Dousman, WI —
OSHA Injury Report: Wisconsin Masonic Home Inc. CP/RSL/MW
Injury · Other recordable case
At a glance
On , an injury at Wisconsin Masonic Home Inc. CP/RSL/MW in Dousman, WI 53118 resulted in other recordable case. Employee was culinary Technician in assisted-living facilities without on-site nursing care facilities.
Where did this happen?
- Establishment
- Wisconsin Masonic Home Inc. CP/RSL/MW
- Parent company
- Wisconsin Masonic Home inc.
- Street
- 410 N. Main Street
- City
- Dousman
- State
- WI
- ZIP
- 53118
- On-site location
- Bathroom
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Having an asthma attack.
What happened
Employee dropped inhaler then leaned on the sink to reach for it. The sink gave way and the employee struck their head on the sink while falling.
Injury or illness
Laceration above the eye.
Object or substance involved
Sink.
Summary line
Laceration above the eye after hitting sink.
Employee and industry
- Job description
- Culinary Technician
- SOC code
- 35-2021 — Food Preparation Workers
- NAICS code
- 623312 — Assisted-living facilities without on-site nursing care facilities
- NAICS vintage
- 2012
- Avg employees
- 204
- Total hours worked
- 250064
- EIN
- 390813463
- Establishment ID
- 62234
- Employer case #
- CP-25-2
When (timing detail)
- Date of incident
- Shift started
- 11:00
- Time of incident
- 19:05
- Filing year
- 2025
- Submitted
- 02MAR26:16:20:00
Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2025. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.