Inspection Detail

Case Status: CLOSED

Inspection: 1579805.015 - 112690 - Yener Obdulio Perez Agustin Llc

Inspection Information - Office: Indiana Department Of Labor

Inspection Nr: 1579805.015

Report ID: 0551800

Date Opened: 02/18/2022

Site Address:
112690 - Yener Obdulio Perez Agustin Llc
13942 Brisbane Dr
Fishers, IN 46038

Mailing Address:
3540 Richard Ave, Lawrence, IN 46226

Union Status: NonUnion

SIC:1761

NAICS: 238170/Siding Contractors

Inspection Type: Fat/Cat

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 03/31/2022

Emphasis: S:Fall

Case Closed: 11/28/2022

Related Activity
Type	Activity Nr	Safety	Health
Referral	1866740	Yes
Accident	1869337

Case Status: CLOSED

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	4			1		5
Current Violations	4			1		5
Initial Penalty	$4,500	$0	$0	$0	$0	$4,500
Current Penalty	$2,250	$0	$0	$0	$0	$2,250
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	Latest Event
1.	01001	Serious	19260020 B01	04/04/2022	04/29/2022	$300	$600	$0	I - Informal Settlement
2.	01002	Serious	19260451 G01 I	04/04/2022	04/08/2022	$1,050	$2,100	$0	I - Informal Settlement
3.	01003	Serious	19260452 K04	04/04/2022	04/08/2022	$600	$1,200	$0	I - Informal Settlement
4.	01004	Serious	19260454 A	04/04/2022	04/29/2022	$300	$600	$0	I - Informal Settlement
5.	02001	Other	19040032 B02 II	04/04/2022	04/28/2022	$0	$0	$0	I - Informal Settlement

Investigation Summary

Investigation Nr: 144793.015

Event: 02/16/2022

Employee falls from roof and dies from head injury

At 12:00 a.m. on February 16, 2022, an employee worked on the second story of a house. At some point, the employee fell from a walk board and hit his head on the ground. The employee was hospitalized but later died from a head injury.

Keywords: Fall, Fall From Elevation, Fall Protection, Head, Roof

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	1579805.015	21	M	Fatality		Occupation not reported

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