Abstract: At 2:00 p.m. on November 5, 2019, an employee working as a laborer for a commercial building contractor was working at a temporary site consisting of a restaurant building under renovation. The employee was changing the ceiling tiles from an 8-foot long Werner step ladder. The employee is employed as a permanent full-time employee of the employer. The employee had replaced about 10 ceiling tiles and after replacing the last tile he was descending the ladder. He was on the 2nd step from the the ground when he missed the first step and fell onto the concrete floor. The employee stated that he was carrying the old tile in his hands as he climbed down. He also reported he had been carrying the new tiles up the ladder with him by hand. In addition, he stated that he had to step on the 2nd and 1st step from the top cap of the ladder to reach to the ceiling. However, the employee was not carrying anything at the time he fell. The employee sustained a head injury which required a surgery. He was transported to the hospital, where he was hospitalized for 20 days.