Inspection Detail

Inspection: 300864667 - Mathis Brothers Furniture

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 300864667

Report ID: 0950633

Date Opened: 01/26/2004

Site Address:
Mathis Brothers Furniture
81410 Highway 111
Indio, CA 92201

Mailing Address:
, , 00000

Union Status: NonUnion

SIC:5712

NAICS: 442110/Furniture Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 06/15/2004

Emphasis:

Case Closed: 07/13/2008

Related Activity
Type	Activity Nr	Safety	Health
Accident	101153690

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				4		4
Current Violations				3		3
Initial Penalty	$0	$0	$0	$6,310	$0	$6,310
Current Penalty	$0	$0	$0	$300	$0	$300
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	Contest	Latest Event	Note
1.	01001	Other	342 A	06/15/2004	06/29/2004	$0	$5,000	$0	07/20/2004	I - Informal Settlement	Citation has been deleted.
2.	01002	Other	3203 B01	06/15/2004	06/29/2004	$0	$375	$0	07/20/2004	I - Informal Settlement
3.	01003	Other	3650 S07	06/15/2004	06/29/2004	$0	$185	$0	07/20/2004	I - Informal Settlement
4.	01004	Other	3656 E	06/15/2004	06/29/2004	$300	$750	$0	07/20/2004	I - Informal Settlement

Investigation Summary

Investigation Nr: 201158854

Event: 12/20/2003

Employee Fractures Hand in Fall from Stock Picker

At approximately 2:24 p.m. on December 20, 2003, an employee was operating a stock picker, Crown, Model-E, Serial Number 1A264683, to put a box of furniture on a shelf in the Aisle Number 18. He was standing on the platform of the stock picker and the platform was elevated about 18 ft above the floor level. As he tried to push the box, his foot slipped and he fell on to a concrete floor. The accident caused multiple fractures on his right hand which required a surgery and hospitalization for 5 days.

Keywords: FRACTURE, HOISTING MECHANISM, SLIP, FALL, HAND

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	300864667			Hospitalized injury	Fracture	Freight, stock and material handlers, n.e.c.

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