Fort Wayne, IN — 2023-01-19

OSHA Injury Report: Evergreen Village at Fort Wayne

Injury · Days away from work

At a glance

On 2023-01-19, an injury at Evergreen Village at Fort Wayne in 12523 Auburn Rd, Fort Wayne, IN 46845 resulted in days away from work. 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: Days away from work (code 2)
Type: Injury (code 1)
Days away from work: 1

Before the incident

dicing food

What happened

cut finger

Injury or illness

cut to left index finger

Object or substance involved

knife

Summary line

cut to left index finger with knife

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 #: 3

When (timing detail)

Date of incident: 2023-01-19
Shift started: 6:00:00.000
Filing year: 2023
Submitted: 19FEB24:20:55:00

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View Evergreen Village at Fort Wayne's full OSHA safety record →

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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.