Inspection Detail
Inspection: 316113810 - Team Carolinas, Inc. Dba Domino'S Pizza
Inspection Information - Office: Nc Department Of Labor - Charlotte
Site Address:
Team Carolinas, Inc. Dba Domino'S Pizza
623 Highway 29 North
China Grove, NC 28023
Mailing Address:
623 Highway 29 North, China Grove, NC 28144
Union Status: NonUnion
SIC:5812
NAICS: 722211/Limited-Service Restaurants
Inspection Type: Accident
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Safety
Close Conference: 11/02/2011
Planning Guide: Safety-Manufacturing
Emphasis:
Case Closed: 01/04/2012
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 102100302 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $0 | $0 | $0 | $2,250 | $0 | $2,250 |
| Current Penalty | $0 | $0 | $0 | $500 | $0 | $500 |
| 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 | 19040039 A | 11/22/2011 | 11/25/2011 | $500 | $2,250 | $0 | I - Informal Settlement |
Investigation Summary
On July 28, 2011, Employee #1 was walking up to a residence to deliver a pizza, when he apparently fell from the front porch of the residence, striking his head on the sidewalk. Employee #1 was killed.
Keywords: DELIVERY WORK, HEAD, STRUCK AGAINST, WALKING SURFACE, FALL, CONCRETE
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 316113810 | Fatality | Other | Occupation not reported |
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