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Inspection Detail
Inspection: 125531525 - Safeway Inc.
Inspection Information - Office: American Canyon District Office
Site Address:
Safeway Inc.
100 Calistoga Rd
Santa Rosa, CA 95405
Mailing Address:
Po Box 9070, Pleasanton, CA 94588
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: 04/14/2005
Planning Guide: Safety-Manufacturing
Emphasis:
Case Closed: 05/05/2005
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 361601875 |
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 2 | 2 | ||||
| Current Violations | ||||||
| Initial Penalty | $0 | $0 | $0 | $450 | $0 | $450 |
| Current Penalty | $0 | $0 | $0 | $0 | $0 | $0 |
| 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 | 4186 B | 04/25/2005 | 05/12/2005 | $0 | $225 | $0 | I - Informal Settlement | Citation has been deleted. | |
| 2. | 01002 | Other | 3249 B | 04/25/2005 | 05/12/2005 | $0 | $225 | $0 | I - Informal Settlement | Citation has been deleted. |
Investigation Summary
At approximately 11:30 p.m. on April 11, 2005, Safeway employees were engaged in horseplay in the store parking lot. Employee #1 jumped on the back of a coworker's car. When the coworker backed the car and turned into a parking spot, Employee #1 fell off. Her face struck the pavement, and she lost consciousness. Employee #1 was hospitalized for a concussion, a cervical disc injury, and a left hand fracture.
Keywords: FRACTURE, UNCONSCIOUSNESS, STRUCK AGAINST, RIDING ON EQUIPMENT, BACK, FALL, NECK, CONCUSSION, FACE, HORSEPLAY
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 125531525 | Hospitalized injury | Concussion | Stock handlers and baggers |