Inspection Detail

Inspection: 312555451 - Julie'S Cafe Inc

Inspection Information - Office: Appleton Area Office

Inspection Nr: 312555451

Report ID: 0521100

Date Opened: 02/18/2010

Site Address:
Julie'S Cafe Inc
411 South Military Avenue
Green Bay, WI 54301

Mailing Address:
2130 Velp Avenue, Green Bay, WI 54303

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: 04/02/2010

Emphasis:

Case Closed: 02/09/2011

Related Activity
Type	Activity Nr	Safety	Health
Accident	100651512

Violation Summary
Violations/Penalties	Serious	Willful	Repeat	Other	Unclass	Total
Initial Violations	1					1
Current Violations	1					1
Initial Penalty	$2,500	$0	$0	$0	$0	$2,500
Current Penalty	$1,000	$0	$0	$0	$0	$1,000
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	Serious	19100022 A02	04/21/2010	10/13/2010	$1,000	$2,500	$0	05/13/2010	F - Formal Settlement

Investigation Summary

Investigation Nr: 200651693

Event: 02/05/2010

Employee Fractures Ankle in Fall, Later Dies of Blood Clot

Employee #1 slipped on a wet floor and fell at a restaurant. Prior to the incident another employee had been asked to clean up the water station at the restaurant. The station cart was moved so the corner of the carpet could be flipped up to sweep under it. A little bit of water was swept into the main aisle after which the carpet was put back in place along with the cart. The employee then continued sweeping until she heard Employee #1 fall. Employee #1 fractured her left ankle. Employee #1 died two days later from a blood clot.

Keywords: BLOOD CLOT, SLIP, FALL, SLIPPERY SURFACE, WATER

Investigated Inspection
#	Inspection	Age	Sex	Degree of Injury	Nature of Injury	Occupation
1	312555451			Fatality	Fracture	Occupation not reported

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