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Inspection Detail
Inspection: 1569779.015 - 99 Cents Only Stores Llc
Inspection Information - Office: Los Angeles District Office
Site Address:
99 Cents Only Stores Llc
4000 Union Pacific Ave.
Commerce, CA 90023
Mailing Address:
4000 Union Pacific Ave., Commerce, CA 90023
Union Status: NonUnion
SIC:
NAICS: 493110/General Warehousing and Storage
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 04/04/2022
Emphasis:
Case Closed: 05/09/2022
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1845275 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $475 | $0 | $475 |
| Current Penalty | $0 | $0 | $0 | $475 | $0 | $475 |
| 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 | 3203(A)(8) | 04/05/2022 | 05/09/2022 | $475 | $475 | $0 | Z - Issued |
Investigation Summary
At 12:40 p.m. on November 9, 2021, an employee was operating a Raymond 8410 pallet jack. The pallet jack went over a piece of wood, which got stuck underneath the pallet jack, bringing it to an abrupt stop. The employee fell off the pallet jack and hit his head on the ground. The employee sustained a concussion and was hospitalized.
Keywords: Concussion, Fall, Head, Pallet Jack
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1569779.015 | 65 | M | Hospitalized injury |