PORT JERVIS, NY ·
OSHA Injury Report: H511-AHV-MOUNTAIN RD HV
Injury · Other recordable case
At a glance
On , an injury at H511-AHV-MOUNTAIN RD HV in 252 MOUNTAIN RD, PORT JERVIS, NY 12771 resulted in other recordable case. Employee was DSP in non-profit agency.
Where did this happen?
- Establishment
- H511-AHV-MOUNTAIN RD HV
- Parent company
- ADAPT OF THE HUDSON VALLEY
- Street
- 252 MOUNTAIN RD
- City
- PORT JERVIS
- State
- NY
- ZIP
- 12771
- On-site location
- Kitchen
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
removing a person supported from the living room due to a behavior
What happened
Person supported threw a grill at her
Injury or illness
Grill hit her in the back of the head
Object or substance involved
Grill
Summary line
Person supported threw a grill at her hitting her in the head
Employee and industry
- Job description
- DSP
- SOC code
- 00-9900: Insufficient Information - NIOSH
- NAICS code
- 623210: NON-PROFIT AGENCY
- NAICS vintage
- 2012
- Employees at this establishment (2025 average)
- 14
- Hours worked at this establishment (2025 total)
- 29,614
- EIN
- 862864372
- Establishment ID
- 1046728
- Employer case #
- 2602
When (timing detail)
- Date of incident
- Shift started
- 22:00
- Time of incident
- 08:00
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-04
More injuries at H511-Ahv-Mountain RD HV
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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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