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Inspection Detail
Inspection: 300840154 - Brothers Deli Burlingame
Inspection Information - Office: Foster City District Office
Site Address:
Brothers Deli Burlingame
1351 Howard Street
Burlingame, CA 94010
Mailing Address:
, , 00000
Union Status: NonUnion
SIC:5812
NAICS: 722110/Full-Service Restaurants
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 02/24/2004
Emphasis:
Case Closed: 02/24/2004
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 101124923 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 2 | 2 | ||||
| Initial Penalty | $0 | $0 | $0 | $5,075 | $0 | $5,075 |
| Current Penalty | $0 | $0 | $0 | $5,075 | $0 | $5,075 |
| 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 | 02/23/2004 | 02/26/2004 | $5,000 | $5,000 | $0 | 03/18/2004 | F - Formal Settlement | |
| 2. | 01002 | Other | 3273 A | 02/23/2004 | 03/12/2004 | $75 | $75 | $0 | 03/18/2004 | F - Formal Settlement |
Investigation Summary
At approximately 11:30 a.m. on September 15, 2003, Employee #1 was working as a waitress at her employer's restaurant. As she was walking toward the kitchen to pick up an order, she tripped on the raised edge of the non-slip mat placed against the edge of the regular carpet. In falling, her elbow struck the edge of a nearby shelf and was fractured. Her injuries required hospitalization for extensive treatment.
Keywords: FRACTURE, SLIP, TRIPPED, ELBOW, WORK SURFACE
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 300840154 | Hospitalized injury | Fracture | Occupation not reported |