Inspection Detail

Inspection: 310635503 - Pw Supermarkets, Inc.

Inspection Information - Office: Fremont District Office

Inspection Nr: 310635503

Report ID: 0950612

Date Opened: 02/27/2007

Site Address:
Pw Supermarkets, Inc.
20620 Homestead Rd.
Cupertino, CA 95014

Mailing Address:
2277 Alum Rock Ave., San Jose, CA 95116

Union Status: NonUnion

SIC:5411

NAICS: 445110/Supermarkets and Other Grocery (except Convenience) Stores

Inspection Type: Accident

Scope: Partial

Advanced Notice: N

Ownership: Private

Safety/Health: Safety

Close Conference: 03/09/2007

Emphasis:

Case Closed: 05/12/2008

Related Activity
Type	Activity Nr	Safety	Health
Accident	102522745

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	$0	$0	$0
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	03/27/2007	03/30/2007	$0	$5,000	$0	04/25/2007	F - Formal Settlement

Investigation Summary

Investigation Nr: 202495347

Event: 02/17/2007

Employee Hits Head on Safe Door and Sustains Concussion

At approximately 8:45 a.m. on February 17, 2007, Employee #1, a bookkeeper, was counting bills and coins, and she opens up the top safe swing door at an approximate 90-degree angle. Employee #1 proceeded to open up the bottom door, and started counting bills on the tile floor. While on both knees, Employee #1 attempted to stand up, hitting the top of her head on the bottom of the top safe door. Employee #1 sustained a concussion, and blood in the brain after hitting her head on the metal two-door safe. Employee #1 was hospitalized.

Keywords: HEAD, STRUCK AGAINST, SAFE, CONCUSSION

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	310635503			Hospitalized injury	Concussion	Bookkeepers, accounting and auditing clerks

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