SAN CLEMENTE, CA ·
OSHA Injury Report: ABS-0029-0028-04563 FAC-04563-SAN CLEMENTE-CA
Other illness · Other recordable case
At a glance
On , an other illness at ABS-0029-0028-04563 FAC-04563-SAN CLEMENTE-CA in 989 AVENDIA PICO, SAN CLEMENTE, CA 92673 resulted in other recordable case. Employee was food Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- ABS-0029-0028-04563 FAC-04563-SAN CLEMENTE-CA
- Parent company
- The Vons Companies Inc
- Street
- 989 AVENDIA PICO
- City
- SAN CLEMENTE
- State
- CA
- ZIP
- 92673
- On-site location
- BACKROOM
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Other illness (code 6)
Before the incident
PRODUCT SELECTION
What happened
EE was beginning to fill light head and decided to go to the breakroom and sit down Once he passed through the double doors he passed out fell He hit the back of his head He got up proceeded to breakroom and passed out again for 3 5 second
Injury or illness
Concussion Skull Strained Faint
Object or substance involved
Faint
Summary line
EE was beginning to fill light head and decided to go to the breakroom and sit down Once he passed through the double doors he passed out fell He hit the back of his head He got up proceeded to breakroom and passed out again for 3 5 second
Employee and industry
- Job description
- Food Clerk
- SOC code
- 53-7065: Stockers and Order Fillers
- NAICS code
- 445110: Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Employees at this establishment (2025 average)
- 107
- Hours worked at this establishment (2025 total)
- 179,655
- EIN
- 381623900
- Establishment ID
- 1142016
- Employer case #
- 107189
When (timing detail)
- Date of incident
- Shift started
- 11:09
- Time of incident
- 12:55
- Filing year
- 2025
- Submitted to OSHA
- 2026-02-21
More injuries at ABS-0029-0028-04563 Fac-04563-San Clemente-Ca
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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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