SAN PABLO, CA ·
OSHA Injury Report: 20500002-568 STORE 568 - SAN PABLO
Injury · Days away from work
At a glance
On , an injury at 20500002-568 STORE 568 - SAN PABLO in 13110 SAN PABLO AVENUE, SAN PABLO, CA 94805 resulted in days away from work. Employee was assistant Manag in supermarkets and Other Grocery Retailers except Convenience Retailers.
Where did this happen?
- Establishment
- 20500002-568 STORE 568 - SAN PABLO
- Parent company
- Smart and Final STORE
- Street
- 13110 SAN PABLO AVENUE
- City
- SAN PABLO
- State
- CA
- ZIP
- 94805
- On-site location
- SALESFLOOR
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 10
- Days restricted or transferred
- 99
Before the incident
NORMAL DUTIES
What happened
Per report Employee states she was ambulating with her cane employee slipped on ice with left foot but did not fall Presenting Complaint Left FOOT Left BACK LOWER LUMBAR SACRAL Left ARM LOWER Left ARM UPPER EE given a provider referral
Injury or illness
Strained Back Slipped Bodily reaction
Object or substance involved
Bodily reaction
Summary line
Per report Employee states she was ambulating with her cane employee slipped on ice with left foo
Employee and industry
- Job description
- Assistant Manag
- SOC code
- 9999: Uncoded
- NAICS code
- 445110: Supermarkets and Other Grocery Retailers except Convenience Retailers
- NAICS vintage
- 2022
- Employees at this establishment (2024 average)
- 116
- Hours worked at this establishment (2024 total)
- 71,578
- EIN
- 954297897
- Establishment ID
- 1117584
- Employer case #
- 13619
When (timing detail)
- Date of incident
- Shift started
- 17:00
- Time of incident
- 19:22
- Filing year
- 2024
- Submitted to OSHA
- 2025-02-27
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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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