Inspection Detail

Case Status: CLOSED

Inspection: 1290314.015 - Jensen Enterprises, Inc.

Inspection Information - Office: Van Nuys District Office

Inspection Nr: 1290314.015

Report ID: 0950643

Date Opened: 01/26/2018

Site Address:
Jensen Enterprises, Inc.
Heller Circle & Plum Canyon Intersection
Santa Clarita, CA 91350

Mailing Address:
14221 San Bernardino Ave., Fontana, CA 92335

Union Status: NonUnion

SIC:

NAICS: 327390/Other Concrete Product Manufacturing

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/24/2018

Emphasis:

Case Closed: 10/03/2019

Related Activity
Type	Activity Nr	Safety	Health
Accident	1283505

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				1		1
Current Violations				1		1
Initial Penalty	$0	$0	$0	$300	$0	$300
Current Penalty	$0	$0	$0	$300	$0	$300
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	3210(B)	04/24/2018	05/29/2018	$300	$300	$0	05/02/2018	O - Administrative Law Judge Order

Investigation Summary

Investigation Nr: 104931.015

Event: 10/26/2017

Employee slips and falls from an elevated work surface and s

At 10:51 a.m. on October 26, 2017, an employee was installing a concrete utility vault into an existing excavation. The employee completed the task and was packing up his equipment to leave the site. While strapping down several outrigger pads on top of an elevated work platform for the QMC Boom Crane Truck, the employee slipped and fell, bounced off the ground, and fell into the space between the concrete vault wall and the excavation wall. The employee suffered contusions to the head and right knee. The employee was hospitalized 24 hours after the accident.

Keywords: Boom Truck, Contusion, Elevated Work Plat, Fall, Head, Knee, Slip

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1290314.015	54	M	Non Hospitalized injury		Crane Operator

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