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Inspection Detail
Inspection: 125540112 - State Compensation Insurance Fund
Inspection Information - Office: American Canyon District Office
Site Address:
State Compensation Insurance Fund
5900 State Farm Dr
Rohnert Park, CA 94928
Mailing Address:
, , 00000
Union Status: Union
SIC:6321
NAICS: 524113/Direct Life Insurance Carriers
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: StateGovt
Safety/Health: Safety
Close Conference: 05/15/2007
Emphasis:
Case Closed: 12/18/2008
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 101023232 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 2 | 2 | ||||
| Initial Penalty | $0 | $0 | $0 | $5,450 | $0 | $5,450 |
| Current Penalty | $0 | $0 | $0 | $1,250 | $0 | $1,250 |
| 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 | 05/15/2007 | 05/18/2007 | $1,000 | $5,000 | $0 | 06/04/2007 | F - Formal Settlement | |
| 2. | 01002 | Other | 3231 D | 05/15/2007 | 06/08/2007 | $250 | $450 | $0 | 06/04/2007 | F - Formal Settlement |
Investigation Summary
At approximately 4:15 p.m. on March 28, 2007, an employee, an office assistant, fell while she was descending the second floor stairs and her shoe caught on a non-slip strip. This resulted in her falling to the stair landing. She fractured her left tibia and fibia. She was hospitalized and treated for a fractured leg.
Keywords: FRACTURE, STAIR, FALL, WORK SURFACE, LEG
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 125540112 | Hospitalized injury | Fracture | Personnel clerks, except payroll and timekeeping |