Abstract: At approximately 12:40 p.m. on September 25, 2011, Employee #1 was working as a service clerk at a Walgreens drugstore in the Castro District of San Francisco, California. He was organizing items on the top shelf above the store's cosmetic section, which was 7.5 feet (2.3 meters) above the floor. Employee #1 used a 6 foot (1.8 meter) stepladder, with a highest standing level of 3.83 feet (1.17 meters). The ladder was placed sideways to reach the 20 inch deep (0.5 meters deep) shelf. Employee #1 lost his balance and fell approximately 4 feet (1.2 meters). He suffered a compression fracture of his T12 vertebra, and he was hospitalized for several days at San Francisco General Hospital. The accident was reported to the District Office by the San Francisco Fire Department a few hours later. A compliance officer went to the site of the accident on October 10, 2011. The cause of the accident was Employee #1's use of the wrong type of ladder for the task. T8 CCR 3276(e)(15)(A) requires an employee to climb or work with the body near the middle of the step or rung and not overreach from this position. Due to space limitations, however, the stepladder had to be placed parallel to the shelf, forcing the employee to bend sideways and overreach. This resulted in his losing his balance and falling. The employer was not cited with a serious accident-related violation, due to the height of fall. Other violations of Title 8 were observed, and the employer was cited accordingly.