Salem, OR —
OSHA Injury Report: #21 HAYESVILLE ROTH'S
Injury · Other recordable case
At a glance
On , an injury at #21 HAYESVILLE ROTH'S in 4746 Portland Rd NE, Salem, OR 97305 resulted in other recordable case. Employee was deli Clerk in supermarkets.
Where did this happen?
- Establishment
- #21 HAYESVILLE ROTH'S
- Parent company
- Roth IGA Foodliner, Inc.
- Street
- 4746 Portland Rd NE
- City
- Salem
- State
- OR
- ZIP
- 97305
- On-site location
- Deli Dept
What was the outcome?
- Outcome
- Other recordable case (code 4)
- Type
- Injury (code 1)
Before the incident
Assisting customers in the Deli Dept
What happened
While turning around the employee hit her elbow on a metal counter
Injury or illness
elbow bruise contusion
Object or substance involved
a metal counter
Summary line
While turning around the employee hit her elbow on a metal counter
Employee and industry
- Job description
- Deli Clerk
- SOC code
- 35-3023 — Fast Food and Counter Workers
- NAICS code
- 445110 — Supermarkets
- NAICS vintage
- 2022
- Avg employees
- 44
- Total hours worked
- 65685
- EIN
- 930506597
- Establishment ID
- 999850
- Employer case #
- 3
When (timing detail)
- Date of incident
- Shift started
- 10:00:00.000
- Time of incident
- 13:00:00.000
- Filing year
- 2023
- Submitted
- 29MAR24:19:51:00
More injuries at #21 HAYESVILLE ROTH'S
View #21 HAYESVILLE ROTH'S'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.