Dousman, WI —
OSHA Injury Report: Wisconsin Masonic Home Inc. CP/RSL/MW
Injury · Days away from work
At a glance
On , an injury at Wisconsin Masonic Home Inc. CP/RSL/MW in Dousman, WI 53118 resulted in days away from work. Employee was facilities Lead 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
- Maintenance House
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 2
- Days restricted or transferred
- 17
Before the incident
Was walking through the maintenance house.
What happened
Missed a step going from one room to the other. Tripped and fell. Two steps.
Injury or illness
Contusion on left arm. Contusion on left ribs chest. Strained right knee.
Object or substance involved
Concrete floor. Wooden steps. His elbow is what pressed into his ribs when trying to break his fall and bruised those.
Summary line
Missed stairs from kitchen to shop and fell. Contusion left arm. Contusion left ribs & chest. Strained right knee.
Employee and industry
- Job description
- Facilities Lead
- SOC code
- 9999 — Uncoded
- NAICS code
- 623312 — Assisted-living facilities without on-site nursing care facilities
- NAICS vintage
- 2022
- Avg employees
- 181
- Total hours worked
- 231112
- EIN
- 390813463
- Establishment ID
- 62234
- Employer case #
- CP-23-4
When (timing detail)
- Date of incident
- Shift started
- 6:56:00.000
- Time of incident
- 13:45:00.000
- Submitted
- 16FEB24:15:38:00
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.