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Inspection Detail
Inspection: 1501724.015 - Sam'S West, Inc.
Inspection Information - Office: Little Rock Area Office
Site Address:
Sam'S West, Inc.
3500 Se Club Blvd
Bentonville, AR 72712
Mailing Address:
702 Sw 8th Street Mail Stop 0505, Bentonville, AR 72716
Union Status: NonUnion
SIC:
NAICS: 452111/Department Stores (except Discount Department Stores)
Inspection Type: Referral
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/10/2020
Emphasis:
Case Closed: 12/01/2022
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Referral | 1681230 | Yes |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | 2 | |||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $13,653 | $0 | $0 | $0 | $0 | $13,653 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| 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 | Serious | 19100178 O01 | 04/29/2021 | 05/25/2021 | $0 | $13,653 | $0 | 05/21/2021 | F - Formal Settlement | Citation has been deleted. |
| 2. | 02001 | Other | 19040029 B08 | 04/29/2021 | $0 | $0 | $0 | 05/21/2021 | F - Formal Settlement |
Investigation Summary
At 9:30 p.m. on November 1, 2020, an employee working for a department store was standing by an apparel table in the clothing area on the sales floor. The employee was struck by merchandise that fell from the forks of a forklift. The employee sustained a contusion and trauma to her abdomen and ribs, requiring hospitalization.
Keywords: Abdomen, Aisle, Blunt force, Blunt force trauma, Chest, Contusion, Department Store, Falling Object, Forklift, Industrial Truck, Lack of Engineering Controls, Material Handling, Palletized Cargo, Powered Industrial Vehicle, Rib, Struck By, Walking Surface, Work Surface
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1501724.015 | 18 | F | Hospitalized injury |