Bloomington, IN —
OSHA Injury Report: Evergreen Village at Bloomington
Injury · Other recordable case
At a glance
On , an injury at Evergreen Village at Bloomington in Bloomington, IN 47401 resulted in other recordable case. Employee was certified Nursing Assistant in assisted-living facilities with on-site nursing facilities.
Where did this happen?
- Establishment
- Evergreen Village at Bloomington
- Parent company
- Gardant Management Solutions/Evergreen Village
- Street
- 3607 South Heirloom Drive, Bloomington
- City
- Bloomington
- State
- IN
- ZIP
- 47401
- On-site location
- 2nd Floor Hallway
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Escorting a resident back to her room. Stand by assist as needed.
What happened
As the employee was providing assistance she tripped on the carpet and fell to the floor without catching herself. She landed on her face and right hip.
Injury or illness
Pain bruising to the effected areas.
Object or substance involved
Floor- due to trip.
Summary line
Fall with bruising to the face and hip
Employee and industry
- Job description
- Certified Nursing Assistant
- SOC code
- 31-1131 — Nursing Assistants
- NAICS code
- 623311 — Assisted-living facilities with on-site nursing facilities
- NAICS vintage
- 2022
- Avg employees
- 68
- Total hours worked
- 93493
- Establishment ID
- 819971
- Employer case #
- UHC2306339
When (timing detail)
- Date of incident
- Shift started
- 6:00:00.000
- Time of incident
- 16:15:00.000
- Submitted
- 30JAN24:17:15:00
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.