Santa Rosa, CA —
OSHA Injury Report: Spring Lake Village
Injury · Other recordable case
At a glance
On , an injury at Spring Lake Village in Santa Rosa, CA 95409 resulted in other recordable case. Employee was lead Server in retirement communities, continuing care.
Where did this happen?
- Establishment
- Spring Lake Village
- Parent company
- Front Porch
- Street
- 5555 Montgomery Dr.
- City
- Santa Rosa
- State
- CA
- ZIP
- 95409
- On-site location
- Dining room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
employee was walking by the dining area
What happened
Employee tripped on a wheel of a walker that was protruding from under a storage island causing him to fall on his back with his right elbow hitting the ground
Injury or illness
right elbow contusion
Object or substance involved
walker wheel
Summary line
right elbow contusion
Employee and industry
- Job description
- Lead Server
- SOC code
- 9999 — Uncoded
- NAICS code
- 623311 — Retirement communities, continuing care
- NAICS vintage
- 2022
- Avg employees
- 230
- Total hours worked
- 354267
- EIN
- 954538269
- Establishment ID
- 1125235
- Employer case #
- 14
When (timing detail)
- Date of incident
- Shift started
- 10:58:00.000
- Time of incident
- 18:00:00.000
- Submitted
- 29FEB24:02:18:00
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.