Pacoima, CA —
OSHA Injury Report: 704-00377
Injury · Other recordable case
At a glance
On , an injury at 704-00377 in 12765 Van Nuys Blvd, Pacoima, CA 91331 resulted in other recordable case. Employee was dELI BAKERY LEA in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 704-00377
- Parent company
- Food 4 Less FoodsCo
- Street
- 12765 Van Nuys Blvd
- City
- Pacoima
- State
- CA
- ZIP
- 91331
- On-site location
- DELI FREEZER
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
WALKING
What happened
EE WAS WALKING OUT OF THE FREEZER AND SLIPPED AND FELL ON HER TAILBONED HURTING HER RIGHT KNEE AND HER NECK
Injury or illness
Strained Right Knee Fall FREEZER FLOOR
Object or substance involved
FREEZER FLOOR
Summary line
Strained Right Knee Fall FREEZER FLOOR
Employee and industry
- Job description
- DELI BAKERY LEA
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 75
- Total hours worked
- 106200
- EIN
- 951456805
- Establishment ID
- 967172
- Employer case #
- 866274
When (timing detail)
- Date of incident
- Shift started
- 6:00:00.000
- Time of incident
- 9:30:00.000
- Filing year
- 2023
- Submitted
- 28FEB24:17:07:00
More injuries at 704-00377
View 704-00377'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.