Safety Incidents OSHA Severe Injury Reports · 2015–2025
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OSHA Injury Report: Southfork

Injury · Other recordable case

On , an injury at Southfork in 1345 Jonestown Rd, Winston Salem, NC 27103 resulted in other recordable case. Employee was executive Director in assisted-living facilities without on-site nursing care facilities.

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Establishment
Southfork
Street
1345 Jonestown Rd
City
Winston Salem
State
NC
ZIP
27103
On-site location
dining room
Outcome
Other recordable case (code 4)
Type
Injury (code 1)

employee walked into dining room

employee walked into dining room to set the table and slipped in small puddle of water caused left foot to go out in front of her fell on right knee

right knee contusion

slip fall

employee walked into dining room to set the table and slipped in small puddle of water caused left foot to go out in front of her fell on right knee

Job description
Executive Director
SOC code
11-9111: Medical and Health Services Managers
NAICS code
623312: Assisted-living facilities without on-site nursing care facilities
NAICS vintage
2022
Employees at this establishment (2023 average)
46
Hours worked at this establishment (2023 total)
82,570
EIN
871932840
Establishment ID
962856
Employer case #
2
Date of incident
Shift started
08:15
Time of incident
12:00
Filing year
2023
Submitted to OSHA
2024-02-07

Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections, so no per-record IMIS deep link exists.

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