Abstract: At 11:15 a.m. on October 30, 2018, an employee was working for a school district facilities department. He was working at a middle school. He worked full time as a painter. The facilities department conducted construction projects on Los Angeles Unified schools throughout the district. The employee was painting around and behind the outer newly installed HVAC system air conditioner of bungalow classroom B-13. He was working alone, using a 2.4-meter (8-foot) A-frame ladder. As he painted the bungalow, the outside window grating on which he had hung his pail of paint pulled away from the bungalow. It struck him in the face, knocking him off the ladder and onto a concrete surface. He suffered a head injury. A coworker, working as an HVAC fitter, was working approximately 21 meters (70 feet) from the employee. He heard the ladder fall and rushed to assist the employee. The coworker contacted the school's nurse and called for emergency medical personnel. The fire department and paramedics arrived at the school, performed first aid and transported the employee to the LAC + USC Medical Center in Los Angeles. At USC Medical Center, the employee was admitted to the intensive care unit (ICU) and treated for a bruised brain. He was hospitalized. The management of the area facilities department for the school district notified the Long Beach CAL-OSHA office at approximately 2:35 p.m. that same day. The division arrived at the middle school at approximately 10:30 a.m. on November 7, 2018, to conduct an investigation of the incident. The failure of the employer to inspect and evaluate the middle school work site prior to the work at bungalow 13 resulted in the employee�s choosing and using the ladder incorrectly. No accident-related serious citations were issued.