Fond du Lac, WI —
OSHA Injury Report: Agnesian St. Francis Home
Injury · Job transfer or restriction
At a glance
On , an injury at Agnesian St. Francis Home in Fond du Lac, WI 54935 resulted in job transfer or restriction. Employee was food Service Associate LTC in nursing Care Facilities (Skilled Nursing Facilities).
Where did this happen?
- Establishment
- Agnesian St. Francis Home
- Parent company
- SSM Health
- Street
- 33 Everett Street
- City
- Fond du Lac
- State
- WI
- ZIP
- 54935
- On-site location
- Kitchen Dietary
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 11
Before the incident
Lifting
What happened
I was lifting pans out of the hotbox and must have moved wrong
Injury or illness
Strain
Object or substance involved
NonPatient Handling HoldingCarrying
Summary line
I was lifting pans out of the hotbox and must have moved wrong
Employee and industry
- Job description
- Food Service Associate LTC
- SOC code
- 35-3041 — Food Servers, Nonrestaurant
- NAICS code
- 623110 — Nursing Care Facilities (Skilled Nursing Facilities)
- NAICS vintage
- 2022
- Avg employees
- 188
- Total hours worked
- 264568
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC170309
When (timing detail)
- Date of incident
- Shift started
- 6:00:00.000
- Time of incident
- 12:15:00.000
- Submitted
- 29FEB24:21:33:00
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.