BLOOMINGTON, IL —
OSHA Injury Report: NAI-0032-0032-00116 FAC-00116-BLOOMINGTON-IL
Injury · Other recordable case
At a glance
On , an injury at NAI-0032-0032-00116 FAC-00116-BLOOMINGTON-IL in BLOOMINGTON, IL 61701 resulted in other recordable case. Employee was courtesy Clerk in supermarkets and Other Grocery except Convenience Stores.
Where did this happen?
- Establishment
- NAI-0032-0032-00116 FAC-00116-BLOOMINGTON-IL
- Parent company
- Jewel Food Stores Inc
- Street
- 2203 EAST OAKLAND AVE
- City
- BLOOMINGTON
- State
- IL
- ZIP
- 61701
- On-site location
- BREAKROOM
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
NORMAL JOB DUTIES
What happened
Walking up to breakroom Stepped into the breakroom and fell Fell on back Floorcare was mopping at the time Left arm and back sore Now has a headache
Injury or illness
Strained Left Lower arm Fall Floor
Object or substance involved
Floor
Summary line
Walking up to breakroom Stepped into the breakroom and fell Fell on back Floorcare was mopping at the time Left arm and back sore Now has a headache
Employee and industry
- Job description
- Courtesy Clerk
- SOC code
- 53-7064 — Packers and Packagers, Hand
- NAICS code
- 445110 — Supermarkets and Other Grocery except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 149
- Total hours worked
- 165390
- EIN
- 361282500
- Establishment ID
- 1140660
- Employer case #
- 85707
When (timing detail)
- Date of incident
- Shift started
- 7:00
- Time of incident
- 5:46
- Filing year
- 2024
- Submitted
- 24FEB2025:18:53:00
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.