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Safety Incidents OSHA Severe Injury Reports · 2015–2025

Fort Wayne, IN —

OSHA Injury Report: Evergreen Village at Fort Wayne

Injury · Days away from work

At a glance

On , an injury at Evergreen Village at Fort Wayne in 12523 Auburn Rd, Fort Wayne, IN 46845 resulted in days away from work. Employee was cNA 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
Parking lot

What was the outcome?

Outcome
Days away from work (code 2)
Type
Injury (code 1)
Days away from work
2

Before the incident

walking

What happened

Slipped on ice walking in the parking lot

Injury or illness

no apparent injury noted per employee but soreness

Object or substance involved

ice in parking lot

Summary line

slipped and fell on ice injured right leg and buttocks

Employee and industry

Job description
CNA
SOC code
31-1131 — Nursing Assistants
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 #
4

When (timing detail)

Date of incident
Shift started
22:00:00.000
Time of incident
5:40:00.000
Filing year
2023
Submitted
19FEB24:21:01:00

More injuries at Evergreen Village at Fort Wayne

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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.