Fort Wayne, IN —
OSHA Injury Report: Evergreen Village at Fort Wayne
Injury · Days away from work
At a glance
On , an injury at Evergreen Village at Fort Wayne in Fort Wayne, IN 46845 resulted in days away from work. Employee was cNA in assisted-living facilities without on-site nursing care facilities.
Where did this happen?
- Establishment
- Evergreen Village at Fort Wayne
- Parent company
- Evergreen Village at Fort Wayne
- Street
- 12523 Auburn Rd
- City
- Fort Wayne
- State
- IN
- ZIP
- 46845
- On-site location
- Parking lot
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 2
Before the incident
walking
What happened
Slipped on ice walking in the parking lot
Injury or illness
no apparent injury noted per employee but soreness
Object or substance involved
ice in parking lot
Summary line
slipped and fell on ice injured right leg and buttocks
Employee and industry
- Job description
- CNA
- SOC code
- 31-1131 — Nursing Assistants
- NAICS code
- 623312 — Assisted-living facilities without on-site nursing care facilities
- NAICS vintage
- 2022
- Avg employees
- 51
- Total hours worked
- 79092
- EIN
- 830615937
- Establishment ID
- 1005464
- Employer case #
- 4
When (timing detail)
- Date of incident
- Shift started
- 22:00:00.000
- Time of incident
- 5:40:00.000
- Submitted
- 19FEB24:21:01:00
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.