Centerville, IN —
OSHA Injury Report: Ambassador Centerville Management LLC
Injury · Other recordable case
At a glance
On , an injury at Ambassador Centerville Management LLC in Centerville, IN 47330 resulted in other recordable case. Employee was dietary in nursing homes.
Where did this happen?
- Establishment
- Ambassador Centerville Management LLC
- Parent company
- Ambassador Centerville Management LLC
- Street
- 705 East Main St.
- City
- Centerville
- State
- IN
- ZIP
- 47330
- On-site location
- Dietary stockroom
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
[REDACTED] was in the kitchen stockroom getting equipment he needed
What happened
He slipped in water and fell
Injury or illness
Pain to the right Knee
Object or substance involved
Water
Summary line
Slipped and fell right knee on water
Employee and industry
- Job description
- Dietary
- SOC code
- 31-9099 — Healthcare Support Workers, All Other
- NAICS code
- 623110 — Nursing homes
- NAICS vintage
- 2022
- Avg employees
- 165
- Total hours worked
- 5269295
- EIN
- 880564555
- Establishment ID
- 958251
- Employer case #
- 3
When (timing detail)
- Date of incident
- Shift started
- 6:00:00.000
- Time of incident
- 10:45:00.000
- Submitted
- 08FEB24:20:04:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year unspecified. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.