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Safety Incidents OSHA Severe Injury Reports · 2015–2025

OSHA Injury Report: Janesville - Main Store

Injury · Days away from work

On , an injury at Janesville - Main Store in Janesville, WI 53545 resulted in days away from work. Employee was courtesy Clerk in supermarkets and Other Grocery except Convenience Stores.

Establishment
Janesville - Main Store
Parent company
HYVEE INC
Street
5884 Westown Parkway
City
Janesville
State
WI
ZIP
53545
On-site location
Property of Mitch Woodstock 2721 S. Tollefson Rd. Orfordville WI 53576 608-728-3088
Outcome
Days away from work (code 2)
Type
Injury (code 1)
Days away from work
15
Days restricted or transferred
15

Delivering flowers

[REDACTED] got out of the van and was greeted by 2 dogs (small black lab and believes a golden retriever) both friendly. [REDACTED] started walking up to the house on a paved walkway with the golden following him. About 10 feet from the steps the golden retriever cut in front of him and [REDACTED] fell forward and to the left landing on his left side elbow that was tucked against his body clipboard in left hand and flowers in the right hand. [REDACTED] got up and walked up the steps to the door ringing the doorbell a few times then called the man to notify him that he had a floral delivery. The man asked about his two rugrats [REDACTED] left the flowers on the table as instructed and walked to the van being escorted by the two friendly dogs and [REDACTED] left.

INJURY TYPE: Fracture || BODY PART(S) AFFECTED: - Chest(Ribs Sternum & Soft Tissue)

carrying a clipboard and floral arrangement

Closed fracture of multiple ribs left side from a fall.

Job description
Courtesy Clerk
SOC code
53-7064 — Packers and Packagers, Hand
NAICS code
445110 — Supermarkets and Other Grocery except Convenience Stores
NAICS vintage
2012
Avg employees
246
Total hours worked
319621
EIN
420325638
Establishment ID
1028340
Employer case #
2024-5
Date of incident
Shift started
8:00
Time of incident
11:30
Filing year
2024
Submitted
28FEB2025:20:13:00

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.