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Inspection Detail
Case Status: CLOSED
Inspection: 1454624.015 - Aoc San Felipe Opco, Lp
Inspection Information - Office: Fremont District Office
Inspection Nr: 1454624.015
Report ID: 0950612
Date Opened: 01/08/2020
Site Address:
Aoc San Felipe Opco, Lp
4463 San Felipe Rd
San Jose, CA 95135
Mailing Address:
4463 San Felipe Rd., San Jose, CA 95135
Union Status: NonUnion
SIC:
NAICS: 623312/Homes for the Elderly
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 03/26/2020
Emphasis:
Case Closed: 02/17/2021
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1532285 |
Case Status: CLOSED
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $5,000 | $0 | $5,000 |
| Current Penalty | $0 | $0 | $0 | $3,000 | $0 | $3,000 |
| 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) | 03/27/2020 | $3,000 | $5,000 | $0 | 04/20/2020 | O - Administrative Law Judge Order |
Investigation Summary
Investigation Nr: 123036.015
Event: 01/04/2020
Employee fractures and dislocates shoulders in slip and fall
At 3:00 p.m. on January 4, 2020, an employee was going to help a resident and the employee slipped and fell on spilled food. The employee suffered a fractured and dislocated shoulders, resulting in hospitalization.
Keywords: Dislocated, Fall, Fall On Same Level, Fracture, Healthcare, Shoulder, Slip
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1454624.015 | 68 | F | Hospitalized injury | Occupation Not Listed |