Inspection Detail

Case Status: CLOSED

Inspection: 1498102.015 - Poly Timber Tree Service Inc.

Inspection Information - Office: Monrovia District Office

Inspection Nr: 1498102.015

Report ID: 0950644

Date Opened: 10/19/2020

Site Address:
Poly Timber Tree Service Inc.
423 S. Grand Ave.
West Covina, CA 91791

Mailing Address:
8248 Birchbark Ave, Pico Rivera, CA 90660

Union Status: NonUnion

SIC:

NAICS: 561730/Landscaping Services

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 04/13/2021

Emphasis:

Case Closed: 05/12/2021

Related Activity
Type	Activity Nr	Safety	Health
Accident	1667267

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	$260	$0	$260
Current Penalty	$0	$0	$0	$260	$0	$260
FTA Penalty	$0	$0	$0	$0	$0	$0

Violation Items
#	Citation ID	Citation Type	Standard Cited	Issuance Date	Abatement Due Date	Current Penalty	Initial Penalty	FTA Penalty	Contest	Latest Event	Note
1.	01001	Other	3421(A)	04/16/2021	05/21/2021	$85	$85	$0		Z - Issued
2.	01002	Other	3427(A)(3)(A)	04/16/2021	05/21/2021	$175	$175	$0		Z - Issued

Investigation Summary

Investigation Nr: 130465.015

Event: 09/28/2020

Employee incurs multiple injuries after falling from tree

At 7:50 a.m. on September 28, 2020, Employee #1 was trimming small branches from a big branch he was standing on, approximately 20 feet above the ground. He moved towards the end of the branch to trim the smaller branches. Employee #1 fell off the branch onto concrete steps in the neighboring property. Employee #1 sustained fractured ribs, a kidney injury, and a heel injury. He was hospitalized.

Keywords: Concrete Surface, Fall, Fall From Elevation, Foot, Fracture, Kidney, Rib, Tree Branch, Tree Trimming

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1498102.015	58	M	Hospitalized injury		Laborers, except construction

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