Inspection Detail

Inspection: 307457051 - California, State Of,Fairview Developmental Center

Inspection Information - Office: San Bernardino District Office

Inspection Nr: 307457051

Report ID: 0950633

Date Opened: 06/10/2005

Site Address:
California, State Of,Fairview Developmental Center
2501 Harbor Blvd,Program 6,Resident 21, Room 70
Costa Mesa, CA 92626

Mailing Address:
2501 Harbor Blvd, Costa Mesa, CA 92626

Union Status: Union

SIC:8063

NAICS: 622210/Psychiatric and Substance Abuse Hospitals

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 10/12/2005

Emphasis:

Case Closed: 01/15/2014

Related Activity
Type	Activity Nr	Safety	Health
Accident	102442324

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations				1		1
Current Violations				1		1
Initial Penalty	$0	$0	$0	$5,000	$0	$5,000
Current Penalty	$0	$0	$0	$5,000	$0	$5,000
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	10/12/2005	10/17/2005	$5,000	$5,000	$0		-

Investigation Summary

Investigation Nr: 202441143

Event: 05/30/2005

Employee Is Injured When Struck by Cabinet

At approximately 4:45 p.m. on May 30, 2005, Employee #1, a psychiatric technician assistant and regular full-time employee of the Fairview Developmental Center in Costa Mesa, CA, suffered a serious workplace injury when a male client became unruly and pulled a television cabinet to the ground. Employee #1 attempted to stop the cabinet from falling over and it struck her face as it fell. Initially, coworkers came to her aid, and she was later transported to the Western Medical Center in Santa Ana, CA, for emergency medical care. She remained hospitalized for four days. Medical records showed that Employee #1 sustained facial lacerations and a concussion.

Keywords: HEAD, HEALTH CARE WORKER, HEALTH CARE FACILITY, LACERATION, STRUCK BY, WORKPLACE VIOLENCE, CONCUSSION, FACE, PSYCH ILLNESS

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	307457051			Hospitalized injury	Concussion	Health aides, except nursing

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