Inspection Detail
Inspection: 1015896.015 - Champion Ballroom Academy Inc.
Inspection Information - Office: San Diego District Office
Site Address:
Champion Ballroom Academy Inc.
3580 5th Avenue
San Diego, CA 92103
Mailing Address:
3580 5th Avenue, San Diego, CA 92103
Union Status: NonUnion
SIC:
NAICS: 713990/All Other Amusement and Recreation Industries
Inspection Type: Fat/Cat
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 04/27/2015
Emphasis:
Case Closed: 01/31/2017
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 928818 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $5,000 | $0 | $5,000 |
| Current Penalty | $0 | $0 | $0 | $1,000 | $0 | $1,000 |
| FTA Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| # | Citation ID | Citaton Type | Standard Cited | Issuance Date | Abatement Due Date | Current Penalty | Initial Penalty | FTA Penalty | Contest | Latest Event | Note |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. | 01001 | Other | 342(A) | 04/27/2015 | $1,000 | $5,000 | $0 | 06/01/2015 | F - Formal Settlement |
Investigation Summary
At 7:00 p.m. on December 20, 2014, an employee was carrying boxes of shoes up the stairwell. Next, the employee possibly blacked out while climbing the stairs and fell backwards. The employee's head struck a metal object and she sustained a fatal traumatic head injury.
Keywords: Fainted, Fall, Head, Struck Against
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1015896.015 | 67 | F | Fatality | Managers and administrators, n.e.c |
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