Inspection Detail

Inspection: 119636736 - Hidden Valley Lake Associates

Inspection Information - Office: American Canyon District Office

Inspection Nr: 119636736

Report ID: 0950615

Date Opened: 06/01/2004

Site Address:
Hidden Valley Lake Associates
18174 Hidden Valley Road
Middletown, CA 95461

Mailing Address:
P.O. Box 628, Middletown, CA 95461

Union Status: NonUnion

SIC:8641

NAICS: 813990/ Other Similar Organizations (except Business, Professional, Labor, and Political Organizations)

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Health

Close Conference: 06/18/2004

Emphasis:

Case Closed: 06/18/2004

Related Activity
Type	Activity Nr	Safety	Health
Accident	361600851

Investigation Summary

Investigation Nr: 201020195

Event: 05/26/2004

Waitress is hospitalized after falling

At approximately 10:00 a.m. on May 26, 2004, a waitress at the Hidden Valley Lake Association was working during the morning rush when she tripped and fell hard, face first, on the carpet. She got up and attempted to continue serving, but according to witnesses, appeared flushed and disoriented. She was driven to a hospital, where she was admitted after being examined. The injured employee stated that she tripped while turning. The employee underwent a series of tests to rule out stroke as a possible cause of the accident. She experienced bruises and a possible chipped tooth as a result of her fall.

Keywords: ABRASION, FALL, FACE, CONTUSION, LEG

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	119636736			Hospitalized injury	Bruise/Contus/Abras	Occupation not reported

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