Racine, WI —
OSHA Injury Report: 534-00378
Injury · Days away from work
At a glance
On , an injury at 534-00378 in 5111 Douglas Ave, Racine, WI 53402 resulted in days away from work. Employee was bAKERY CLERK in supermarkets and Other Grocery Except Convenience Stores.
Where did this happen?
- Establishment
- 534-00378
- Parent company
- Roundy's
- Street
- 5111 Douglas Ave
- City
- Racine
- State
- WI
- ZIP
- 53402
- On-site location
- BY THE TIME CLOCK
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 16
Before the incident
REACHING FOR HER NAME TAG
What happened
EE was going to clock in and when she reached over to get her name tag out of her purse she lost her balance she fell over EE sustained cut on her nose EE has received medical attention
Injury or illness
Lacerated Anterior Nose Fall FLOOR
Object or substance involved
FLOOR
Summary line
Lacerated Anterior Nose Fall FLOOR
Employee and industry
- Job description
- BAKERY CLERK
- SOC code
- 51-3011 — Bakers
- NAICS code
- 445110 — Supermarkets and Other Grocery Except Convenience Stores
- NAICS vintage
- 2022
- Avg employees
- 126
- Total hours worked
- 152304
- EIN
- 390854535
- Establishment ID
- 966292
- Employer case #
- 866526
When (timing detail)
- Date of incident
- Shift started
- 12:00:00.000
- Time of incident
- 12:05:00.000
- Filing year
- 2023
- Submitted
- 28FEB24:20:55:00
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View 534-00378'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.