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Inspection Detail
Inspection: 312355241 - Pac N Save
Inspection Information - Office: Oakland District Office
Site Address:
Pac N Save
555 Floresta Blvd
San Leandro, CA 94578
Mailing Address:
, , 00000
Union Status: Union
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: 03/23/2009
Emphasis:
Case Closed: 10/23/2009
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 361612419 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | 2 | 2 | ||||
| Initial Penalty | $0 | $0 | $0 | $1,025 | $0 | $1,025 |
| Current Penalty | $0 | $0 | $0 | $150 | $0 | $150 |
| 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 | 3203 A06 | 03/24/2009 | 04/26/2009 | $0 | $465 | $0 | I - Informal Settlement | ||
| 2. | 01002 | Other | 3272 C | 03/24/2009 | 04/26/2009 | $150 | $560 | $0 | I - Informal Settlement |
Investigation Summary
On January 26, 2009, Employee #1, a bakery deli clerk, tripped on a hose that had been left on the floor and fell on her side. Approximately three minutes later, she noticed her arm was injured. Employee #1 was hospitalized at Kaiser Hospital in Hayward for an open fracture of her left elbow. The employer reported that another worker admitted to leaving the hose in the bakery department walkway during a 10 minute break. No other contributing factors were found.
Keywords: FRACTURE, HOSE, TRIPPED, FALL, ELBOW, WORK SURFACE, INATTENTION
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 312355241 | Hospitalized injury | Fracture | Sales counter clerks |