Fond du Lac, WI ·
OSHA Injury Report: Agnesian St. Francis Home
Injury · Days away from work
At a glance
On , an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in days away from work. Employee was assisted Living Representative LTC in nursing Care Facilities Skilled Nursing Facilities.
Where did this happen?
- Establishment
- Agnesian St. Francis Home
- Parent company
- SSM Health
- Street
- 33 Everett Street
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- Basement corridor
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 7
- Days restricted or transferred
- 9
Before the incident
Staff member 's toe stuck to the floor as she was walking. She fell head first into the floor.
What happened
EE 's toe stuck to floor when walking causing head to strike floor with ribcage fracture.
Injury or illness
Fracture
Object or substance involved
Fall Slip Trip All Other
Summary line
Staff member 's toe stuck to the floor as she was walking. She fell head first into the floor.
Employee and industry
- Job description
- Assisted Living Representative LTC
- SOC code
- 31-1131: Nursing Assistants
- NAICS code
- 623110: Nursing Care Facilities Skilled Nursing Facilities
- NAICS vintage
- 2012
- Employees at this establishment (2024 average)
- 191
- Hours worked at this establishment (2024 total)
- 279,848
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC175813
When (timing detail)
- Date of incident
- Shift started
- 06:00
- Time of incident
- 11:15
- Filing year
- 2024
- Submitted to OSHA
- 2025-02-08
More injuries at Agnesian St. Francis Home
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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