Jefferson, IA —
OSHA Injury Report: Jefferson - Main Store
Injury · Days away from work
At a glance
On , an injury at Jefferson - Main Store in 106 W Washington St Ste 1, Jefferson, IA 50129 resulted in days away from work. Employee was hychi Clerk in supermarkets and Other Grocery (except Convenience) Stores.
Where did this happen?
- Establishment
- Jefferson - Main Store
- Parent company
- HY-VEE, INC.
- Street
- 106 W Washington St Ste 1
- City
- Jefferson
- State
- IA
- ZIP
- 50129
- On-site location
- Store sidewalk
What was the outcome?
- Outcome
- Days away from work (code 2)
- Type
- Injury (code 1)
- Days away from work
- 6
- Days restricted or transferred
- 6
Before the incident
riding his knee scooter
What happened
fell off his knee scooter coming into the store
Injury or illness
INJURY TYPE: All Other Injuries NOC || BODY PART(S) AFFECTED: - Foot
Object or substance involved
Employee recently had surgery on his foot and is using a knee scooter to get around. He fell off his scooter coming to work
Summary line
Right foot contusion from hitting crack and falling off knee scooter
Employee and industry
- Job description
- Hychi Clerk
- SOC code
- 53-7065 — Stockers and Order Fillers
- NAICS code
- 445110 — Supermarkets and Other Grocery (except Convenience) Stores
- NAICS vintage
- 2022
- Avg employees
- 94
- Total hours worked
- 115857
- EIN
- 420325638
- Establishment ID
- 1028341
- Employer case #
- 2023-1
When (timing detail)
- Date of incident
- Shift started
- 15:22:00.000
- Time of incident
- 15:23:00.000
- Filing year
- 2023
- Submitted
- 29FEB24:15:46:00
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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.