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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Fort Wayne, IN —

OSHA Injury Report: Evergreen Village at Fort Wayne

Injury · Other recordable case

At a glance

On , an injury at Evergreen Village at Fort Wayne in 12523 Auburn Rd, Fort Wayne, IN 46845 resulted in other recordable case. Employee was cook in assisted-living facilities without on-site nursing care facilities.

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Where did this happen?

Establishment
Evergreen Village at Fort Wayne
Parent company
Evergreen Village at Fort Wayne
Street
12523 Auburn Rd
City
Fort Wayne
State
IN
ZIP
46845
On-site location
Kitchen

What was the outcome?

Outcome
Other recordable case (code 4)
Type
Injury (code 1)

Before the incident

Cutting food

What happened

cutting food and cut left hand

Injury or illness

cut to left hand

Object or substance involved

knife

Summary line

Laceration to left hand

Employee and industry

Job description
Cook
SOC code
35-2012 — Cooks, Institution and Cafeteria
NAICS code
623312 — Assisted-living facilities without on-site nursing care facilities
NAICS vintage
2022
Avg employees
51
Total hours worked
79092
EIN
830615937
Establishment ID
1005464
Employer case #
2

When (timing detail)

Date of incident
Shift started
6:00:00.000
Time of incident
9:00:00.000
Filing year
2023
Submitted
19FEB24:20:51:00

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Source

Data from OSHA ITA Form 300/301 electronic submissions, filing year 2023. ITA Case Detail records are establishment-reported submissions, not OSHA inspections — no per-record IMIS deep link exists.