Inspection Detail

Inspection: 125945311 - Walmart

Inspection Information - Office: Long Beach District Office

Inspection Nr: 125945311

Report ID: 0950635

Date Opened: 12/28/2004

Site Address:
Walmart
8450 La Palma Ave
Buena Park, CA 90620

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5311

NAICS: 452112/Discount Department Stores

Inspection Type: Accident

Scope: Complete

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 01/27/2005

Planning Guide: Safety-Manufacturing

Emphasis:

Case Closed: 09/13/2010

Related Activity
Type	Activity Nr	Safety	Health
Accident	362467011

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				2		2
Current Violations				2		2
Initial Penalty	$0	$0	$0	$840	$0	$840
Current Penalty	$0	$0	$0	$840	$0	$840
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	3203 A07	02/02/2005	03/02/2005	$280	$280	$0		-
2.	01002	Other	3273 A	02/02/2005	02/15/2005	$560	$560	$0		-

Investigation Summary

Investigation Nr: 201036613

Event: 11/14/2004

Employee Is Injured in Trip and Fall

On November 14, 2004, Employee #1, an associate in the Fabric department wanted to make an outside phone call. There was no phone in the lounge on that day. Employee #1 went to the lay-away department by walking through the hallway which connects the lounge with the lay-away department. There is a door from the hallway to the lay-away department that opens inside the lay-away department. The door, when fully open, rests against a built-in desk approximately 30-in. high. There was a phone on the desk approximately 22 in. from the door opening. Employee #1 made a phone call using that phone. As Employee #1 was coming out of the lay-away department through the door she tripped. As Employee #1 fell to the concrete floor she heard some kind of sound as if the phone set which she just used fell on the floor. Employee #1 suffered a dislocated left shoulder and a fractured left upper arm near the shoulder joint and was hospitalized for five days.

Keywords: FRACTURE, SHOULDER, TRIPPED, DISLOCATED, FALL, ARM

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	125945311			Hospitalized injury	Dislocation	Stock and inventory clerks

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