Jackson, CA —
OSHA Injury Report: Amador Residential Care Facility
Other illness · Other recordable case
At a glance
On , an other illness at Amador Residential Care Facility in Jackson, CA 95642 resulted in other recordable case. Employee was cAREGIVER in assisted-living facilities without on-site nursing care facilities.
Where did this happen?
- Establishment
- Amador Residential Care Facility
- Parent company
- Amador Residential Care Facility
- Street
- 155 Placer Drive
- City
- Jackson
- State
- CA
- ZIP
- 95642
- On-site location
- RESIDENT ROOM
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Other illness (code 6)
Before the incident
SHE WAS CAREGIVING ASSISTING RESIDENT BACK TO BED
What happened
EMPLOYEE WAS REDIRECTING RESIDENT TO BED WHEN RESIDENT BECAME AGITATED AND ELBOWED EMPLOYEE IN THE FACE
Injury or illness
TOOTH DISLOCATION
Object or substance involved
RESIDENT ELBOW
Summary line
TOOTH DISLOCATION FROM RESIDENT [REDACTED]
Employee and industry
- Job description
- CAREGIVER
- SOC code
- 31-1122 — Personal Care Aides
- NAICS code
- 623312 — Assisted-living facilities without on-site nursing care facilities
- NAICS vintage
- 2022
- Avg employees
- 27
- Total hours worked
- 61573
- Establishment ID
- 1042134
- Employer case #
- 3
When (timing detail)
- Date of incident
- Shift started
- 22:00:00.000
- Time of incident
- 0:40:00.000
- Submitted
- 12MAR24:18:51:00
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.