Centerville, IN —
OSHA Injury Report: Ambassador Centerville Management LLC
Injury · Other recordable case
At a glance
On , an injury at Ambassador Centerville Management LLC in Centerville, IN 47330 resulted in other recordable case. Employee was certified Nursing Assistant in nursing Care Facility.
Where did this happen?
- Establishment
- Ambassador Centerville Management LLC
- Parent company
- Ambassador Centerville Management LLC
- Street
- 705 East Main Street
- City
- Centerville
- State
- IN
- ZIP
- 47330
- On-site location
- Supply room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
She went into the supply room to get supplies for the resident.
What happened
As she was walking out of the supply room her feet got tangled in a packing belt that came out of a box. She fell on both knees and hands.
Injury or illness
Swelling and bruising to both knees.
Object or substance involved
Packing belt
Summary line
Swelling and bruising to both knees.
Employee and industry
- Job description
- Certified Nursing Assistant
- SOC code
- 31-1131 — Nursing Assistants
- NAICS code
- 623110 — Nursing Care Facility
- NAICS vintage
- 2012
- Avg employees
- 180
- Total hours worked
- 243445
- Establishment ID
- 958251
- Employer case #
- 0004
When (timing detail)
- Date of incident
- Shift started
- 5:00
- Filing year
- 2024
- Submitted
- 10FEB2025:21:49:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.