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Inspection Detail
Case Status: CLOSED
Inspection: 1487472.015 - Forest Manor Inc. D/B/A
Inspection Information - Office: Long Island Area Office
Inspection Nr: 1487472.015
Report ID: 0214700
Date Opened: 08/10/2020
Site Address:
Forest Manor Inc. D/B/A
6 Medical Plaza
Glen Cove, NY 11542
Mailing Address:
6 Medical Plaza, Glen Cove, NY 11542
Union Status: NonUnion
SIC:
NAICS: 623110/Nursing Care Facilities
Inspection Type: Fat/Cat
Scope: Partial
Advanced Notice: N
Ownership: Private
Safety/Health: Health
Close Conference: 08/10/2020
Emphasis:
Case Closed: 11/08/2021
| Type | Activity Nr | Safety | Health |
|---|---|---|---|
| Accident | 1640997 |
Case Status: CLOSED
| Violations/Penalties | Serious | Willful | Repeat | Other | Unclass | Total |
|---|---|---|---|---|---|---|
| Initial Violations | 1 | 1 | ||||
| Current Violations | 1 | 1 | ||||
| Initial Penalty | $13,494 | $0 | $0 | $0 | $0 | $13,494 |
| Current Penalty | $8,100 | $0 | $0 | $0 | $0 | $8,100 |
| 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. | 01001A | Serious | 19100134 C01 | 11/02/2020 | 11/30/2020 | $8,100 | $13,494 | $0 | I - Informal Settlement | ||
| 2. | 01001B | Serious | 19100134 E01 | 11/02/2020 | 11/30/2020 | $0 | $0 | $0 | I - Informal Settlement | ||
| 3. | 01001C | Serious | 19100134 F02 | 11/02/2020 | 11/30/2020 | $0 | $0 | $0 | I - Informal Settlement | ||
| 4. | 01001D | Serious | 19100134 H02 I | 11/02/2020 | 11/30/2020 | $0 | $0 | $0 | I - Informal Settlement | ||
| 5. | 01001E | Serious | 19100134 K01 | 11/02/2020 | 11/30/2020 | $0 | $0 | $0 | I - Informal Settlement |
Investigation Summary
Investigation Nr: 128476.015
Event: 04/23/2020
Employee with COVID-19 infection dies
At 9:00 a.m. on April 23, 2020, an employee became infected with COVID-19 and died.
Keywords: Infectious Disease
| # | Inspection | Age | Sex | Degree of Injury | Nature of Injury | Occupation |
|---|---|---|---|---|---|---|
| 1 | 1487472.015 | 60 | M | Fatality | Physical therapists |