DeForest, WI —
OSHA Injury Report: American Girl Retail, Inc.
Injury · Other recordable case
At a glance
On , an injury at American Girl Retail, Inc. in 612 Burton Blvd, DeForest, WI 53532 resulted in other recordable case. Employee was custodian NE in general warehousing and storage.
Where did this happen?
- Establishment
- American Girl Retail, Inc.
- Parent company
- Mattel
- Street
- 612 Burton Blvd
- City
- DeForest
- State
- WI
- ZIP
- 53532
- On-site location
- Truck Driver Entryway
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Vacuuming a rug the rug came up causing her to lose balance and fall. Complained about back and side pain. Incident described through interpreter. Description was typed and signed by [REDACTED] - AG security officer. At [REDACTED] [REDACTED] [REDACTED] and [REDACTED] came to the lobby to inform myself and [REDACTED] that there was and injured employee at the 2nd floor first aid room. Told she hurt her back. [REDACTED] and I went up to the 2nd floor first aid room at [REDACTED]. She sitting on the couch cot crying and holding her right side. [REDACTED] was asked to be there as an interpreter. He asked her what caused the injury to her back. She said she was vacuuming a rug by the downstairs men 's bathroom and it came up causing her to fall down. She stood up and felt pain in her back and right side. Asked what time it happened and she said [REDACTED]. Asked her if she would like to lie down. She did but appeared to be in pain. At [REDACTED] her supervisor [REDACTED] came up to the room
What happened
Vacuuming a rug the rug came up causing her to lose balance and fall. Complained about back and side pain. Incident described through interpreter. Description was typed and signed by [REDACTED] - AG security officer At [REDACTED] [REDACTED] [REDACTED] and [REDACTED] came to the lobby to inform myself and [REDACTED] that there was and injured employee at the 2nd floor first aid room. Told she hurt her back. [REDACTED] and I went up to the 2nd floor first aid room at [REDACTED]. She sitting on the couch cot crying and holding her right side. [REDACTED] was asked to be there as an interpreter. He asked her what caused the injury to her back. She said she was vacuuming a rug by the downstairs men 's bathroom and it came up causing her to fall down. She stood up and felt pain in her back and right side. Asked what time it happened and she said [REDACTED]. Asked her if she would like to lie down. She did but appeared to be in pain. At [REDACTED] her supervisor [REDACTED] came up to the room
Injury or illness
Vacuuming a rug the rug came up causing her to lose balance and fall. Complained about back and side pain. Incident described through interpreter. Description was typed and signed by [REDACTED] - AG security officer At 9:10AM 7 24 2023 [REDACTED] and [REDACTED] came to the lobby to inform myself and [REDACTED] that there was and injured employee at the 2nd floor first aid room. Told she hurt her back. [REDACTED] and I went up to the 2nd floor first aid room at 9:12AM. She sitting on the couch cot crying and holding her right side. [REDACTED] was asked to be there as an interpreter. He asked her what caused the injury to her back. She said she was vacuuming a rug by the downstairs men 's bathroom and it came up causing her to fall down. She stood up and felt pain in her back and right side. Asked what time it happened and she said 8:45AM. Asked her if she would like to lie down. She did but appeared to be in pain. At 9:14AM her supervisor [REDACTED] came up to the room to see abou
Object or substance involved
Vacuuming a rug the rug came up causing her to lose balance and fall. Complained about back and side pain. Incident described through interpreter. Description was typed and signed by [REDACTED] - AG security officer At 9:10AM 7 24 2023 [REDACTED] and [REDACTED] came to the lobby to inform myself and [REDACTED] that there was and injured employee at the 2nd floor first aid room. Told she hurt her back. [REDACTED] and I went up to the 2nd floor first aid room at 9:12AM. She sitting on the couch cot crying and holding her right side. [REDACTED] was asked to be there as an interpreter. He asked her what caused the injury to her back. She said she was vacuuming a rug by the downstairs men 's bathroom and it came up causing her to fall down. She stood up and felt pain in her back and right side. Asked what time it happened and she said 8:45AM. Asked her if she would like to lie down. She did but appeared to be in pain. At 9:14AM her supervisor [REDACTED] came up to the room to see abou
Summary line
Vacuuming a rug the rug came up causing her to lose balance and fall. Complained about back and side pain. Incident described through interpreter. Description was typed and signed by [REDACTED] - AG security officer At [REDACTED] [REDACTED] [REDACTED]
Employee and industry
- Job description
- Custodian NE
- SOC code
- 37-2011 — Janitors and Cleaners, Except Maids and Housekeeping Cleaners
- NAICS code
- 493110 — General warehousing and storage
- NAICS vintage
- 2022
- Avg employees
- 141
- Total hours worked
- 102553
- EIN
- 562418552
- Establishment ID
- 1182648
- Employer case #
- 1
When (timing detail)
- Date of incident
- Shift started
- 7:00:00.000
- Time of incident
- 8:53:00.000
- Filing year
- 2023
- Submitted
- 28FEB24:16:25:00
More injuries in this industry (NAICS 493110)
Rancho Cucamonga, CA—
087-RCDC
MATTESON, IL—
WM 6504
COLDWATER, MI—
WM 6043
MARCY, NY—
WM 6038
CULLMAN, AL—
WM 6006
More injuries in WI
CHIPPEWA FALLS, WI—
WM 5373
PLYMOUTH, WI—
WM 3497
HUDSON, WI—
8900 HUDSON HOSPITAL CLINICS
Brodhead, WI—
Kuhn North America
Brodhead, WI—
Kuhn North America
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.