Fond du Lac, WI —
OSHA Injury Report: Agnesian St. Francis Home
Injury · Other recordable case
At a glance
On , an injury at Agnesian St. Francis Home in 33 Everett Street, Fond du Lac, WI 54935 resulted in other recordable case. Employee was admin SpvRN LTC S 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
- Conference Room
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Walking behind chair when another employee moved their computer charging cord causing me to trip over it landing on my right knee.
What happened
coworker moved their computer charging cord causing employee to fall and injury right knee
Injury or illness
Contusion
Object or substance involved
Cord
Summary line
Walking behind chair when another employee moved their computer charging cord causing me to trip over it landing on my right knee.
Employee and industry
- Job description
- Admin SpvRN LTC S
- SOC code
- 9999 — Uncoded
- NAICS code
- 623110 — Nursing Care Facilities Skilled Nursing Facilities
- NAICS vintage
- 2012
- Avg employees
- 191
- Total hours worked
- 279848
- EIN
- 391029998
- Establishment ID
- 662786
- Employer case #
- WC174966
When (timing detail)
- Date of incident
- Shift started
- 7:40
- Time of incident
- 9:45
- Filing year
- 2024
- Submitted
- 08FEB2025:02:53:00
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View Agnesian St. Francis Home's full OSHA safety record →
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Source
Data from OSHA ITA Form 300/301 electronic submissions, filing year 2024. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.