Rochester, IN —
OSHA Injury Report: 021-00427
Injury · Other recordable case
At a glance
On , an injury at 021-00427 in Rochester, IN 46975 resulted in other recordable case. Employee was coffee Shop Cle in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 021-00427
- Parent company
- Kroger Central KMA
- Street
- 2040 Peace Tree Vlg
- City
- Rochester
- State
- IN
- ZIP
- 46975
- On-site location
- STARBUCKS NEAR NAPKIN DISPENSERS
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
WALKING TO REFILL NAPKINS
What happened
EE TRIPPED AND FELL OVER WET FLOOR SIGN EE HAS PAIN TO HER RIGHT SHOULDER LEFT KNEE CUT TO RIGHT RING FINGER
Injury or illness
Strained Right Upper arm Fall on same level FLOOR
Object or substance involved
FLOOR
Summary line
Strained Right Upper arm Fall on same level FLOOR
Employee and industry
- Job description
- Coffee Shop Cle
- SOC code
- 9999 — Uncoded
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2012
- Avg employees
- 123
- Total hours worked
- 174278
- EIN
- 311569568
- Establishment ID
- 963668
- Employer case #
- 867278
When (timing detail)
- Date of incident
- Shift started
- 5:10
- Time of incident
- 6:20
- Filing year
- 2024
- Submitted
- 25FEB2025:19:46:00
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.