Fond du Lac, WI ·
OSHA Injury Report: Agnesian St. Francis Home
Injury · Job transfer or restriction
At a glance
On , an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in job transfer or restriction. Employee was certified Nursing Assistant LTC in nursing Care Facilities Skilled Nursing Facilities.
Where did this happen?
- Establishment
- Agnesian St. Francis Home
- Parent company
- SSM Health
- Street
- 33 Everett Street
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- outside sidewalk
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 19
Before the incident
walking in from lunch break and observing resident getting into vehicle- tripped over curb walking back into building
What happened
I tripped and fell on my right side knee hip shoulder area. Once I entered the building
Injury or illness
Strain
Object or substance involved
Different Level - Height
Summary line
I was coming in from my lunch break at [REDACTED]. I was walking towards the entrance door and was looking at a resident that was leaving the building. Before I knew it I tripped and fell on my right side knee hip shoulder area.
Employee and industry
- Job description
- Certified Nursing Assistant LTC
- SOC code
- 31-1131: Nursing Assistants
- NAICS code
- 623110: Nursing Care Facilities Skilled Nursing Facilities
- NAICS vintage
- 2012
- Employees at this establishment (2025 average)
- 335
- Hours worked at this establishment (2025 total)
- 284,657
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC178193
When (timing detail)
- Date of incident
- Shift started
- 06:00
- Time of incident
- 12:00
- Filing year
- 2025
- Submitted to OSHA
- 2026-01-14
More injuries at Agnesian St. Francis Home
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.
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