Inspection Detail

Case Status: CLOSED

Inspection: 1232541.015 - Cisi Jeffery B

Inspection Information - Office: San Francisco District Office

Inspection Nr: 1232541.015

Report ID: 0950611

Date Opened: 05/10/2017

Site Address:
Cisi Jeffery B
2942 Webster St.
San Francisco, CA 94123

Mailing Address:
801 Pepper Rd., Petaluma, CA 94952

Union Status: NonUnion

SIC:

NAICS: 236116/New Multifamily Housing Construction (except Operative Builders)

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/18/2017

Emphasis:

Case Closed: 02/05/2018

Related Activity
Type	Activity Nr	Safety	Health
Accident	1202855

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$760	$0	$760
Current Penalty	$0	$0	$0	$760	$0	$760
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citaton Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Other	3276(E)(15)	10/18/2017		$435	$435	$0		Z - Issued
2.	01002	Other	3276(F)	10/18/2017	12/07/2017	$325	$325	$0		Z - Issued

Investigation Summary

Investigation Nr: 99642.015

Event: 04/13/2017

Employee falls from ladder and incurs back injuries

At 9:49 a.m. on April 13, 2017, Employee #1, employed by a construction company, was performing roofing work at a two-story residential home remodeling. He was climbing an extension ladder while carrying roofing materials in one hand. Employee #1 was approximately half way up the ladder when his foot slipped on a wet rung. Employee #1 fell approximately 20 to 25 feet. Emergency services were called, and Employee #1 was transported to the hospital. He was admitted and treated for back abrasions and a spinal hematoma.

Keywords: Abrasion, Back, Extension Ladder, Fall, Fall Protection, Material Handling, Residential Construction, Roof, Slippery Surface, Spine

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1232541.015	23	M	Non Hospitalized injury		Carpenter

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