CACI No. VF-3103. Neglect - Employer Defendant Only (Welf. & Inst. Code, §§ 15610.57,
Judicial Council of California Civil Jury Instructions (2023 edition)
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VF-3103.Neglect - Employer Defendant Only (Welf. & Inst. Code,
§§ 15610.57, 15657; Civ. Code, § 3294(b))
We answer the questions submitted to us as follows:
1. Was [name of plaintiff/decedent] [65 years of age or older/a
dependent adult] while [he/she/nonbinary pronoun] was in [name of
defendant]’s care or custody?
1. Yes No
1. If your answer to question 1 is yes, then answer question 2. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
2. Was [name of plaintiff/decedent] in [name of defendant]’s care or
custody?
2. Yes No
2. If your answer to question 2 is yes, then answer question 3. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
3. Did one or more of [name of defendant]’s employees fail to use
that degree of care that a reasonable person in the same situation
would have used in assisting in personal hygiene or in the
provision of food, clothing, or shelter?
3. Yes No
3. If your answer to question 3 is yes, then answer question 4. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
4. Was the employee’s conduct a substantial factor in causing harm
to [name of plaintiff/decedent]?
4. Yes No
4. If your answer to question 4 is yes, then answer question[s] 5
[and 6]. If you answered no, stop here, answer no further
questions, and have the presiding juror sign and date this form.
5. What are [name of plaintiff/decedent]’s damages?
[a. Past economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
449
[other past economic loss $ ]
[a. Total Past Economic Damages: $ ]
[b. Future economic loss
[lost earnings $ ]
[lost profits $ ]
[medical expenses $ ]
[other future economic loss $ ]
[b. Total Future Economic Damages: $ ]
[c. Past noneconomic loss, including [physical
pain/mental suffering:] $ ]
[d. Future noneconomic loss, including [physical
pain/mental suffering:] $ ]
5. TOTAL $
[6. Did [name of plaintiff] prove by clear and convincing evidence that
an officer, a director, or a managing agent of [name of defendant]
had advance knowledge of the unfitness of the employee and
employed [him/her/nonbinary pronoun] with a knowing disregard
of the rights or safety of others?
[6. Yes No
[6. If your answer to question 6 is yes, then answer question 7. If you
answered no, stop here, answer no further questions, and have
the presiding juror sign and date this form.
7. Did [name of plaintiff] prove 1 through 4 above by clear and
convincing evidence and also prove by clear and convincing
evidence that the employee acted with
[recklessness/malice/oppression/ [or] fraud]?
7. Yes No]
7. [If your answer to question 7 is yes, then answer question 8. If
you answered no, stop here, answer no further questions, and
have the presiding juror sign and date this form.
8. What were [name of decedent]’s damages for noneconomic loss for
pain, suffering, or disfigurement incurred before death?
]
VF-3103 ELDER ABUSE & DEPENDENT ADULTS
450
Signed: Presiding Juror
Dated:
After [this verdict form has/all verdict forms have] been signed, notify
the [clerk/bailiff/court attendant] that you are ready to present your
verdict in the courtroom.
New September 2003; Revised April 2007, April 2008, October 2008, December
2010, December 2016
Directions for Use
This verdict form is based on CACI No. 3103, Neglect - Essential Factual Elements,
CACI No. 3104, Neglect - Enhanced Remedies Sought, and CACI No. 3102B,
Employer Liability for Enhanced Remedies - Employer Defendant Only.
The special verdict forms in this section are intended only as models. They may
need to be modified depending on the facts of the case.
Question 3 can be modified to correspond to the alleged wrongful conduct as in
element 3 of CACI No. 3103.
If specificity is not required, users do not have to itemize all the damages listed in
question 5 and do not have to categorize “economic” and “noneconomic” damages,
especially if it is not a Proposition 51 case. The breakdown of damages is optional
depending on the circumstances.
Questions 6 and 7 are required to obtain employer liability for enhanced remedies,
including attorney fees and costs. (See Welf. & Inst. Code, § 15657; Code Civ.
Proc., § 377.34.) Question 6 may be altered to correspond to one of the alternative
bracketed options in CACI No. 3102B.
If the neglect led to the elder’s death, in question 5 include only item 5a for past
economic loss. But also include the transitional language after question 7 and
include question 8.
If punitive damages are sought, incorporate language from a verdict form for
punitive damages. (See CACI Nos. VF-3900-VF-3904.)
If there are multiple causes of action, users may wish to combine the individual
forms into one form. If different damages are recoverable on different causes of
action, replace the damages tables in all of the verdict forms with CACI No. VF-
3920, Damages on Multiple Legal Theories.
If the jury is being given the discretion under Civil Code section 3288 to award
prejudgment interest (see Bullis v. Security Pac. Nat’l Bank (1978) 21 Cal.3d 801,
814 [148 Cal.Rptr. 22, 582 P.2d 109]), give CACI No. 3935, Prejudgment Interest.
This verdict form may need to be augmented for the jury to make any factual
findings that are required in order to calculate the amount of prejudgment interest.
ELDER ABUSE & DEPENDENT ADULTS VF-3103
451
© Judicial Council of California.
