FOUNTAIN VALLEY, CA —
OSHA Injury Report: 0411 - FOUNTAIN VALLEY CA
Injury · Job transfer or restriction
At a glance
On , an injury at 0411 - FOUNTAIN VALLEY CA in FOUNTAIN VALLEY, CA 85008 resulted in job transfer or restriction. Employee was mAINTENANCE CLERK in wholesale Grocer.
Where did this happen?
- Establishment
- 0411 - FOUNTAIN VALLEY CA
- Parent company
- Costco Wholesale
- Street
- 17900 NEWHOPE STREET
- City
- FOUNTAIN VALLEY
- State
- CA
- ZIP
- 85008
- On-site location
- OUTSIDE PARKING LOT
What was the outcome?
- Outcome
- Job transfer or restriction (code 3)
- Type
- Injury (code 1)
- Days restricted or transferred
- 63
Before the incident
Setting up a pressure washer
What happened
[REDACTED] was setting up pressure washer outside and tripped on a planter
Injury or illness
Bruise or Contusion Shoulder Left Side
Object or substance involved
Floor Walking Surface
Summary line
Bruise or Contusion Shoulder Left Side Fall from Same Level Floor Walking Surface
Employee and industry
- Job description
- MAINTENANCE CLERK
- SOC code
- 49-9071 — Maintenance and Repair Workers, General
- NAICS code
- 455211 — Wholesale Grocer
- NAICS vintage
- 2022
- Avg employees
- 412
- Total hours worked
- 614920
- EIN
- 911223280
- Establishment ID
- 1217365
- Employer case #
- WC608G8032
When (timing detail)
- Date of incident
- Shift started
- 4:00:00.000
- Submitted
- 04MAR24:19:34:00
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.