Abstract: At approximately 10:00 a.m. on June 20, 2012, Employee #1, an insulation installer employed by a construction contractor, was working at the rear side of a single-level four-unit residential building in Coachella, CA. This was one of 12 buildings, each consisting of four separate residential units, for a total of 48 units. The project involved blowing cellulose insulation through the building attics, using an insulation blower machine. Employee #1 had completed three units and, on the day of the incident, had returned to begin work on other units. Employee #1 used an 8-foot A-frame step ladder in the closed position to access the roof of an 8-foot high building to install insulation through the attic. The top of the ladder extended only to the midpoint of the roof eaves. Employee #1 and Coworker #1 both used the ladder to ascend to the roof and descend from the roof multiple times by stepping onto the top cap of the ladder. Then Employee #1 stepped onto the top cap of the ladder once again as he attempted to descend from the roof level. The footing of the ladder slipped as he positioned his feet on the second rung from the top cap. Employee #1 fell approximately 7 feet to ground level. Employee #1 was transported to Desert Regional Medical Center by ambulance. He was admitted for rib fractures, multiple internal injuries, and a sprained wrist. According to medical records, after receiving treatment for his injuries, Employee #1 was discharged from hospital on June 26, 2012. Employee #1 had been employed by the contractor as an Insulation Installer for approximately 6 days when the incident occurred. Because the employer had left the site earlier that day to attend another project and Coworker #1 was away from the site taking a lunch break, there were no direct witnesses to the incident.