IIamam familiar
familiar with
with the
the firm's
firm's practice
practice of collection
collection and
and processing
processing correspondence
correspondencefor
mailing. Under
mailing. Under that practice,
practice, itit would
would bebe deposited
deposited with
with the
the U.
U. S.
S. Postal
Postal Service
Service onon that
that
same
same dayday withwith postage
postage thereon
thereon fully
fully prepaid
prepaid at
at Bakersfield,
Bakersfield, California,
California, in
in the
the ordinary
ordinary
course business. II am
course of business. am aware
aware that
that on
on motion
motion of the
the party
party served,
served, service
service isis presumed
presumed
invalid ifif postal
invalid postal cancellation
cancellation date
date or postage
postage meter
meter date
date isis more
more than
than one
one day
day after date
date of
deposit for mailing
deposit mailing in
in affidavit.
affidavit.
II declare
declare under
under penalty
penalty of perjury
perjury under
under the
the laws
laws of the
the State
State of California
California that
that the
the
foregoing is
foregoing is true
true and
and correct.
correct.
Tom Newell
Tom Newell
Page 34 of 75
Filed 01/08/2007
~....¢P08~
OFFICE OF COUNTY COUNSEL
•
Risk Management '9<;j_~_H ...
• ~«zy -_-.....~-
co 4 --AIiIiI!l!IIIV.-
Kern County Administrative Center ~ - PlT., •. V BOWls
1115 Truxtun Avenue
Bakersfield, California 93301
• 02 1A $ 00.390
• 0004620836 SEP 1 5 2006
MAilED FROM ZIP CODE 93301
Document 15
)
Case 1:07-cv-00026-OWW-TAG
SGG7i+i632-7~ C,Q~.~ I! ,!,,!! ,UI"! ",! ",! L!,!! IlL,,, II" ,!,Il Ill!'!'!,Ll 11/
I!
,. .---".
EXHIBIT 4
California Department of Fair Employment and

Housing Complaint dated 8/3/06 & Amended
Complaint dated 11/14/06
* * * EMPLOYMENT
EMPLOYMENT * * *
COpy
COPY
COMPLAINT OF
COMPLAINT OF DISCRIMINATION
DISCRIMINATION UNDER
UNDER DFEH
DFEH
- ## NOT FOR -
SERVICE
SERVICE
THE PROVISIONS
THE PROVISIONS OF
OF THE
THE CALIFORNIA
CALIFORNIA DFEH
DFEH USE
USE ONLY
ONLY
FAlR EMPLOYMENT
FAIR EMPLOYMENT ANDAND HOUSING
HOUSING ACT
ACT
CALIFORNIA DEPARTMENT
CALIFORNIA DEPARTMENTOF
OF FAIR
FAIR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR NAME
YOUR NAME (indicate
(indicate Mr.
Mr. or
or Ms.)
Ms.) TELEPHONE NUM
TELEPHONE NUMBER (INCLUDE AREA
BER (INCLUDE AREA CODE)
CODE)
M r . David
Mr. D a v i d F. J a d w i n , DO,
F . Jadwin, DO, FCAP
FCAP ( 8 1 8 ) 541-0496
(818) 541-0495
ADDRESS
ADDRESS
3 1 8 4 Beaudry
3184 B e a u d r y Terrace
Terrace
CITYISTATEIZI P
CITY/STATE/ZIP COUNTY
COUNTY COLNTY CODE
COUNTY CODE
G l e n d a l e , CA
CA 91208-1745 L o s Angeles
Los Angeles
NAMED IS
NAMED IS THE
THE EMPLOYER,
EMPLOYER, PERSON,
PERSON, LABOR
LABOR ORGANIZATION,
ORGANIZATION, EMPLOYMENT
EMPLOYMENT AGENCY,
AGENCY, APPRENTICESHIP
APPRENTICESHIP COMMITTEE,
COMMITTEE,
STATE OR
OR STATE
OR OR LOCAL
LOCAL GOVERNMENT
GOVERNMENT AGENCY
AGENCY WHO
WHO DISCRIMINATED
DISCRIMINATED AGAINST
AGAINST ME:
ME:
NAME
NAME TELEPHONE
TELEPHONE NUMBER
NUMBER (Include
(Include Area
Area Code)
Code)
C o u n t y of
County o f Kern
Kern ( 6 6 1 ) 868-3585
(661) 868-3585
ADDRESS
ADDRESS 1 DFEH USE
DFEH USE ONLY
ONLY
C l e r k of
Clerk o f the
t h e Board
B o a r d of S u p e r v i s o r s , County
o f Supervisors, C o u n t y Administration
A d m i n i s t r a t i o n Building,
B u i l d i n g , 5th
5 t h Floor
Floor
CITYISTATEIZIP
COUNTY 1 COUNTYCODE
COUNTY CODE
B a k e r s f i e l d , CA
93301 Kern
Kern
NO. OF
NO. EMPLOYEESIMEMBERS (if
OF EMPLOYEES/MEMBERS ( ~known)
known)
f DATE
DATE MOST
MOST RECENT
RECENT OROR CONTINUING
CONTINUING DISCRIMINATION
DISCRIMINATION :; RESPONDENT
RESPONDENT CODE
CODE
A p p r o x . 7,500
Approx. 7,500 TOOK
TOOK PLACE
PLACE (month,
(month, day,
day, and
and year) ~ u l 10,
year) July y
1 0 , 2006
2006
THE PARTICULARS
THE PARTICULARS ARE:
ARE:
On
On July 10, fired
fired _ -denied
denledemployment
employment _-denied
denledfamily
fam~lyor
ormedical
medical leave
leave
July 1 0 , 2006
2006 IIwas
Was 1 a laid
1 doffofl _ -denied
denledpromotion
promobon _-den"d
denledpregnancy
pregnancyleave
kave
A X demoted
..Mdemoted -denied
denledtransfer
transfer _-denied
denledequal
equalpay
pay
harassed
-harassed -
XX
XX denied
deniedaccommodation
acmmmodabon _-denied ngMto
deniedright to wear
wear pants
pants
-
_ _ genetic
genetlccharacteristics
charactenstlcstesting
testlng _- _ impermissible
impermlsslblenon-job·related
non-job-relatedinquiry
lnqulry _ denied
deniedpregnancy
pregnancyacrommodation
awommodabon
~foroed
L x f o r c e dtoto quit
quit ..Mother(spedfy) r e t a l i a t e d against
X X o h r ( s p e d y ) retaliated asalGt
by
by M r . Peter
Mr. P e t e r Bryan,
B r y a n , et
e t al.
al. C h i e f Executive
Chief E x e c u t i v e Officer
O f f i c e r of
o f Kern
K e r n Medical
M e d i c a l Center
Center
Name of
Name of Person
Person Job
Job Title (supervisorlmanagerlpersonnel director/etc.)
Title (supervisor/manager/personnel directorletc.)
sex __national ong~nlancestry

national origin/ancestry ~
XX physical
- phys~cal disablihty
disability -cancer
cancer XX (Circle
...xL (Circle one)
one) filing;
filing;
because of my:
because my: -age
_ age -marital
manta1status
status ...KX.. mental
mentaldisability
d~saolllty _-g enetlccharacteristic
genetic charactenstic Protesting; participating
Protesting; participating inin
- rellg~on
_religion -sexual onentation
sexual orientation investigation
Investigation (retaliation
(retaliation for)
for)
-race/color
race~w~or -association
assoaatlon (m)
~other(sp<lCify)-=C=-F=-RA=--
Z o f i e r CFRA _
the
the reason
reason given
given by
by M r . Peter
Mr. P e t e r Bryan,
B r y a n , Chief
C h i e f Executive
E x e c u t i v e Officer
O f f i c e r of
o f Kern
K e r n Medical
M e d i c a l Center
Center
Name of
Name of Person
Person and and Job
Job Title
Title
Was because
Was because P l e a s e see
Please s e e attachment.
attachment.
[please
of [please
state what
state
you believe
you believe to
to
reason(s)]
be reason(s)]
be
wlsh to
IIwish to pursue
pursue this
this matter
matter in
in court.
court. II hereby
hereby request
request that
that the
the Department
Department of
of Fair
Fair Employment
Employment and
and Housing
Housrng provide
provide aa right-to-sue
right-to-sue notice.
notice. II understand
understand that
that ifif II
want aa federal
want federal notice
notice of
of right-to-sue,
right-to-sue, II must v i s ~the
must visit the
t US.
U S. Equal
Equal Employment
Employment Opportunity
Opportunity Commission
Commission (EEOC)
(EEOC) to
to file
frle aa complaint
complaint within
within 30
30 days
days of
of receipt
recelpt of
of the
the
DFEH "Notice
DFEH "Notice of
of Case
Case Closure,"
Closure." oror within
within 300
300 days
days ofof the
the alleged
alleged discriminatory
drscrimlnatory act,
act, whichever
whichever is
is earlier.
earlier.
II have
have not
not been
been coerced
coerced into
into making
making this
this request,
request, nor do II make
nor do make itit based
based on
on fear
fear of
of retaliation
retaliation ifif II do
do not
not do
do so.
so. II understand
understand itit is
is the
the Department
Department of
of Fair
Fair
Employment and
Employment and Housing's
Housing's policy
policy to
to not
not process
process or
or reopen
reopen aa complaint
complaint once
once the
the complaint
complaint has
has beenbeen closed
closed on
on the
the basis
b a s k of
of "Complainant
"Complainant Elected
Elected Court
Court Action."
Action."
declare under
IIdeclare under penalty
penalty of
of perjury
perjury under
under the
the laws
laws of
of the
the State
State of
o f California
California that
that the
the foregoing
foregoing is
i s true
true and
and correct
correct of
of my
m y own
own knowledge
knowledge except
except as
as to
t o matters
matters
stated on
stated o n my
my information
information and
and belief,
belief, and
and as
as to
t o those
those matters believe itit to
matters II believe to be
be true.
true. ..
D atedl-
Dated
7-31 -06
3 I -- tJ t
COMPLAINAM
SIGNATURE
~t
At Glendale
Glendale
City
City
0 3 2806
AUG 031006
DATE FILED
DATE FILED. ! ,r.P,'·
j i P ./
1.!..JLt -'....-1;1"! !,-.;'\. ..... ~¥, .-
r1\1 °"'0'"
;t$;il . .~L
'yi\lill-NT
~
••) , 1 ,,~l~,jt
' L,
DFEH-300-03 (01/05)
DFEH-300-03 (01105) LH\lil 1 ' 9\~It\I~
3!'-\!-1[)i CI i-
DEPARTMENT OF
DEPARTMENT OF FAIR
FAlR EMPLOYMENT AND
AND HOUSING
HOUSING ST&E d~,~\j:'tmNIA
STA'1£ B + ~ ~ S N I A
RIGHT-TO-SUECOMPLAINT
RIGHT-TO-SUE COMPLAINT INFORMATION
INFORMATION SHEET
SHEET
DFEH needs
DFEH needs aa separate
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
organization, employment
employment agency,
agency,
apprenticeship committee,
apprenticeship committee, state
state or
or local
local government
government agency
agency you
you wish
wish to
to file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company and
company and an
an individual(s),
individual(+ please
please complete
complete separate
separate complaint
complaint forms
forms naming
naming thethe company
company or or an
an individual
individual inin the
the
appropriate area.
appropriate area.
Please complete
Please complete the
the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
statistical purposes,
purposes, and
and
return with
return with your
your signed
signed complaint(s):
complaint(s):
YOUR RACE:lETHNICITY
YOUR RACE:/ETHNICITY (Check(Check one)
one) YOUR GE~JQJ;R:
YOUR GENDER: - Female
Female x
&xx Male
Male
- African-American
African-American
- African
African -- Other
Other OCCUPATION:
YOGR OCCUPATION:
YOUR
_- Asian/Pacific
AsianIPacific Islander
Islander (specify)
(specify) _ - Cleric31
Ciericsl
xx
- Caucasian (Non-Hispanic)
XX Caucasian (Non-Hispanic) - Craft
Craft
- Native
Native American
American _- Equipment
Equipment Operator
Operator
_- Hispanic(specify)
Hispanic(specify) _ Laborer
- Laborer
_- Manager
Manager
PRIMARY LANGUAGE
YOUR PRIMARY
YOUR LANGUAGE (specify)
(specify) _- Paraprofessional
Paraprofessional
Enqlish
English -xx Professional
..Lx Professional
- Sales
Sales
YOUR AGE:
YOUR AGE: &_1
5 7 - Service
Service
_- Supervisor
Supervisor
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF YOUR
YOUR NATIONAL
NATIONAL - Technician
Technician
ORIGINIANCESTRY. YOUR
ORIGIN/ANCESTRY. YOUR NATIONAL
NATIONAL
ORIGINIANCESTRY (specify)
ORIGIN/ANCESTRY (specify) HOWYOU
HOW YOU HEARD
HEARD ABOUT
ABOUT DFEH:
DFEH:
-xx
xx Attorney
Attorney
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF OF DISABILITY,
DISABILITY, - Bus/BART
BusIBART Advertisement
Advertisement
YOUR DISABILITY:
YOUR DISABILITY: Community Organization
Community Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
BloodICirculation - EDD
-- -EDD
- Brain/Nerves/Muscles
Brain/Nerves/Muscles - Friend
Friend
_- Digestive/Urinary/Reproduction
Digestive/Urinary/Reproduction - Human
Human Relations
Relations Commission
Commission
_- Hearing
Hearing - Labor
Labor Standards
Standards Enforcement
Enforcement
- Heart
Heart _- Local
Local Government
Government Agency
Agency
-xx Limbs
xx Limbs (Arms/Legs)
(ArmsILegs) - Poster
Poster
- xx Mental
xx Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
- Sight
Sight - Radio
Radio
- Speech/Respiratory
SpeechIRespiratory _- Telephone
Telephone Book
Book
- Spinal/Back
SpinalIBack - TVTV
- DFEH
DFEH Web
Web Site
Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF MARITAL
MARITAL STATUS,
STATUS,
YOUR MARITAL
YOUR MARITAL STATUS:
STATUS: (Check
(Check one)
one) DO YOU
DO YOU HAVE
HAVE AN
AN ATTORNEY
ATTORNEY WHO
WHO HAS
HAS AGREED
AGREED
TO REPRESENT YOU ON YOUR EMPLOYMENT
- Cohabitation
Cohabitation
DISCRIMINATION CLAIMS IN COURT? IF YOU CHECK
-Divorced
Divorced
"YES", YOU WILL BE RESPONSIBLE FOR HAVING
- Married
Married
_- Single YOUR ATTORNEY SERVE THIS DFEH COMPLAINT.
Single
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF OF RELIGION,
RELIGION, No
YOUR RELIGION:
YOUR RELIGION: (specify)
(specify)
PLEASE PROVIDE
PLEASE PROVIDE YOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF OF SEX,
SEX, THE
THE REASON:
REASON: Eugene
Eugene D.
D. Lee,
Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
Law
Law Office
Office of
of Eugene
Euqene Lee
Lee
- Orientation
Orientation
-
_ Pregnancy
Pregnancy 445
445 South
South Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
-
_ Denied
Denied Right
Right to
to Wear
Wear Pants
Pants Los Angeles, CA 90071
~Ana:3i:~
_- Other
Other Allegations (List)
Allegations (List)
DFEH-300-03-1 (01/05)
DFEH-300-03-1 (01105) oursignature date
Department of
Department of Fair
Fair Employment
Employment and
and Housing
Housing
State of
State of California
California
EMPLOYMENT * * *
* * * EMPLOYMENT COPY
COpy
!BNDER
COFjIPLAINT OF DISCRIMINATION UNDER
COrllPLAINT DFEH #
DFEH #~~~~~.-.....""--
CALlFORNlA
PROVIS1ONS OF THE CALIFORNIA
THE PROVISIONS DFEH
DFEH USE
USE ONLY
FAlR EMPLOYMENT
FAIR EMPLOYMENT AND HOUSING ACT ~ --
FAIR EMPLOYMENT
CALIFORNIA DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING
HOUSING
NAME (indicate
YOUR NAME (indicate Me
Mr. or Ms.)
Ms.) TELEPHONE NUMBER (INCLUDE AREA CODE)
Mr. David
Mr. David F. Jadwin, DO,
F . Jadwin, FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
Beaudrv Terrace
3184 Beaudry
3184 Terrace
CITYISTATEIZI P
CITY/STATE/ZIP COUNTY COUNTY CODE
COUNTY
Clendale, CA 91208-1745
Glendale, 91208-1745 Los Angeles
Los Angeles
NAMED IS THE EMPLOYER,
NAMED EMPLOYER, PERSON,
PERSON, LABOR ORGANIZATION, EMPLOYMENT AGENCY,
AGENCY, APPRENTICESHIP COMMITTEE,
OR STATE OR LOCAL GOVERNMENT AGENCY WHO DISCRIMINATED AGAINST ME:
ME:
h ME
N.-\ME NUMSER (Include Area Code)
TELEPHONE NUMBER
; :rn Medical
r:ern Medical Center
Center (661) 326-2000
(661)326-2000
DRESS
;F.. ·DRESS DFEH USE
DFEH USE ONLY
Flower Street
i 3 3 0 Flower
1330 Street
CITYISTATEIZIP
CITY/STATE/ZIP COUNTY I COUNTY CODE
COUNTY
-':akersfield, CA
~akersfield, CA 93305-4197
93305-4197 Kern
Kern
NO. EMPLOYEESIMEMBERS (if known)
NO. OF EMPLOYEES/MEMBERS known) DATE MOST RECENT
DATE RECENT OR CONTINUING
DISCRIMINATION : RESPONDENT CODE
Approx.
Approx. 1,300
1,300 TOOK
T o O K PLACE
PLACE (month,
(month. day,
day. and year) July
july 10,
1 0 , 2006
2006
THE PARTICULARS ARE
THE ARE
On July
On July 10,
10, 2006
2006 II was
fired
fired -
_ denied
denled employment -
_ denled family
denied famlly or medical
medical leave
leave
Was _laid off
=laid of -
_ denied
denled promotion
pmmobon -
_ denied
denled pregnancy
pregnancy leave
Ax
--.XX demoted
demoted denied
denled transfer
transfer _ denied equal
-denled equal pay
_harassed
harassed XX denied
denied accommodation
acmmrncdabon -
_ denied
denled right
nght to wear pants
pants
-
_ _ genetic characteristics
charaderisbcs testing
testlng -
_ _ impermissible
impermlssrble non-jab-related
non-job-relatedinquiry
inqully _ denied
denied pregnancy
pregnancy accommodation
acmrnmcdabon
~forced
X X f o r ~ e dto quit -lQ;other r ( m ) re
X X o t h e(spe<:ify) retaliated
tal iat ed againstaqalEt
by Mr. Peter
by Mr. Peter Bryan,
Bryan, et
et al.
al. Chief Executive
Chief Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
Person
Name of Person directortetc.)
Job Title (supervisor/manager/personnel director/etc.)
sex -
_ nat~onalorigin/ancestry
national ongldancestry -
XX
Xi[ physical
phys~caldisability
disabll~ty cancer one) filing;
(Circle one)
...xL (Circle flllng,
because my:
because of my: -sex
_age -marital
manta1status ..xx..
X X mental
mental disability
d~sabll~ty -
_ genetic
genet~ccharaclen.tic Protest~ng,participating
partlc~patlnginIn
-age charactenstlc Protesting;
-religion
_religion __sexual onentatton
sexual orientation lnvestlgatlon (retaliation
investigation (retallatlon for)
for)
_ race/color
race/w!or association
assoaat~on X X oher(speuiy) CFRA
~olt1er(speafy)----".C,,-F~RA,-,- _
the reason
reason given
given by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
Name of Person and Job Title
Was because
VVas because Please
Please see
see attachment.
attachment.
[please
of [please
state what
you believe
you believe to
be reason(s)]
be reason(s)]
wlsh to pursue this matter in
II wish in court.
court. I hereby request that the Department of Fair Employment and Housing provide a right-to-sue notice. I understand that if I
want a federal notice of right-to-sue, U.S. Equal
right-to-sue. II must visit the U.S. Equal Employment Opportunity Commission (EEOC) (EEOC) to file a complaint within 30 days of receipt of
o f the
DFEH "Notice of Case Closure," or within 300 days of the alleged
DFEH alleged discriminatory act,
act, whichever is earlier.
have not been

I have Into making this request,
been coerced into request, nor do I make based on fear of retaliation if II do not do so. II understand it is the Department of Fair
make it based Fa~r
reopen a complaint once the complaint has been
Employment and Housing's policy to not process or reopen been closed
closed on the basis of "Complainant
"Complainant Elected Court Action."
:::00 IF;'j'dobeIiOf'
penaity of
II declare under penalty o f perjury under the laws of
o f the State of
o f California that the foregoing is true and correct of
o f my own knowledge except as to
t o matters
and as t o those matters I believe i t t o be t r u
,od "tolli~O~_'IiOI;"'~~~_ C-.
. _
COMPLAI~
Dated
~t
At Glendale
Glendale
City
RECEPJED
DATE FILED:
DATE FILED:
(01105)
DFEH-300-03 (01/05)
FAlR EMPLOYMENT
DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING

RIGHT-TO-SUE INFORMATION SHEET
QF'::H s?$,?rate signed
, - ~ d sa separate
3 r li-i ""cds signed complaint
compla~ntfor each
eacn emfJ1'jy:;r,
ernp~<~,?r, person, labor
person, lsbor organiZ3tioll,
organ~za:ii>ii, employment a g e ICY,
empioyment age'icy,
apprent~ceshrpcommittee,
apprenticeship comm~ttee,state or local
local government agency you wish
wlsh to file against.
agalnst If you are filing
fil~ngagainst
aga~nstboth
both a
company and and an individual(s),
~ndiwdual(s),please complete separate complaint forms naming
naming the company or an individual
ind~vidualin
in the
appropriate area.
appropriate area.
Please complete the following so that DFEH

Please DFEH can process your complaint and for DFEH
DFEH for statistical purposes, and
return with your signed complaint(s):
return
YOUR RACE:/ETHNICITY (Check one) YOUR GENDER: xx Male

GENDER: - Female AX
African-American
- African-American
- African
African -- Other
Other OCCUPATION:
YOUR OCCUPATION:
_ Asian/Pacific Islander
- AsianIPacific Islander (specify)
(specify) _ - Clerical
Clerical
-xs
xx Caucasian
Caucasian (Non-Hispanic) - Craft
Craft
- Native
Native American
American Equipment Operator
_ Hispanic(specify).
- Hispanic(specify) _ Laborer
- Laborer
- Manager
Manager
LANGUAGE (specify)
YOUR PRIMARY LANGUAGE (specify) - Paraprofessional
Paraprofessional
Enqlish
~x
- Sales
Sales
YOUR AGE: 22
5 7 Service
_ Supervisor
- Supervisor
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF YOUR NATIONAL - Technician
Technician
ORIGINIANCESTRY, YOUR NATIONAL
ORIGIN/ANCESTRY, NATIONAL
ORIGIN/ANCESTRY HEARD ABOUT DFEH:
HOW YOU HEARD
xx Attorney
xx
-
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF DISABILITY,
BuslBART Advertisement
Advertisement
DISABILITY:
YOUR DISABILITY: - Community Organization
AIDS
- AIDS - EEOC
EEOC
- Blood/Circulation
EDD
BrainINerveslMuscles - Friend
Friend
- Digestive/Urinary/Reproduction
DigestivelUrinarylReproduction - Human
Human Relations
Commission
_ Hearing
- Hearing - Labor Standards Enforcement
Labor Standards Enforcement
- Heart
Heart - Local
Local Government Agency
Government Agency
-xx Limbs (Arms/Legs)
xx (ArmsILegs) - Poster
Poster
-xx
xx Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
_ Sight
- Sight - Radio
Radio
_ Telephone
- Telephone Book
Book
-
_ Speech/Respiratory
SpeechIRespiratory
_ Spinal/Back
- SpinalIBack - n/
TV
- DFEH
DFEH WebWeb Site
Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF MARITAL STATUS,
STATUS: (Check one) DO YOU HAVE
DO HAVE AN ATTORNEY WHO HAS
HAS AGREED
TO REPRESENT YOU ON ON YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation
DISCRIMINATION CLAIMS IN
DISCRIMINATION IN COURT? IF
IF YOU CHECK
- Divorced
Divorced
"YES", YOU WILL BE
Married
Married "YES". BE RESPONSIBLE FOR HAVING
_ Single YOUR ATTORNEY SERVE THIS DFEH
DFEH COMPLAINT.
- Single
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF RELIGION,
RELIGION, No
YOUR RELIGION:
RELIGION: (specify)
(specify)
PLEASE PROVIDE YOUR ATTORNEY'S NAME,
PLEASE NAME,
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IF FILING
IF FILING BECAUSE
BECAUSE OF SEX, SEX, THE REASON:
REASON: Eugene D.
Eugene Lee, ESq'
D . Lee, (SB# 236812)
Esq. (SB# 236812)
- Harassment
Harassment
Law Office
Law Office of Euqene Lee
of Eugene Lee
- Orientation
Orientation
-
_ Pregnancy
Pregnancy 445
445 South
South Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
-
_ Denied
Denied Right
Right to
to Wear
Wear Pants
plot
Pants
c~fZ:zr~
_ Other
- Allegations (List)
DFEH-300-03-1(01/05)
DFEH-300-03-1 (01105) your Signature
Your Date
Housing
Department of Fair Employment and Housing
California
State of California
copy
COPY
* * * EMPLOYMENT
EMPLOYMENT * * **NOT SERVICE
FOR SERVICE
NOT FOR
COMPL~dNT
CO?::P'_FtfNT OF
OF D!SCRIMINATION
D!SC21MlNATION UNDER
UNDE3 DFi::-! it,#-
DFEH
THE PFaOVlSlONS OF
THE PROVISIONS THE CALIFORNIA
OF THE CALIFORNIA DFEH USE
DFEH USE ONLY
ONLY
FAlR EMPLOYMENT
FAIR EMPLOYMENT ANDAND HOUSING
HOUSING ACT
CALIFORNIA DEPARTMENT OF
OF FAIR
FAlR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR NAME
YOUR NAME (indicate
(lndlcate Mr.
Mr or Ms.)
Ms ) NUMBER (INCLUDE
TELEPHONE NUMBER (INCLUDE AREA CODE)
CODE)
Mr. David
Mr. David F. Jadwin, DO,
F. Jadwin, FCAP
DO, FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
Beaudry Terrace
3 1 8 4 Beaudry
3184 Terrace
ClTYlSTATElZlP
CITYISTATE/ZIP COUNTY COUNTY CODE
COUNTY CODE
Glendale, CA
Glendale, CA 91208-1745
91208-1745 Los Angeles
Los Angeles
NAMED IS
NAMED IS THE
THE EMPLOYER,
EMPLOYER, PERSON,
PERSON, LABOR
LABOR ORGANIZATION,
ORGANIZATION, EMPLOYMENT AGENCY, APPRENTICESHIP COMMITTEE,
COMMITTEE,
OR STATE
OR STATE OR
OR LOCAL
LOCAL GOVERNMENT
GOVERNMENT AGENCY WHO DISCRIMINATED
DISCRIMINATED AGAINST ME:
ME:
NAME
NAME TELEPHONE
TELEPHONE NUMBER
NUMBER (Include
(Include Area
Area Code)
Code)
Mr. Peter Bryan
Mr. Peter Bryan (661) 326-2000
(661)326-2000
ADDRESS 1 DFEH USE
DFEH USE ONLY
ONLY
Kern Medical
Kern Medical Center,
Center, 1830 Flower street
1 8 3 0 Flower Street
ClTYlSTATElZlP
CITYISTATE/ZIP COUNTY : COUNTY CODE
COUNTY CODE
Bakersfield, CA
Bakersfield, CA 93305-4197
93305-4197 Kern
Kern
NO OF
NO. OF EMPLOYEES/MEMBERS
EMPLOYEESIMEMBERS (if
( ~known)
f DATE MOST
DATE MOST RECENT OR CONTINUING
DISCRIMINATION :; RESPONDENT
RESPONDENT CODE
CODE
Approx 1,
Approx. .
1 , 3300
00 PLACE (month,
TOOK PLACE (month, day, and year) July
day, and July 10,
1 0 , 2006
2006
THE PARTICULARS
THE PARTICULARS ARE
ARE.
On July II was
was -denied
_ denied employment _
On J U ~ Y10,
1.0, 2006
2006
fired dented emooyment -denied
deniedfamily
famtly or medical leave
or medical leave
--?Of
laid off -
_ promobon
denled promotion _dented
_ pregnanqleave
denred pregnancy leave
L X demoted
- M demoted -demed
denledtransfer
transfer -denied
_ denledequal
equal pay
-harassed
harassed -XX denied
deniedaa:ommodation
ammodation -denied
_ ngMto
denled right pants
to wear pants
-
_ genehc characteristics
_ genetic characteristicstesting
tesbng -
_ Impermisstblenon-job-related
_ lmpennissible non-job-relatedinquiry
lnqutry _ denied pregnancy
denied pregmncy acoommodation
ammmodation
Xxforced to
--1Q::forced qu~t
to quit -
-Molher(spedfy) retaliated against
XXoher(speafy) retaliated aqainst
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et
et al.
al. Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
Name of Person
Name Person (superv~sor/manager/personneldirectorletc.)
Job Title (supervisorlmanagerlpersonnel
sex -
_ natlonal origin/ancestry
national ong~nlancestry XX physical
~ physlcaldisability
dtsabil~ty -cancercancer ...KL (Circle one) filing;
(Circle one) flllng,
because my: -""
because of my: _age
-age -marital
manta1status
status ..xx.. mental
mental disability
disability -genetic
_ charactensttc
g enellc characterislic Protesting, participating
partlclpatlng in
In
Protesting;
-reltgion
_religion _sexual onentatlon
investigat~on(retaliation for)
-race/color
race~w~or assouation
assoaation X
~ X olher(specify)---=C=-F::..:RA::..:-
omer 1-( CFRA ~
reason given
the reason given by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of Kern Medical
of Kern Medical Center
Center
Name of Person and Job Title
Was because
because Please
Please see
see attachment.
attachment.
of [please
[please
state what
you believe
believe to
be reason(s)]
reason(s)]
II wish to pursue this matter in court. II hereby request that the Department of Fair Employment and Housing provide a right-to-sue notice. II understand that if I
want a federal notice of right-to-sue, II must vvisit t U.S.
~ s ithe U.S. Equal
Equal Employment Opportunity Commission (EEOC) to file a complaint within 30 days of receipt ooff the
DFEH
DFEH "Not~ce
"Notice of Case Closure."
Closure," or within 300 days of the alleged discr~minatory
discriminatory act, whichever is earlier.
II have not been coerced into making this request, nor do II make it based on fear of retaliation if II do not do so. I understand it is the Department of Fair
Employment and Housing's policy to not process or reopen a complaint once the complaint has been closed on the basis of "Complainant
Elected Court Action."
Action"
I declare under penalty ooff perjury under the laws ooff the State ooff California that the foregoing iiss true and correct of my own knowledge except as tto
o matters
::t:: on
7 Inf;;atio:a; belief, and as to those matters I bel_ie_v_e_it_t_o_b_~ --~--'-C-O-M-P-:-IN-~-\~:-Tt-'S-S-IG-N-A-TBECE"lED
__U_J_.
~t Glendale
Glendale
At
AUG 032006
City
DEPT i-( tlViENT
DATE FILED:
FILED Af\jD HOUSiNG
DFEH-300-03 (01105)
(01105)
DEPARTMENT OF FAlR
FAIR EMPLOYMENT AND
AND HOUSING STATE OF CALIFORNIA
RIGHT-TO-SUE COMPLAINT
INFORMATION SHEET
needs a separate signed
OFEH n88eJ3
DF:::H s~gnedcomplaint
conlplaint for
fdr each
each emp!o/d,
e m p ! o j ~ r ,person, labor organization,
einploynlent agency,
aS?ncy,
committee, state
apprenticeship committee, state or local
local government agency you you wish
wish toto file
file against.
against. If you
you are
are filing
filing against both
both a
company and
company and an
an individual(s),
individual(s), please
please complete
complete separate
separate complaint forms naming naming the
the company or an an individual
individual in
in the
the
appropriate
appropriate area.
area.
Please complete
Please complete the
the following
following so
so that DFEH
DFEH can
can process
process your complaint and
and for DFEH
DFEH for statistical purposes,
purposes, and
and
return with
return with your
your signed
complaint(s):
YOUR RACE:lETHNICITY
YOUR RACE:/ETHNICITY (Check
(Check one)
one) YOUR GENDER:
Female xxxx Male
Male
African-American
- African
African -- Other
Other YOUR OCCUPATION:
YOUR OCCUPATION:
_- Asian/Pacific
Islander (specify)
(specify) _ Clerical
- Clerical
xx
-: a Caucasian
Caucasian (Non-Hispanic)
(Non-Hispanic) - Craft
Craft
- Native
Native American
Equipment Operator
Operator
_- Hispanic(specify)
Hispanic(specify) _ - Laborer
Laborer
_- Manager
Manager
YOUR PRIMARY
YOUR PRIMARY LANGUAGE
LANGUAGE (specify)
(specify) _- Paraprofessional
Paraprofessional
English
Enqlish -
LXxx Professional
Professional
- Sales
Sales
YOUR AGE:
YOUR AGE: ~2
.2.-..2. - Service
Service
_- Supervisor
Supervisor
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF
OF YOUR NATIONAL
Technician
ORIGIN/ANCESTRY,
YOUR NATIONAL
NATIONAL
ORIGIN/ANCESTRY
(specify) HOW YOU
HOW YOU HEARD
HEARD ABOUT DFEH:DFEH:
xx
xx
- Attorney
Attorney
IF FILING
IF FlLlNG BECAUSE
Advertisement
YOUR DISABILITY:
YOUR DISABILITY: _- Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
BloodlCirculation - EDD
EDD
BrainINerveslMuscles - Friend
Friend
DigestiveIUrinarylReproduction - Human
Human Relations
Commission
_- Hearing
Hearing - Labor
Labor Standards
Enforcement
- Heart
Heart - Local
Local Government
Government Agency
Agency
- xx Limbs
xx Limbs (Arms/Legs)
Poster
xx Mental
xx
- Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
_- Sight
Sight - Radio
Radio
_- Speech/Respiratory
SpeechlRespiratory _- Telephone
Telephone Book
Book
_- Spinal/Back
SpinallBack - 1V
TV
- DFEH
DFEH Web
Web Site
Site
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF
OF MARITAL
MARITAL STATUS,
STATUS,
YOUR MARITAL
STATUS: (Check
(Check one)
one) DO YOU
DO YOU HAVE
HAVE AN
AN ATTORNEY
ATTORNEY WHO
WHO HAS
HAS AGREED
AGREED
TO REPRESENT
TO REPRESENT YOU
YOU ON
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation
DISCRIMINATION CLAIMS
IN COURT?
COURT? IFIF YOU
YOU CHECK
CHECK
- Divorced
Divorced
"YES". YOU
"YES", YOU WILL
WILL BE
BE RESPONSIBLE
RESPONSIBLE FOR
FOR HAVING
HAVING
- Married
Married
_ Single
Single YOUR ATTORNEY
YOUR ATTORNEY SERVE
SERVE THIS
THIS DFEH
DFEH COMPLAINT.
COMPLAINT.
IF
IF FILING
FlLlNG BECAUSE
RELIGION, xxYes No
YOUR RELIGION:
YOUR RELIGION: (specify)
(specify)
PLEASE PROVIDE
PLEASE PROVIDE YOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF OF SEX,
SEX, THE
THE REASON:
REASON: Eugene D. Lee,
Euqene D, Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
Law
Law Office
Office of
of Eugene
Euqene Lee
Lee
- Orientation
Orientation
_- Pregnancy
Pregnancy 445
445 South
South Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
_- Denied
Denied Right
Right to
to Wear
Wear Pants
Pants
d~~~\
Los Anqeles, CA 90071
_- Other
Other Allegations
Allegations (List)
DFEH-300-03-1(01105)
DFEH-300-03-1 (01105)
(List)
~
_' "!3l(.tJ6
-¥---------f~-a-te-
Signature bate
Department
Department of of Fair
Fair Employment
Employment and Housing
and Housing
State
State of
of California
Cal~fornia
** ** ** EMPLOYMENT
EMPLOYMENT** ** ** COpy
COPY
r , $ ~ ? r \INT
co:"~Pt r OF elseRIMINAT/ON
l,:R: u;T ~ C ~ ~
: - : ~ S C R I ~ J I ~ N UilDER
A DY;Z: 1 .'f
-
THE Pi{OVlSiONS
THE ;'i<OV~S30;i.d5OFOF THETHE CALIFORNIA
CALlFORNlA DFEH
DFEHUSE
USEONLY
ONLY
FAlR EMPLOYMENT
FAIR AND HOUSING
EMPLOYMENTAND HOUSING ACT
ACT
CALIFORNIADEPARTMENT
OF FAIR
FAIR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR NAME
YOUR NAME(indicate
(~ndlcateMr or
Mr. or Ms.)
Ms ) TELEPHONE NUMBER
TELEPHONE NUMBER (INCLUDE
(INCLUDEAREA
AREA CODE)
CODE)
Mr. David
Mr. David F.
F. Jadwin,
Jadwin, DO,
DO, FCAP
FCAP (818)
( 8 1 8 ) 541-0496
541-0496
ADDRESS
ADDRESS
Beaudrv Terrace
3 1 8 4 Beaudry
3184 Terrace
ClTYlSTATEIZlP
COUNTY COUNTY
COUNTY CODE
CODE
Glendale, CA
91208-1745 T,os
Los
- A-n.2a -p-l -pc,
- - Angeles -
NAMED IS
NAMED IS THE
THE EMPLOYER,
EMPLOYER, PERSON,
PERSON, LABOR
LABOR ORGANIZATION,
EMPLOYMENT AGENCY,
COMMITTEE,
OR STATE
OR STATE OR LOCAL GOVERNMENT
OR LOCAL GOVERNMENTAGENCY
AGENCY WHO
WHO DISCRIMINATED
DISCRIMINATED AGAINST
AGAINST ME:
ME:
NAME
NAME TELEPHONE
TELEPHONE NUMBER
NUMBER (Include
(IncludeArea
Area Code)
Code)
Dr. Irwin Harris
Dr. Irwin Harris (661) 326-2000
(661)326-2000
ADDRESS
ADDRESS 1 DFEH USE
DFEH USEONLY
ONLY
Kern Medical
Center, 1830 Flower Street
ClTYlSTATElZlP
CITY/ST ATE/ZI P COUNTY
COUNTY I COUNTY CODE
COUNTYCODE
Bakersfield, CA
93305-4197 Kern
Kern
NO. OF
(if known)
known) DATE
DATE MOST
MOST RECENT
RECENT OR OR CONTINUING
DISCRIMINATION :i RESPONDENT
RESPONDENTCODE
CODE
Approx . 1,300
Approx. 1,3 00 TOOK
TOOK PLACE
PLACE (month,
(month, day,
day, and
and year)
year) July
July 10,
1 0 , 2006
2006
THE PARTICULARS
ARE:
On
On July
~ u l y10,
10,2006 II was
fired
fired _-denied employment
&nied employment _- denied
denledfamily
fan;lly or
ormedical
rned~calleave
leave
2006 Was -
-laid laid off
0, _-dented promotion
denied promotion _-denied
denledpregnancy
pregnancyleave
leave
AXXXdemoted
demoted _-denied
denledtransfer
transfer _-dented equalpay
_ denied equal pay
-harassed
harassed 2
~ denied
denledaccommodation
acmmrncdabon -
_ _ denied rightto
denledright towear
wear pants
pants
- geneticcharacteristics
_ _ genetic charadensticstesting
tesbng _- non-job-relatedinquiry
impermissiblenon-jab-related
_ impermissible lnqulry _ _ denied
denied pregnancy
pregnancyaccommodation
acmmmcdabon
~forced
X X f o r c e d to
to quit
qu~t -lQS;olher(spedfy) retaliated against
XXomer(specty) retaliated aqaizt
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et et al.
al. Chief Executive
Center
Name of
Name of Person
Person Job Title
Job (supervisorlmanagerlpersonnel director/etc.)
my:
because of my: sex _ natlonalorigin/ancestry
_ _ national ong~ntancestry -
XX physical
~ disability
physlcal disability -cancer
cancer XX (Circle
...KX- (Circle one)
one) filing;
filing;
because -sex
-age
_age -marital
manta1status
status .xx..
-
XX mental
mentaldisability
dtsablllty -9genetic
_ e n e k characteristic
charactensbc Protesting; participating in
Protesting; participating in
_ reig~on
_~religion -sexualsexual orientation
onentabon investigation
investigation (retaliation
(retaliation for)
for)
-race/color
race~mior assouat~on
-assodation XX
~ olher(specify)---=:C=-F.ooRA"-'-
other(spmfy) CFRA _
the reason given

the reason given by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
officer of Kern Medical
Center
Name of
Name of Person
Person and
and Job
Job Title
Title
Was because
Was because Please
please see
see attachment.
attachment.
[please
of [please
state what
state
believe to
you believe
you to
be reason(s)]
be reason(s)]
II wish
wish to
to pursue
pursue this matter in court. II hereby request
in court. request that the
the Department of Fair
Fair Employment and
and Housing notice. II understand
Housing provide a right-to-sue notice. understand that if II
right-to-sue, II must visit
want a federal notice of right-to-sue, vislt the U.S.
U.S. Equal
Equal Employment Opportunity
Opportunrty Commission (EEOC)
(EEOC) to file a complaint
complaint within 30
30 days of receipt of
o f the
DFEH "Notice of Case
DFEH Case Closure,"
Closure," or within 300
300 days of the alleged
alleged discriminatory act,
act, whichever is
is earlier.
earlier.
I have not been Into making

been coerced into making this request,
request, nor do I make
make it based
based on
on fear of retaliation if II do not do so.
so. II understand
understand it is
is the Department of Fair
Employment and Housing's policy to not process
and Housing'S process or reopen
reopen a complaint
complaint once
once the complaint
complaint hashas been
been closed
closed on
on the basis
basis of "Complainant Elected
Elected Court Action."
II declare
declare under penalty of perjury under the laws
laws of the State of California that the foregoing i
stated on my info ation and belief, and as to those matters I belie' true. .
knowledge except as to matters
Dated _--l-+----''-'-I-_O
Dated _? _ -
/ ' COMPLAINANT'S SIG
COMPLAINANTS SIGN. I ~r C.. , \
r\C~-.Jl_~ 'J ,~
I FD
~t
At Glendale
Glendale
City
AUG 03 PfiOE
i3 3 Z006
DATE FILED:
DATE FILED: DEPT. Jr iil.\rI L.\J1MENT
DFEH-300-03 (01/05)
DFEH-300-03 (01105) A~\\D qnl \C:,\l\\~
DEPARTMENT OF FAlR
FAIR EMPLOYMENT AND HOUSING . j \ s¥J>!ff.' lY~CALIFORNIA
INFORMATION SHEET
C i - E i i needs
Cr:c::H aeparate signed
neeJ-, a2 separate srgned complaint
corr,,d~nt for each employer,
enploysr, person,
person, labor
ianor organization, 2nlpiujment "'Jeney,
c)igd:ll/L.tlCii;, employment ,;-,?cy
apprentrceshrp committee,
apprenticeship commrttee, state or local
local government agency you wish
w ~ s hto file against.
agalnst If you are filing against
agalnst both
both a
indlvidual(s), please complete separate complaint forms naming
company and an individual(s), narnlng the company or an individual
ind~vidualin In the
appropriate area.
appropriate
DFEH can process your complaint and for DFEH

Please complete the following so that DFEH DFEH for statistical purposes,
purposes, and
return
RACE:/ETHNICITY (Check one)

YOUR RACE:lETHNICITY YOUR GENDER: Female x
- Female xx Male
- African-American
African-American
- African
African -- Other
_ AsianIPacific
- Asian/Pacific Islander
Islander (specify)
Clerical
-xx Caucasian (r'Jon-Hispanic)
XX Caucasian jrJon-Hispanic) - Craft
Craft
- Native American
Native American - Equipment
_Equipment Operator
Operator
_ Hispanic(specify)
- Hispanic(specify) _ - Laborer
Laborer
-
_ Manager
Manager
YOUR PRIMARY LANGUAGE (specify) -
_ Paraprofessional
Paraprofessional
English
Enqlish -xx Professional
.x.x Professional
- Sales
Sales
YOUR AGE: r5 _ 7l - Service
Service
_ Supervisor
- Supervisor
IF FILING
IF FlLlNG BECAUSE OF YOUR NATIONAL - Technician
Technician
ORIGINIANCESTRY. YOUR NATIONAL
HOW YOU HEARD DFEH:
-xx Attorney
IF FILING
IF FlLlNG BECAUSE OF DISABILITY, - Bus/BART Advertisement
DISABILITY:
YOUR DISABILITY: - Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
Friend
- Digestive/Urinary/Reproduction
Human Relations
Commission
- Hearing
Hearing - Labor
Labor Standards
Enforcement
- Heart
Heart -
_ Local
Local Government
Government Agency
Agency
-xx Limbs (Arms/Legs)
Poster
-xx
x x Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
_ Sight
- Sight - Radio
Radio
-
SpeechIRespiratory -
_ Telephone
Telephone Book
Book
-
_ Spinal/Back
SpinalIBack - TV
Tv
- DFEH
DFEH Web
Web Site
Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF MARITAL STATUS,
STATUS: (Check one) DO YOU HAVE
HAVE AN ATTORNEY WHO HAS
HAS AGREED
- Cohabitation
Cohabitation
IF YOU CHECK
- Divorced
Divorced
"YES". YOU WILL BE
"YES", BE RESPONSIBLE FOR HAVING
HAVING
- Married
Married
_ Single YOUR ATTORNEY SERVE THIS DFEH
DFEH COMPLAINT.
- Single
IF FILING
IF FlLlNG BECAUSE
RELIGION, -
xxYes - No
RELIGION: (specify)
YOUR RELIGION:
PLEASE NAME,
PHONE NUMBER:
ADDRESS AND PHONE NUMBER:
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF SEX, SEX. THE REASON:
REASON: Eugene D . Lee, Esg.
Euqene D, Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
Orientation Law Office
O f f i c e of
of Eugene
Euqene Lee
- Orientation
- Pregnancy
_ Pregnancy 445
4 4 5 South Figueroa
F i g u e r o a Street,
S t r e e t , Suite
S u i t e 2700
2700
_ Denied
- Denied Right
Right to
to Wear
Wear Pants
Pants
_ Other
- Allegations (List)
Other Allegations (List) LOSAn~
DFEH-300-03-1(01/05)
DFEH-300-03-1 (01105) W ~ i ~ n a t u r e date
Department of Fair
Department F a ~ Employment
r Houstng
and Housing
Cal~forn~a
State of California
COpy
COPY
EMPLOYMENT ** * *
* * * EMPLOYMENT
COMPLAINT OF
COMPLAINT OF DISCR1~JlIi'L\TION 'J: r:!2
DIScR!:AlPt -\TI "i4 U:r),,:R ~ 7 7#3 : ~ NOT
DFf::;~ -"-
FOR
- ---". "
SERVICE
SERVICF
..--
THE PROVISIONS
THE PF(OVlS10idSOF T H E CAliFORNIA
OF THE CALiiORhlA DFEH
DFEH USE
USE ONLY
ONLY
FAlR EMPLOYMENT
FAIR EMPLOYMENT AND AND HOUSING
HOUSING ACT ACT
CALIFORNIA DEPARTMENTOF OF FAIR
FAIR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR NAME
YOUR NAME (indicate
(indicateMr.
Mr. or
or Ms.)
Ms.) TELEPHONE
TELEPHONE NUM BER (INCLUDE
NUMBER (INCLUDE AREA
AREA CODE)
CODE)
Mr. David
Mr. David F. F. Jadwin,
Jadwin, DO, FCAP
DO, FCAP 541-0496
( 8 1 8 ) 541-0496
(818)
ADDRESS
ADDRESS
Beaudrv Terrace
3 1 8 4 Beaudry
3184 Terrace
CITYISTATEIZIP
CITY/STATE/ZIP COUYTY
COUNTY COUNTY
COUNTY CODE
CODE
;:endale, CA
CA 91208-1745 Los '> j-les
Los .:"'.....'l.·=-leles
NAMED IS
NAMED IS THE
THE EMPLOYER,
EMPLOYER, PERSON,
PERSON, LABOR
LABOR ORGANIZATION,
EMPLOYMENT Ac;l::r~cY,
AGzrlCY, APPRENTICESHIP
COMMITTEE,
OR STATE
OR STATE OROR LOCAL
LOCAL GOVERNMENT
GOVERNMENT AGENCY
AGENCY WHO A W I N S T r,1[
DISCRIMIhIATEDAGAINST
WH3 DISCRIMIt'-JATED _;'- - - -_
NAME
NAIVE .-------.- '---TELi:;-fic;';,E ~ NUMBER
I L L _ r i \IE NUMBER (Include
(IncludeArea
Area Code)
Code)
Dr. Eugene
Dr. Eugene Kercher
Kercher
ADDRESS
ADDRESS l DFEH USE
DFEH USEONLY
ONLY
Kern Medical
Center, 1830
1830 Flower
Flower Street
Street
ClTYlSTATElZlP
COUNTY I COUNTYCODE
COUNTY CODE
3akersfield, CA
93305-4197 Kern
Kern '
NO. OF
(if known)
known) DATE
DATE MOST
MOST RECENT
DISCRIMINATION :l RESPONDENT
RESPONDENT CODE
CODE
Approx. 1,300
Approx. 1,300 TOOK
TOOK PLACE
PLACE (month,
(month, day,
day, and
and year) July 10,
year) July 2006
lo, 2006
THE PARTICULARS
ARE:
On July
On July 10,
10, 2006
2006 I1 was
fired
tired _-denieddenledemployment
employment -
_ _ denied
deniedfamily
famllyor
ormedical
medicalleave
leave
was __ laid 1a1doff
OR _-denieddenledpromotion
promobon _- denied
denledpregnancy
pregnangleave
leave
xx
..KZdemoled
demoted -denieddemedlIansfer
transfer -
__ denied
denledequal
equalpay
pay
harassed
-harassed XX denied accommodation
denled accommcdahon _-denied
denledright
nghtto
to wear
wear pants
pants
-
_ _ genetic
genetlccharacteristics
charadensbcstesting
testlng - ~mpen~sslble
_ _ impermissible non-job-relatedinquiry
non-jab-related Inquiry _ _ denied
denledpregnancy
acmmmcdabon
~forced
X x f o r c e d to
to quit
qult ..KZolher(spedfy) retaliated
X X o ~ e r ( s p e a f y ) retaliated aqalnst
against
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et al.
et al. Chief Executive
Officer of of Kern
Kern Medical
Medical Center
Center
Name of
Name of Person
Person Job
Job Title (supe~isorlmanagerlpersonneldirector/etc.)
sex -
_ _ national
nattonalorigin/ancestry
ongin~ancestry -XX physical
..M phys~ca~disabiiity
d~sab~i~ty cancer
cancer XX (Circle
...xL (Circle one)
one) filing;
filing;
because of
because of my:
my: -"""
_age
-age _manta status .xx.
X X mental
mentaldisability
disabiltty -genetic charactenst~c
genetic charactel;stic Protesting; participating in
participating in
marital status Protesting;
_religion
-religion _sexual onentabon
~nvestigation(retaliation
(retaliation for)
for)
-race/color
raceico~or -assodation
assouation ..Molher(spedfy)-::eC.=..F.:..:RA=-=--
X o f i e r (speafy) CFRA _
the reason
the reason given
given by
by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
Name
Name of
of Person
Person and
and Job
Job Title
Title
Was because
Was because Please
Please see
see attachment.
attachment.
[please
of [please
state what
state
you believe
you believe to
to
reason(s)]
be reason(s)]
be
II wish
w~sh to pursue
to pursue this
this matter
matter in
in court.
court. II hereby
hereby request
request that
that the
the Department
Department of
of Fair
Fair Employment
Employment and
and Housing provide aa right-to-sue
Housing provide right-to-sue notice.
notice. II understand
understand that
that ifif II
want aa federal
want federal notice
notice of
of right-to-sue,
right-to-sue, II must
must visit
visit the
the US.
U S. Equal
Equal Employment
Commission (EEOC)
(EEOC) to
to file
file aa complaint
complaint within
within 30
30 days
days of
of receipt
receipt of
of the
the
DFEH "Notice
DFEH "Notice of
of Case
Case Closure,"
Closure," oror within
within 300
300 days
days of
of the
the alleged discriminatory act,
alleged discriminatory act, whichever
whichever is
is earlier.
earlier.
have not
II have not been
been coerced
coerced into
into making
making this
this request,
request, nor
nor do
do II make
make itit based
based on
on fear
fear of
of retaliation
retaliation if~fII do
do not
not do
do so.
so. II understand
understand it~tis
is the
the Department
Department of
of Fair
Fa~r
Employment and
Employment and Housing's
Housing's policy
policy to
to not
not process
process or
or reopen
reopen aa complaint
complaint once
once the
the complaint
complaint has
has been
been closed
closed on
on the
the basis
basis of
of "Complainant
Elected Court
Court Action."
Action."
IIdeclare
declare under
under penalty
penalty of
of perjury
perjury under
under the
the laws
laws of
of the
::,:: on m~,,,~,;n.n 6bt" .n' uto 'h~. m.tt.~, b'g~. ~

Dated -
the State
State of
o f California
California that
that the
the foregoing
foregoing is
i s true
true and
and correct
correct of
of my
my own
own knowledge
knowledge except
except as
\ I
as to
t o matters
matters
_
At
~t
Glendale
Glendale
/
COMPLAINANTS SIGNAF?E CEt\l ED
City
City
AUG 032006
DATE FILED:
DATE FILED:
DEPT, Gr-t/-un l.iViiL.VIIVIENT
DFEH-300-03 (01/05)
DFEH-300-03 (01105) l).l\i!) Wil'I('II).[['
DEPARTMENT OF
DEPARTMENT OF FAIR
FAlR EMPLOYMENT
EMPLOYMENT AND
AND HOUSING
HOUSING . Ii;./ I siA;\-:Ji;~.:cALlFORNIA
RIGHT-TO-SUE
RIGHT-TO..SUE COMPLAINT
COMPLAINT INFORMATION
INFORMATION SHEET
SHEET
DFcH rieeds
DFEH needs aa s~;\..i_;te
sC:!';:rJ'e signed
signed comi:laint
complaint for
for each
each empli;y:r,
emplc;:Jr, person,
person, laoor organiZd( ,n, employr~12rit
labor orgrcni;d:::ii, employment ?L.?i:Cy,
Tj":i1Cy,
apprenticeship
committee, state
state or
or local
local government
government agency
agency you you wish
wish to
to file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company
company and
and an
an individual(s),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company or or an
an individual
individual in
in the
the
appropriate area.
appropriate area.
Please complete
Please complete the
the following so that
following so that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
return with
return with your
your signed
complaint(s):
YOUR RACE:/ETHNICITY
YOUR RACE:lETHNICITY (Check
(Check one)
one) YOUR
YOUR GENDER:
GENDER: - Female
Female x
&xx Male
Male
African-American
- African-American
African -- Other
- African Other YOUR
YOUR OCCUPATION:
OCCUPATION:
_ Asian/Pacific Islander (specify)
- AsianIPacific Islander (specify) _ - Clerical
Clerical
xx
- Caucasian
(Non-H~spanic) Craft
- Craft
Native American
- Native American -
_ Equipment Operator
Operator
_ Hispanic(specify)
Laborer
_ Manager
- Manager
YOUR PRIMARY LANGUAGE (specify) _ Paraprofessional
-
English
E nqlish -xx Professional
LX
- Sales
YOUR AGE: .2.-2
r_l_ - Service
_ Supervisor
-
IF FlLlNG
FILING BECAUSE OF YOUR NATIONAL - Technician
ORIGIN/ANCESTRY,
ORIGIN/ANCESTRY (specify)
ORIGINIANCESTRY HOW YOU HEARD ABOUT DFEH:
xx Attorney
-
FILING BECAUSE OF DISABILITY,
IF FlLlNG DISABILITY. - BusIBART
Bus/BART Advertisement
Advertisement
YOUR DISABILITY:
DISABILITY: -
_ Community
Organization
- AIDSAIDS - EEOC
EEOC
Blood/Circulation
EDD
Brain/Nerves/Muscles
- BrainINerveslMuscles - Friend
Friend
Digestive/Urinary/Reproduction - Human
Human Relations Commission
_- Hearing
Hearing - Labor Standards
Enforcement
- Heart
Heart - Local
Local Government
Government Agency
Agency
-xx Limbs
Limbs (Arms/Legs)
Poster
xx
-x x Mental
Mental - Prior Contact with
with DFEH
DFEH
_- Sight
Sight - Radio
Radio
_- Speech/Respiratory
SpeechlRespiratory _
- Telephone
Telephone Book
Book
_ Spinal/Back - TV
N
- DFEH
DFEH Web
Web Site
Site
IF
IF FILING BECAUSE OF
FlLlNG BECAUSE OF MARITAL
MARITAL STATUS,
STATUS,
YOUR
YOUR MARITAL
MARITAL STATUS:
STATUS: (Check one)
one) DO YOU
DO YOU HAVE
HAVE AN
AN ATTORNEY WHOWHO HAS
HAS AGREED
AGREED
TO REPRESENT
TO REPRESENT YOUYOU ON
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation DISCRIMINATION CLAIMS
IN COURT?
COURT? IFIF YOU
YOU CHECK
CHECK
- Divorced
Divorced
"YES". YOU
"YES". YOU WILL
WILL BE
BE RESPONSIBLE
RESPONSIBLE FOR
FOR HAVING
HAVING
- Married
Married
YOUR ATTORNEY SERVE
YOUR SERVE THIS
THIS DFEH
DFEH COMPLAINT.
COMPLAINT.
_- Single
Single
IF xxYes
-
xxYes No
-No
IF FILING
FlLlNG BECAUSE
RELIGION,
YOUR
YOUR RELIGION:
RELIGION: (specify)
(specify)
PLEASE PROVIDE
PLEASE PROVIDE YOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IF Euqene D.
Eugene Lee, Esq.
D. Lee, (SB# 236812)
Esq. (SB# 236812)
IF FILING
FlLlNG BECAUSE
BECAUSE OF OF SEX.
SEX. THE
THE REASON:
REASON:
Harassment
- Harassment Law Office
Law O f f i c e of
of Eugene
Euqene Lee
Lee
- Orientation
Orientation
_- Pregnancy
Pregnancy South Figueroa
4 4 5 South
445 Figueroa Street,
S t r e e t , Suite
S u i t e 2700
2700
_- Denied
DeniedRight
Right to
to Wear
Wear Pants
Pants
_- Other
Allegations (List)
~_,/~9~
DFEH-300-03-1
DFEH-300-03-1(01/05)
(01105) Date
Date
Department
Department ofofFair
F a ~Employment
Employment
r and
and Housing
Housing
State
Stateof
ofCalifornia
Cal~fornia
Case 1:07-cv-00026-OWW-TAG Document 15 Filed 01/08/2007 (~Opy
COPY
Page 46 of 75
** ** ** EMPLOYMENT NOT FOR

EMPLOYMENT** ** ** NOT FOR SERVICE
SERVIC'
CDMPLAINTC:F
COMPLAINT ;C'.FDISCRIMINATION
DfSCRIM!NATIONUJ'H)ER
L?:'3ER DFZ11 2
DFEH#
THE PROVISIONS
THE PROVISIGNSOF THECALIFORNIA
OFTHE CALlFORNiA ----- DFEH
DFEHUSE
USEONLY
ONLY
FAlR EMPLOYMENT AND HOUSING
FAIR EMPLOYMENT AND HOUSING ACT ACT
OFFAIR
FAlREMPLOYMENT ANDHOUSING
EMPLOYMENTAND HOUSING
YOURNAME
YOUR NAME(indicate
(indicateMr.
Mr.ororMs.)
Ms.) TELEPHONENUM
TELEPHONE NUMBER (INCLUDE
BER (INCLUDE - -
AREA CODE)
- CODE)
AREA
\ ---
Mr. David F.F. Jadwin,
Mr. David Jadwin,DO, FCAP
DO,FCAP (818)
( 8 1 8 ) 541-0496
541-0496
ADDRESS
ADDRESS
Beaudry Terrace
3 1 8 4 Beaudry
3184 Terrace
CITYISTATEIZIP
COUNTY COUNTYCODE
COUNTY CODE
Glendale, CA
Los Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
EMPLOYMENTAGENCY,
AGENCY,APPRENTICESHIP
COMMITTEE,
STATEOR
ORSTATE
OR ORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO DISCRIMINATEDAGAINST
WHODISCRIMINATED AGAINST ME:
ME:
NAldE
NAIJlE TELEPHONE
TELEPHONENUMBER
NUMBER(Include
(IncludeArea
AreaCode)
Code)
Dr. Scott
Dr. Scott Ragland
Ragland (661)326-2000
(661) 326-2000
ADDRESS
ADDRESS I DFEH
DFEHUSE
USEONLY
ONLY
Kern Medical
Center. 1830 Flower
1 8 3 0 Flower
- Street
Street
- - . -
ClTYlSTATElZlP
COUNTY I COUNTYCODE
COUNTY CODE
Bakersfield,CA
93305-4197 Kern
Kern
NO OF
NO OFEMPLOYEES/MEMBERS
EMPLOYEESIMEMBERS(if(ifknown)
known) DATEMOST
DATE MOSTRECENT
RECENTOR ORCONTINUING
CONTINUINGDISCRIMINATION
DISCRIMINATION : IRESPONDENT
RESPONDENTCODE
CODE
Approx 1,300
Approx. .
1,3 00 TOOKPLACE
TOOK PLACE(month,
(month,day,
day,and
andyear) JIJ~Y10,
year)July 1 0 , 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On July nred _denied
-denied employment _-denied
denledfamily
famllyorwmedical
medicalleave
leaw
On July 10,
10, 2006
2006 I1was
was -
_laid
-1a1d
fired
off
0
, -
_
denled employment
promobon
denledpromotion _ -
denied
deniedpregnancy
pregnancyleave
leave
-XX demoted
~demoted denied
deniedtransfer
transfer _ -
denied
denledequal
equalpay
pay
-harassed
harassed --xx denied
denledaa:ommodation
accnmmodafjon _- denledright
denied wearpants
ngMtotowear pants
_- _ genetic charaderisbcstesting
geneticcharacteristics tesbng _- lmpenissiblenon-job-related
impermissible non-job-related
inquiry
inquiry __denied
dmedpregnancy
mmmodation
-
~forced quit
Xxforcedtotoquit -
~other(spedfy) retaliated against
XXother(speafy) retaliated asainst
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et et al.
al. Chief Executive
Officer of of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Person JobTitle
Job Title(supervisor/manager/personnel
(supe~isorlmanagerlpersonnel directorletc )
director/etc.)
becauseof
of my: -"" sex
my: _age _- ong~n~ancestry
nationalorigin/ancestry
national -
MXXphysical
phys~ca~ dlsablllty
disability cancer
_cancer X X (Circle
.lQL.. (Clrcleone)
one)filing;
flllng.
because -age -marital
manta1status
status -
-.XX..
XX mental
mentaldisability
dtsablllty _-genetic
genet~ccharacteristic
charactenstic Protestcng,participating
Protesting; part~c~pat~ng inIn
- rellg~on
_rel1gion -sexual onentatlon
lnvestlgatlon (retaliation
(retallatlonfor)
for)
-race/color
race/color -assodatlon
assouation -
Mother(specify)_C:::.F=-.RAo=
XX oher(speufy) CFRA _
thereason
the reasongiven by Mr.
givenby Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
Nameof
Name ofPerson
Personand
andJob
JobTitle
Title
Was because
Was because Please
Please see
see attachment.
attachment.
[please
of [please
of
statewhat
state what
you believe
you believeto
to
bereason(s)]
be reason(s)]
I Iwish
w~sh to pursue
to pursuethis
this matter
matterinincourt
court. I Ihereby
herebyrequest
requestthatthatthe
theDepartment
Departmentofof Fair
FairEmployment
EmploymentandandHousing
Housingprovide
provideaaright-to-sue
right-to-suenotice.
notice. I Iunderstand
understandthat
that ifif I I
want aafederal
want federalnotice
noticeofofright-lo-sue,
right-to-sue,I Imust
mustvisit
visit the
the U.S.
U.S.Equal
EqualEmployment
EmploymentOpportunity
OpportunityCommission
Commission (EEOC)
(EEOC)to fileaacomplaint
tofile complaintwithin
within 30 daysof
30 days ofreceipt
receiptof
of thethe
DFEH"Notice
DFEH "NoticeofofCase
CaseClosure,"
Closure,"ororwithin
within 300
300days
daysof ofthe
thealleged
allegeddiscriminatory
discriminatoryact,
act,whichever
whicheverisisearlier.
earlier.
IIhave
havenot
not been
beencoerced
coercedinto
intomaking
makingthisthis request,
request, nor
nordodoIImake
makeitit based
basedononfear
fear of
of retaliation
retaliation ififIIdo
do not
not do
doso.
so. rIunderstand
understand itit isisthe
the Department
Department of
of Fair
Fa~r
Employmentand
Employment andHousing'S
Housing'spolicy
policy to
to not
notprocess
processoror reopen
reopenaa complaint
complaintonce
oncethe
thecomplaint
complaint hashasbeenbeenclosed
closed on
onthe
the basis
basisof
of "Complainant
ElectedCourt
CourtAction."
Action."
I Ideclare
declareunder
underpenalty
penalty of perjuryunder
ofperjury underthe
thelaws
lawsof
ofthe
theState
Stateof of California
Californiathat
thatthe
theforegoing
foregoing isistrue
true and
andcorrect
correctof
of my
myown
ownknowledge
knowledgeexcept
except as
asto
tomatters
matters
matters IIbelieve
stated on my jnf mation and belief, and as to those matters believe ititto ,-,"" r7(}______
Dated
Dated
.~fo 'CL4:-J if
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DFEH-300-03(01/05)
DFEH-300-03 (01105)
DEPARTMENTOF
DEPARTMENT OF FAIR
FAlREMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING STATE
STATE OF
OF CALIFORNIA
CALIFORNIA
INFORMATIONSHEET
SHEET
needs aa separate
GFEH needs
CFEH separate signed
signed complaint
cornplaint for
for each
each employer,
employer, person,
person, lab,x
l a b r organization,
employment agency,
agency,
state or
or local
local government
government agency
agency you
you wish
wish to
to file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company and
company and an individual@),please
an individual(s), please complete
complete separate
separate complaint
complaint forms
forms naming
naming the the company
company or or an
an individual
individual in
in the
the
appropriate
appropriate area.
area.
Please complete
Please complete the
the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
return with
return with your
your signed complaint(s):
YOUR RACE:/ETHNICITY(Check (Check one)
one) YOUR GENDER:
Female x
&xx Male
Male
African-American
- African-American
- African
African -- Other
YOUR OCCUPATION:
_- Asian/Pacific
Islander (specify).
Clerical
xx
->:x Caucasian
Craft
- Native
NativeAmerican
Equipment Operator
Operator
-
_ Hispanic(specify)
Laborer
-
_ Manager
Manager
YOUR PRIMARY
LANGUAGE (specify)
(specify) -
_ Paraprofessional
Paraprofessional
English xxProfessional
-
jQ{ Professional
- Sales
Sales
YOUR
YOUR AGE:
AGE: 22
57 - Service
Service
-
_ Supervisor
Supewisor
IFFILING
IF FILING BECAUSE
BECAUSEOFOF YOUR
YOUR NATIONAL
Technician
ORIGIN/ANCESTRY,
ORIGINIANCESTRY.YOUR
YOUR NATIONAL
NATIONAL
ORIGIN/ANCESTRY
ORIGINIANCESTRY(specify)
(specify) HOWYOU
HOW YOU HEARD
HEARDABOUT
ABOUT DFEH:
DFEH:
xx Attorney
-
xx Attorney
IF
IFFILING
FlLlNG BECAUSE
BECAUSEOF OF DISABILITY,
Advertisement
YOUR
YOUR DISABILITY:
DISABILITY: -
_ Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
Brain/Newes/Muscles - Friend
Friend
Human Relations
RelationsCommission
Commission
_- Hearing
Hearing - Labor
LaborStandards
Enforcement
- Heart
Heart _- Local
LocalGovernment
GovernmentAgency
Agency
xx Limbs
xx
- Limbs (Arms/Legs)
(ArmslLegs) - Poster
Poster
xx
xx
- Mental
Mental - Prior
PriorContact
Contactwith
with DFEH
DFEH
_- Sight
Sight - Radio
Radio
_- Speech/Respiratory _- Telephone
TelephoneBook
Book
SpeechIRespiratory
_- Spinal/Back
SpinallBack - TV
n/
- DFEH
DFEHWebWebSite
Site
IF
IFFILING
FlLlNGBECAUSE
BECAUSEOFOFMARITAL
MARITALSTATUS,
STATUS,
YOUR
YOUR MARITAL
MARITALSTATUS:
STATUS:(Check
(Checkone)
one) DOYOU
DO YOU HAVE
HAVEAN
AN ATTORNEY
ATTORNEY WHO
WHO HAS
HASAGREED
AGREED
TOREPRESENT
TO REPRESENTYOU
YOUONONYOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation
DISCRIMINATIONCLAIMS
DISCRIMINATION CLAIMSIN
INCOURT?
COURT? IFIFYOU
YOUCHECK
CHECK
- Divorced
Divorced
"YES".YOU
"YES", WILLBE
YOUWILL BERESPONSIBLE
RESPONSIBLEFORFORHAVING
HAVING
- Married
Married
YOURATTORNEY
YOUR ATTORNEYSERVE
SERVETHIS
THISDFEH
DFEHCOMPLAINT.
COMPLAINT.
- Single
Single
IFIFFILING
FILINGBECAUSE
BECAUSEOF OFRELIGION,
RELIGION, xxYes No
YOUR
YOURRELIGION:
RELIGION:(specify)
(specify)
PLEASEPROVIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESSAND
ADDRESS ANDPHONE
PHONENUMBER:
NUMBER:
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF OFSEX,
SEX,THE
THEREASON:
Euqene D, Lee,Esq.
Esq. (SB#
( S B # 236812)
236812)
- Harassment
Harassment
Law Office
Law Office of
of Eugene
Euqene Lee
Lee
- Orientation
Orientation
_-Pregnancy
Pregnancy 445
445 South
South Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
- Denied
DeniedRight
RighttotoWear
WearPants
Pants Los Angeles, CA 90071
_-Other
Other Allegations(List)
Allegations (List)
DFEH-300-03-1
DFEH-300-03-1(01/05)
(01105) %#signature Date
Department
DepartmentofofFair
FairEmployment
Employmentand
andHousing
Housing
State
StateofofCalifornia
Callforma
** ** ** EMPLOYMENT
EMPLOYMENT** ** ** COpy
COMPLAINT
COPjlPLAlNTOF
OFDISCRIMINATION
DISCRIMINATIONUNDERUNDER DFEH NOT' FOR
D F F ~#. -f ~~ NOT SER6ICE
-SERVICE
FOR
THE
THEPROVISIONS
PRO'JISIONS OF
OFTHE
THE CALIFORNiA
CALlFORNlA DFEH
DFEHUSE
USEONLY
ONLY
FAIR
FAIREMPLOYMENT
EMPLOYMENTAND AND HOUSING
HOUSINGACT
ACT
CALIFORNIA OFFAIR
DEPARTMENTOF FAlREMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR
YOURNAME
NAME(indicate
(indicateMr.
Mr.ororMs.)
Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER (INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr. David Jadwin,DO, FCAP
DO, FCAP (818)
( 8 1 8 ) 541-0496
541-0496
ADDRESS
ADDRESS
3184 aeaudrv
3 1 8 4 Beaudry2
Terrace
Terrace
- -
ClTYlSTATElZlP
CITY/STATE/liP COUNTY
COUNTY COUNTY CODE
Glendale, CA
Los Angeles COUNTY CODE
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
ORGANIZATION, EMPLOYMENT EMPLOYMENTAGENCY, AGENCY, APPRENTICESHIP
COMMITTEE,
STATEOR
ORSTATE
OR ORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY WHO Dl",,-SC=Rc.:.:I=M:..:..:IN.,;.:.A~T-=E=D...:.A..:..::G~A.:.:.:IN,-,-S:::..T.:......:.;..:M=E,-:
AGENCYWHO D!SCRIMINATED AGAINST ME: _-:;=;=:-=-;-;-;:::-;~~=:-;;-:-;--;---"---;,,...-,--,
NAME
NAME TELEPHONE
TELEPHONE NUMBER
NUMBER (Include
(IncludeArea
Area Code)
Code)
D~·.
Cr.. JenniferAbraham
Jennifer Abraham (661)
( 6 6 1 )326-2000
326-2000
AD3RESS
ADDRESS ; DFEHUSE
DFEH USEONLY
ONLY
Kzrn Medical
Center,1830 Flower Street
ClTYlSTATElZlP
CITY/STATE/liP COUNTY
COUNTY : COUNTY
COUNTY CODE
CODE
Bakersfield,CA
93305-4197 Kern
Kern
NO.OF
NO. OFEMPLOYEES/MEMBERS
EMPLOYEESIMEMBERS (if(ifknown)
known) DATE
DATEMOST
MOSTRECENT
DISCRIMINATION :iRESPONDENT
RESPONDENTCODE
CODE
Approx 1,300
Approx. .
1 , 3 00 TOOK
TOOKPLACE
PLACE(month,
(month,day,
day,and
andyear) july 10,
year) July 1 0 , 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On July
On J U ~ 10,
Y10,2006
2006 I Iwas
was -EOV
-laid off
fired _
_-
- denied employment
denied employment
denied
denledpromotion
p m o b
_
-
_-
denied family or medical leave
den14fam~lyor medical leave
denied
denledpregnancy
pregnancyleave
leave
LXXXdemoted
demoted _ - denied
denledtransfer
transfer _-denied
denied equal
equalpaypay
- harassed
harassed ~-XXdenied
deniedaccommodation
ammmodabon _- deniedrighllo
denied right towear
wearpants
pants
_-_ genetic
geneilccharacteristics
charaaeristrcstesting
tesbng _ _ impermissible
impermissiblenon-jab-related inquiry
non-job-relatedinquiry _ denied
deniedpregnancy
amommodahon
-
~fOrced
Xxforcedtotoquit
qult -
-.XXolher(sped1Y)
XXotter(w) retaliated against
retaliated asalzt
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et et al.
al. Chief Executive
Center
Name
NameofofPerson
Person Job
JobTitle
Title(supervisor/manager/personnel
(supe~isorlmanagerlpersonnel director/etc.)
directorletc.)
sex _- natlonalorigin/ancestry
national ong~n/ancestq -
~
XXphysical
physlcaldisability
disablllty -cancer
canoer X X (Circle
..xL (Circleone)
one) filing;
fil~ng;
becauseof
because ofmy:
my: _age
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-age -marital
manta1 status
status JQL mental
mentaldisability
d~sab~lity _-genetic
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charactensbc Protesting;participating
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-religlon
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(retaliation for)
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assouat~on ~XXolher(specify)---"'C.=..F.:..:RA=-
other(spmfy) CFRA _
the reasongiven
thereason givenby
by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Personand
andJob
JobTitle
Title
Wasbecause
Was because Please
Please see
see attachment.
attachment.
of[please
of [please
state
b ~ a what
~ tj
wrist
believetoto
youbelieve
you
reason(s)]
bereason(s)]
be
wishtotopursue
I Iwish pursuethis matterinincourt.
thismatter court. I Ihereby
herebyrequest
requestthat
thatthe
theDepartment
DepartmentofofFair
FairEmployment
Employmentand
andHousing
Housingprovide
notice. IIunderstand
understand that
that ifi f II
wantaafederal
want federalnotice right-to-sue,I Imust
noticeofofright-to-sue, mustvisit
visitthe
theU.S.
U.S.Equal
EqualEmployment
Commission(EEOC)
(EEOC)to
to file
file aa complaint
complaintwithin
withln 3030 days
days of
of receipt
receipt of
of the the
"NoticeofofCase
DFEH"Notice
DFEH CaseClosure,"
Closure,"ororwithin
within300
300days
daysofofthe
thealleged
discriminatoryact,
act,whichever
earlier.
havenot
t Ihave notbeen
beencoerced
coercedinto
intomaking
makingthis
thisrequest,
request,nor
nordo
doI Imake
makeititbased
basedon
onfear
fearof
ofretaliation
retaliation ififI Ido
do not
notdo
doso.
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understanditit isisthe
the Department
Departmentof
of Fair
Fair
Employmentand
Employment andHousing's
Housing'spolicy
policytotonot
notprocess
processor
orreopen
reopenaacomplaint
complaintonce
oncethe
thecomplaint
complaint has
hasbeen
beenclosed
closedon
onthe
the basis
basisof
of "Complainant
ElectedCourt
Court Action."
Action."
;7p
I Ideclare
declareunder
underpenalty
penaltyofofperjury
perjuryunder
underthe
thelaws
lawsof ofthe
theState
StateofofCalifornia
Californiathat
thatthe
theforegoing
foregoingisi strue
trueand
andcorrect
correctof my own
o fmy o w nknowledge
knowledgeexcept
except as
as to
t o matters
matters
statedon
stated myinformation
o nmy informationand
andbelief,
belief,and
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asto
t othose
thosematters
mattersI IbelievejJ·t.-re-be-tAl~
belie .....
Dated 7J31/{p
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ANT'S SIGNArti:-
Glendale
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411~~032006
AUG
DATEFILED:
FILED. tJfYI, Jr ihlfi
)k?;, ur Liij ;!:Ljy:ylENT
r/?!tl tiViiLUYIV1ENT
DATE
DFEH-300-03(01/05)
DFEH-300-03
DEPARTMENTOF
(01105)
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING
"D HOUSING
HOuciMG
.Ll~D
STATE OF
OF CALIFORNIA
CALIFORNIA
DEPARTMENT STATE
RIGHT-TO-SUECOMPLAINT
RIGHT-TO-SUE COMPLAINTINFORMATION
INFORMATIONSHEET
SHEET
neeas aa separat3
C F t i i needs
CFEH sepain:.. signed cornpia~ntfor
signed complaint each
f ~each
r employx, person,
employ,:;r, person, laborlabor organization,
o;ganrzation, er::plc,yrnent
er:!pIctl/ment agency,
agency,
apprenticeshipcommittee,
stateoror local
localgovernment
government agency
agency you
you wish
wish toto file
file against.
against. IfIf you
you are
are filing
filing against both aa
against both
companyand
company andan
anindividual(s),
pleasecomplete
completeseparate
separatecomplaint
complaint forms
forms naming
company or or an
an individual
individual inin the
the
appropriate
appropriatearea.
area.
Pleasecomplete
Please completethe
thefollowing
following so
sothat
thatDFEH
DFEHcan
canprocess
processyour
yourcomplaint
complaint and
andfor
for DFEH
DFEHfor
for statistical
purposes,and
and
returnwith
return withyour
yoursigned
signedcomplaint(s):
complaint(s):
YOURRACE:/ETHNICITY
YOUR RACE:IETHNICITY(Check
(Checkone)
one) YOUR
YOUR GENDER:
GENDER: - Female
Female xx Male
Male
- African-American
African-American
- African -
African- Other
Other YOUR
YOUR OCCUPATION:
OCCUPATION:
_-Asian/Pacific
AsianIPacificIslander
Islander(specify)
- Clerical
xx
-xx Caucasian
Craft
-Native
NativeAmerican
American - Equipment
EquipmentOperator
Operator
_-Hispanic(specify)
Laborer
- Manager
Manager
YOURPRIMARY
YOUR PRIMARYLANGUAGE
LANGUAGE(specify)
(specify) - Paraprofessional
Paraprofessional
English
Enqlish -
.xx
xx Professional
Professional
- Sales
Sales
YOURAGE:
YOUR AGE: rl
2...-2 - Service
Service
_- Supervisor
Supervisor
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF
OFYOUR
YOUR NATIONAL
NATIONAL Technician
Technician
ORIGIN/ANCESTRY. YOURNATIONAL
NATIONAL
ORIGINIANCESTRY(specify)
HOW YOU HEARD
HEARDABOUT
ABOUT DFEH:
DFEH:
xx
-xx Attorney
Attorney
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF OFDISABILITY.
BusIBARTAdvertisement
Advertisement
YOURDISABILITY:
Organization
-AIDS AIDS - EEOC
EEOC
- Blood/Circulation
Blood/Circulation - EDD
EDD
Friend
_-Digestive/Urinary/Reproduction
Human Relations
Commission
_-Hearing
Hearing - Labor Standards Enforcement
-HeartHeart - Local
LocalGovernment
Government Agency
Agency
xx
- xx Limbs (ArmslLegs)
Limbs(Arms/Legs) - Poster
Poster
xx
-xx Mental
Mental - Prior
PriorContact
Contact with
with DFEH
DFEH
_-SightSight - Radio
Radio
_-Speech/Respiratory
Telephone Book
Book
_-Spinal/Back
SpinallBack - TV
n/
- DFEH
DFEHWeb
Web Site
Site
IFIFFILING
FlLlNGBECAUSE
BECAUSEOFOFMARITAL
MARITALSTATUS.
STATUS,
YOURMARITAL
YOUR MARITALSTATUS:
STATUS:(Check
(Checkone)
one) DOYOU
DO YOU HAVE
HAVE AN
AN ATTORNEY
ATTORNEY WHOWHO HAS
HASAGREED
AGREED
-Cohabitation
Cohabitation TO REPRESENT
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
-Divorced
Divorced DISCRIMINATIONCLAIMS
INCOURT?
COURT? IFIF YOU
YOU CHECK
CHECK
"YES". YOU
"YES". WILL BE
YOU WILL BE RESPONSIBLE
RESPONSIBLE FORFOR HAVING
HAVING
- Married
Married
_-Single YOUR ATTORNEY
YOUR ATTORNEY SERVE
SERVE THIS
THIS DFEH
DFEH COMPLAINT.
COMPLAINT.
Single
IFIFFILING
FILINGBECAUSE
BECAUSEOF OFRELIGION.
RELIGION, -
xxYes -No
No
YOURRELIGION:
YOUR RELIGION:(specify)
(specify)
PLEASE PROVIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IFIFFILING
FILINGBECAUSE
BECAUSEOF OFSEX,
SEX.THE
THEREASON:
REASON: Eugene
Euqene D.
D. Lee,
Lee, ESq.
~ s q (SB#
.(SB# 236812)
236812)
-Harassment
Harassment
Law Office
Law of Eugene
Office of Euqene Lee
Lee
- Orientation
Orientation
_- Pregnancy
Pregnancy 445 s o u t h Figueroa
4 4 5 South Figueroa Street,
S t r e e t , Suite
S u i t e 2700
2700
_- Denied
DeniedRight
RighttotoWear
Wear Pants
Pants 0
- OtherAllegations
_ Other Allegations (List)
(List)
DFEH-300-03-1(01/05)
DFEH-300-03-1
DepartmentofofFair
(01105)
F a ~Employment
Employment
r andHousing
Hous~ng
v
Department and
Callforma
StateofofCalifornia
State
EMPLOYMENT** ** **
** ** ** EMPLOYMENT COPY cop-y
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PRO'llSlGNS OF THECALIFORNIA
CALlFORMIA DFEH
DFEHUSE
USEONLY
ONLY
FAlREMPLOYMENT
FAIR EMPLOYMENTAND AND HOUSING
HOUSINGACT
ACT
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME(indicate
(indicateMr.
Mr.ororMs.)
Ms.) TELEPHONENUM
TELEPHONE NUMBER (INCLUDEAREA
BER (INCLUDE AREA CODE)
CODE)
Mr. David
Mr. David F. Jadwin,DO,
F. Jadwin, FCAP
DO, FeA? ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
3184 Seaudrv
3 1 8 4 Beaudry
- - z
Terrace
Terrace
-
CITYISTATEIZIP
COUNTY COUNTY CODE
COUNTY CODE
Glendale,CA
CA 91208-1745 ---
Los
T.nc Angeles
A n n ~ l q ~
---2---
NAMEDIS
NAMED THE EMPLOYER,
ISTHE PERSON,LABOR
EMPLOYER, PERSON, LABORORGANIZATION,
EMPLOYMENTAGENCY,
COMMITTEE,
STATEOR
OR STATE
OR OR LOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCY WHO
WHO DISCRIMINATED
DISCRIMINATEDAGAINST
AGAINSTME:
ME:
NAME
NAME TELEPHONE
TELEPHONENUMBERNULIEER(Include
(InciudeArea
Area Code)
Code)
Dr. William Roy
Dr. William Roy ( 6 6 1 ) 327-9800
(661) 327-9800
ADDRESS
ADDRESS I DFEHUSE
DFEH USEONLY
ONLY
Truxtun Avenue
6 0 0 1 DD Truxtun
6001 Avenue 420
420
CITYISTATEIZIP
COUNTY i COUNTYCODE
COUNTY CODE
Bakersfield,CA
93309 Kern
Kern
NO.OF
EMPLOYEESIMEMBERS(if
(ifknown)
known) DATE
DATEMOST
MOSTRECENT
DISCRIMINATION RESPONDENTCODE
: IRESPONDENT CODE
TOOK
TOOK PLACE
PLACE(month,
(month,day,
day,and
andyear)
year) July
July 10,
10, 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
_-
On July
On JU~Y 2006
10, 2006
10, I1was
was - fired
fired
of,
--,Id laid off
_
_
-deniedenied
- d employment
employment
denledpromotion
denied pmmobon _-
deniedfamily
denied med~cal
familyorormedical
deniedpregnancy
_ denied pregnancyleave
leave
leave
leave
AXXXdemoted
demoted _- deniedtransfer
denied transfer _-denied equalpay
_ denied equal pay
-harassed
harassed ~3denied
deruedaccommodation
aommrnodaDon _- deniedright
_ denied nghttotowear pants
wearpants
- geneticcharacteristics
_ _ genetic charadensbcstesting
tesbng _- irnpermlssiblenon-jab-related
_ impermissible non-job-relatedlnqulry
inquiry deniedpregnancy
_ _ denied pregnancyacoommodation
acmmrnodation
- totoquit
xxforced
--.2Q[forced quit - retaliated
X X o t h e r ( w a ~ ) retaliated asal%t
-lQ;oIl1er(spedfy) against
by
by Mr. Peter
Mr. Peter Bryan,
Bryan, et al.
et al. Chief Executive
Chief Officer of
Executive Officer of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Person Job
JobTitle (supervisorlmanagerlpersonneldirector/etc.)
Title(supervisor/manager/personnel directorletc.)
becauseof
because my: _-""
ofmy: sex _-national onglnlancestry
national origin/ancestry A physlcaldisability
physical dlsablllty -cancer
cancer X X (Circle
....KL (C~rcleone)filing;
one) f~l~ng,
_ age
-age -mantal
manta1status
status -
2QL
XX mental
mentaldisability
dlsabtl~ty -genetic
_ genettccharaciensbc
characteristic Protest~ng,
Protesting; part~crpatrng
participating inIn
- religion
_religion -sexual
sexualorientation
onentallon lnvestlgatlon(retaliation
investigation (retallatlonfor)
for)
- racetm~or
race/color -assodation
assaaabon X X omer(spx.ty) CFRA
Aolt1er(speci!y)-...=C-=-F-=-RA=- _
the reason
the reasongiven
givenby
by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Center
Nameof
Name ofPerson
Personand
andJob
JobTitle
Title
Was because
Was because Please
Please see
see attachment.
attachment.
of[please
of [please
statewhat
state what
youbelieve
you believeto
to
bereason(s)]
be reason(s)]
wishtotopursue
I Iwish pursuethis
thismatter
matterinincourt.
court. I Ihereby
herebyrequest
requestthat
thatthe
theDepartment
DepartmentofofFair
FairEmployment
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right-to-suenotice.
notice. I Iunderstand
understandthat
that ififI I
wantaafederal
want federal notice
noticeof
ofright-to-sue,
rlght-to-sue,I Imust
mustvisit
vlsitthe
theU.S.
U.S.Equal
EqualEmployment
Commission(EEOC)
(EEOC)to
tofile
file aacomplaint
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within 30
30days
daysof
ofreceipt
receiptof
o fthethe
DFEH "Not~ce
DFEH"Notice ofofCase
CaseClosure,"
Closure," or
orwithin
within300
300days
daysof ofthe
thealleged
discriminatory act,
act,whichever
earlier.
havenot
I Ihave notbeen
beencoerced
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intomaking
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this request,
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ofretaliation
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the'Department of Fair
Department of Fair
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of"Complainant
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I Ideclare
declareunder
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thelaws
lawsof
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theState
Stateof
ofCalifornia
Californiathat
thatthe
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trueand
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ofmy ownknowledge
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asto
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Dated _ _-+
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---,f-_:_e_I_~_f,_a_n_d_a_s_t_O_<h~. m,".~ "'~ 1-. ~----------
I
v
COMPLAINANT'S SIGNATURE
COMPLAINANTS SIGNATURE R.·.' Frt.
At Glendale
~t Glendale \. - f ,.4 f _ f 1. ·~ D
~. r:-. n.. I.r:-
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AUG 03 -::rn"
DATEFILED:
DATE FILED OE"P'" I'
, '- t,r .....
l.UUu
DFEH-300-03(01/05)
DFEH-300-03 (01105) 1 I I,' WYiVI[NT
DEPARTMENTOF
DEPARTMENT OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING M4f):!WS5~roeRNIA
INFORMATION SHEET
on:.:
DFt,II ;,. -
,, <b!, ,3d separate
separa'd signed
s i g n 4 con:p!aint
(,dil ; ~ ' a ~ n;vr
rt, each person, labor organization,
employer, person.
edLn employer, oryaiiiza:lon, employment ayerlcy,
ernployrn=.l,t agency.
apprentlceshlp committee,
apprenticeship comrn~ttee,state or local government agency you wish wtsh to file against.
agalnst. If you are filing
f~lingagainst
aga~nstboth
both a
company and ~ndiv~dual(s),
and an individual(s). please complete separate complaint forms naming the company or an individual in in the
appropriate area.
appropriate area
Please complete the following so that DFEH

Please DFEH can process your complaint and for DFEH
DFEH for statistical purposes.
purposes, and
return

YOUR RACE:lETHNICITY GENDER:
YOUR GENDER: - Female &xx
x Male
- African-American
African-American
African -- Other
- African Other YOUR OCCUPATION:
_ Asian/Pacific
- AsianIPacific Islander
Islander (specify)
Clerical
->:
x
xx Caucasian
Caucasian (Non-Hispanic) - Craft
Craft
- Native
Native American
American -
_ Equipment
Equipment Operator
Operator
_ Hispanic(specify),
Laborer
_ Manager
- Manager
YOUR PRIMARY LANGUAGE (specify) _ Paraprofessional
- Paraprofessional
Enqlish
English - xx Professional
.lQ{
- Sales
Sales
YOUR AGE: rl
2.-.2 - Service
Service
_ Supervisor
- Supervisor
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF YOUR NATIONAL - Technician
Technician
ORIGINIANCESTRY, YOUR NATIONAL
HOW YOU HEARD DFEH:
-xx Attorney
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF DISABILITY.
DISABILITY, - Bus/BART Advertisement
DISABILITY:
YOUR DISABILITY: - Community Organization
_ Community Organization
AIDS
- AIDS - EEOC
EEOC
- Blood/Circulation
EDD
- Bra in/Nerves/Muscles
Friend
-
_ Digestive/Urinary/Reproduction
DigestiveIUrinarylReproduction - Human
Human Relations
Commission
_ Hearing
- Hearing - Labor Standards Enforcement
- Heart
Heart - Local
Government Agency
-xx
x x Limbs (ArmsILegs)
Limbs (Arms/Legs) - Poster
Poster
-xx Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
_ Sight
- Sight - Radio
Radio
-
SpeechlRespiratory _ Telephone
- Telephone Book
Book
_ Spinal/Back
- SpinallBack - TV
n/
- DFEH
DFEH Web
Web Site
Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF MARITAL STATUS.
STATUS,
MARITAL STATUS:
YOUR MARITAL STATUS: (Check one) DO YOU HAVE
00 HAVE AN ATTORNEY WHO HAS
HAS AGREED
- Cohabitation
Cohabitation
IF YOU CHECK
- Divorced
Divorced
BE RESPONSIBLE FOR HAVING
"YES". YOU WILL BE
- Married
Married
YOUR ATTORNEY SERVE THIS DFEH
DFEH COMPLAINT.
COMPLAINT.
-
_ Single
Single
IF FILING
IF FILING BECAUSE
RELIGION, xxYes
- - No
YOUR RELIGION:
RELIGION: (specify)
PLEASE PROVIDE
ATTORNEY'S NAME.
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF SEX,
SEX. THE REASON:
REASON: Eugene Lee, Esg.
Euqene D. Lee, Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
- Orientation
Orientation Law
L a w Office o f Eugene
O f f i c e of Euqene Lee
Lee
-
_ Pregnancy
Pregnancy 445 South Figueroa
4 4 5 South Figueroa Street,
S t r e e t , Suite
S u i t e 2700
2700
-
_ Denied
Denied Right to Wear Pants
Pants L s Angeles, CA~071
- Other Allegations
(List)
c... 1L
DFEH-300-03-1
DFEH-300-03-1(01/05)
(01105) Signature
Hous~ng
Department of Fair Employment and Housing
Cal~forn~a
State of California
Attachment to Dr. David F. Jadwin’s Complaint of Discrimination Against County

of Kern, Kern Medical Center, Mr. Peter Bryan, and Affiliated Entities
Until July 10, 2006, I was Chair of Pathology at Kern Medical

Center (“KMC”), a hospital that is owned and operated by the
County of Kern in California. My employment began in December
2000, pursuant to an employment contract which I executed on
October 24, 2000. On November 12, 2002, I executed a subsequent
employment contract with KMC with a five-year term ending on
October 4, 2007.
I was recruited to rebuild the pathology service. I was able to

dramatically improve the performance of the department and
patient care throughout the hospital. However, I experienced
almost immediate resistance to the changes I made. In 2002, I
began to suffer professional mistreatment and harassment by a few
members of the KMC medical staff in retaliation for my efforts to
address critical deficiencies in the quality of patient care and
inefficiencies at the hospital. The tortious attacks, hostile
environment and the conduct of the administration eventually
caused me to succumb to debilitating depression, anxiety and
insomnia, etc., for which I sought, and continue to receive,
expert medical help.
Finally, in January 2006, I discussed my disability and my

various grievances with Mr. Peter Bryan, CEO of KMC, and
requested medical leave. Mr. Bryan agreed that I should take at
least six months of time off while continuing on as Chair. I
thus continued to work on a part-time basis, capably managing the
Pathology Department and fulfilling all essential chair duties.
I later submitted a formal application for intermittent medical
leave of absence accompanied by a doctor’s note which certified
that I would need to work on a part-time basis until on or about
September 2006.
On April 28, 2006, Mr. Bryan met with me and subsequently sent to
me a formal memo which stated, “I also mentioned that after
Monday it would be preferable for you not to have an intermittent
work schedule and it would be easier on the department to just
have you on leave until your status is resolved.” From that
point on, I was no longer permitted to take intermittent leave or
work part-time as an accommodation of my disability.
In addition, Mr. Bryan initially stated that I would have until

June 16 to decide whether or not I would resign my position. In
his April 17 memo to me, Mr. Bryan stated “When you return to
full time from your medical leave I need for you to make a
decision that you will either accept the conditions and work on
improving your relationships or you will step down as chairman.”
In his April 28 memo to me, Mr. Bryan reiterated, “Finally, I
said that by June 16, 2006 you needed to give me your decision
about your employment status. Your options were to either return
full time or resign your position.”
On May 5, I underwent medically necessary sinus surgery to treat

a long-standing medical condition, and on May 29, I suffered a
serious fall which fractured two bones in my foot and avulsed a
ligament in my ankle. On May 31, I sent a letter to Mr. Bryan,
requesting an extension of the June 16 deadline.
On June 13, 3 days prior to the June 16 deadline he had promised

me, Mr. Peter Bryan (CEO of KMC) summarily informed me by email
that I was being stripped of chairmanship effective June 17, 2006,
due to my taking excessive sick leaves and my subsequent alleged
“inability to provide consistent and stable leadership in the
department for most of the past eight to nine months”. Mr. Bryan
further stated that he was going to grant me 90 days of personal
leave, despite the fact that I had not yet exhausted the 6
months’ of cumulative sick leave permitted under Kern County
rules.
As of June 13, I had taken, in the aggregate, 12 weeks of CFRA

sick leave and approximately 3-4 additional weeks of County sick
leave based on doctor’s certifications which I submitted.
Prior to June 13, Mr. Bryan had not communicated to me his

concerns regarding my sick leaves. In fact, as noted above, Mr.
Bryan had in at least two written communications told me that I
would have until June 16, 2006 to decide whether to continue or
resign my position at KMC.
On June 26, Mr. Bryan stated that I had “recently been seen on
the hospital campus” while on my personal necessity leave of
absence. He then took the drastic measure of ordering me to
“refrain from entering the facility for any reason other than
seeking medical attention”, “refrain from contacting any employee
or faculty member of Kern Medical Center for any reason other
than seeking medical attention”, and stated that “usage of any
and all equipment as well as access to any and all systems has
been suspended while [on my] approved personal necessity leave of
absence”. I discovered that this included suspension of my email
and voice mail accounts, to which I require access in order to
manage ongoing patient care issues. Mr. Bryan concluded his
letter by saying that “Failure to comply with the instructions of
this letter, are grounds for disciplinary actions up to and
including termination of your contract with the County of Kern.”
On June 29, my attorney, Mr. Eugene Lee, sent a letter to Ms.

Karen Barnes, Deputy County Counsel for the County of Kern,
disclosing my intention to pursue legal remedies against KMC and
certain of its officers and employees, and requesting that KMC
preserve all evidence relating to my claims. The letter
specifically stated that I would be pursuing claims for, among
other things, disability discrimination, failure to accommodate
disability, retaliation for taking California Family Rights Act
medical leaves, etc.
2
On July 3, I filed a Tort Claims Act form with the County of Kern,
describing my related tort and contractual breach claims. In
that form, I specifically named as potential defendants Mr. Bryan,
Dr. Irwin Harris, Dr. Eugene Kercher, Dr. Scott Ragland, and Dr.
Jennifer Abraham, all KMC officers and employees, and Dr. William
Roy, a contract physician.
I later learned from Deputy County Counsel Karen Barnes in her

reply letter to Mr. Lee of July 18, that on July 10, the KMC
Joint Conference Committee had formally voted to accept Mr.
Bryan’s recommendation that I be removed as Chair of the
Pathology Department. I had no prior notice of this meeting or
its agenda.
3
AMENDED COPY COpy

AMENDED
EMPLOYMENT'It*'It*'It* NOT
'It*'It*'It* EMPLOYMENT NOTFOR
FOR SERVICE
SERVICE
COMPLAINTOF
COMPLAINT OFDISCRIMINATION
DISCRIMINATIONUNDER
UNDER DFEH##
DFEH E200607-T-0166-00-prc
~200607-T-0166-00-prc
THE
THEPROVISIONS
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YOURNAME
YOUR NAME(indicate
(~nd~cateMrororMs.)
Mr. Ms ) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr. David
Jadwln, DO, FCAP
DO, FCAP (818)
(818)541-0496
541-0496
ADDRESS
ADDRESS
3184Beaudry
3184 Beaudry Terrace
Terrace
ClTYlSTATElZlP
CITY/STATE/ZIP COUNTYCODE
CODE
Glendale
Glendale,, CACA 91208-1745
91208-1745 COUNTY
LosCOUNTY
Angeles COUNTY
Los Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
ORGANIZATION,EMPLOYMENT
EMPLOYMENTAGENCY,
APPRENTICESHIPCOMMITTEE
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NAME
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Kern Medical
Kern Medical Center
Center (661)326-2000
(661)326-2000
ADDRESS
ADDRESS : DFEH
DFEHUSE
USEONLY
ONLY
1830 Flower
1830 ---
Flower Street
Street -
ClTYlSTATElZlP
COUNTYCODE
Bakersfield, CA
93305-4197 Kern
Kern
NO.OF
known) DATE
DATEMOST
MOSTRECENT
DISCRIMINATION : :RESPONDENT
RESPONDENTCODE
CODE
Approx. 1,300
Approx. 1,300 TOOK
TOOKPLACE
PLACE(month,
(month,day,
day,and
andyear) July 10,
year)July 10, 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
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2006 I Iwas
was =;yon
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Peter Bryan,-=.et=-..:a::..:l:.;.~ et al. --:-:-=-C=.:h~~~·e:..:f=-=E~x:::e~cu.'!.t=.;~!:..:·v~e~O:::f.=.f.::.i~ce~r~o~f~K~e~r~n...;M~e~d~i~c~a~l:...,;:C:=e~n.=:te~r~
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becauseofofmy:
because -"
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Nameof
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andJob
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Please see
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attachment.
of[please
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youbelieve
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I Iwish
wishtotopursua
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court. I Ihereby
herebyrequest
requestthat
thatthe
theDepartment
DepartmentofofFair
FairEmployment
Employmentand and Housing
Housingprovide
understand that
that ifif II
want
wantaafederal
federalnotice
noticeof right-to-sue,IImust
ofright-to-sue. mustvisit
visilthe
the U,S.
U.S.Equal
EqualEmployment
Commission (EEOC)
(EEOC) to
to file
file aa complaint
complaint within
within 30
30 days
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of receipt
receipt of
of thethe
DFEH"Notice
CaseClosure."
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within 300
300days
daysof ofthe
thealleged
discriminatoryact,
act, whichever
earlier.
I Ihave
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coercedinto
intomaking
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request, nor
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makeitit based
basedonon fear
fear of
of retaliation
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do not
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so. IIunderstand
understand itit is
is the
the Department
Department of
of Fair
Fair
Employment
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policyto
tonot
not process
processoror reopen
reopenaa complaint
complaint once
once the
the complaint
complaint has has beenbeen closed
closed on
on the
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basis of
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I Ideclare
declareunder
underpenalty
Denaltvof
ofperjury
~ e r l u under
wunder the
the laws
lawsof the State
ofthe State of
ofCalifornia
California that that the
the foregoing
foregoing Is
Istrue
true and
and correct
correct of
of my
my own
own knowledge
knowledge except
except es
as to
t o matters
matters
statedon
stated onmymyinformation
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-
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('
Dated
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Glendale
~t Glendale
At
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FILED:
DATEFILED:
DATE
DFEH-300-03(01/05)
DFEH-300-03 (01105)
DEPARTMENTOF
DEPARTMENT OF FAIR
FAlR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
1 4 2006
NOV 142006
BEPT. OF FAIR
DEPT. FAlR EMPLOYMENT
AND HOUSING
RIGHT-TOSUE
RIGHT-TO-SUE COMPLAINT INFORMATION SHEET
SHEET
DFEH needs a separate signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
government agency
apprenticeship committee, state or local government agency you
you wish
wish toto file you are
against. IfIf you
file against. are filing
filing against
against both
both aa
company and an individual@),
indiVidual(s), please complete
complete separate
separate complaint
complaint forms
forms naming
company or or an
an individual
individual in
in the
the
appropriate area,
appropriate area.
Please complete
complete the following
following so that DFEH can process your complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
retum complaint(s):
YOUR
YOUR RACE:/ETHNICITY (Check one)
RACE:lETHNICITY (Check one) YOUR GENDER: _ - Female x
x
xx Male
Male
- African-American
African-American
- African -
African - Other
OCCUPATION:
-
_ Asian/Pacific
AsianlPacific Islander
Islander (specify),
Clerical
-
Eo
xX Caucasian
Crafl
- Native
Native American
American -
_ Equipment
EqUipment Operator
Operator
-
_ Hispanic(specify),
Hispanic(specify) _
- Laborer
Laborer
-
_ Manager
YOUR PRIMARY
PRIMARY LANGUAGE
LANGUAGE (specify)
(specify) -
_ Paraprofessional
Paraprofessional
English
jQ( Professional
- Sales
Sales
YOUR
YOUR AGE:
AGE; --
L..1.
5 7 - Service
Service
- Supervisor
_ Supervisor
IF
IF FILING
FILING BECAUSE
BECAUSE OF
OF YOUR
YOUR NATIONAL
Technician
ORIGIN/ANCESTRY,
YOUR NATIONAL
NATIONAL
ORIGIN/ANCESTRY
(specify) HOW YOUYOU HEARD
-xx Attorney
IF
IF FILING
FlLlNGBECAUSE
YOUR
YOUR DISABILITY:
DISABILITY: -
_ Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
Brain/NerveslMuscles - Friend
Friend
-
Human Relations
Commission
-
_ Hearing
Hearing - Labor
Labor Standards
Enforcement
Heart
Heart -
_ Local
Local Government
Government Agency
Agency
jQ{ Limbs
Limbs(Arms/Legs)
Poster
xx
- xx Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
-
_ Sight
Sight - Radio
Radio
-
SpeechIRespiratory -
_ Telephone
Telephone Book
Book
-
_ SpinallBack
SpinallBack - TV
w
- DFEH
DFEHWeb
Web Site
Site
IF
IFFILING
FlLlNGBECAUSE
BECAUSEOFOF MARITAL
MARITALSTATUS,
STATUS,
YOUR
YOUR MARITAL
MARITALSTATUS:
STATUS: (Check
(Checkone)
one) QO YOU
DO YOU HAVE
HAVF AN
AN ATTORNEY
ATTORNEY WHOWHO HAS
HAS AGREED
AGREED
TO REPRESENT
REPRESENT YOUYOU ON
ON YOUR
YOUR EMPLOYMENT
EMPLOYWT
- Cohabitation
Cohabitation
TO
CLAIMS IN
IN COURT?
COURT? IFIF YOU
YOU CHECK
CHECK
- Divorced
Divorced
DISCRIMINATION
"YES". YOU
·YES·, YOU WILL
WILL BE
BE RESPONSIBLE
RESPONSIBLEFOR FOR HAVING
HAVING
- Married
Married
YOUR ATTORNEY
YOUR ATTORNEY SERYE
SFRVE THIS
THIS DFEH
DFEHCOMPLAINT,
COMPLAINT.
-
_ Single
Single
IFIFFILING
FlLlNGBECAUSE
RELIGION, -
xx Yes
"gYes -No
No
YOUR
YOUR RELIGION:
RELIGION:(specify)
(specify)
PI FASEPROYIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME,
ADDRESSAND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF OFSEX,
SEX.THE
THEREASON:
REASON: Eugene D.
Eugene D. Lee,
Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
Law Office
Office of Euqene Lee
of Eugene Lee
- Orientation
Orientation Law
_-Pregnancy
445 South
Street, Suite
Suite 2700
2700
=-
-
Denied
DeniedRight
Other
RighttotoWear
OtherAllegations
WearPants
Allegations(List)
Pants
(List)
c,
'~
"
DFEH-300-03-1
DFEH-300-03-1(01/05)
(01105) Date
Department
DepartmentofofFair
FairEmployment
Employmentand
andHousing
Housing
StateofofCalifornia
Slate California
AMENDED
AMENDED COPY COpy
***EMPLOYMENT***
* * * EMPLOYMENT * * * NOT
NOTFOR
FOR SERVICE
SERVICE
-- -
COMPLAINT
COMPLAINTOF
OFDISCRIMINATION
DISCRIMINATIONUNDER
UNDER DFEH#__
DFEH # E_2_00_6_07_-T_-_01_6_6-_01_-_
~200607-T-0166-01-prc p r_c _
THEPROVISIONS
THE PROVISIONSOF
OFTHE
THECALIFORNIA
CALIFORNIA DFEH
DFEHUSEUSEONLY
ONLY
FAlREMPLOYMENT
FAIR EMPLOYMENTAND
ANDHOUSING
HOUSINGACT
ACT
CALIFORNIA DEPARTMENTOF FAlREMPLOYMENT
OFFAIR EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME(indicate
(indicate Mr.ororMS.)
Mr. Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr. DavidF.F.Jadwin,
Mr.David Jadwin,DO, DO, FCAP
PCAP (818)541-0496
(818) 541-0496
ADDRESS
ADDRESS
3184Beaudry
3184 Beaudn, Terrace
Terrace
CITYISTATEIZIP
CITY/STATE/ZIP COUNTY CODE COUNTY COUNTY CODE
Glendale,CA
91208-1745 LosCOUNTY
Los Angeles
Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
EMPLOYMENTAGENCY,
APPRENTICESHIPCOMMITTEE,
COMMITTEE,
ORSTATE
OR STATEORORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO
WHODISCRIMINATED
AGAINSTME:
ME:
NAME
NAME TELEPHONE
TELEPHONENUMBER
NUMBEROnclude
flncludeArea
AreaCode)
Code)
County ofof Kern
County Kern (661)
(661)868-3585
868-3585
ADDRESS
ADDRESS i DFEH
DFEHUSE
USEONLY
-ONLY -
Clerk
Clerk ofof the
theBoard
Board ofof Supervisors,
Supervisors, County
County Administration
Administration Building,
Building, 5th 5th Floor
Floor
ClTYlSTATElZtP
COUNTY : COUNTY CODE
COUNTYCODE
Bakersfield, CA
93301 Kern
Kern
---
NO.OF
known) DATE
DATEMOST
MOSTRECENT
DlSCRlMtNATlON : RESPONDENT
; RESPONDENTCODE
CODE
Approx. 7,500
Approx. 7,500 TOOKPLACE
TOOK PLACE(month,
(month,day.
day,and
andyear) ~ u l 10,
year)July y10, 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On~ u g u s t3,3, 2006
On August 2006 I lwas
was -,,,
-
nred
_l8Idoll
fired _deried~
_ denied pIIlITIOion
,-prmc&
ll
~ deried IaTiIy or medcalleave
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deriedpreg1lIrC/
deried leave
leave
..M
XXdanded
dllrnaecl denied Iransfer
dmadbcrrler _ - equalpay
denied equal pa,
- tl8rlIssed
massed
e c $ r l $ ~ t testing
c h a rcI1enIeterlstlcs
_ - ~ i egenetll: Wng _
-KX--JX~-In'_'
JrX'_....
- inpermisllble ncn-jllb-l9lated inqUiry
inpairrlMemnjc&e4Btsd Wiry
-
_denied
_deried
demdrighlto nwear
r i ~ to
m e x m~
- d a i e d PfllI11'Il:Y
pant.
-pans
m&m
..1LXIoroed
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1QL_(!jlOCitf) ) retaliated against aaainst and
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interactive
interactive process
process
.
--
bY---=Mc.:.:r:...;.~p..::e.::.t:::;er:=....:B::..:ry~a::.:n~,_e:::;t::......:a::::l:...;.:....-
by Mr. Peter Bryan, et a1 -:-:-__C:::;h~i::.:e::.:f:.......::E::::x:;:e..::cu:::.t=.;l~·
Chief Executive v:..::e~O:=f.=.f.:::.i:::ce::.:r::..-..::o~f~K::::e.=.r~n...;M~e::;d~l::.:'
Officer of Kern Medical c::.::a~l:.......::C..::e~n.:::;te=.;r~
Center _
NameofofPerson
Name Person Job
JobTitle
(supe~isor/managerlpersonnel director/etc.)
directorletc.)
becauseofofmy:
because my: -"
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sex
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_religion
rehgton
-rscsrtola
raoeIccIor
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e sassOClaliOn
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amental
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..xx.... (Circle
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for)
thereason
the reasongiven by Mr.
givenby Mr. Peter
Peter Bryan.
Bryan, Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Personand
andJob
JobTitle
Title
Wasbecause
Was because Please
Please see
see attachment.
attachment.
of[please
of [please
statewhat
state what
youbelieveto
you believe to
be reasonIs)l
bereason(s)] . ..
I wish
I w.shtolopursue
pursuethis
thismailer court I Ihereby
matterinincourt, herebyrequest
requestthat
thatthe
theDepartment
DepartmentofofFair
FairEmployment
Housingprovide
prov~de aaright-te-sue
r~ght-to-sue not~ceI Iunderstand
notice. understandthat
that if~fII
want
wantaafederal
federalnotice
noticeofofright-to-sue,
mustvisit
visitthe
theU.S.
U.S.Equal
EqualEmployment
Commission(EEOC)
(EEOC)totofile
fileaacomplaint
complaint within
within 30
30days
daysof
ofreceipt
receiptof
ofthethe
DFEH"Notice
OFEH "NoticeofofCase
CaseClosure,"
Closure,"ororwithin
within300 daysofofthe
300days thealleged
discriminatoryact,
act,whichever
earlier.
havenot
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makeititbased
basedon
onfear
fearofofretaliation
retaliationififI Ido
donol
notdo
doso,
so. I Iunderstand
understandititisisthe
the Department
DepartmentofofFair
Fair
Employment
EmploymentandandHousing's
Housing'spolicy
policytotonot
notprocess reopenaacomplaint
processororreopen complaintonce
oncethe
thecomplaint
complainthas hasbeenbeenclosed
closedon
onthe thebasis
basisof
of"Complainant
ElectedCourt
CourtAction"
Action."
I Ideclare
declareunder
underpenalty
penaltyofofperjury
perjuryunder
underthe
thelaws
lawsofofthe
theState
StateofofCalifornia
Callfomlathat thatthe
theforegoing
forego1 Is true and correct of my own knowledge except as to matters
statedon
staled onmy
myInformation
informationand
andbelief,
belief,and
andas
astot othose mattersI Ibelieve
thosematters b e t i e ~iteto
- be true.
oatedjj/,
Dated
~//), ,--~-, --' -'---
{ (
Glendale
At,qt Glendale I
City
City
DATEFILED:
DATE FILED:
RECEIVED
RECEIVED
DFEH-300-03(01/05)
(0 1105)
DFEH·300-03
DEPARTMENTOF
DEPARTMENT OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING NOV st.t4~L1FORNIA
NOV ~ P ~ ~ L I F o R N I A
DEPT.
DEPT. OF
OF FAIR
FAlR EMPLOYMENT
EMPLOYMENT
. AND HOUSING
AND HQCSING
RIGHT-TOSUE COMPLAINT
INFORMATION SHEET
DFEH needs
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
state or
or local
local government
government agency
agency you
you wish
wish to
to file
file against.
against. If
If you
you are
are filing
filing against
against both
both a
a
company and
company and an
an individual(s),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the company or an individual
individual in the
appropriate
appropriate area.
area.
Please complete
Please complete the
the following
following so
so that
that DFEH
DFEH can
can process
process your complaint
complaint and
and for DFEH
DFEH for statistical
purposes, and
retum
retum with
with your
your signed
complaint(s):
YQUR
RACE:IETHNICITY (Check
(Check one)
one) GENDER: _
YOUR GENDER: - Female &x Male
Female 1QC
-
-
African-American
African-American
_ African -
African - Other
YOUR OCCUPATION:
-
_ Asian/Pacific
AsianlPacificIslander
Islander(specify),
Clerical
-
Exx Caucasian
Craft
- Native
NativeAmerican
American -
_ Equipment
Equipment Operator
Operator
- Hispanic(specify)
_ Hispanic(specify), _
- Laborer
Laborer
-
_ Manager
Manager
YOUR PRIMARY
LANGUAGE(specify)
(specify) -
_ Paraprofessional
Paraprofessional
English
JQ{ Professional
- Sales
Sales
YOUR AGE:
YOUR AGE: ~.1..
12 - Service
Service
- Supervisor
_ Supervisor
IF
IFFILING
FILINGBECAUSE
BECAUSEOFOF YOUR
YOUR NATIONAL
Technician
ORIGIN/ANCESTRY, YOUR NATIONAL
NATIONAL
HOW YOU HEARD
HEARDABOUT
ABOUT DFEH:
DFEY;
-xx Attorney
1Q< Attorney
IFFILING
IF FILINGBECAUSE
BECAUSEOF OF DISABILITY.
Advertisement
YQUR
YOUR DISABILITY:
DISABILITY: _- Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
Friend
-
Human Relations
Commission
-
_ Hearing
Hearing - Labor
Labor Standards
Enforcement
- Heart
Heart -
_ Local
Local Government
Government Agency
Agency
-xx Limbs
xx Limbs(Arms/Legs)
Poster
-
Exx Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
-
_ Sight
Sight - Radio
Radio
-
SpeechlRespiratory -
_ Telephone
Telephone Book
Book
-
_ Spinal/Back
SpinallBack - TV
lv
- DFEH
DFEHWebWeb Site
Site
IFIFFILING
FILINGBECAUSE
BECAUSEOFOFMARITAL
MARITALSTATUS,
STATUS,
YOURMARITAL
YOUR MARITALSTATUS:
STATUS:(Check
(Check one)
one) DOYOU
DO YOU HAVE
HAVEAN
AN ATTORNEY
ATTORNEY WHO
WHO HAS
HAS AGREED
AGREED
JO REPRESENT
TO REPRESENTYOUYOU QN
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation
INCOURT?
COURT? IFIF YOU
YOU CHECK
CHECK
- Divorced
Divorced
"YES". YOU
"YES·, WILLBE
YOUWILL BERESPONSIBLE
RESPONSIBLEFQR FOR HAVING
HAVING
-Married
Married
-
_ Single
Single
YOUR ATTORNEY
YQUR ATTORNFY SERVE
SERVETHIS
THIS DFEH
DFEHCQMPLAINT.
COMPI AINT.
IFIFFILING
FlLlNGBECAUSE
RELIGION, -
xxYes
EYes -No
No
YOURRELIGION:
(specify)
PLEASEPROVIDE
PLEASE PROVIDEYQUR
YOUR ATTQRNEY'S
ATTORNEY'S NAME,
N W
ADDRESSAND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
Eugene D. Lee,
Eugene D. Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF OFSEX, THEREASON:
SEX.THE REASON:
- Harassment
Harassment
Office of Lee
Euqene Lee
- Orientation
Orientation Law
-
_ Pregnancy
445 South
Street, Suite
Suite 2700
2700
-
_ Denied
DeniedRight
RighttotoWear
WearPants
Pants
-
_ Other
OtherAllegations
Allegations(List)
DFEH-300-03-1(01/05)
DFEH-300-03-1
(List)
(01105) ignature
rC"'--t
Date
Date
l(tt/PC-
DepartmentofofFair
Department FairEmployment
Employmentand Housing
andHousing
StateofofCalifornie
State California
Case 1:07-cv-00026-OWW-TAG Document 15
·-----~e er~¥--I
Filed 01/08/2007
... Page 59 of 75
NOT
NOT FOR
FOR SERVICE
SERVlCE
AMENDED
AMENDED
'Ie* 'Ie* 'Ie* EMPLOYMENT
EMPLOYMENT'If* 'Ie* 'If*
COMPLAINTOF
DISCRIMINATIONUNDER
UNDER DFEH#_
DFEH # _E_20_06_0_7-_T_-0_16_6-_0_2-~pr_c
~200607-T-0166-02-prc _
THEPROVISIONS
THE PROVISIONSOF
OFTHE
THECALIFORNIA
CALIFORNIA OFEH
OFEHUSE
USEONLY
ONLY
FAlREMPLOYMENT
FAIR ANDHOUSING
EMPLOYMENTAND HOUSINGACT
ACT
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME(indicate
(indicateMr,
Mr.ororMs.)
Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr, David F.F. Jadwin,
Mr. David Jadwin, DO,
DO, FCAP
FCAP (818) 541-0496
(818) 541-0496
AODRESS
ADDRESS
3184 Beaudry
3184 Beaudrv Terrace
Terrace
buUN I 1 COUNTY
LUUN I Y CODE
LUUt
Glendale. CA
93208-1 745 Los Angeles
NAMED IS THE EMPLOYER, PERSON, LABOR ORGANIZATION, EMPLOYMENT AGENCY, APPRENTICESHIP COMMITTEE,
OR STATE OR LOCAL GOVERNMENT AGENCY WHO DISCRIMINATED AGAINST ME:
NAME TELEPHONE NUMBER (Include Area Code)
Mr. Peter
Mr. Peter Bryan
Bryan (661)326-2000
(661)326-2000
ADDRESS
ADDRESS I DFEHUSE
DFEH USEONL
ONLYY
Kern Medical
Center, 1830
1830 Flower
Flower Street
Street
C ITYISTATEIZIP
CITY/STATEIZIP COUNTY
COUNTYCODE
Bakersfield, CA
93305-4197 Kern
Kern
NO.OF
NO, OFEMPLOYEES/MEMBERS
EMPLOYEESIMEMBERS(if( ~known)
known)
f DATEMOST
DATE MOSTRECENT
DISCRIMINATION ::RESPONDENT
RESPONDENT COOE
CODE
Approx. 1,300
Approx. 1,300 TOOKPLACE
TOOK PLACE(mon\h,
(month,day,
day,and year) July
andyear) july 10,
lo, 2006
2006
--
THEPARTICULARS
THE PARTICULARSARE:
ARE:
_det18def11llOl'mll1l ~ der1ed!lrfiy a __
On August
On ~ u g u s t3,3, 2006
2006 IIwas
was =kYm
-XXdFmrsd
-geneaC
smao~
~ m c c W i S bC
0e
W
_
-xx deried
xx-
det18d prcmoIon
_ _
8CC\lIl1l1OdllI
impenrj_llOI>jObielat8d
~ W W rtnj&fdaW U
ohlr(opedryjretaliated
F-(-)retaliated
""","'Y
'Wry
-dened ri{11t to wear
rn
denied
a q a i n i and~ed
against and=?
accorrm:>dalia:
=
_det18d
derlBd pI8gllI1Cy_
equal pay
pallS
Interactive
interactive process process
by
--
by---!M~r:.:.e.-=P-=e~t.::e=.r..;B~r::..y~a==n~,:....::e~t~ac.=l.:..
Mr. Peter Bryan, et al. Chief..;E::;x~e::.:c::.:u::.:t:.::i:.:v..:::e~O=f::.f=ic::.e:;r:;...:o~f~K~e:.::r:.:.n:....:.M::::e;:::d~i.:::c:::a=l~c::.en:.:.t::.:e::.:r:..-
.:::C:.:h=i:::.e::.f Executive Officer of Kern Medical Center _
Nameof
Name ofPerson
Penon Job
JobTille
(supe~isorlmanagerlpersonnel director/etc,)
direclorletc.)
- n a ~ i mcx1girJlIrlClll8lry
a~awrd~ M
~ p hphysical
yricad iahmy
disability _ J&- (Circle
.lOL- (Circle one)
one) filing;
filing;
becauseof
because my:
ofmy: -"
_oga
-age
_national
- maltal
m lstatus
stalua ..xx.
~ m emental
raelddml d1sa1l11~
ClI100r
genetic ch8J'a<terilltlc
_,gena(icch~~&b Protesting;
participating inin
- religion
_religion aaxuaI_on
-dorfen(allm investigation
(retallation for)
for)
_ -
llllllliI:da
-m -assoclallon
awxMm -
XX
~OIher(specifY)~CF;:,.:RA~
CFRA _
the
the reason
reasongiven
givenby
by Mr.
Mr. Peter
Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of
of Kern
Kern Medical
Medical Center
Center
Nameof
Name of Person
Personand
and Job
Job Title
Title
Was because
Was because Please
Please see attachment.
Bee attachment.
of [please
of [please
statewhat
state what
you believe
you believe toto
be reason(s)]
be reason[s)l
, ,a
IIwish
wishtoto pursue
pursuethis
this matter
matter inincourt,
court. IIhereby
hereby request
request thatthat the
the Department
Departmentofof Fair
Fair Employment
Employment and
and Housing
Housing provide
right-to-sue notice,
not~ce II understand
understand that
that if11iI
want
want aa federal
federalnotice
noticeof of right.ta-sue,
right-to-sue, IImust
must visit
visit the
the U,
U.S.S. Equal
Equal Employment
Commission (EEOC)
(EEOC) to file
file ea complaint within 30
30 days of receipt
receipt of the
DFEH"Notice
DFEH "Not~ceofof Case
Case Closure,"
Closure," or within 300
or within days of
300days of the
the alleged
discriminatory act.
act, whichever Is
is earlier.
earlier.
IIhave
have nol
no! been
beencoerced
coerced into
into making
making this
this request,
request, nor
nor do
do II make
make itit based
basedon
on fear
fear of retaliation if IIdo
of retaliation do not
not do so. IIunderstand it is
is the Department
Department of Fair ,
Employment
Employment and
and Housing's
Housing's policy
policy to
to not
not process
process or
or reopen
reopen aa complaint
complaint once
once the
the complaint
complaint has
has been
been closed on
on the basis of "Complainant Elected
Elected Court Action
Action""
IIdeclare
declare under
under penalty
penalty of
of perjury
perjury under
under the
the laws
laws of
of the
the State
State of California that the foregoing Is true a d correct of my own knowledge ellcept as to matters
stated on my I formation and belief, Ind 18 to thoae matters I believe· true.
I (
Dated _'"-/-'Uo:....J.:...s.::....=':..------
Dated
~
..,~~~~~-----
COMPLAINANT'S SIGNATURE
~t
At Glendale
Glendale
City
1
City
DFEH-300-03 (01/05)
(01105)
DATE FILED:
DATE FILED: RECEIVED
DFEH-300-03
DEPARTMENT OF
DEPARTMENT OF FAIR
FAlR EMPLOYMENT
EMPLOYMENT AND
AND HOUSING
HOUSING NOVATf '4 ~6tl60RNIA
DEPT. OF FAlR
FAIR EMPLOYMENT
AND HOUSING
I
INFORMATION SHEET
DFEH needs
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
apprenticeship
apprenticeship committee, state or
committee, state or local
local government
government agency
agency you
you wish
wish to
to file
file against.
against. If you
you are
are filing
filing against
against both
both a
company and
company and an
an individual(s),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company or an
an individual
individual in
in the
appropriate area.
appropriate area.
Pleasecomplete
Please complete the
the following
following SO
so that
that DFEH
DFEH can
can process
process your complaint
complaint and
and for DFEH
DFEH for statistical
statistical purposes, and
returnwith
retum with your
your signed complaint(s):
YOUR BACE:/EIHNICITY
YOUR RACE:/ETHNICITY (Check
(Check one)
one) GENDER: _
Female ~
x x Male
Male
- African-American
African-American
-
-
African -
African - Other
Other
_ AsianlPacific
Islander (specify)
(specify) _
YOUR OCCUPATION:
OCCUPATION:
- Craft
Clerical
Clerical
-xx Caucasian
xx Caucasian (Non-Hispanic)
- Native
NativeAmerican
American - Laborer
_ Equipment
Equipment Operator
Operator
-
_ Hispanic(specify)
Hispanic(specify) _ - Manager
Laborer
_-
YOUR PRIMARY
LANGUAGE (specify)
(specify) - Paraprofessional
_ Paraprofessional
Enqlish
English - Sales
xx
Professional
JQC
Professional
-
_
YOUR AGE:
YOUR AGE: ~1
.2.-.2.. - Service
Service
- Supervisor
_ Supervisor
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF YOUR
YOUR NATIONAL
Technician
YOUR NATIONAL
ORIGIN/ANCESTRY (specify) HOW YOU
HOW YOU HEARD
-xx Attorney
JQ<:
IF FILING
IF FlLlNG BECAUSE
DISABILITY, - BuslBART Advertisement
Bus/BART
YOUR PISABILlTY;
YOUR DISABILITY: -
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
- Friend
-
- Brain/Nerves/M uscles
BrainlNen/eslMuscles
-
Friend
-
DigestivelUrinarylReproduction
-
-
_ Hearing
Hearing Labor Standards Enforcement
- Heart
Heart -
_ Local
-
Government Agency
a Limbs (Arms/Legs)
.Al< Limbs (ArmslLegs) Poster
-
Exx Mental
Mental - Prior Contact with
Prior Contact with DFEH
DFEH
- - Radio
Radio
_ Sight
-
Sight
SpeechlRespiratory -
_ Telephone
Telephone Book
-
_ Spinal/Back
SpinallBack - lV
TV
- DFEH Web Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF MARITAL
MARITAL STATUS,
STATUS,
MARITAL STATUS;
YOUR MARITAL STATUS: (Check
(Check one)
one) DO YOU HAVE AN ATTORNEY WHO HAS AGREED
- Cohabitation
Cohabitation
DISCRIMINATION
DISCRIMINATION CLAIMS IN COURT? IF YOU CHECK
- Divorced
Divorced
- Married
Married
"YES". YOU WILL BE RESPONSIBLE FOR HAVING
YOUR ATTORNEY SERVE THIS DFEH COMPLAINT.
-
_ Single
Single
IF ElLING
IF FlLlNG BECAUSE
RELIGION, -
xxYes - No
RELIGION: (specify)
YOUR RELIGION:
PLEASE
PLEASE PROVIDE
PROViDE YOUR ATTORNEY'S NAMF
NAME,
ADDRESS AND PHONE NUMBER:
NUMBER
Eugene D.
D. Lee,
Lee, Esq. (SB#
(SB# 236812)
236812)
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF SEX, REASON
SEX. THE REASON:
- Harassment
Harassment
- Orientation
Orientation
Law Office of Euqene
Eugene Lee
Lee
-
_ Pregnancy
Pregnancy 4445 South Figueroa
4 5 south Figueroa Street,
Street, Suite
Suite 2700
2700
-
_ Denied
Denied Right
Right to Wear Pants
Pants Los Angeles, CA 900 1
-
_ Other Allegations
Allegations (List)
DFEH-300-03-1 (01105)
DFEH·300·03·1 (01105) -¥eillHll1tlnature
Department of
Department of Fair
Fair Employment
Employment and
and Housing
Housing
State of
State California
of California
AMENDED
AMENDED
******EMPLOYMENT
EMPLOYMENT******
COMPLAINTOF
DISCRIMINATIONUNDER
UNDER DFEH#!----!~u:B!~~~~p
DFEH
THEPROVISIONS
THE PROVISIONSOF THECALIFORNIA
OFTHE CALIFORNIA E E
FAlREMPLOYMENT
FAIR EMPLOYMENTANDANDHOUSING
HOUSINGACT
ACT
CALIFORNIA DEPARTMENTOF FAlREMPLOYMENT
OFFAIR EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME (indicate
(indicate Mr.Mr.
oror Ms.)
Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr.David
Mr. DavidF.F.Jadwin,
Jadwin,DO, DO, FCAP
FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
BeaudryTerrace
3184Beaudry
3184 Terrace
ClTYlSTATElZlP
CITY/STATE/ZIP COUNTY COUNTY
COUNTYCODE
CODE
Glendale,CACA91208-1745
Glendale, 91208-1745 LosCOUNTY
Los Angeles
Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION.
EMPLOYMENTAGENCY,
COMMITTEE,
ORSTATE
OR STATEORORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO DISCRIMINATEDAGAINST
WHODISCRIMINATED AGAINSTME:
ME:
NAME
NAME TELEPHONE
TELEPHONENUMBER
NUMBERQnclude
flncludeArea
AreaCode)
Code)
- - ~
Dr. Irwin
Dr. IrwinHarris
Harris (661)326-2000
(661)326-2000
ADDRESS
ADDRESS I DFEH
DFEHUSE
USEONLY
ONLY
KernMedical
Center, 1830 FlowerStreet
1 8 3 0Flower Street
ClNlSTATElZlP
COUNTY : COUNTYCODE
COUNTY CODE
Bakersfield, CA
93305-4197 Kern
Kern
:"7 O~F;;:E:::M:7.P::-L':;;O::-:Y=E~ES=::/:::M:=E;:M::'BE:::R:-:S:-(::::il:'::kc.::.no";'w-n-:-)
N::'o':.:.
NO. OF EMPLOYEESIMEMBERS (if known)-----=-DA':":T=E~M:":"O~S=T~R::-:E::-:C::-::E:::-N:::T:-::O::-::R~C:-O:-:N--T~IN-:-U-:-I:":"NG-=:-::D"'IS::-::C--R--:IM~''''N'';'A:;TI::':O~N:-----;
DATE MOST RECENT OR CONTINUING DISCRIMINATION RESPONDENT
:RESPONDENTCODe
CODE
- -
----
Approx. 1,300
Approx, 1,300 TOOKPLACE
TOOK PLACE(month,
(month,day,
day,and
andyear) ~ u l 10,
year)July y1 0 , 2006
2006
--
THEPARTICULARS
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--:-=:::.:Ch:.:.:1::;· Executive Officer of Kern Medical Center _
NameofofPerson
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becauseofofmy:
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the reasongiven
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by Peter Bryan,
Mr. Peter
Mr, Bryan, Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
Name01ofPerson
Name Personand
endJob
JobTitle
Title
Wasbecause
Was because Please
Please see
see attachment,
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[please
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be reason(s)]
I Iwish
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requestthat
thatthe
theDepartment
DepartmentofofFair Employmentand
FairEmployment andHousing
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provideaaright-te-sue
understandthat
thatififII
want
wantaalederal
federalnotice right-to-sue,I Imust
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visitthe
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Commission(EEOC)
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Fair
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notprocess
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I Ieleclare
declareunder penalty01ofperjury
underpenalty perjuryunder
underthe
thelaws ofthe
laws01 theSIaIe
StateofofCalifornia
Californiathat
thatthe
theforegoing
foregoingIsistrue
trueand
andcorrect
correctof
of my
myown
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knowledgeexcept
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as to
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matters
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lief, and as to those matters beleveItItto betrue.
t obe true. ~ (1
. ,.~
\ ~(J ~/"):.., . .•
Dated t\ ~Y. ~ tLUt..& -
COMPLAINAA'S'5 SIGNATURE
COMPLAINA SIGNATURE
~~....._ - - -
Glendale
~t Glendale
At
City
City
DATEFILED:
DATE FILED:
DFEH-300-03(01/05)
DFEH-300-03 (01105)
DEPARTMENTOF
DEPARTMENT OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
NOV 142006
UEPI OF FAIR
DEPT. EMPLOYMENT
FAlR EMPLOYMENT I
AND HOUSING
INFORMATION SHEET
DFEH needs
separate signed
signed complaint
complaint for each
each employer, person,
person, labor organization,
employment agency,
state or
or local
local govemment
government agency
agency you
you wish
wish to
to file
file against.
against. If
If you
you are
are filing
filing against
against both
both a
a
company and
company and an
an individual(s),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company oror an
an individual
individual in
in the
the
appropriate
appropriate area.
area.
Please complete
Please complete the
the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
retum
retumwith
with your
your signed
complaint(s):
YOUR RACE:IETHNICITY (Check
(Check one)
one) GENDER: _
YOUR GENDER - Female x x Male
Female ]g Male
- African-American
African-American
- -
African
African - Other
Other
-
YOUR OCCUPATION:
YOUR OCCUPATION:
-
_ Asian/Pacific
AsianlPacificIslander
Islander(specify),
Clerical
-
ExX Caucasian
(Non-Hispanic) - CraR
Craft
- Native
NativeAmerican
American - Equipment Operator
- Hispanic(specify)
_ Hispanic(specify), _ - Laborer
Laborer
-
_ Manager
Manager
YOUR PRIMARY
YOUR PRIMARYLANGUAGE
LANGUAGE(specify)
(specify) -
_ ParaprofessIonal
Paraprofessional
English
Enslish - xx Professional
..x.x Professional
- Sales
Sales
YOUR AGE:
YOUR AGE: .L.l.
~1 - Service
Service
-
_ Supervisor
Supervisor
IF
IFFILING
FlLlNGBECAUSE
BECAUSEOFOF YOUR
YOUR NATIONAL
Technician
ORIGIN/ANCESTRY YOUR NATIONAL
NATIONAL
ORIGINlANCESTRY
(specify) HOW YOU
HOW YOU HEARD
HEARDABOUT
ABOUT DFEH:
DFEH:
-
Mxx Attorney
Attorney
IFIFFILING
FILINGBECAUSE
BECAUSEOF OF DISABILITY.
BusIBARTAdvertisement
Advertisement
YOUR DISABILITY'
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
BloodlCirculation -
- EDD
EDD
BrainlNerveslMusdes - Friend
Friend
-
HumanRelations
RelationsCommission
Commission
-
_ Hearing
Hearing - labor
Labor Standards
Enforcement
- Heart
Heart - local
_ Local Govemment
GovernmentAgency
Agency
Limbs(Arms/Legs)
..lQS: Limbs (ArmslLegs) - Poster
Poster
-xxxx Mental
Mental - Prior
Contactwith DFEH
_- Sight
Sight - Radio
Radio
-
Telephone Book
Book
-
_ Spinal/Back
SpinallBack - TV
TV
- DFEH
DFEHWeb
Web Site
Site
IFIFFILING
FILINGBECAUSE
BECAUSEOFOFMARITAL
MARITALSTATUS,
STATUS,
YOURMARITAL
YOUR MARITALSTATUS:
STATUS:(Check
(Checkone)
one) DOYOU
DO YOU HAVE
HAVE AN
AN ATTORNEY
ATTORNEY WHOWHO HAS
HAS AGREED
AGREED
TO REPRESENT
TO REPRESENTYOU YOU ON
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Cohabitation
Cohabitation
IJSCRlMlNATlON CLAIMS
CLAIMS IN
INCOURT?
COURT? IFIFYOU
YOU CHECK
CHECK
- Divorced
Divorced
DISCRIMINATION
'YES". YOU WILLBE
YOU WILL BE RESPONSIBLE
RESPONSIBLEFOR FOR HAVING
HAVING
- Married
Married
·YES·,
-
_ Single
Single
YOUR ATTORNEY
YOUR ATTORNEY SERVE
SERVE THIS
THIS DFEH
DFEHCOMPLAINT,
COMPLAINT.
!F FILING
IF FlLlNGBECAUSE
BECAUSEOF OFRELIGION.
RELIGION. -
xxYes
xx Yes -No
No
YOURRELIGION:
(specify)
PLEASEPROVIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME.
NAME,
ADDRESSAND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IFIFFILING
FlLlNGBECAUSE
BECAUSEOF SEX.THE
OFSEX, THEREASON:
REASON: Eugene D,
Eugene D. Lee,
Lee, Esq. (SB# 236812)
Esq. (8B# 236812)
- Harassment
Harassment
Law Office
Office of
of Eugene
Euqene Lee
Lee
- Orientation
Orientation Law
-
_ Pregnancy
Pregnancy 445
4 4 5 South
south Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
- DeniedRight
_ Denied RighttotoWear
WearPants
Pants
7; bG
LOS Angeles, CA 9 071
-
1 1//+6
DFEH-300-03-1(01/05)
(01105)
I dte
DFEH-300-03-t . .
DepartmentofofFair
Department FairEmployment
Employmentand
andHousing
Housing
StateofofCalifornia
State California
EMPLOYMENT**** **
******EMPLOYMENT
AMENDED
AMENDED C
' fOPY
COMPLAINTOF
DISCRIMINATIONUNDER
UNDER DFEH#
DFEH ~~r~(§~ffHR\rJ:£:::!n
THEPROVISIONS
THE PROVISIONSOF
OFTHE
THECALIFORNIA
CALIFORNIA DFEH USE ONLY ~
FAlREMPLOYMENT
FAIR ANDHOUSING
EMPLOYMENTAND HOUSINGACT
ACT
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME(indicate
(ind~cateMrororMs.)
Mr. Ms ) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr. David
Mr. Davld F.F. Jadwin,
Jadwin, DO, DO, FCAP
FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
BeaudrvTerrace
3 1 8 4 Beaudry
3184 Terrace
----- .
CITYISTATEIZIP
COUNTY COUNTY
COUNTYCODE
CODE
Glendale, CA
CA 91208-1745 Los
Los Angeles
Angeles
NAMED THEEMPLOYER,
NAMEDISISTHE EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
EMPLOYMENTAGENCY,
COMMITTEE,
ORSTATE
OR STATEORORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO
WHODISCRIMINATED
AGAINSTME:
ME:
NAME
NAME TELEPHONE
TELEPHONENUMBER
NUMBEROnclude
OncludeArea
AreaCode}
Code)
Dr. Eugene
Dr. Eugene Kercher
Kercher
ADDRESS
ADDRESS I DFEHUSE
DFEH USEONLY
ONLY
Kern Medical
Center, 1830 Flower Street
CITYISTATEIZIP
COUNWCODE
Bakersfield, CA
Bakersfield, 93305-4197
CA 93305-4197 Kern
Kern
NO.OF
known) DATEMOST
DATE MOSTRECENT
DISCRIMINATION : :RESPONDENT
RESPONDENTCODE
CODE
Approx. 1,300
Approx, 1,300 TOOKPLACE
TOOK PLACE(month,
(month,day,
day,and
andyear) july 10,
year)July 1 0 , 2006
2006
--
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On August
On nugust 3,3, zoo6
2006 was
I lwas
XXdErnted
_-"'1'Ioymart
-we+
--promoIIcn
--prmpllor
__
dsnledmns(er
-xx_~
I!?zdem-
--pregmcy-
~ deriedlarTily or _ _
-
_--prsgrsry-
denied equal pay
-d=.iedsqdw
rn
XX wed iamb cr ~ K W
--wm-paxsngtrt te_pwIIs
_denied
-gmk cmaderisika tas6ng impemissible
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m n + ~_ Inqqlry
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by
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Chief Executive Officer f;.;l:,:'c::.:e~r~o~f~Ke:::;r~n~M::.::e:.::d~i.::c::::::a=-l_c:;e::.;n~t:.::e~r,--
of Kern Medical Center _
NameofofPerson
Name Person JobTitle
Job Title(supervisor/manager/personnel
(supe~isorlmanager/penonnel directorletc.)
director/etc.)
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participating inin
_
(retaliationfor)
for)
thereason
the reasongiven
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by Mr. Peter
Mr. Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Personand
andJob
JobTitle
Title
Wasbecause
Was because Please
Please see
see attachment.
attachment.
of[please
of [please
statewhat
state what
you believe
you believe toto
be reason(s)]
be reason{s)]
I Iwish
wishtotopursua
pursuethis
thismalter
matterinincourt.
court. I Ihereby
herebyrequest
requestthatthatthe
theDepartment
DepartmentofofFair
FairEmployment
Employmentandand Housing
Housingprovide
understandthat
that ifif II
want afederal
wanta federalnotice
noticeof
ofright.te-sue,
must visit
visit the
IheU.S,
U.S.Equal
EqualEmployment
Commission (EEOC)
(EEOC)to
to file
file aa complaint
complaint within
within 30
30 days
days of
of receipt
receipt of
of thethe
DFEH"Notice
CaseClosure,"
Closure,"ororwithin
within300
300days
daysof ofthe
the alleged
discriminatoryact,
act, whichever
whicheverIsisearlier,
earlier.
I Ihave
havenot
notbeen
beencoerced
coercedinto
intomaking
makingthis
thisrequest,
request, nor
nordo'
do Imake
makeitit based
basedon
on fear
fear of retaliation ifif rI do
of retaliation do not
notdo
do so.
so. IIunderstand
understand itit isis the
the Department
Department of
of Fair
Fair
Employment
Housing'spolicy
policyto
tonot
not process
processor reopenaa complaint
or reopan complaint once
oncethe
the complaint
complaint hashas beenbeen closed
closed on
on the
the basis
basis of
of "Complainant
Elected Court
Court Action."
I Ideclare
declareunder
underpenalty
penalty of
ofperjury
perjuryunder
underthe
thelaws
l a wof
ofthe State of
theStale ofCalifornia
Csllfomlathat
thatthe
stated on my Info atlon and belief, and as to those matters I believe lOo be t e,
J} .~
the foregoing istrue
foregoing Is true and
and co rect of
coLrect my own
of my
-
own knowledge
knowledge except
_<..:......~~~-:.::.L.-~,.=;:::==----
except as
as to
to matters
matters
Dated
Dated
COMPLAINA 1'5 SIGNATURE
Glendale
~t Glendale
At
City
City
DFEH-300-03(01/05)
DFEH·300·03
DEPARTMENTOF
(01105)
OF FAlR
FAlR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
DATE FILED:
DATE FILED:
RECEIVED
STATE OF
STATE OF CALIFORNIA
CALIFORNIA
DEPARTMENT
14 2006
NOV 142006
DEPT, OF FAIR
DEPT. FAlR EMPLOYMEN
EMPLOYMEN
AND HOUSING
HOOSING
INFORMATION SHEET
DFEH needs
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
committee, state
apprenticeship committee. state or local
local govemment
government agency you
you wish to file against.
against. If you are filing
filing against both
both a
company and
company and an individual(s), please
an individual(s), please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company or
or an
an individual
individual in
in the
the
appropriate area.
appropriate area.
Please complete
Please complete the
the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
return with
retum with your signed
complaint(s):
RACE:IETHNICIN (Check
YOUR RACE:/ETHN1C1TY (Check one) GENDFR: _
Female M
x x Male
Male
- African-American
African-American
- African
African -- Other
Other OCCUPATION:
YOUR OCCUPATION:
-
_ AsianlPacific
Asian/Pacific Islander
Islander (specify),
- Clerical
-
Exx Caucasian
(Non-Hispanic) _ Craft
- Native American
Native American -
_ Equipment
Equipment Operator
Operator
-
_ Hispanic(specify)
Laborer
-
_ Manager
PRIMARY LANGUAGE
YOUR PRIMARY LANGUAGE (specify)
(specify) -
_ Paraprofessional
Paraprofessional
Enslish
JLx Professional
- Sales
Sales
YOUR AGE;
AGE: ~2
.2.......1.. - Service
Service
-
_ Supervisor
Supervisor
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF YOUR NATIONAL
Technician
ORIGIN/ANCESTRY (specify) HOW YOU YOU HEARD
HEARD ABOUT DFEH:
-xx Attorney
lQ.C Attorney
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF OF DISABILITY, - Bus/BART Advertisement
DISABILITY:
YOUR DISABILITY: -
_ Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
- - BloodlCirculation -
--
EDD
EDD
- Brain/NerveslMuscles
BrainlNerveslMuscles - Friend
-
Friend
-
DigestiveIUrinarylReproduction
-
Human
Human Relations
Commission
-
_ Hearing
Hearing Labor
Labor Standards
Enforcement
- Heart
Heart -
_ Local
Local Govemment
- Poster
Agency
Government Agency
- Limbs (Arms/Legs)
xx Limbs (AnnsILegs) Poster
- xx Mental
lQ.C Mental - Prior
Contact with DFEH
-
_ Sight
Sight - Radio
Radio
-
Speech/Respiratory -
_ Telephone
Telephone Book
Book
-
_ Spinal/Back
SpinallBack - lV
Tv
- DFEH
DFEH Web
Web Site
Site
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF
OF MARITAL
MARITAL STATUS,
MARITAL STATUS:
YOUR MARITAL STATUS: (Check one) DO you
PO YOU HAVE
HAVE AN
AN ATTORNEY
ATIORNEY WHO HASHAS AGREED
AGREED
REPRESENT you ON YOUR EMPLOYMENT
- Cohabitation
Cohabitation
TORFPRESFNTYOUONYOUREMPLOYMENT
TO
IN COURT?
COURT? IF
IF YOU
YOU CHECK
CHECK
- Divorced
Divorced
- Married
Manied
"YES", YOU
"YES·, YOU WILL BE RESPONSIBLE FOR
BE RESPONSIBLE FOR HAVING
HAVING
-
_ Single
Single
YOUR ATTORNEY SERVE THIS DFEH
ATIORNEY SERVE DFEH COMPLAINT.
COMPLAINT.
IF FILING
IF FlLlNG BECAUSE
BECAUSE OF RELIGION.
RELIGION, -xx Yes
jQCYes - No
No
YOUR RELIGION:
RELIGION: (specify)
PLEASE
PLEASE PROVIDE
PROVIDE YOUR ATTORNEY'S
ATIORNEY'S NAME,
NAME,
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER
Eugene D.
D. Lee,
Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
IF FlLlNG BECAUSE
IF FILING BECAUSE OF OF SEX,
SEX. THE
THE REASON:
REASON:
- Harassment
Harassment
- Orientation
Orientation
Euqene Lee
-
_ Pregna~r;y
Pregnarsy 445
445 South Figueroa Street,
Street, Suite 2700
2700
-
_ Denied
Denied Right
Right to
to Wear
Wear Pants
Pants
-
_ Other
Other Allegations
Allegations (List)
(List) --.. ~
\0 •••
DFEH-300-03-1 (01105)
DFEH-300-03-1 (01105)
Department of Fair Employment
Department Employment and Housing
Housing
State of California
Slale California
***E~[~ENT***
* * * E ~ ~ B ~ *E* * N T,
COMPLAINTOF
DISCRIMINATIONUNDER
UNDER DFEH#
DFEH E200607-COEX
THEPROVISIONS
THE PROVISIONSOF THECALIFORNIA
OFTHE CALIFORNIA -NOI~FW~lRmSEPVICE
FAIR
FAlREMPLOYMENT
EMPLOYMENTAND ANDHOUSING
HOUSINGACT
ACT .... 1 "" -' .4
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
YOURNAME
YOUR NAME(indicste
(indicateMr.
Mr.ororMs.)
Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr. David
Mr. David F.P. Jadwin,
Jadwin, DO, DO, FCAP
FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
Beaudry Terrace
3184 Beaudry
3184 Terrace
ClTYlSTATElZlP
COUNTY COUNTY
COUNTYCODE
CODE
Glendale, CA
91208-1745 Los
Los Angeles
Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION.
EMPLOYMENTAGENCY,
APPRENTICESHIPCOMMITTEE
COMMITTEE,
ORSTATE
OR STATEORORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO
WHODISCRIMINATED
AGAINST ME:
ME: '
NAME
NAME TELEPHONE
TELEPHONENUMBER
NUMBEROnclude
(lnclude Area
Area Code)
Code)
Dr. Scott
Dr. Scott Ragland
Ragland (661) 326-2000
(661)326-2000
ADDRESS
ADDRESS 1 DFEHUSE
DFEH USEONLY
ONLY
Kern Medical
Center. 1830 Flower
1 8 3 0 Flower
- -~ Street
------
Street ~
C ITYISTATEIZIP
COUNTY I COUNTYCODE
COUNTY CODE
Bakersfield, CA
93305-4197 Kern
Kern
NO.OF
known) DATEMOST
DATE MOSTRECENT
DISCRIMINATION ::RESPONDENT
RESPONDENT CODE
CODE
----
Approx. 1,300
Approx. 1,300 TOOK
ToOK PLACE
PLACE(monlh,
(month,day,
day,and
andyear) july 10,
year) July 1 0 , 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On August 3, 2006 I was _ftr8d
_
--8f11lIo'j!T'8'I
derled pranotion
_-
lQL
XX derled
_ flIfriIy ex me<icalleave
JlRlI1&l'l'
WedfsnlryUIlledca~ leave
_Iaidolf
~derT1aed deried transfef _--equelpay
doned equal pay
-xx dIried lICIXlITlIl10da _- doned
deriedright W9flt pants
right10lower
_-haraa.Iedchanleteriolics
chammbur team
genetic
~ W I C testing mpamiSsibl8 1lOIl1_led IrqJify
lmpermlssiblemnjoMslatsdhpny _ jlI8gW1CY a:ccmmodalial
OmaMPdabQ)
pn(r
-
.JLXtoroed
Xxmmd lo qut10 quit ~ .... (If*:IIy) retaliated
lnteractlve
retaliated agaiiiSt
process
interactive process
a g a i n iand
i zdenied
mied
by Mr.
by_M:.:;r::...:... Peter..:B::.:r~y..::a:::n~,
. ...:p,;:e:::t.:::,e::.r Bryan,--::.e=..t..:a:.:l:.;.:..-
et al. ~_:_::::.;Ch::.:l;.:'
Chief Executive
e:;f:..-::E:::x::::e.:::,c.:;:.u:::.;t v~e:....:::O:.::f.=f.=i.:::.ce.:::.r::......:o::.:f:.......::K::::e:.::r~n,-M=ed~l;.:·
l .=.;' Officer of Kern Medical c:;a~l:....:::C::::e~n.:::.t.:::.er=--
Center _
Nameof
Name ofPerson
Person JobTitle
Job (supervisor/manager/personneldirector/etc.)
Title(supervisor/manager/personnel directorletc.)
becauseof
because ofmy: -"
my: _age sax _-national a@in~ancest+
d o n a toriginlanoestrY X X p h y sdisability
..!Kphysical ~
diMity -
_an:er
CB~OBT ...xA- (Circle
(Circle one)
one) filing;
fihng,
-age -mnalmarital stetus
stalua ..xx... menial
mawdisability
d m _g e d genetic
i c e h achlnderisllc
ndenstk Protesting;
Protesting, participating
participating in
in
*-n
_religion _- s ~sexual
d a bDlierUtion
Mm investigation
(retaliation for)
for)
-raWx+a
raceI<:oIor apsaraiion
_association -
.1Qf._(speciIy)...;CF::..:RA~
XX *(spad(y) CFRA _
thereason
the reasongiven
givenby
by Mr. Peter
Mr. Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
Nameof
Name of Person
Personand
andJob
Job Title
Title
Wasbecause
Was because Please
Please see attachment.
see attachment.
of[please
of [please
statewhat
state what
youbelieve
you believeto
to
be reason(s)]
be reason(s)]
IIwish
wlshtotopursue
pursuethis
thismatter
matter inincourt.
court. IIhereby
hereby request
request thatthat the
the Department
Departmentofof Fair
Fair Employment
Employmentandand Housing
Housing provide
provide aa right-to-sue notice. II understand
right-to-sue notice. understand that if I1
want
want aafederal
federalnotice
notlceof
of right-to-sue,
right-to-sue, IImust
must visit
visit the
the U.S.
U.S. Equal
Equal Employment
Commission (EEOC)
(EEOC) to
to file
file aa complaint within 30
complaint within 30 days of receipt of
Of the
DFEH"Notice
DFEH "Noticeof
of Case
CaseClosure,"
Closure,"or or within
within 300
300 days
days of of the
the alleged
discriminatory act.
act, whichever
whichever is
is earlier.
earlier.
IIhave
have not
notbeen
beencoerced
coercedinto
into making
makingthisthis request,
request, nor do IImake
nor do make itit based
based on
on fear
fear of
of retaliation
do not
not do so. II understand
do so. understand itit is
is the Department
Department of Fair
Employment
Employmentand
and Housing's
Housing'spolicy
policy to
to not
not process
process or
or reopen
reopen aa complaint
wmplaint once
once the
the complaint
wmplaint has has beenbeen closed
closed on
on the
the basis
basis of "Complainant Elected
Elected Court
Court Action."
Actlon."
Ideclare under penalty of perjury under the laws of the State of California that the foregoing i s true and correct of my own knowledge except as to matters
Dated_~:-"'-=-_-I-
Dated _ C -
~ ~ M P L A I N ~ N TSIGNATURE
S
Glendale
~t Glendale
At
City
City
DATE FILED
DATE FILED. RECEIV D
DFEH-300-03(01105)
DFEH·30o-03 (01105)
DEPARTMENT OF
DEPARTMENT OF FAIR
FAlR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING STATE OF c"R~rNf4 2006
DEPT. OF FAIR EMPLO
LIEPI MEN"
f:MPLO MEN
AND HOUSING 1
RIGHT·TO-SUE COMPLAINT
RIGHT-TO-SUE INFORMATION SHEET
COMPLAINT INFORMATION SHEET
DFEH needs
needs aa separate
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
apprenticeship
committee, state
state or
or local
local government
government agency
agency you
you wish
wish toto file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company
company and
and an
an individual@),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company or or an
an individual
individual in
in the
the
appropriate area.
appropriate area.
Please complete the

the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
retum with your signed complaint(s):

YOUR RACE:IETHNICITf YOUR GENDER;
YOUR GENDER: _ - Female
Female x
xx Male
Male
- African-American
African-American
- African - Other YOUR
YOUR OCCUPATION:
OCCUPATION:
-
_ AsianlPacific
Asian/Pacific Islander (specify),
Islander (specify) _ - Clerical
Clerical
-xx Caucasian
E Caucasian (Non-Hispanic)
(Non-Hispanic) - CCraft
raft
- Native American
Native American - Equipment
Operator
- Hispanic(specify)
_ Hispanic(specify)~ _
- Laborer
Laborer
-
_ Manager
Manager
PRIMARY LANGUAGE - Paraprofessional
_ Paraprofessional
English
.1Lx
- Sales
YOUR AGE: rl
..L..1.. - Service
-
_ Supervisor
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF YOUR NATIONAL
Technician
ORIGIN/ANCESTRY.
NATIONAL
ORIGIN/ANCESTRY
(specify) you HEARD ABOUT DFEH:
HOW YOU
-xx Attorney
JQC Attomey
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF OF DISABILITY, - BuslBART
BusfBART Advertisement
YOUR
YOUR DISABILITY:
DISABILITY; -
Organization
- AIDS
AIDS - EEOC
EEOC
- BloodfCirculation - EDD
EDD
=
-
-
-
Blood/Circulation
BrainfNervesiMuscles
BrainlNewes/Muscles
Digestive/UrinaryfReproduction
_ Hearing
- Friend
Friend
- Human
Human Relations
- Labor Standards Enforcement
Enforcement
Hearing
Heart
Heart - Local
_ Local Govemment
Government Agency
..lQ( Limbs
Limbs (Arms/Legs)
-
JQCxx Mental
Mental - Radio
Prior Contact
Contact with DFEH
DFEH
-
_ Sight
Sight - Radio
- Telephone
-
SpeecWRespiratory _ Telephone Book
Book
-
_ Spinal/Back
SpinallBack - TV
- DFEH
DFEH Web
Web Site
Site
IF
IF FILING
FlLlNGBECAUSE
BECAUSEOFOF MARITAL
MARITAL STATUS,
STATUS,
YOUR
YOUR MARITAL
MARITALSTATUS:
STATUS: (Check
(Check one)
one) DO YOU
DO YOU HAVE
HAVE AN
AN ATTORNEY WHO HASHAS AGREED
- Cohabitation
Cohabitation
TOREPRESENTYOUONYOUREMPLOYMENT
CLAIMS IN
IN COURT?
COURT? IF
IF YOU
YOU CHECK
- Divorced
Divorced
DISCRIMINATION
- Married
Married
"YES". YOU
·YES", YOU WILL
WILL BE
BE RESPONSIBLE
RESPONSIBLE FOR
FOR HAVING
HAVING
-
_ Single
Single
YOUR ATTORNEY SERVE
YOUR SERVE THIS
THIS PFEH
DFEH COMPLAINT.
COMPLAINT.
IF
IFFILING
FII INGBECAUSE
BECAUSEOF OF RELIGION.
RELIGION, EYes No
YOUR
YOUR RELIGION:
RELIGION: (specify)
(specify)
PLEASE PROVIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME.
NAME.
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER
NUMBER:
IFIFFILING Eugene D.
Eugene Lee, Esq.
D. Lee, (SB# 236812)
E s q . (SB# 236812)
FlLlNGBECAUSE
BECAUSEOF OF SEX.
SEX. THE
THE REASON:
REASON:
- Harassment
Harassment
- Orientation
Orientation
Law Office
Law O f f i c e of
o f Eugene
Euqene Lee
Lee
-
_ Pregnancy
4 4 5 South
S t r e e t , Suite
S u i t e 2700
2700
-
_ Denied
DeniedRight
RighttotoWear
Wear Pants
Pants
-
_ Other
OtherAllegations
Allegations(List)
(List)
OFEH·300·03·1
DFEH-300-03-1(OIl05)
(01105) Date
Department
Departmentof FairEmployment
ofFair Employmentand
andHousing
Housing
StateofofCalifornia
Slale California
COMPLAINT OF
OF DISCRIMINATION
DISCRIMINATIONUNDER
UNDER DFEH #~7FC1R-Sl;tC"feE
E#~WENT
* * * E~[mENT *** COPY
COpy
COMPLAINT DFEH
THE PROVISIONS
THE PROVISIONS OF
OF THE CALlFORNlA
THE CALIFORNIA DFEH USE ONLY·" Y. -' .I
FAlR EMPLOYMENT AND HOUSING

FAIR EMPLOYMENT AND HOUSING ACTACT
CALIFORNIA DEPARTMENTOF FAlR EMPLOYMENT
OF FAIR EMPLOYMENTAND
AND HOUSING
HOUSING
YOUR NAME
YOUR NAME(indicate
(indicate Mr.
Mr. or
or Ms.)
Ms.) TELEPHONE
TELEPHONENUMBER
NUMBER (INCLUDE
(INCLUDEAREA
AREA CODE)
CODE)
Mr. David
Mr. F. Jadwin,
David F. DO, FCAP
Jadwin, DO, FCAP ( 8 1 8 ) 541-0496
(818) 541-0496
ADDRESS
ADDRESS
Beaudrv* Terrace
3 1 8 4 Beaudry
3184 Terrace
CITYISTATEIZIP
COUNTY COUNTY
COUNTY CODE
CODE
Glendale, CA
91208-1745 Los
Los Angeles
NAMED IS
NAMED IS THE
THE EMPLOYER,
EMPLOYER, PERSON,
PERSON, LABOR
LABOR ORGANIZATION,
EMPLOYMENT AGENCY,
APPRENTICESHIP COMMITIEE,
COMMITTEE,
STATE OR
OR STATE
OR OR LOCAL
LOCAL GOVERNMENT
GOVERNMENT AGENCY
AGENCY WHO
WHO DISCRIMINATED
AGAINST ME:
ME:
NAME
NAME TELEPHONE
TELEPHONE NUMBER
NUMBER Onclude
(Include Area
Area Code)
Code)
Dr. Jennifer
Dr. Jennifer Abraham (661)326-2000
(661) 326-2000
ADDRESS
ADDRESS I DFEH USE
DFEH USE ONLY
ONLY
Center, 1830
Kern Medical center, Street
CITYISTATEIZIP
COUNTY I COUNTYCODE
COUNTY CODE
Bakersfield, CA
Bakersfield, 93305-4197
CA 93305-4197 Kern
Kern
NO. OF
EMPLOYEESIMEMBERS(if known)
known) DATE MOST
DATE MOST RECENT
DISCRIMINATION :;RESPONDENT
RESPONDENTCODE
CODE
1,300
Approx. 1,300
Approx. TOOK PLACE
TOOK PLACE (month,
(month, day.
day, and
and year)
year) July 10,
1 0 , 2006
2006
THE PARTICULARS
ARE:
__~ ~_farrilyormedcil_
fired
On August 3, 2006 I was _laIdol!
_ _ pIQ11ltIon _X X denied
~ ~ a - l e a n ,
preg'81Cy""
-dE-'jpeOgxy-
dIlnIed Inmfer _ _ oquaI pay
...1.QScIElrT1aBd --xx_ a>cXlII1"IllldB --*pay
_doried to _ pants
hlnssed -deriedrighI ripm to wear pants
_ genetic charBc:teristlcs resting impermissible nor>-job-related Inqo.Mry _ ~ llClXmllOdation
-lLXioroed to ~ xx-ISI*ft) retaliated agairiS't and denied

interactive process
bY---=M,;:.r:...:.~P.:::.e=-te::;r:....:B;,;:ry:..L.::a=n.:..
by Mr. Peter Bryan,• ...;e::..;t:-:a;,;:l;..:. et al. Chief Executive Officer c::.:e::.:r;...;::O.:::.f.....:.:K::.;er::..;n:::...:.M.:.:e::.:d::.:i;.;;cc.::a=.l-=-Ce=.:n~t::.:e;,;:r'--
--.,;C::;h.:.:i;.;;e;.;;f-=:.Ex:.:.e::.;c::..;u::.:t:.:i;..:v..;;e--::.o::.;f::..;fJ.::.:· of Kern Medical Center _
Name of Person
Name Penon (supervisorlmanagerlpersonneldirector/etc.)
Job Title (supervisor/manager/personnel directorletc.)
my:
because of my:
because -" sex -
_ naaral orlgif\llVlces1ry
nationel oti@~mceay aphyslcal
.M. p h y u disability
diility -arocer CBXXI ...xL (Circle one) filing;
_age
-age _
-mmeriIaI s1a1us
status 1Ql1llllrtal
rn<isabIlIly
c b a ~ -
_ genetic
~enacicchsradenstk Cheractenstlc Protesting:
Protesting; participating in
in
-
_religion
rel~g~on -~~
_ 0fierUIi00
S8JCUlII investigation
investigalion (retaliation for)
rO-- rac:e/CClor -cssmabn
_association
M_(specity}....:C~F::.:RA~
XX am(*) CFRA _
reason given by
the reason Mr.
Mr. Peter Bryan,
Bryan, chief Executive Officer of Kern Medical Center
Name
Name of Person and Job Tille
Title
Was because
because Please see attachment.
attachment.
of [please
state what
you believe to
be reason(s)]
reason(s)]
\\ wish to mailer iin
\0 pursue this matter 'hereby
n court. I Employment and Housing provide a right-to-sue notice. II understand
hereby request that the Department of Fair Employment understand that 11
if II
want a federal notice ofof right-to-sue.
right-to-sue, I must visit the U.S. Equal Employment Opportunity Commission (EEOC) to file a complaint
complaint within 30 days of rece~pt
receipt of the
DFEH "Notice of Case Closure." or within 300 days of the alleged discriminatory act,act. whichever is earlier.
II have not been coerced into making this requesl,

request, nor do II make it based of retaliation if I do not do so. II understand it is the Department of Fair
besed on fear of
Employment and Housing's policy lo
Employment to not process or reopen a complaint once the complaint has been closed on the basis of "Complainant
"Complainant Elected Court Action."
II declare under penalty of

of perjury under the llaws of the State of
a m of of Callfornla
California that the foregoing is
il true and correct
correct of my own knowledge except as
al tto matters
o matter3
stated on my Infor atlon an~ belief, and al to thOle matters
matters II believe It tto
believe it ~e true.
o be true. . ~
-A /1 - .. ~(1
EEl ~r-
• to \ .....·..
Dated
Dated i It f"
COMPLAINANT'S IGNATURE
- - - - - -
COMPLAINANT'S~GNATURE
At Glendale
A( Glendale
Citv
City
DFEH-300-03
DFEH-300-03 (01105)
DATE FFILED:
DATE (LED: RECE\VED
DEPARTMENT
DEPARTMENT OF
(01/05)
OF FAlR
FAIR EMPLOYMENT
EMPLOYMENT AND
AND HOUSING
HOUSING Nol14 ~O~IFORNIA
~rEPT. OF
E p OF fMPLO~MENl
FAIR EMPLOYMENT
x FAIR
)- . AND
AND HOUSING
HOUSING

RIGHT-TOSUE SHEET
DFEH needs a separate signed complaint for for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
committee, state or local government
govemment agency
agency you
you wish
wish toto file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company and an individual@),
individual(s), please complete
complete separate
separate complaint
complaint forms
forms naming
company or or an
an individual
individual in
in the
the
appropriate area.
appropriate area.
Please complete the following

Please following so that DFEH can process your complaint and for
for DFEH for
for statistical
purposes, and
and
retum with your
return with your signed
complaint(s):
YOUR
YOUR RACE:IETHNICITY
RACE:/ETHNICITY (Check one) YOUR GENDER:
GENDER: _ - Female &lSJS.x Male
Male
- African-American
African-American
- African
African -- Other
- Asian/Pacific
_ AsianlPacific Islander
Islander (specify),
(specify) _
- Clerical
Clerical
-
Exx Caucasian
(NowHispanic) - Craft
craft
- Native
Native American
American -
_ Equipment
Equipment Operator
Operator
- Hispanic(specify)
_ Hispanic(specify) _
- Laborer
Laborer
-
_ Manager
YOUR
YOUR PRIMARY
PRIMARY LANGUAGE
LANGUAGE (specify)
(specify) -
_ Paraprofessional
Paraprofessional
English
Enqlish -
Exx Professional
Professional
-
_ Sales
YOUR AGE:
YOURAGE: L..1.
22 - Service
Service
-
_ Supervisor
IF
IF FILING
FlLlNG BECAUSE
BECAUSE OF
OF YOUR
YOUR NATIONAL
Technician
ORIGIN/ANCESTRY,
QRIGINIANCESTRY. YOUR
YOUR NATIONAL
NATIONAL
ORIGIN/ANCESTRY
(specify) HOW YOU
HOW YOU HEARD
HEARD ABOUT PFEH:
DFEH;
-
xx Attorney
xx Attorney
IF
IF FILING
FlLlNGBECAUSE
BECAUSEOF OF DISABILITY,
BudBART Advertisement
Advertisement
YOUR
YOUR DISABILITY:
DISABILITY: _- Community
Organization
- AIDS
AIDS - EEOC
EEOC
- Blood/Circulation
EDD
=
-
-
- Brain/NerveslMuscles
BrainlNerveslMuscles
Digestive/Urinary/Reproduction
_ Hearing
Hearing
- Friend
Friend
- Human
Human Relations
- Labor
Labor Standards
Commission
Enforcement
Heart
Heart _- Local
Local Government
Government Agency
Agency
2
.,Xl( Limbs
Limbs(Arms/Legs)
Poster
-
Mxx Mental
Mental - Prior
Prior Contact
Contact with
with DFEH
DFEH
-
_ Sight
Sight - Radio
Radio
_- Telephone
-
SpeechlRespiratory Telephone Book
- TV
Book
-
_ Spinal/Back
SpinaltBack TV
- DFEH
DFEHWeb
Web Site
Site
IF
IFFILING
FlLlNGBECAUSE
BECAUSEOFOFMARITAL
MARITALSTATUS,
STATUS,
YOUR
YOUR MARITAL
MARITALSTATUS:
STATUS: (Check
(Checkone)
one) DOYOU
DO YOU HAVE
HAVEAN
AN ATTORNEY
ATTORNEY WHO
WHO HAS
HAS AGREEp
AGREED
- Cohabitation
Cohabitation
TO REPRESENT
ON YOUR
YOUR EMPLOYMENT
EMPLOYMENT
- Divorced
Divorced
DISCRIMINATION
'YES". YOU
CLAIMS IN
WILL BE
YOU WILL
INCOURT?
COURT? IF
BE RESPONSIBLE
RESPONSIBLE FOR
IF YOU
YOU CHECK
CHECK
FOR HAVING
HAVING
- Married
Married
·YES",
-
_ Single
Single
YOUR ATTORNEY
YOUR ATTORNFY SERVE
SERVE THIS
THIS DFEH
DFEH COMPLAINT.
COMPLAINT.
IFIFFILING xxYes No
FlLlNGBECAUSE
RELIGION,
YOUR
YOURRELIGION:
RELIGION:(specify)
(specify) BEASE PROVIDE
PLEASE PROVIDEYOUR
YOUR ATTORNEY'S
ATTORNEY'S NAME,
NAME.
ADDRESSAND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IFIFFILING
Euqene D.
Eugene Lee, Esq.
D . Lee, (SB# 236B12)
Esq. (SB# 236812)
FlLlNGBECAUSE
BECAUSEOF OFSEX,
SEX,THE
THEREASON:
REASON;
- Harassment
Harassment
- Orientation
Orientation
_-Pregnancy
Law Office
Law Office of
of Eugene Lee
Euqene Lee
=
445 South
445 Figueroa Street, S u i t e 2700
Street, Suite 2700
- Denied RighttotoWear
DeniedRight WearPants
Pants
- Other
Other Allegations(List)
Allegations (List)
.'
DFEH-300-03·' (01105)
Date
. .
Department
DepartmentofofFair
FairEmployment
Employmentand
andHousing
Housing
State
StateofofCalifom ia
California
AMENDED
* * * EMPLOYMENT * * *
COMPLAINT OF DISCRIMINATION UNDER ~FEH
# ~ 2 0 0 6 0 7 - ( 3 3 ~ ~ ~
THE PROVISIONS OF THE CALIFORNIA
FAlR EMPLOYMENT AND HOUSING ACT NOTpfl,FL?3
ERVICE
OFFAIR
FAlREMPLOYMENT
EMPLOYMENTAND
ANDHOUSING
HOUSING
YOURNAME
YOUR NAME(indicate
(~nd~cateMrororMs,)
Mr, Ms ) TELEPHONE
TELEPHONENUMBER
NUMBER(INCLUDE
(INCLUDEAREA
AREACODE)
CODE)
Mr.David
Mr. Davld F.F. Jadwin,
Jadwln,DO, FCAP
DO, FCAP (818)
(818)541-0496
541-0496
ADDRESS
ADDRESS
Beaudry Terrace
3184 Beaudry
3184 Terrace
ClTYlSTATElZlP
CITY/STATE/ZIP COUNTY COUNTY
COUNTYCODE
CODE
Glendale, CA
91208-1745 LosCOUNTY
Los Angeles
Angeles
NAMEDISISTHE
NAMED THEEMPLOYER,
EMPLOYER,PERSON,
PERSON,LABOR
LABORORGANIZATION,
EMPLOYMENTAGENCY,
COMMITTEE,
ORSTATE
OR STATEORORLOCAL
LOCALGOVERNMENT
GOVERNMENTAGENCY
AGENCYWHO
WHODISCRIMINATED
DISCRIMINATEDAGAINST ME.
AGAINSTME:
NAME
NAME TELEPHONE
TELEPHONENUMBERNUMBERQnclude
(lnclude Area
AreaCode)
Code)
Dr. William
Dr. Wllllam Roy
Roy ( 6 6 1 ) 327-9800
(661) 327-9800
ADDRESS
ADDRESS a DFEH
DFEHUSE
USEONLY
ONLY
6 0 0 1DD Truxtun
6001 Truxtun Avenue
Avenue 420
420
ClTYlSTATElZlP
COUNNCODE
Bakersfield, CA
93309 Kern
Kern
NOOF
NO, OFEMPLOYEES/MEMBERS
EMPLOYEESIMEMBERS(if(tfknown)
known) DATE
DATEMOST
MOSTRECENT
DISCRIMINATION :RESPONDENT
!RESPONDENTCODE
CODE
TOOK
TOOKPLACE
PLACE(month.
(month.day,
day.and
andyear)
year)July
JULY 10,
1 0 , 2006
2006
THEPARTICULARS
THE PARTICULARSARE:
ARE:
On August
On _ftred __-flITllI~ ~_farrjlyormedcalleave
~ u g u s t3,3 , 2006
2006 I Iwas
was z:;d
_Ieidofr
denied pIllIl104Ia1 _ _ prvg>n:y leave
-
--lili
XXdolIlQed
danoled
-xx _lICCCITrnlldaIIon
- - _ --equoIp8Y
-mw har8soed -defied righllo _ pa1t'
-@ characteristicS
_genetic m a l s 6 9Iesbng
leshng mperrmrsblenon.job-rllIsted
Impermlsstlle b.r€ia(edmquiry
inqujry -1""'!l!&lCY
dsied lI<XXllm'<lda\i
OaxmmdaDDn
-
-lLXtorced
xxfcimd10I0quit
quit Ewisy
~~(~)retaliated
~nteractive
rTalialiated againsc
Interact ve process process
a g a i n 3 and
a n m denied
i e d
by
--
by Mr. Peter
Mr. Peter Bryan,
Bryan, et et al.
al. Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical center
Center
NameofofPerson
Name Person Job
JobTitle
(supervisorlmanagerlpersonneldirector/etc,)
directorletc.)
_-Wonal wwrn4anmstry
national originl«lC8.lIy JQl
z p h physical l disobJily
y r i e s disability _ an:« .1lli- (Circle
(Circleone)
one)filing;
filrng;
becauseofofmy:
because -"
my: _ege
-age
sex
-merital
merim&talUS
rtaw .xx..
XX_mental
r
nmcjsabifity
asability h a r e acherecteriSbc
_- g ~ cgene!lc etistic Protesting;
participating inin
-
_religion
religion -~ m w h b m
S8J<UIlIOrientalion investigation
investigat~on(retaliation
(retaliation for)
for)
rO- llICIlot<llor -essodetion
msaciafiwr -
JQl~(spedfy)-:::;CF~RA=-
XX c#xr(spedly) CFRA _
thereason
the reasongiven
givenby
by Mr. Peter
Mr. Peter Bryan,
Bryan, Chief
Chief Executive
Executive Officer
Officer of of Kern
Kern Medical
Medical Center
Center
NameofofPerson
Name Personand
andJob
JobTitle
Title
Wasbecause
Was because Please
Please see
see attachment.
attachment.
of [please
of [please
state what
youbelieve
you believetoto
bereason(s)]
be reason(s)]
I Iwish
wishtotopursue
pursuethis
matterinincourt, herebyrequest
requestthat
thatthe
theDepartment
Departmentof ofFair
FairEmployment
Employmentand and Housing
Housingprovide
provideaa right-la-sue
right-to-sue notice,
understandthat
that ifif II
wantaafederal
want federalnotice
noticeofofright-la-sue,
right-lo-sue,I Imust
mustvisillhe
visit theU,S,
U.S.Equal
EqualEmployment
Commission (EEOC)
(EEOC)10
to file
file aa complainl
complaint within
within 30
30 days
days of
of receipt
rece~ptof the
of the
DFEH"Nolice
CaseClosure,"
Closure."or orwithin
within300300days
daysof oflhe
thealleged
discriminatoryact,
act, whichever
whichever isisearlier,
earlier.
I Ihave
havenol
notbeen
beencoerced
coercedinlo
intomaking
makingthis
thisrequest.
request, nor
nordo do IImake
makeititbased
basedononfear
fear of
of relalialion
do nol
not do so. IIunderstand
do so, understand itit is
is Ihe
the Department
Department of
of Fair
Fair
Employment
Housing'spolicy
policyto
to not
notprocess
process oror reopen
r e o w n aa complainl
complaint once
oncethe
the complaint
complaint hashas beenbeen closed
closed on
on the
the basis
basis of
of "Complainant
Elected Court
Court Action,"
Action."
I Ideclare
declareunder
underpenalty
penaltyof
ofperjury
perjury under
underthe
thelaws
lawsof
ofthe
theState
Stateof Californiathat
of California that the
theforegoing
foregoing isis true
true and
and correct
correct of my own
of my own knowledge
knowledgeexcept
except as
as to
to matters
matters
m a t t e nIIbelieve
stated on my info stlon and belief, snd as to those matters believeItItto
t o. be
bstrue.
. true.
Dated if l~ oIP '-'J)··t:W:J.

<
~--=-t.._ _
~OMPLAINANT'S
Dated
FE
Glendale
~t Glendale
At
City
DFEH-300-03(01/05)
DFEH-300-03
DEPARTMENTOF
DEPARTMENT
(01105)
OF FAIR
FAlR EMPLOYMENT
EMPLOYMENTAND
AND HOUSING
HOUSING
DATE FILED:
DATE FILED:
RECEIVED
RECE'VED STATE
STATE OF
OF CALIFORNIA
CALIFORNIA
I 4 2006
NOV 142006
DEPT
\)En OF FAN £MPLOYMENT
. FAIR EMPLOYMENT
HOl!SING
AND HOUSING

COMPLAINT INFORMATION SHEET
DFEH needs
needs aa separate
separate signed
signed complaint
complaint for
for each
each employer,
employer, person,
person, labor
labor organization,
employment agency,
agency,
apprenticeship
committee, state
state or
or local
local government
govemment agency
agency you
you wish
wish toto file
file against.
against. IfIf you
you are
are filing
filing against
against both
both aa
company
company and
and an
an individual(s),
please complete
complete separate
separate complaint
complaint forms
forms naming
naming the
the company
company or or an
an individual
individual in
in the
the
appropriate area.
appropriate area.
Please complete the

the following
following so
so that
that DFEH
DFEH can
can process
process your
your complaint
complaint and
and for
for DFEH
DFEH for
for statistical
purposes, and
and
retum with
return with your
your signed
complaint(s):
YQUR RACE:IETHNICITY
YOUR RACE:/ETHNIClry (Check one) YOUR
YOUR GENDER;
GENDER: _ - Female
Female &xE Male
Male
- African-American
African-American
- African -- Other
African Other YOUR
YOUR OCCUPATION:
OCCUPATION:
-
_ Asian/Pacific Islander (specify)
AsianlPacific Islander (specify) _ - Clerical
Clerical
-xx Caucasian (Non-Hispanic)
XX (Non-Hispanic) - Craft
Craft
- Native American
Native American - Equipment Operator
- Hispanic(specify)
_ Hispanic{specify), _
- Laborer
Laborer
-
_ Manager
PRIMARY LANGUAGE (specify) -
_ Paraprofessional
Paraprofessional
English
Enqlish -xx
jQ{ Professional
- Sales
YOUR AGE:
AGE; --
'§"..1.
5 7 - Service
- Supervisor
_ Supervisor
IF
IF FILING
FILING BECAUSE
BECAUSE OF YOUR NATIONAL
ORIGIN/ANCESTRY,
- Technician
Technician
NATIONAL
ORIGIN/ANCESTRY
(specify) HOW YOU HEARD ABOUT DFEH:
-xx Attorney
1QC Attomey
IF
IF FILING
FlLlNG BECAUSE
DISABILITY, BuslBART
Bus/BART Advertisement
YOUR
YOUR DISABILITY:
DISABILITY: - Community Organization
- AIDS
AIDS - EEOC
- Blood/Circulation
EDD
Brain/NerveslMuscles Friend
Friend
-
Digestive/UrinarylReproduction - Labor
Human
-
_ Hearing
Hearing - Labor Standards Enforcement
- Heart
Heart - Local
_ Local Govemment Agency
Government Agency
-xx
xx Limbs
Limbs (Arms/Legs)
Poster
-
Exx Mental
Mental - Prior Contact
Contact with
- Telephone
with DFEH
DFEH
-
_ Sight
Sight Radio
Radio
-
SpeechlRespiratory - TVTelephone Book
_ Book
-
_ Spinal/Back
SpinallBack -T'f
- DFEH
DFEH Web
Web Site
Site
IF FILING
IF FILINGBECAUSE
BECAUSEOFOF MARITAL
MARITALSTATUS,
STATUS,
YOUR MARITAL
STATUS: (Check
(Check one)
one) DO YOU
PO YOU HAVE
HAVE AN
AN ATTORNEY WHO HASHAS AGREED
- Cohabitation
Cohabitation
TO REPRESENT
ON YOUR EMPLOYMENT
EMPLOYMENT
- Divorced
Divorced
IN COURT?
COURT? IF
IF YOU
YOU CHECK
CHECK
- Married
Manied
"YES". YOU
"YES', YOU WILL BE RESPONSIBLE
WILL BE RESPONSIBLE FOR
FOR HAVING
HAVING
-
_ Single
Single
ATTORNEY SERVE
YOUR ATTORNEY
YOUR THIS DFEH
SERVE THIS DFEH COMPLAINT.
COMPLAINT.
IFFILING
IF FlLlNGBECAUSE
BECAUSEOF OF RELIGION,
RELIGION, -
xxYes
EYes No
No
YOUR RELIGION:
YOUR RELIGION; (specify)
(specify)
PLEASE PROVIPE
PLEASE PROVIDE YOUR
YOUR ATTORNEY'S
ATTORNFY'S NAME,
NAME,
ADDRESS AND
ADDRESS AND PHONE
PHONE NUMBER:
NUMBER:
IFFILING
IF FlLlNGBECAUSE
BECAUSEOF SEX. THE
OF SEX, THE REASON:
Eugene D. Lee, Esq.
Esq. (SB#
(SB# 236812)
236812)
- Harassment
Harassment
- Orientation
Orientation Law Office of
Eugene Lee
Lee
-
_ Pregnancy
Pregnancy 445
4 4 5 South
south Figueroa
Figueroa Street,
Street, Suite
Suite 2700
2700
-
_ Denied
DeniedRight
RighttotoWear
Wear Pants
Pants
-
_ Other
OtherAllegations
Allegations(List)
."
/
(List)
<
1'
. (01105).
DFEH-300-03-1(01/05)
DFEH-300-03-1 W r Signature
Department
DepartmentofofFair
FairEmployment
Employmentand
andHousing
Housing
StateofofCalifornia
State California
Attachment to
Attachment to Dr.
Dr. David F. Jadwin's
David F. Jadwin's Complaint
Complaint of
of Discrimination
Discrimination Against
Against County
County
of Kern,
of Kern, Kern
Kern Medical
MedicalCenter,
Center, Mr.
Mr. Peter
Peter Bryan,
Bryan, and
and Affiliated
Affiliated Entities
Entities
Until July
Until July 10, 2006, II was
10, 2006, was Chair
Chair of
of Pathology
Pathology at
at Kern
Kern Medical
Medical
Center ("KMC"),
Center ("KMC"), aa hospital
hospital that
that is
is owned
owned and
and operated
operated by
by the
the
County of
County of Kern
Kern in
in California.
California. MyMy employment
employment began
began in
in December
December
2000, pursuant
2000, pursuant to
to an
an employment
employment contract which II executed
contract which executed on
on
October 24,
October 24, 2000.
2000. OnOn November
November 12, 2002, II executed
12, 2002, executed aa subsequent
subsequent
employment contract
employment contract with
with KMC
KMC with
with aa five-year
five-year term
term ending
ending on
on
October 4,
October 4, 2007.
2007.
was recruited
II was recruited toto rebuild
rebuild the
the pathology service. II was
pathology service. was able
able to
to
dramatically improve
dramatically improve the
the performance
performance of
of the
the department
department and
and
patient care
patient care throughout
throughout the
the hospital.
hospital. However,
However, II experienced
experienced
almost immediate
almost immediate resistance
resistance to
to the changes II made.
the changes made. InIn 2002,
2002, II
began to
began to suffer
suffer professional
professional mistreatment
mistreatment and
and harassment
harassment byby aa
few members
few members of
of the
the KMC
KMC medical
medical staff
staff in
in retaliation
retaliation for
for my
my
efforts to
efforts to address
address critical
critical deficiencies
deficiencies inin the
the quality
quality of
of
patient care
patient care and
and inefficiencies
inefficiencies at
at the
the hospital.
hospital. TheThe tortious
tortious
attacks, hostile
attacks, hostile work
work environment
environment and
and the
the conduct
conduct of
of the
the
administration eventually
administration eventually caused
caused me
me to
to succumb
succumb toto debilitating
debilitating
depression, anxiety
depression, anxiety and
and insomnia,
insomnia, etc.,
etc., for
for which
which II sought,
sought, and
and
continue to
continue to receive,
receive, expert
expert medical
medical help.
help.
Finally, in
Finally, in January 2006, II discussed
January 2006, discussed my
my disability
disability and
and my
my
various grievances
various grievances with
with Mr.
Mr. Peter
Peter Bryan,
Bryan, CEO
CEO of
of KMC,
KMC, and
and
requested
requested medical
medical leave.
leave. Mr.Mr. Bryan
Bryan agreed
agreed that
that II should
should take
take at
at
least six
least six months
months of
of time
time off
off while
while continuing
continuing onon as Chair. II
as Chair.
thus continued
thus continued to to work
work on
on aa part-time
part-time basis,
basis, capably
capably managing
managing
the Pathology
the Pathology Department
Department and
and fulfilling
fulfilling all
all essential
essential chair
chair
duties. I later submitted a formal application for intermittent
duties. I later submitted a formal application for intermittent
medical leave
medical leave ofof absence
absence accompanied
accompanied by doctor's note
by aa doctor's note which
which
certified that II would
certified that would need
need toto work
work on
on aa part-time
part-time basis
basis until
until
on or
on or about
about September
September 2006.
2006.
On
On April
April 28,
28, 2006,
2006, II had
had aa meeting
meeting with
with Mr.
Mr. Bryan,
Bryan, during
during which
which
he
he announced
announced his
his unilateral
unilateral decision
decision toto revoke
revoke my
my intermittent
intermittent
leave.
leave. Discussion
Discussion was
was neither
neither invited
invited nor permitted. II was
nor permitted. was
therefore
therefore forced
forced to
to comply
comply with
with the
the order.
order. Mr.Mr. Bryan
Bryan followed
followed
the meeting
the meeting up
up with
with aa toned-down
toned-down memo
memo that
that stated,
stated, "I
"I also
also
mentioned
mentioned that
that after
after Monday
Monday it
it would
would be
be preferable
preferable for
for you
you not
not
to
to have
have an
an intermittent
intermittent work
work schedule
schedule and
and it
it would
would be
be easier
easier on
on
the
the department
department to
to just
just have
have you
you on
on leave
leave until
until your
your status
status is
is
From that
resolved." From
resolved." that point
point on,
on, II was
was no
no longer
longer permitted toto
take intermittent
take intermittent leave
leave oror work
work part-time
part-time as
as an
an accommodation
accommodation ofof
my disability.
my disability.
In addition,
In addition, Mr.
Mr. Bryan
Bryan initially
initially stated that I I would
stated that would have
have until
until
June 16
June 16 to
to decide
decide whether
whether or or not would resign
not I I would resign mymy position.
position. In In
his April
his April 17 memo to
17 memo to me,
me, Mr.
Mr. Bryan
Bryan stated
stated "When
"When you
you return
return to
to
full time
full time from
from your
your medical
medical leave
leave I I need
need for
for you
you toto make
make aa
decision that you will either accept the conditions
decision that you will either accept the conditions and and work
work on
on
improving your relationships or you will step down
improving your relationships or you will step down as chairman." as chairman."
In his
In his April
April 2828 memo
memo to
to me,
me, Mr.
Mr. Bryan
Bryan reiterated, "Finally, I I
reiterated, "Finally,
said that
said that by
by June
June 16,
16, 2006
2006 you
you needed
needed to to give
give meme your
your decision
decision
about your
about your employment
employment status.
status. Your
Your options
options were
were toto either
either return
return
full time or resign your position." At the April
full time or resign your position." At the April 28 meeting, Mr. 28 meeting, Mr
Bryan orally
Bryan orally told
told me
me that
that II would
would be be fired
fired if
if II did
did not
not choose
choose
to return
to return as
as aa chair
chair at
at the
the end
end of
of mymy leave.
leave.
On May 5,5, II underwent

On May underwent medically
medically necessary
necessary sinus
sinus surgery
surgery to
to treat
treat
aa long-standing
long-standing medical
medical condition,
condition, and
and on
on May 29, II suffered
May 29, suffered aa
serious fall
serious fall which
which fractured
fractured two
two bones
bones in
in my
my foot
foot and
and avulsed
avulsed aa
ligament in
ligament in my
my ankle.
ankle. OnOn May 31, II sent
May 31, sent aa letter
letter to
to Mr.
Mr. Bryan,
Bryan,
requesting an extension of the June 16 deadline
requesting an extension of the June 16 deadline due to my due to my
medical difficulties.
medical difficulties.
On June
On June 13,
13, 33 days
days prior
prior to
to the
the June
June 16
16 deadline
deadline he he had
had promised
promised
me, Mr.
me, Mr. Peter
Peter Bryan (CEOof
Bryan (CEO of KMC)
KMC) summarily
summarily informed
informed me
me by
by email
email
that II was
that was being
being stripped
stripped of
of chairmanship
chairmanship effective
effective June
June 17,
17,
2006, due
2006, due to
to my
my taking
taking excessive
excessive sick
sick leaves
leaves and
and my
my subsequent
subsequent
alleged "inability
alleged "inability toto provide
provide consistent
consistent andand stable
stable leadership
leadership
in the
in the department
department forfor most
most of
of the
the past
past eight
eight toto nine
nine months".
months".
Mr. Bryan further
Mr. Bryan further stated
stated that
that he
he was
was going
going to
to grant
grant me
me 90
90 days
days
of personal
of personal leave,
leave, despite
despite the
the fact that II had
fact that had not
not yet
yet exhausted
exhausted
the 66 months'
the months' ofof cumulative
cumulative sick
sick leave
leave permitted
permitted under
under Kern
Kern
County rules.
County rules.
According to
According to the
the human
human resources
resources department
department at
at KMC,
KMC, as
as of
of June
June
13,
13, II had
had taken,
taken, inin the
the aggregate,
aggregate, 12
12 weeks
weeks of
of CFRA
CFRA sick
sick leave
leave
and
and approximately
approximately 3-43-4 additional
additional weeks
weeks of
of County
County sick
sick leave
leave
based
based onon doctor's
doctor's certifications
certifications which
which II submitted.
submitted.
Prior
Prior to
to June
June 13, Mr.
13, Mr. Bryan had
Bryan had not
not communicated
communicated to
to me
me his
his
concerns
concerns regarding my
regarding my sick
sick leaves. In fact, as noted above, Mr.
leaves. In fact, as noted above, Mr.
Bryan
Bryan had
had in
in at
at least
least two
two written
written communications
communications told
told meme that
that II
would
would have
have until
until June
June 16,
16, 2006
2006 to
to decide
decide whether
whether to
to continue
continue oror
resign my
resign my position
position atat KMC.
KMC.
On
On June
June 26,
26, Mr.
Mr. Bryan
Bryan stated
stated that
that II had
had "recently
"recently been
been seen
seen onon
the
the hospital
hospital campus"
campus" while
while on
on my
my personal
personal necessity
necessity leave
leave of
of
absence.
absence. HeHe then
then took
took the
the drastic
drastic measure
measure of
of ordering
ordering me
me to
to
"refrain
"refrain from
from entering
entering the
the facility
facility for
for any
any reason
reason other
other than
than
seeking
seeking medical
medical attention",
attention", "refrain
"refrain from
from contacting
contacting any
any
2
employee
employee or
or faculty
faculty member
member of
of Kern
Kern Medical
Medical Center
Center for
for any
any reason
reason
other than seeking
otherthan seeking medical
medical attention",
attention", and
and stated
stated that
that "usage
"usage of
of
any and all equipment as well as access to any and all
any and all equipment as well as access to any and all systems systems
has
has been
been suspended
suspended while
while [on
[on my]
my] approved
approved personal
personal necessity
necessity
leave
leave of
of absence".
absence". II discovered
discovered that
that this
this included
included suspension
suspension
of
of my
my email
email and
and voice
voice mail
mail accounts,
accounts, to
to which
which II require
require access
access
in
in order
order to
to manage
manage ongoing
ongoing patient
patient care
care issues.
issues. Mr.
Mr. Bryan
Bryan
concluded
concluded his
his letter
letter by
by saying
saying that
that "Failure
"Failure toto comply
comply with
with the
the
instructions
instructions ofof this
this letter,
letter, are
are grounds
grounds for
for disciplinary
actions
actions upup to
to and
and including
including termination
termination ofof your
your contract
contract with
with
the
the County
County ofof Kern."
Kern."
On
On June
June 29,
29, my
my attorney,
attorney, Mr.
Mr. Eugene
Eugene Lee,
Lee, sent
sent aa letter
letter to
to Ms.
Ms.
Karen Barnes,
Karen Barnes, Deputy
Deputy County
County Counsel
Counsel for
for the
the County of
of Kern,
Kern,
disclosing
disclosing my
my intention
intention to
to pursue
pursue legal
legal remedies
remedies against
against KMC
KMC and
and
certain
certain of
of its
its officers
officers and
and employees,
employees, and
and requesting
requesting that
that KMC
KMC
preserve
preserve all
all evidence
evidence relating
relating to
to my
my claims.
claims. The
The letter
letter
specifically
specifically stated
stated that
that II would
would be
be pursuing
pursuing claims
claims for,
for, among
among
other
other things,
things, disability
disability discrimination,
discrimination, failure
failure to
to accommodate
accommodate
disability,
disability, retaliation
retaliation for
for taking
taking California
California Family
Family Rights
Rights Act
Act
medical
medical leaves,
leaves, etc.
etc.
On
On July
July 3,
3, II filed
filed aa Tort
Tort Claims
Claims Act
Act form
form with
with the
the County of
of
Kern,
Kern, describing
describing mymy related
related tort
tort and
and contractual
contractual breach claims.
claims.
In
In that
that form,
form, II specifically
specifically named
named as
as potential
potential defendants
defendants Mr.
Mr.
Bryan,
Bryan, Dr.
Dr. Irwin
Irwin Harris,
Harris, Dr.
Dr. Eugene
Eugene Kercher,
Kercher, Dr.
Dr. Scott
Scott Ragland,
Ragland,
and
and Dr.
Dr. Jennifer
Jennifer Abraham,
Abraham, all
all KMC
KMC officers
officers and
and employees,
employees, and
and Dr.
Dr.
William
William Roy,
Roy, aa contract
contract physician.
physician.
II later
later learned
learned from
from Deputy
Deputy County
County Counsel
Counsel Karen
Karen Barnes
Barnes in
in her
her
reply
reply letter
letter to Mr. Lee
to Mr. Lee of
of July
July 18,
18, that
that on
on July
July la,
10, the
the KMC
KMC
Joint
Joint Conference
Conference Committee
Committee had
had formally
formally voted toto accept
accept Mr.
Mr.
Bryan's
Bryan's recommendation that II be
recommendation that be removed
removed as
as Chair
Chair of
of the
the
Pathology
Pathology Department.
Department. II had
had no
no prior
prior notice
notice of
of this
this meeting oror
its agenda.
its agenda.
On
On September
September 19,
19, II protested
protested the
the over
over 35%
35% reduction
reduction in
in my base
base
salary
salary KMC
KMC was
was proposing due
due to
to the removal of
the removal of my chair
chair duties.
duties.
On
On September
September 20,
20, the
the interim
interim CEO,
CEO, Mr.
Mr. David
David Culberson,
Culberson, sent
sent me aa
letter
letter dismissing
dismissing my
my concerns
concerns about
about my pay reduction.
reduction.
3
EXHIBIT 5
Notice of Intent to Sue from Plaintiff to the California

Labor & Workforce Development Agency dated 1/5/07
(213) 992-3299
TELEPHONE
L A W O F F I C E O F ELEE@LOEL.COM
E-MAIL
E U G E N E L E E
(213) 596-0487 555 WEST FIFTH S TR EET, SUITE 3100 WWW.LOEL.COM
FACSIMILE LOS ANGELES, CALIFORNIA 90013-1010 WEBSITE
January 5, 2007
VIA US MAIL
California Labor and Workforce Development 100011.001

Agency (LWDA)
801 K Street, Suite 2101
Sacramento CA 95814
Re: Notice of California Labor Code § 1102.5 violation pursuant to

California Labor Code §§ 2699.3(a)(1)
Dear LWDA representative,
Pursuant to California Labor Code § 2699.3(a)(1), aggrieved employee David F. Jadwin, D.O.,
current employee of the County of Kern at Kern Medical Center hereby notifies the California
Labor and Workforce Development Agency (LWDA) and the County of Kern of the Section
1102.5 Labor Code violations committed by the County of Kern (Kern Medical Center) against
Dr. Jadwin. The enclosed, as yet unfiled, complaint identifies that Section 1102.5 of the Labor
Code has been violated and the facts and theories which support this violation.
Very truly yours,
EUGENE D. LEE
encl.: Complaint & Exhibits

cc: Karen Barnes, Esq.
Deputy County Counsel for Kern County

15-2 Exhibits To FAC

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Case 1:07-cv-00026-OWW-TAG Document 15 Filed 01/08/2007 Page 1 of 75

1 Eugene Lee, SBN 178988

5 Attorney for Plaintiff

7 EASTERN DISTRICT OF CALIFORNIA

JADWIN v. COUNTY OF KERN: EXHIBITS TO FIRST AMENDED COMPLAINT 1

Second employment contract dated 10/5/02

THEREFORE, itit isis agreed

E.E. AABoard Directorswill

(2) Administrative expenses

G.G. CountyCountywillwillcover allprofessional

Professional fees shall

6.6. PRACTICE GROUPS

County shall provide

5.5. RETIREMENT PLAN

3.3. REVIEW ANDAPPEAL

Review and appeal

2.2. ASSISTANCE INLITIGATION

Any and all

19. PROFESSIONAL RESPONSIBILITIES

County and Core Physician recognize that Core Physician

22. SOLE AGREEMENT

KERN COUNTY PERSONNEL CONTRACT

a. IsIs inin compliance

c.c. County further desires

1.1 . Exhibit "A," section

Tort Claims Act complaint dated 7/3/06

4. Provide injury, damage or loss incurred

ATTACHMENT – CLAIM AGAINST THE COUNTY OF KERN

Pursuant to an employment contract (“Contract”), Complainant was

Prior to June 14, Mr. Bryan had not communicated to Complainant

The demotion/termination constituted retaliation by Mr. Bryan

i) need for follow-up on failure of a formerly-employed KMC

incorrect patient diagnoses and greatly increased expense

C. Per Se Libel / Ratification by KMC

In a letter dated October 17, 2005, Drs. Eugene Kercher

Complainant also seeks to bring claims of intentional infliction

4. Provide a general description of the injury, damage or loss incurred so far

Attorney’s fees (approx. $40,000 so far) and other costs.

Severe emotional distress (and reimbursement of associated

Letter from the Office of the County Counsel for the

California Department of Fair Employment and

sex __national ong~nlancestry

have not been

RIGHT-TO-SUE COMPLAINT INFORMATION

Please complete the following so that DFEH

YOUR RACE:/ETHNICITY (Check one) YOUR GENDER: xx Male

the reason given

I have not been Into making

DFEH can process your complaint and for DFEH

RACE:/ETHNICITY (Check one)

::,:: on m~,,,~,;n.n 6bt" .n' uto 'h~. m.tt.~, b'g~. ~

** ** ** EMPLOYMENT NOT FOR

Please complete the following so that DFEH

RACE:/ETHNICITY (Check one)

Attachment to Dr. David F. Jadwin’s Complaint of Discrimination Against County

Until July 10, 2006, I was Chair of Pathology at Kern Medical

I was recruited to rebuild the pathology service. I was able to

Finally, in January 2006, I discussed my disability and my

In addition, Mr. Bryan initially stated that I would have until

On May 5, I underwent medically necessary sinus surgery to treat

On June 13, 3 days prior to the June 16 deadline he had promised

As of June 13, I had taken, in the aggregate, 12 weeks of CFRA

Prior to June 13, Mr. Bryan had not communicated to me his

** EMPLOYMENT NOT FOR