Criteria File: rg INSPECTION DATA CASE AUDIT REPORT 04/10/13 13:54 Case Farms Processing, Inc. Estab Name Site Address: 121 Rand Street Morganton NC 28655 Inspection # : 315114611 Opt. Inspection #: 031-11 Supervisor 10 02307 CSHO 10 S8606 Inspection Type Programmed Planned Entry Dt 11/10/10 Close Conf Dt 05/04/11 Infor Conf Date 05/31/11 PMA STATUS PMA DATE Contest(active) NO Final Order 01/09113 Case Close Dt Mait Address: PO Box 308 Morganton NC 28680 Contt Corp PENALTY DATA ( S Uf1lJla ry) FTA Penal ty ****",***** Penalty ",********* Due Date Current Assessed Interest Adm Fees Res Waived Status $ $ $ 8225.00 0.00 0.00 PAYMENT DATA (Summary) Total Payments: $ 8225.00 Next Install Dt: Last Install Dt: Number of installments: 0 PENALTY COLLECTION DATA (Summary) Dt Transferred Amt Transferred (Orig) DCAT $ 0.00 (FTA) DCAT $ 0.00 SOL 0.00 0.00 0.00 $ $ $ VIOLATION DATA (Detail) Actions Contest Penalty/ Haz # Rec Exp lnst Iss. Dt/ Abatements Evnt/Act FAP V ID Standard Code FTA Ot Date Ty/Cmp Date Type FTA Pen Std Abt MS Pen * ***** ** •• *. ",.** .* ** .***",*", ••*. * '" ."'** "'*** *****"'** **"'***"'* ", * *",****** '" ***","''''''''''*''' ", ** ** *. * '" '" * o 01001 o 01002 o 01003 o 01004 o 01005 1904 0004 a 1904 0007 b 3 615 1904 0007 b 4 ----- 1904 0029 b 3 01/18/13 _ 615 .... _-- 615 1904 0030 a PAYMENT DATA (Detail) OSHA-163 Nr. Payment Ot *••*."''''.* *"'*"'*"'** 508067311 615 615 Ref/UnH *"''''**** Amount Paid "'*"'*."''''**''' $ 8225.00 13 05/06/1' 05/18/11 A 03/11/13 $ $ 17 05/06/11 05/18/11 A 03/11/13 $ 41 05/06/11 05/18/'1 A 03111/13 $ 6 05/06/11 05/18/11 A 03/11/13 3 05/06/11 05/11/11 A 03/11/13 FTA Paid **"'**"''''*** $ 0.00 Total Paid *",***"'**"'''' $ 8225.00 $ $ $ $ $ $ 7000.00 X 1645.00 P 7000.00 X 1645.00 P 7000.00 X 1645.00 P A N 7000.00 X 1645.00 P A N 7000.00 X 1645.00 P A N A N J A N '" t:Q ~~~~~~~~~~~~~~ii~~iiiiiiiiiii ~~~~~~~~~~~~~~~~~--~ M to rn Postmark Here Cl Cl Cl ~- dQ- ~\ Cl ru to Total PostagE Atty. General's Ofc.lLabor Section N.C. Depatiment of Justice sr;f:ii(."AjirNo: 9001 Mail. Service Center Of PO Box No. cltY;siiie:ZiA Raleigh, NC 27699-9001 ru r:>L"~-Sent 0 IT' Cl Cl r'- '.: SENDER:'<,COMPLETE THIS SECTION ~ ~ ~ .c' j., J. • ~, • "" • ~r , III Complete Items 1, 2, and 3. Also cO!'l1plete item.. 4. If Restricted Delivery is desired. Print your name and address on the reverse so that ,we can return the cardto you. III Attach thjs~ card to the back of'the mailpiece, or on the front if space permits. III 1. Article Addressed to: C''''-~t. ~fv-'\!' P~c.t.wt~\::tv\C ~lS\\ 4:1ol\ i ; . Atty. General's Ofc.ILabor Section N.C. Department of Justice 9001 Mail Service Center Raleigh, NC 27699-9001 , 2. Article Number I (Transfer from seNlce (abel) \ ·PS Form 3811, February 2004 ! 7009 2820 0003 8128 8868 Domestic RetUrn Receipt 102595.Q2·M·1540 : j • Complete items 1, 2, and 3. Also complete Item 4 if Restricted Delivery is desired. .. Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailpiece, or on the fron't if space permits. r ~ t' n Agent r=t Addressee ~ "mrnl&imt·%'m!f!.1tfg.1!tttn"tJf'fJt~_ N to 315114611 CIT/Attn: Case Farms Processing, P.O. Box 308 Morganton, NC 28680-0308 rn o o o o ru 3.~rvice Type tp.Certifled Mail o Registered o o Express Mail . EO ru ~ .RQtWFA Reeeipt fEll' Man:b.aQdlse Insured Mail 0- 4. Restricted Delivery? (&tra Fee) o o 0 Yes I'-- , 2. Article Number (rransfer from service label) PS Form ' .. ,: . peA "'" \' cO ' ru \1. Article Addressee. to: 7009 2820 0003 8128 9711 3811, February 2004 Domestic Return Receipt UNITED STATES POSTAL SERVICE 102595-02-M·1540 I :I I First-Class Mail Postage & Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • N. C. Department of Labor 204 Charlotte Hwy., Ste. B Asheville, NC 28803 Postage I ' c' CartifiedFie . Return Receipt F"ee (Endorsement ReqUI~d>' 1 ' - - - - - - - - ; Postmark Here Restricted Delivery Fee (Endorsement RequIred) Total Poslagt I I 315114611 CIT/Attn: Case Farms Processing, P.O. Box 308 Morganton, NC 28680-0308 JUl 7 2011 BEFORE THE NORTH CAROLINA OCCUPATIONA ~~~sm~~......-l HEALTH REVIEW COMMISSION COMMISSIONER OF LABOR OF THE STATE OF NORTH CAROLINA OSHANC NO. 2011·5181 INSPECTION NO. 315114611 CSHO 10: S8606 Complainant, v. CASE FARMS PROCESSING INC and Its successors ORDER FOR EXTENSION OF TIME TO FILE COMPLAINT Respondent. THIS MATTER is before the undersigned on Motion of Complainant for an extension of time in which to file the Complaint in the above captioned matter. Respondent has no objection to this extension of time. IT IS HEREBY ORDERED that the motion is GRANTED and Complainant shall -':::;<~~4-----' 2011 . . Oscar A. Keller Jr., ChalrmaO/ North Carolina Occupational Safety and Health Review Commission CERTIFICATE OF SERVICE I HEREBY CERTIFY that I have this date served a copy of the foregoing OROER FOR THE EXTENSION OF TIME TO FILE COMPLAINT upon: JOHN J DOYLE JR CONSTANGY BROOKS & SMITH LLP 100 N CHERRY STREET WINSTON-SALEM NC 27101 LARISSA WILLIAMSON NC DEPARTMENT OF JUSTICE LABOR SECTION PO BOX 629 RALEIGH NC 27602-0629 by depositing a copy of the same in the United States Mail, First Class; NC OEPARTMENT OF LABOR LEGAL AFFAIRS DIVISION 1101 MAIL SERVICE CENTER RALEIGH NC 27699-1101 by depositing a copy of the same in the NCDOL Interoffice Mail. THIS THE '7 ~ DAY OF ~ 2011. OSCAR A. KELLER, JR. C IRMAN _ C /XJ.v}~~. Nancy D. aney Docket a Office Adml ·strator NC Occupational Safe & Health Review Commission ------ --------------- 1101 Mail Service Center Raleigh, NC 27699-1101 TEL.: (919) 733 ..3589 FAX.: (919) 733 ..3020 !l.JfI t , ' iJ" (f 7/UJ-I;t -luc~) CtfiL ~.i -.;t \Cj..J..4....; f"'I..tf/;"f NC OCCUPATIONAL SAFETY AND HEALTH REVIEW COMMISSION 1101 Mail Service Center Raleigh, North Carolina 27699·1101 (919) 733-3589 FAX: (919) 733·3020 http://www.oshrb.state.nc.us June 20, 2011 COMMISSIONER OF LABOR OF THE STATE OF NORTH CAROLINA DOCKET NO. OSHANC: 2011-5181 INSPECTION NUMBER: 315114611 COMPLAINANT, CSHO 10: 58606 v. NOTICE OF POCKETING CASE FARMS PROCESSING INC and its successors RESPONDENT. DEAR JOHN J DOYLe' JR,' .. This is to acknowledge receipt of your NOTICE OF CONTEST, 6/17/2011, received in our office on 6117/2011 and to inform you that jurisdiction over this case is now with the Review Commission. Attached is a form entitled "Statement of Employer'slRespondent's Position." On this form, by checking the appropriate boxes, you can state your position regarding each item of the citation(s); or you can explain your position; or you can request a formal complaint If you do not use the enclosed form, you must submit your own statement of position. IF YOU DO NOT RESPOND WITH EITHER THIS FORM OR YOUR OWN STATEMENT OF POSITION BY MAILING OR DELIVERING IT TO THE REVIEW COMMISSION, POST-MARKED, WITHIN 20 DAYS FROM THE DAY YOU RECEIVED THIS FORM, YOUR RIGHT TO CONTEST THE GOVERNMENT'S ALLEGATIONS IS WAIVED I Send a copy of the completed form and any attachments or your statement of position to both the following offices: NC Occupational Safety & Health North Carolina Department of Justice ----.---- Rtiview'Commissio;"-- ----- -- --- ------..-- Labor Section 1101 Mail Service Center POBox 629 Raleigh NC 276~9-1101 Raleigh, NC 27602·0629 This case wilt more than likely be scheduled for hearing within the next 90 days. Please notify this office within five days from receipt of this notice the dates that you will not be available for hearing within this time frame. This will be used to guide our office in setting your case for hearing. If you do not respond, we will assume that you will be available anytime within the next 90 days. Legal counsel is not required but may be helpful. During any hearing or any other Review Commission proceeding, employers may not be represented by non .. attorneys who are neither owners, nor bona fide full-time officers nor employees of the company (Rule of Procedure .O101(7». If you wish to retain an attorney, you should do so now. The Review Commission will not be inclined to continue cases for respondents who have failed to retain an attorney until a brief time before the hearing. . You are required to post your Notice of Contest and the attached Notice of Employee Rights. You must keep copies of all documents related to this proceeding in a place where employees may examine them. To certify your compliance, we ask that you sign and return a copy of the enclosed Certification of Posting within three working days. Failure to comply will be grounds for immediate dismissal of your Notice of Contest. If we can be of any service to you, please feel free to call. We are enclosing a copy of the Review Commission's Rules of Procedure. The Rules of Procedure may be accessed at our website address: (http://www;oshrb.state.nc.us). Sincerely: Nancy D waney, Docket nd Office Admi istrator NC Occupational Safe & Health Review Commission CERTIFICATE OF SERVICE I HEREBY CERTIFY that J have this date served a copy of the foregoing NOTICE OF DOCKETING upon: ' JOHN J DOYLE JR CONSTANGY BROOKS & SMITH LLP 100 N CHERRY STREET WINSTON·SALEM NC 27101 by depositing same in the United States Mail, Certified Mail, postage prepaid, at Raleigh, North Carolina, and upon: NC DEPARTMENT OF JUSTICE LABOR SECTION P o BOX 629 RALEIGH NC 27602·0629 by depositing same in the First Class Mail, postage prepaid, at Raleigh, North Carolina. NC DEPARTMENT OF LABOR LEGAL AFFAIRS DIVISION 1101 MAIL SERVICE CENTER RALEIGH NC 27699·1101 by depositing same in the Interoffice Mail at Raleigh, North Carolina. THIS THE ~Qte-. DAYOF ~.D< .. 2011. Oscar A. Keller, Jr. Chairman I Nancy 0', Swaney, Dockct'end Office Admtv strator NC Occupational Safety & Health Review Commission 1101 Mail Service Center Raleigh, NC 27699·1101 (919) 733-3589 FAX: (9i9) 733·3020 N.C. Department: ot" Labor CHERIE K. BERRY Commissioner RICARDO CRUZ-SEGARRA District Supervisor Division of Occupational Safety and Health June 17, 2011 Mr. John J. Doyle, Jr. Constangy, Brooks & Smith, LLP 100 North Cherry Street, Suite 300 Winston-Salem, NC 27101-4016 Re: Notice of Contest ofCitation(s) andlor Proposed Penalty OSHA Inspection No.: 315114611 (Case Farms Processing, Inc.) Dear Mr. Doyle: This is to acknowledge your Notice of Contest dated and received in this office on June 17,2011, concerning the above-referenced inspection. We will forward your Notice of Contest within 10 working days of receipt to the Safety and Health Review Commission for docketing. You will receive further communications from that office. If you have questions or need any additional information, please call me at (828) 299-8232. Sincerely, District Supervisor RCS 204 CHARLOTTE HIGHWAY, SUITE B, ASHEVILLE, NORTH CAROLINA 28803-8681 PHONE: (828) 299-8232 FAX: (828) 299-8266 CONSTANGY BROOKS & SMITH, LLP SUlTE300 100 NORTH CHERRY ST. WINSTON-SALEM, NORTH CAROLINA 27101-4016 TELEPHONE: (336) 721-1001 . FACSIMILE: (336) 748-9112 www.constnngy.com June 17, 2011 Via Elnall and U.S. Mail Ricardo Cruz Safety & Health Supervisor North Carolina Department of Labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B Asheville, NC 28803 Re: Case Farms Processing, Inc. 121 Rand Street Morganton, NC 28655 Inspection No. 315114611 (NEP) Dear Mr. Cruz: Please be advised that our client Case Fanns Processing, Inc. wishes to contest in its entirety the Citation and Notification of Penalty issued in connection with the abovereferenced inspection. Please confinn your receipt of this Notice of Contest. I thank you in advance for your cooperation. Sincerely, JJD/cjs cc: ALABAMA NEW JERSEY 1470298.1 GEORGIA CALIFORNIA FLORIDA NORTH CAROLINA SOUTH CAROLINA ILLINOIS MASSACHUSETTS MISSOURI TENNESSEE TEXAS VIRGINIA WISCONSIN Cruz, Ric From: Sent: To: Cc: Subject: Attachments: Smith, Cyndy Friday, June 7,2011 9: Cruz, Ric Doyle, John; crigdon Case Farms/OSHA Ltr - Cruz (NCDOL) Notice of Contest (Case Farms - Recordkeeping) 6-17-11 (1471457 1).PDF This email is sent on behalf of John J. Doyle, Jr. Please see the attachment. Thank you. Cylyndia J. Smith o ---------100 N. Cherry Street, Suite 300 Winston-Salem, NC 27101-4016 Main: 336.721.1001 • Fax: 336.748.9112 • www.constangy.com Atlanta, GA • Asheville, NC • Austin, TX • Birmingham, AL • Boston, MA • Chicago, IL • Columbia, SC • Dallas, TX • Fairfax, VA· Greenville, SC • Jacksonville, FL • Kansas City, MO • Lakeland, FL • Los Angeles County, CA • Macon, GA • Madison, WI • Nashvilte, TN • Princeton, NJ • Port St. Lucie, FL • St. louis, MO • Tampa, FL • Ventura County, CA • Winston Salem, NC H COHFIDENTlJ.\LlTY NOnCE .~ This communication. including any attachments, is from Cons tangy, Brooks 8: Smith, LLP. and contains confidential information intended only for the addressee(s). The information contained in this transmisSion may also be privileged and/or subject to attorney work-product protection. and exempt from disclosure under applicable law. If you are not the intended recipient, any use. dissemination, distribution or copying of this document or its contents is strictly prohibited. If you have received this communication in error, please contact the sender by reply e-mail immediately and destroy all copies of the original message. IRS Circular 230 Notice: Federal regulations apply to written communications (including emaHs) regarding federal tax matters between our firm and our clients. Pursuant to these federal regulations. we inform you that any U.S. federal tax advice in this communication (including any attachments) is not intended or written to be used, and cannot be used, by the addressee or any other p€rson or entity for the purposE' of avoiding penalties that may be imposed __ .. __ _ _ _ _ _ _ under the Intemal RevenueCode. 1 Cruz, Ric From: Sent: To: Subject: Cruz, Ric RE: Informal I received this email. Case Farms, Morganton 828-438-6900 e x t _ To Subject: RE: Informal A reminder, from the no change letter date, 31 May 2011,we have 15 working days to reach an agreement. The suspense date is, 21 June 2011; at that point you need to inform me in writing or your intentions. If your intention is to contest, you need to let me know, otherwise, you will lose you right to contest. Let me know that you received this note and you have no questions. Hopefully we will come to an agreement and the dates will not be relevant. Thanks, ric Ricardo Cruz-Segarra MESH C-MESH N.C. Dept. of Labor, OSH-W Safety & Health Supervisor 204 Charlotte HWY, Suite B Asheville, NC 28803 828-296-7226 Office 828-299-8266 Fax E-mail correspondence to and from this addressee may be subject to the North Carolina Public Records Law and may be disclosed to Third Parties. Ul Please consider the environment before printing this email Cruz, Ric From: Sent: To: Subject: Wednesday, June 01, 2011 11 :33 AM Cruz, Ric RE: Received Ric, I did receive the no-change-Ietter on 5/31/2011. From: Cruz, Ric Sent: Wednesday, une 01, 201 To:_ Su~ Received both of your letters with the info substantiating your request. Also, will you send me an e-mail letting me know you received the No-Change-Letter. Thanks-ric Ricardo Cruz-Segarra MESH C-MESH N.C. Dept. of Labor, OSH-W Safety & Health Supervisor 204 Charlotte HWY, Suite B Asheville, NC 28803 828-296-7226 Office 828-299-8266 Fax E-mail correspondence to and from this addressee may be subject to the North Carolina Public Records Law and may be disclosed to Third Parties. P Please consider the environment before printing this email Click here to report this email as spam. This message has been scanned for malware by Websense. www.websense.com 1 Cruz, Ric From: Sent: To: Subject: Tuesday, May 31,2011 2:17 PM Cruz, Ric RE: NCL Cruz, I got it and I could open it this time! From: Cruz, Ric Sent: Tuesday, May 31, 2011 2:15 PM To:_ Sub_ Please see attachment; let me know if you can open the No-Change-Letter. ric Ricardo Cruz-Segarra MESH C-MESH N.C. Dept. of Labor, OSH-W Safety & Health Supervisor 204 Charlotte HWY, Suite B Asheville, NC 28803 828-296-7226 Office 828-299-8266 Fax E-mail correspondence to and from this addressee may be subject to the North Carolina Public Records Law and may be disclosed to Third Parties. P Please consider the environment before printing this email Click here to report this email as spam. --------This-message-has been scanned for malware by Websense. www.websense.com 1 Ricardo Cruz-Segarra Safety & Health Supervisor Division of Occupational Safety and Health 204 Charlotte Hwy, Suite B Asheville, NC 28803-8681 N.t::. DepJlrt:tncnt of' l.a~or Cherie K. Berry (828) 299-8232 Fax: (828) 299-8266 May 31, 2011 Commissioner Case Farms Processing, Inc. POB 308 Morganton, NC. 28680 RE: OSHA Health Inspection 315114611 OSHA Safety Inspection 314807413 No Change Letter Oea It was good speaking with you this morning. To provide us additional time we require to conclude our negotiations, I'm sending you this No-Change-Letter. You have 15 working days. from the date that you received this letter, to notify the District Supervisor, in writing, of your intention to contest this inspection, should you desire to do so. If you fail to respond, the citations, as proposed by the Commissioner of Labor, shall be deemed final and not subject to review. Should you choose to pay the penalty, please remit payment to: North Carolina Department of labor ATTN.: Budget Collections 1101 Mail Service Center Raleigh, NC. 27699-1101 Thank you for your cooperation in keeping the workplace safe for your employees and don't forget to use our assets, such as the Library and Consultation. Call me if we can help you out. Sincerely, ~-'j J .. ,v'~ tt "~/f;;~i:>tj:~;:0' /:.~~;;~>~e ;(;{~s~(;;;<, .,;>_ ·"Ricardo Cruz-Segarra ;' Safety & Health Compliance Supervisor Cruz, Ric From: Sent: To: Cc: Subject: Attachments: Cruz, Ric OPM Cruz, Ric Emailing: Case Farms NCL.wpd Case Farms NCL.wpd Attached you will find the No-Change-Letter we spoke about. This will give us an additional 15 WORKING days to finish our negotiations. Don't forget to send me the items we spoke about and let me know your received this -mail. Thanks-ric Note: To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 , ' NC Department of Labor Division ofOccnpational Safety and Health THIS FORM 1S FOR YOUR CONV.ENIENCE IN REQUESTING AN INFORMAL CONFERENCE OR FOR CONTESTING PART OR ALL OF THE ENCLOSED CITATION(S). THE FORM OR YOUR REQUEST FOR AN INFORMAL CONFERENCE OR NOTICE OF CONTEST MUST BE POSTMARKED WITHIN 15 WORKING DAYS OF RECEIPT OF THE CITATION(S). Case Farms Processing, Inc. Misty Branch PO Box 308 Morganton, NC 28680'~ 0':' \) 1 Inspection Number: 315114611 Please mark only one of the following boxes and return to the address indicated below. Forms returned with more than one box marked will be treated as a request for an informal conference. PENALTY PAYMENT ENCLOSED IN THE AMOUNT OF $ _ __ [ J Remit to: NC Department of Labor ATIN: Budget - Collections 1101 Mail Service Center Raleigh, NC 27699-1101 REQUEST AN INFORMAL CONFERENCE (YOUR RIGHT TO CONTEST IS RESERVED PENDING THE RESULTS OF THE INFORMAL CONFERENCE) NOTICE OF CONTEST OF CITATION(S) AND/OR PROPOSED PENALTY [ ] Contest ofViolation(s)/Abatement Date(s) _ _ _ _ _ _ _ _ _ _ _ __ Contest of Penalty Amount(s) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Return to: North Carolina Department of labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B - - · Asheville, NC 28803 Attention: Ricardo Cruz-Segarra, District Supervisor Signatur l Name (p Title: ,/ .,... ~ Telepho:..-.__ . -- vate: 5 r/;;z /fib JJ I North Carolina Department of Labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B Asheville, NC 28803 Phone: (828) 299-8232 FAX: (828) 299-8266 Citation and' N otificationofPenalty To: Case Farms Processing, Inc. and its successors PO Box 308 Morganton, NC 28680 Inspection Number: Inspection Date(s): Issuance Date: Report Number CSHO: Inspection Site: 121 Rand Street Morganton, NC 28655 The violation{s) described in this Citation' and Notification of Penalty is (are) alleged to have occurred on or about the day(s) the inspection was made unless otherwise indicated within the description given below. 315114611 11/10/2010 - 05/0412011 05/06/2011 031-11 S8606 - Branch This Citation and Notification of Penalty describes violation(s) of the labor laws of Chapter 95 of the North Carolina General Statutes. The Penalty(ies) listed herein is (are) based on these violations. You must correct the violation(s) referred to in this citation by the date(s) listed and pay the penalty proposed, unl,ess within 15 working days (excluding weekends and holidays) from receipt of this Citation and Notification of Penalty, you mail a request for an infonnal conference or Notice ofContestment to the North Carolina Department of Labor district office at the address shown above. Posting - The law requires that a copy of this Citation and Notification of Penalty be posted immediately in a prominent place at or near the location of the violation(s) cited herein, or , if it is not practicable because of the nature of the employer's operations, where it will be readily observable by all affected employees. This Citation must remain posted until the violation(s) cited herein has (have) been abated, or for 3 working days (excluding weekends and Federal holidays), whichever is longer. The penalty dollar amounts need not be posted and may be marked out or covered up prior to posting. Citation and Notification of Penalty Page 1 of 16 OSHA-2 (Rev. 03/05) Informal Conference - You may request an informal conference. To request an informal conference, you must return the enclosed form marking the block requesting an informal conference or provide other written notice to the district supervisor within 15 working days of receipt of the citation. [Do not mark more than one block on the enclosed form if you \vant an informal conference.] The informal conference must be held no longer than 20 working days from the date you receive the Citation and Notification of Penalty, so your immediate response is necessary if you choose this option. If you make a timely request for an informal conference to discuss any issues related to this Citation and Notification of Penalty, you preserve your right to contest. The time for contestment does not begin until after the informal conference is held and you have been notified of the result(s). At that time you have an additional 15 working days during which you may file a notice of contest, should you so desire. If you decide to request an informal conference, obtain the date, time and location of the informal conference by contacting the District Supervisor, then complete and post the enclosed Notice to Employees near the Citation and Notification of Penalty. Please bring to the conference all supporting documentation of existing conditions and any corrections made thus far. The results of the informal conference will be a revised citation, a notice of no change or an informal settlement agreement. An informal settlement agreement will resolve the matter without litigation or contestment. Right to Contest - You have the right to contest this Citation and Notification of Penalty now or after an informal conference. You may contest all citation items or any individual items. You may also contest proposed penalties and/or abatement dates without contesting the underlying violations. 15 \vorking days after you receive this Citation and Notification of Penalty (if you do not request an informal conference) or 15 \vorking days after you receive the results of the informal conference, the citation(s) and/or proposed penalty(ies) \vill become a final order of the Safety and Health Review Board and may not be revie\ved by any court or agency, unless you file a notice of contestment. Penalty Payment - Penalties are due within 15 working days of receipt of this notification unless a request for an informal conference or notice of unless contestment is forwarded. Make your check or money order payable to North Carolina Department of Labor, OSHA Division and remit to the North Carolina Department of Labor, Attn: Budget Division, 1101 Mail Service Center, Raleigh, NC 27699-1101. You may also make payment by credit card. A form is provided for your convenience. Please indicate the inspection number on the remittance. The North Carolina Department of Labor does not agree to any restriction or conditions or endorsements you put on any check or money order for less than the full amount due, and will cash the check or money order as if these restrictions, conditions, or endorsements do not exist. Notification of Corrective Action - For violations which you do not contest, you should return the OSHA Form 2D (Certification of Abatement) within ten (10) calendar days after the abatement date, to indicate that appropriate corrective action has been taken within the time frame set forth in this citation. You are not required Citation and Notification of Penalty Page 2 of 16 OSHA-2 (Rev. 03/05) to certify abatement if the inspector observed the abatement during the on-site portion of the inspection or observes within 24 hours after identifying the hazard and notes in the citation that abatement has occurred. The certification that abatement is complete must include, for each cited violation, the date and method of abatement and a statement that affected the employees and their representatives have been informed of the abatement. In addition, for repeat, willful and other serious violations as indicated, additional documents demonstrating that abatement is complete is required. This additional documentation may include, but is not limited to, evidence of the purchase or repair of equipment, photographic or video evidence of abatement or other written records. If indicated in the citation, you may be required to submit an abatement plan for each cited violation, when time permitted for abatement is more than 90 calendar days. The plan must identify the violation and the steps to be taken to achieve abatement, including a schedule for completing abatement and how employees will be protected from exposure to the violative condition in the interim until abatement is complete. An employer who submits an abatement plan may be required to also submit periodic progress reports for each cited violation. The citation will indicate whether progress plans are due and the date(s) when the progress reports are due. The employer must include, in each submission required by this notification, company name and address, inspection number, citation and item numbers, a statement that the information submitted is accurate, and a signature of the employer or the employer's authorized representative. The date of the postmark is the date of submission for mailed documents. Employee Notification of Corrective Action - The employer must inform affected employees and their representati vees) about abatement activities, covered by the citations, by posting a copy of each document submitted to the North Carolina Department of Labor, or a summary of the document near the place where the violation occurred, or where it will be readily observable. The employer must inform employees of their right to examine and copy all abatement documents submitted. Posted documents must remain posted for three working days after submission to the Department. Employer Discrimination Unlawful - The law prohibits discrimination by an employer against an employee for filing a complaint or for exercising any rights under this Act. An employee who believes that he/she has been discriminated against may file a complaint no later than 180 days after the discrimination occurred with the NC Department of Labor at the address shown above. Notice to Employees - The law gives an employee or hislher representative the opportunity to object to any abatement date set for a violation if he/she believes the date to be unreasonable. The contest must be in writing and signed. It must be mailed to the North Carolina Department of Labor at the address shown above and postmarked within 20 days-()f the date of the receipt by the employer of this Citation and Notification of Penalty. Notice to Employer - Enclosed are citations and proposed penalties levied against your facility resulting from the Division of Occupational Safety and Health1s compliance inspection of your facility. The penalty for each violation has been reduced depending on your facility's size, good faith, and history. Citation and Notification of Penalty Page 3 of 16 OSHA-2 (Rev. 03/05) North Carolina Department of Labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B Asheville, NC 28803 Phone: (828) 299-8232 FAX: (828) 299-8266 NOTICE TO EMPLOYEES OF INFORMAL CONFERENCE An infonnal conference has been scheduled with OSHA to discuss the citation(s) issued on 05/06/2011. The conference will be held at: ----------------------------(Location) __________________________________ on ___________ at ____________run/pm. (Time) (Date) Employees and/or representatives of employees have a right to attend an informal conference. Citation and Notification of Penalty Page 4 of 16 OSHA-2 (Rev. 03/05) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 Citation 1 Item 1 Type of Violation: 315114611 11110/201005/04/2011 05/06/2011 Nonserious 29 CFR 1904.4(a): Each employer required by this part to keep records of fatalities, injuries, and illnesses did not record each fatality, injury, and illness that was work-related, a new case, and meets one or more of the general recording criteria: a) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses on the OSHA 300 Log for calendar year 2008. 1) On or about April 25, 2008, Coat Room Clerk- An employee received medical treatment beyond fIrst aid and was placed on restricted work activity for 19 days due to a fall while pushing a dolly. 2) On or about September 2, 2008, Cleaner - An employee received medical treatment beyond first aid and was placed on restricted work activity for 7 days due to C02 poisoning. 3) On or about May 13,2008, Shoulder Cutter - An employee received medical treatment beyond first aid and was placed on restricted work activity for 10 days for tendinitis due to overexertion from cutting chicken shoulders. 4) On or about March 24, 2008, Cleaner - An employee received a dental crown after being hit in the mouth by a binder. 5) On or about June 26,2008, Feed Mill Employee - An employee received stitches due to a laceration to the head from fan. 6) On or about January 4, 2008, Loader- An employee received medical treatment beyond fIrst aid and was placed on restricted work activity for 5 days due to contusion of the left hand. 7) On or about February 8, 2008, Truck Driver - An employee was placed on restricted work activity for 2 days due-being hiCin-the head with-a:-metal pole~-'-"- - --.. 8) On or about September 15, 2008, Cutter - An employee received medical treatment beyond first aid due to the rupture of the flexor tendon to the left ring finger, had 28 days away from work, and was placed on restricted work activity for152 days. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 5 of 16 OSHA-2(Rev. 6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/201005/04/2011 05/06/2011 b) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses on the OSHA 300 Log for calendar year 2009. 1) On or about September 18, 2009, Cutter- An employee received medical treatment beyond first aid due to getting chicken grease in the right eye. 2) On or about January 5,2009, Cutter- An employee received medical treatment beyond first and was placed on restricted work activity for 21 days due to tendinitis in the right hand from working on the cutting line. c) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses on the OSHA 300 Log for calendar year 2010. 1) On or about June 10,2010, Truck Driver- An employee received medical treatment beyond first aid due to a contusion and sprain of the left foot and toes from slipping. 2) On or about January 27.2010, Line Worker- An employee received medical treatment beyond first aid due to a fall in the restroom resulting in a chipped tooth. 3) On or about June 1, 2010, C02 Packer- An employee received medical treatment beyond first aid and was placed on restricted work activity for 9 days due to epididymitis. D~t~'::B;.-Whi~h··virii~ti6ri-M~t··.·b~'Ab~t~~: ~o.~~~~~~J~~!l~!Y.{'" . -.' . ." .... ..... 05118/20ill .- $7'000~OO .. .•. ",,'.-."'."'&.,~.--,., See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 6 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: 315114611 11110/201005104/2011 05106/2011 Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 Citation 1 Item 2 Type of Violation: Nonserious 29 CFR 1904.7(b)(3): When an injury or illness involved one or more days away from work, the employer did not record the injury or illness on the OSHA 300 log with a check mark in the space for cases involving days away from work and enter the number of calendar days away from work in the number of days column: a) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2008. 1) On or about December 18, 2008, Mechanic: an employee slipped and fell into a gearbox and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 7 days away from work and 173 restricted work days. 2) On or about January 3,2008, Cutter: an employee developed a ganglion cyst on the right wrist and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 179 restricted work days. 3) On or about May 23, 2008, Maintenance: an employee fractured the left pinky fmger due to getting it caught in the projections of a wheel and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 8 days away from work and 20 restricted work days. 4) On or about September 3, 2008, Stack Off Employee: an employee caught his fmger in a conveyor resulting in a partial amputation to the right index finger and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 62 restricted work days. 5) On or about November 4, 2008, Cutter: an employee received a tendon laceration and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work"and 46-restricted work-days."--6) On or about October 10, 2008, Cutter: an employee reached in a leg skinner and received a partial amputation of the left index finger and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 16 days away from work and 85 restricted work days. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 7 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/201005/04/2011 05106/2011 b) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2009. 1) On or about June 13,2009, Maintenance: an employee received a welding burn to both eyes and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 3 restricted work days. 2) On or about November 19,2009, Sanitation: an employee received a left hand contusion & abrasion and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 61 restricted work days. 3) On or about December 10, 2009, Line Cutter: an employee slipped on the wet floor resulting in a sprain of the right ankle hand and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 26 restricted work days. 4) On or about March 20, 2009, Cleaner: an employee received a partial amputation of the left index finger from machinery and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 2 days away from work and 42 restricted work days. 5) On or about July 28, 2009, Driver: an employee was hit by a forklift resulting in a right wrist sprain, back contusion, and hip contusion and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 2 days away from work and 162 restricted work days. c) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2010. 1) On or about January 14, 2010, Cutter: an employee experienced neck and back strain working on the line and thecase-was-recorded-as-restricled-work-activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 31 restricted work days. 2) On or about January 21,2010, QC: an employee received a tendon laceration from scissors and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 70 restricted work days. 3) On or about February 23, 2010, Bagger: an employee experienced back strain from lifting a box and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 8 restricted work days. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 8 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health .Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11/10/201005/04/2011 05/06/2011 4) On or about July 8, 2010, Sanitation Trainee: an employee fell resulting in a left knee sprain and various contusions and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 120 restricted work days. 5) On or about August 10,2010, Lead Person: an employee caught the left index fmger in a sprocket on the wing line conveyor resulting in a partial amputation and was recorded as re,stricted work activity, when the case resulted in days away from work. The case resulted in 5 days away from work and 42 restricted work days. 6) On or about January 29, 2010, Line Cutter: an employee slipped on the stairs resulting in contusions, abrasions, and back strain and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 179 restricted work days. pate By 'Which'Vi()lation 'Mp$~ .~~,A,b~tedi Proposed'Penalh -. _... ".,_..,- ....,'.' ..,"_.,,".1. _ ~ 7: Citation 1 Item 3 Type of Violation: . Nonserious 29 CFR 1904.7(b)(4): When an injury or illness involved restricted work or job transfer but did not involve death or days away from work, the employer did not record the injury or illness on the OSHA 300 log by placing a check mark in the space for job transfer or restriction and enter the number of restricted or transferred days in the restricted workdays column: a) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log for calendar year 2008. 1) On or about December 4, 2008,.Cutter:_an employee experienced inflammation in the tendons of the right arm and shoulder from overexertion resulting in 32 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 23 days. In addition, the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). 2) On or about December 14, 2008, Live Haul Driver: an employee slipped on the edge of the scale and experienced a sprain/tear of the left knee resulting in 101 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. 3) On or about December 5, 2008, Cutter: an employee experienced a laceration to the left thumb resulting in 5 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 3 days. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 9 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/2010· 05104/2011 05/06/2011 4) On or about November 24, 2008, Trimmer: an employee slipped on the stairs and fractured the tailbone resulting in 41 days of restricted work activity. The employer incorrectly' recorded the restricted work activity as 31 days. 5) On or about November 5, 2008, Leg Debone: an employee fell from a platform due to grease on the floor and fractured the left finger resulting in 75 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 43 days. 6) On or about September 19, 2008, Rework: an employee experienced a shoulder contusion from a tote falling on it, resulting in 22 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 18 days. 7) On or about September 15, 2008, Sanitation: an employee fractured the right index fmger resulting in 89 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 62 days. 8) On or about May 23, 2008, Catcher: an employee experienced eye irritation from particles in the chicken house, reSUlting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 9) On or about January 8, 2008, Cutter: an employee experienced a strained neck, right shoulder and right wrist from overexertion resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 154 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 10) On or about June 24, 2008, Shipping: an employee experienced a partial amputation of the left middle finger from a falling pallet, resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 75 days. 11) On or about January 10, 2008, Cutter: an emp loyee developed a ganglion cyst on the right wrist from repetitive motion resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 139 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 12) On or about February 12, 2008, Chicken Hanger: the employee developed crepitus in the left wrist from repetitive motion and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 10 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/201005/04/2011 05/06/2011 13) On or about February 6,2008, Inspector Helper: the employee developed right shoulder strain from repetitive motion and the employer misclassified the case as an injury (MI) and it should be classified as an illness (M6). 14) On or about February 27, 2008, Leg Debone: an employee experienced a right 10th rib fracture after slipping on chicken fat, resulting in 21 days of restricted work activity. The employer incorrectly recorded the restricted work ,activity as 13 days. 15) On or about March 12, 2008, Cutter: the employee developed a ganglion cyst on the right hand from repetitive motion and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 16) On or about December 10, 2008, Maintenance: an employee experienced a crush and wound injury to the left 5th finger, resulting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 17) On or about December 30, 2008,Cleaner: an employee received a laceration to the head from a metal bar, resulting in 13 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. b) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log for calendar year 2009. 1) On or about December 1, 2009, Supervisor: an employee experienced an avulsion to the right middle finger from a wing saw resulting in 31 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. 2) On or about February 3,2009, Chicken Catcher: an employee experienced hand strain from overexertion from catching chickens resulting in 28 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 10 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 3) On or about March 16, 2009, Supervisor: an employee experienced an avulsion of the right 4th finger tip resulting in 14 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 11 of 16 OSHA-2(Rev. 6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/201005/04/2011 05/06/2011 4) On or about May 15, 2009, Maintenance: an employee experienced an avulsion of left index finger from the well house door closing on his finger resulting in 38 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 5) On or about November 14, 2009, Sanitation: an employee experienced a laceration to the right forearm while cleaning the bird washer resulting in 84 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 33 days. 6) On or about August 18, 2009, Mechanic: an employee experienced back strain from changing a drum during a brake job resulting in 46 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 28 days. 7) On or about December 12, 2009, Maintenance: an employee received a laceration to the left forearm after falling in the Chiller resulting in 16 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 8) On or about January 22, 2009, Supervisor: an employee experienced a ganglion cyst to the right hand from overexertion resulting in 18 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 14 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 9) On or about April 8, 2009, Cutter: an employee experienced tendinitis in the right hand overexertion from pulling chicken breasts apart resulting in 55 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 41 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 10) On or about November 28, 2009, Maintenance: an employee experienced a disc herniation on the left side at L5-S 1· while installing covers on the ice auger in the Ice House resulting in 95 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 90 days. 11) On or about July 27, 2009, Cutter: an employee fractured the left index finger while working in Stack Off resulting in 14 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 12) On or about August 5, 2009, Driver: an employee sustained a left shoulder injury from a driving accident resulting in 101 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 13 days. See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 12 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 315114611 11110/201005104/2011 05106/2011 13) On or about November 19, 2009, Cutter: the employee developed a strain to the right hand from overexertion from pulling skin off chicken breasts and the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). 14) On or about October 16, 2009, Cutter: the employee developed a ganglion cyst to the right wrist from overexertion and the employer misclassified the case as an injury (Ml) and it should be classified as an i~lness (M6). 15) On or about June 8,2009, Driver: the employee was stung on the arm by a bee while driving a truck and the employer misclassified the case as an illness (M6) and it should be classified as an injury (M!). 16) On or about June 2, 2009, Grading: the employee developed a strain to left wrist from overexertion from loading chickens on the coning line and the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 17) On or about May 11, 2009, Maintenance: an employee sprained the right middle finger on a coil in the Ice House resulting in 125 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 109 days. 18) On or about April 7, 2009, Cutter: the employee developed tendinitis in his right thumb and wrist from cutting chicken shoulders and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 19) On or about March 30,2009, Cutter: an employee developed lateral epicondylitis in her right arm from pulling tenders resulting in 18 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. In addition, the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). 20) On or about January 22, 2009, Chicken Catcher: the employee experienced overexertion to the right hand from catching chickens and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 21) On or about February 2, 2009, Chicken Catcher: the employee experienced strained rib muscles while catching chickens and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 22) On or about January 16, 2009, Chicken Catcher: the employee developed lateral epicondylitis of the right elbow from catching chickens and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 13 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: 315114611 11110/201005104/2011 05106/2011 Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 c) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log for calendar year 2010. 1) On or about November 30, 2010, QC: an employee experienced a sprained right ankle from a fall resulting in 22 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 8 days. 2) On or about March 15, 2010, Cutter: an employee developed a ganglion cyst on the right wrist from repetitive motion resulting in 53 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 38 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 3) On or about July 6,2010, Cutter: an employee developed epicondylitis in the right elbow from repetitive motion resulting in 49 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 39 days. In addition, the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). p'a~e'BY"'Which".Violatio~M~.~t. be :tt\bat~;.. hqp~~.~4_·~~I!~!Y_: -- -- ---- .--------- - - - -- - - - - - - " ----- --- See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 14 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health Inspection Number: Inspection Dates: Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. Inspection Site: 121 Rand Street, Morganton, NC 28655 Citation 1 Item 4 Type of Violation: 315114611 11110/201005/04/2011 05/06/2011 Nonserious 29 CFR 1904.29(b)(3): The employer did not enter each recordable injury or illness on the OSHA 300 log within seven (7) calendar days of receiving information that a recordable injury or illness had occurred. a) Located at Case Foods, Inc., Morganton: The employer failed to completely record injuries/illnesses on the OSHA 300 Log within 7 days for calendar year 2010. 1) On or about September 23, 2010, Chicken Catcher: the employer did not have any days recorded in columns K or L for this case. This case resulted in both days away from work and restricted work days. 2) On or about October 21, 2010, Stack Off: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 3) On or about September 21, 2010, Sanitation: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 4) On or about November 3, 2010, Stack Off: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 5) On or about November 2, 2010, Forklift Driver: the employer did not have any days recorded in columns K or L for this case. This case resulted in both days away from work and restricted work days. 6) On or about November 30, 2010, Mechanic: the employer did not have any days recorded in column L for this case. This case resulted in both days away from work and restricted work days. P~~~~j~~:lYh.i~~~~~rii;ti~.;;·'M~t·b;~AbC~t~4~ ~QP~$.~~·t.reJ;Ullty: ()S/181201l ·£7~.QOO~.OO See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 15 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Inspection Number: Inspection Dates: Division of Occupational Safety and Health Issuance Date: Citation and Notification of Penalty Company Name: Case Farms Processing, Inc. 121 Rand Street, Morganton, NC 28655 Inspection Site: Citation 1 Item 5 Type of Violation: 315114611 11110/201005/04/2011 05/06/2011 Nonserious 29 CFR 1904.30(a): The employer did not keep a separate OSHA 300 Log for each establishment that was expected to be in operation for one year or longer: a) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2008. b) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2009. c) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2010. I;;;;~dbt;l;"ib;;d I>~~:tJyWhic,I1,Violation Mustb~.Apa~d.~ '- .. .," ~Q~~e~' P~n~tr; $Z,oo~t.-,~q ~~.~ n.' ict SupervIsor Ricardo Cruz-Segarra See pages 1 through 3 of this Citation and Notification of Penalty for information on employer and employee rights and responsibilities. Citation and Notification of Penalty Page 16 of 16 OSHA-2(Rev.6/93) North Carolina Department of Labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B Asheville, NC 28803 Phone: (828) 299-8232 FAX: (828) 299-8266 INVOICEI DEBT COLLECTION NOTICE Company Name: Inspection Site: Issuance Date: Case Farms Processing, Inc. 121 Rand Street Morganton, NC 28655 05/06/2011 Summary of Penalties for Inspection Number 315114611 .... ,~$,~~:gQ2;Q9.. TOTAL PROPOSED PENALTIES $35;000~00 Please remit payment promptly to North Carolina Department of Labor Attn: Budget - Collections, 1101 Mail Service Center, Raleigh, NC 27699-1101, for the total amount of the uncontested penalties summarized above. Make your check or money order payable to: NC Department of Labor, OSHA Division. For payment by credit card, complete the form provided. Please indicate OSHA's Inspection Number (indicated above) on the remittance. OSHA does not agree to any restrictions or conditions or endorsements put on any check or money order for less than full amount due, and will cash the check or money order as if these restrictions, conditions, or endorsements do not exist. Summary Citation and Notification of Penalty Page 1 of 1 aSH-2 (Rev. 10/03) CONFIRMATION OF ABATEMENT RETURN THIS FORM TO North Carolina Department of Labor Division of Occupational Safety and Health 204 Charlotte Highway, Suite B Asheville, NC 28803 PHONE: (828) 299-8232 FAX: (828) 299-8266 FAILURE TO RESPOND BY THE DUE DATE MAY RESULT IN A FOLLOW-UP INSPECTION COMPANY: LOCATION: Case Farms Processing, Inc. PO Box 308 Morganton, NC 28680 INSPECTION NUMBER: CSHO: 315114611 Misty Branch THE ALLEGED VIOLATIONS LISTED BELOW THAT WERE OBSERVED ON THE 11110/2010 OSHA INSPECTION BY THE NORTH CAROLINA DEPARTMENT OF LABOR SHOULD BE CORRECTED ON OR BEFORE THE ABATEMENT DATES LISTED BELOW. Abatement date: 05/18/2011 for Citation 01 item 001. Corrective action taken Abatement date: 05/18/20 11 for Citation 01 item 002. Corrective action taken Abatement date: 05/18/2011 for Citation 01 item 003. Corrective action taken Abatement date: 05/18/2011 for Citation 01 item 004. Corrective action taken Abatement date: .05/11/2011 for Citation 01 item 005. Corrective action taken THE UNDERSIGNED A TTEST THAT THE ABOVE ITEMS WERE CORRECTED ON OR BEFORE THE PRESCRlBED ABATEMENT DATE. SIGNATURE:._ _ _ _ _ _ _ _ _ _ __ TITLE: _ _ _ _ _ _ _ _ _ _ _ _ _ __ DATE: __________________________ NC Department of Labor Division of Occupational Safety and Health THIS FORM IS FOR YOUR CONVENIENCE IN REQUESTING AN INFORM:AL CONFERENCE OR FOR CONTESTING PART OR ALL OF THE ENCLOSED CITATION(S). THE FORM: OR YOUR REQUEST FOR AN INFORMAL CONFERENCE OR NOTICE OF CONTEST MUST BE POSTMARKED WITHIN 15 WORKING DAYS OF RECEIPT OF THE CITATION(S). Case Farms Processing, Inc. PO Box 308 Morganton, NC 28680 Inspection Number: 315114611 Misty Branch Please mark only one of the following boxes and return to the address indicated below. Forms returned with more than one box marked will be treated as a request for an informal conference. [ ] PENALTY PAYMENT ENCLOSED IN THE AMOUNT OF $,_ __ Remit to: NC Department of Labor ATTN: Budget ~ Collections 1101 Mail Service Center Raleigh, NC 27699-1101 [ ] REQUEST AN INFORMAL CONFERENCE (YOUR RIGHT TO CONTEST IS RESERVED PENDING THE RESULTS OF THE INFORMAL CONFERENCE) [ ] NOTICE OF CONTEST OF CITATION(S) AND/OR PROPOSED PENALTY Contest ofViolation(s)/Abatement Date(s) _ _ _ _ _ _ _ _ _ _ _ __ Contest of Penalty Amount(s) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Return to: North Carolina Department of Labor Division of Occupational Safety and Health ---.-....... -.. -.- - - - ----- ·204 Charlotte Highway, Suite B Asheville, NC 28803 Attention: Ricardo Cruz-Segarra, District Supervisor Signarure: _______________________________________ Name (print or type): _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Title: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Telephone No.: Date: _ _ _ _ __ CREDIT CARD PAYMENT Name: Case Farms Processing, Inc. ... Complete and reiunzto: N. C; Department ofLabor Address: Phone#: ~( Amount: =$_ _ _ _ _ _ _ _ __ (circle one): MasterCard Budget and Management DiviSion 1101· Mail Service Center . l(aleigh, .NC 27699-:1101 .. . Telephone:'(919) 733-7426 . Fax: (919) 733-6197 __~)____________________________ Visa Name (as it appears on credit card): Credit Card Number: -----------------------------------------_ _ _ _ _ _ _ _ _ Exp. Date: _____ Mo.Nr. Cardholder Signature: _________________ Date: ----------------- Payment for Inspection No.: ____________________________ Cut along dotted line OSHA-300A Data Fri May 6, 2011 3 :32PM SUMMARY OSHA-300A DATA Log Year 5.8 TRCRATE (G) (H) (I) (1) Deaths Days Away lob Xfer or Restrict Other Recordable 0 0 38 7 4.7 TRC RATE Log Year\ (G) (H) (I) (1) Days Away Job Xfer or Restrict Otlx:r Recordable 0 0 39 12 7.6 TRC RATE Log yearf (G) (H) Deaths Days Away (ll lob Xfer or Restrict Other Recordable 0 2 32 28 (1) Partial Log Year IIOf N Weeks Total Hours Worked by All Employees 727 Injury and nlness Types .. Columns may not appear in same order as on the paper fonn. (0) (0) Nbr Days Away from Nhr Days Job Xfer or Work Restrict 0 1173 Data Not Available 2008 (MI) (M2) (M3) (M4) (0) (0) Injuries Skin Disorders Respiratory Conditions Poisonings Hearing Losses AU Other Illnesses 42 0 0 0 0 3 I Data Not Required Annual Average Number of Emolovees 3.6 I Partial Log Year tlOf N Weeks Total Hours Worked by All Employees 702 Number of Days Injury and mness Types .. Columns may not appear in same order as on the paper fonn. (0) (*) 0 1777 Data Not Available 2007 (Ml) (M2) (M3) (M4) (O) (*) Injuries Skin Disorders Respiratory Conditions Poisonings Hearing Losses AU Other Illnesses 50 0 0 0 0 1 I Data Not Required Annual Average Number of Employees 4.2 I Partial Log Year # Of f N Weeks Total Hours Worked by All Employees 703 Number of Days Injury and llIness Types ·Columns may Dot appear in same order as on the Diner form .. Columns may not appear in same order as on the paper fonn. CO') (*) Nbr Days Away from Nbr Days Job Xfer or Wor\:: Restrict 39 1004 I 2193176 "'Columns may not appear in same order as 00 the D;lIX'T form Nbr Days Away from Nbr Days lob Xfer 01 Work Restrict I 1559373 Number of Days DART RATE Number of Cases I ·Columns may not appear in same order a.~ on the oanef (orm DART RATE Deaths Data Not Required Annual Average Number of Emplovees 4.9 Number of Cases SUMMARY OSHA-300A DATA I DART RATE Number of Cases SlTl\.fMARY OSHA-300A DATA Data Not Available 2009 1634814 (MI) (M2) (M3) (M4) (0) (0) Injuries Skin Disorders Respiratory Conditions Poisonings Hearing Losses All Other Illnesses 57 0 2 0 0 3 Ricardo Cruz-Segarra Safety & Health Supervisor Division of Occupational Safety and Health 204 Charlotte Hwy, Suite B Asheville, NC 28803-8681 Cherie K. Berry (828) 299-8232 Fax: (828) 299-8266 Commissioner May 10,2011 POB 308 Morganton, NC 28680 RE: ERGO Concerns Dear During the inspection, the Safety and Health Compliance Officer (CSHO) from the Bureau of Compliance of the North Carolinapepartment of Labor, Division of Occupational Safety and Health did observe violations of North Carolina occupational safety and health standards or regulations. Citations for those items were issued on May 6, 2011. Also during this inspection, CSHO's review of your 2008-2010 injury and illness records and first aid logs indicated a number of conditions that could be identified as potential ergonomic stressors. Following is a summary of the data from the first aid logs: YEAR TOTAL VISITS 2010 2009 2008 201 378 1489 POTENTIAL ERGONOMICS RELATED VISITS 42 184 890 %POTENTIAL ERGONOMICS RELATED VISITS 21% 49% 60% At this time, the North Carolina Department of Labor has decided not to issue citations in regards to ergonomic concerns.--As discussed in the closing conference, it is strongly recommended that Case Farms Processing develop and formalize an effective written ergonomiCS program that includes details of the aspects of its program .. An ergonomics program should be fully endorsed by management and be effectively communicated to the employees. The program should consist of at least the following elements: W6rksite Analysis .... Hazard Prevention and Control Training and Education Medical Management Worksite Analysis The worksite analysis should include review of the injury and illness data (OSHA 300 logs, NC-19 forms), employee interviews and on site analysis of the jobs conducted by employees. The worksite analysis will help pinpoint the areas on which you may need to focus first. Hazard Prevention and Controls The prevention and control of ergonomic hazards in the workplace can be accomplished by the use of engineering controls, work practice controls or administrative controls. Training and Education Educating the employees properly on ergonomic hazards and the timely reporting of pain can help inform management of problems before they get out of contro!' The employees and management officials should by trained in the proper techniques and work habits that help reduce ergonomic stress on the body. Medical Management 1. Protocol should be established to provide consistent medical treatment for the employees that experience cumulative trauma disorders (eTOs). 2. An active CTO surveillance program should be implemented to detect the magnitude and location of the problems within the workplace. 3. A conservative and medically- acceptable approach for the treatment of CTOs should be developed. Following proper treatment, a iireturn to work regimen" including light duty jobs and work hardening, should be implemented. An effective ergonomics program implemented in the workplace is essential in preventing the occurrence of CTOs. The recommendations outlined in this letter are basic approaches to preventing and managing eTOs in the workplace. You may find additional approaches to solving the ergonomic problems while implementing your program. The most important aspect of the program is management commitment and participation. The ergonomics program cannot succeed without management support. We appreciate your cooperation. Please contact our office if you have any questions or need additional information. Sincerely, Compliance District Supervisor N.C. Department of Labor Occupational Safety and Health Administration Inspection Report Fn. Mav 6. 2011 3 : 32PM RptID 0453720 Assignment Nr. Site Address CSHO ID S8606 Supervisor ID Inspection Nr. D2307 315114611 Opt. Insp. Nr. 031-11 121 Rand Street Morganton, NC 28655 Mailing Address PO Box 308 Morganton, NC 28680 Type Related Activity Type Satisfied Number Employed in Establishment Covered By Inspection Controlled By Employer Number 615 Advance Notice? 615 Union? 3000 Walkaround? Satisfied No Category No No Interviewed? H. Health Yes SIC Inspected Primary SIC 2015 Secondary SIC NAICS Inspected Primary NAICS 311615 Secondary NAICS I I Inspection Type H. Planned Reason No Inspection Scope of Inspection B. Partial Inspection Health Manufacturing Classification Inspections in Poultry Processing Industry National Emphasis POULTRY RKNEP RECORDKEEPING Local Emphasis Strategic Initiatives Anticipatory Warrant Served? Anticipatory Subpoena Served? Entry Opening Conference Walkaround Days On Site 11110/2010 1111012010 11110/2010 a No No Denial Date 08:30 AM 08:40 AM 09:00 AM Date ReEntered First Closing Conference Second Closing Conference Exit Case Closed No Citations Issued Date ReDenied ReEntered 05/04/2011 02:30 PM 05/04/2011 03:30 PM tional Information l Oracle - OSHA-l(Rev. 5/01) Page 2 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr .315114611 CSHO Signature Date Supervisor Signature Date Oracle - OSHA-l(Rev. S/Ol) N.C. Department of Labor Occupational Safety and Health Administration Inspection Narrative Fri May 6,2011 3:32PM Establishment Name Legal Entity Inspection N r. 315114611 Opt. Case Number 031-11 ICase Farms Processing, Inc. IType of Business IA. Corporation I Additional Citation Mailing Addresses I Organized EjPIoyee Groups Union Representatives Authorized Employee Representatives Name Other Management Duties Title Walk Around? ,~ ~~;.;,;'~~.;~~~~~}:"w;;· o I r-..,;,i."~>i?'·- Oracle - OSHA-IA(Rev. 5104) Page 2 3 Fri May 6, 2011 Case Farms Processing, Inc. Inspection Nr. 315114611 Page 3 Case Farms Processing, Inc. Fri May 6,2011 3:32PM Inspection Nr. 315114611 Oracle - OSHA-IA(Rev. 5104) Page 4 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 Oracle - OSHA-IA(Rev. 5104) Page 5 Fri May 6, 2011 3:32PM Case Farms Processing, Inc. Entry Opening Conference Walkaround Inspection Nr. 315114611 11110/2010 11110/2010 11110/2010 08:30 AM 08:40AM 09:00 AM First Closing Conference Second Closing Conference Exit 05/04/2011 02:30 PM 05104/2011 03:30 PM Case Closed IFollowup Inspection? \~ \Reason Oracle - OSHA-IA(Rev. 5104) Page 6 Case Farms Processing, Inc. Fri May 6,2011 3:32PM Inspection Nr. 315114611 Coverage InfonnationlAdditional Comments SAFETY AND HEALTH NARRATIVE IINSPECTION NUMBER 1315114611 I INTRODUCTION This was a Federal NEP recordkeeping inspection assigned to CSHO Branch by District Supervisor Ricardo Cruz~""I·"/C." Segarra on November 1,2010. 0 Inco and ted credentials to The purpose an scope Inspe n were exp on nspe on can e employer was issued a "Letter to Employer" explaining the purpose and scope of the inspection and a "Medical Access Order Letter" to review employee medical records .. District Supervisor Ricardo Cruz-Segarra assigned CSHO Freeman, CSHO Dowdle and CSHO Thomas to assist with the NEP recordkeeping inspection. The team was onsite from November 201 0 until February 2011 reviewing the OSHA 300 Logs for 2008,2009 and 2010, gathering data and conducing interviews. In addition, to obtaining data onsite, the team visited offsite healthcare providers to conduct interviews and review employee medical records. District Supervisor Ricardo Cruz-Segarra received a phone call on December 9,2010, from a local medical clinic regarding two injuries they treated in 2010 and were concerned about the lack of medical care being provided to employees in regard to workplace injuries. District Supervisor Ricardo Cruz-Segarra and Bureau Chief Tim Childers expanded the scope of the inspection to include the OSHA 300 Log for calendar year 2010. Inspection Procedures per CPL 2 (10-07): Description Comments A) Opening conference conducted on 11/10/10. Opening conference 8) Presentation of Access Order OVI""II~n C) Verified with what actions are taken when an employee experiences an injury/illness. ._ .. , _ .... .._--_ ..... - - - _ . - D)-The employer provided a list of all offsite healthcare providers utilized. E) Obtained copies of Disciplinary Policy, Drug Testing Policy, and Injury Reporting Policy. F) The employer does not hav~ Incentive Program Policy. P e _ sporadic rewards are given to employees such as sweat shirts or free drinks. Verify NAICS code Completed 11/10/10; the correct code is 311615. New Ownership The facility has not changed ownership since December 31, 2007. (Rev 8/05) Page 7 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 Calculate DART This was completed after the ER provided the amended OSHA 300 logs and 300A summaries. The DART rate was different than what was reported in the 001 because the ER was maintaining information for 3 separate facilities on one OSHA 300 Log. Before proceeding with the inspection, the ER had to modify the logs per consultation with Susan Haritos, Standards Officer. The 2008 001 DART rate was 6.0 and the DART rate submitted by the ER during the inspection was 3.56. Please note this was the submitted information and not the actual DART rate. The actual DART rate is 7.5 for 2008 (based on 1,199,488 employee hours worked in 2008). Records Inspection A) Requested OSHA 300 Logs, 301 Forms, Form 19's, 1st Aid Logs, and any medical records on injuries in 2008,2009 & 2010. Reviewed OSHA 300 Logs and 301 Forms for 2008,2009 & 2010 and compared the information recorded to medical notes to verify accuracy. B) Requested a 2008 employee roster and picked every 3rd employee on the roster to establish a sample of employees. The sample size was 377 employees. For this sample of employees, all employee records available (medical fries, HR files, payroll records, 1st Aid Log entries) were reviewed. C) No overrecorded cases were noted on the ER's OSHA 300 Logs for 2008 or 2009. Interviews Interviews were conducted with the followinQ people: Limited Walkaround Inspection This portion of the CPL was not conducted because the facility received a comprehensive safety and health inspection by CSHO Best and CSHO Hall on 11/15/10. Reference inspection numbers 315114876 and 315116814. In addition, the facility received a PSM inspection by CSHO Davis and CSHO Putnam on 12/8/10. Reference inspection number 314807413. I SITE DESCRIPTION Case Farms Processing, Inc. is located at 121 Rand Street in Morganton. The site consists of several buildings (Rev 8/05) Page 8 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 located on approximately nine acres. Buildings on the site include: the primary processing plant, a water pretreatment building, the offal processing building with the attached boiler house, a truck garage, a scale house, various storage buildings, and twelve cooling sheds where the chicken trailers are staged. There are several paved parking areas surrounding the primary buildings. The facility is enclosed by fencing and exterior security is provided by a contract security service. The chicken processing plant is a 83,000 square-foot, multi-story building with concretewa"s, concrete floors, and a built-up roof. The building is protected by portable fire extinguishers in the production areas and an automatic fire sprinkler system in the office areas. There are two supervised fire alarm systems in various parts of the building that are activated by water-flow sensors in the fire sprinkler system and manual pull stations. Evacuation routes are posted throughout the building. IPROCESSDEsc~pnON Case Farms Processing, Inc. is a poultry processing facility. Chickens are transported to the plant from contract growing farms in cages loaded onto semi-trailers. The trailers are staged in open-air cooling sheds and then moved to the processing building for unloading as needed. Live chickens are dumped from the cages into the live hang room where the chickens are hung upside down on shackles on an overhead transport conveyor. The chickens then pass through a decapitation process. The carcases are carried into the picking room where they are scalded and defeathered. The carcases then go through the evisceration room where the internal organs are removed. The carcases go through a water bath where they are cleaned and cooled. They then move to a second processing area where the carcase is cut up. In one area, employees process the breast, wings, and tenders and in the leg debone area, the legs and thighs are separated. The chicken parts are packed in boxes with dry ice and moved to the cooler room where they are held prior to being loaded onto semi-trailers for shipment. Additional portions of the carcases, including the feet, are processed and packed for shipment to secondary processors. The processing plant operates Monday - Friday, 10-12 hours per day. Sanitation [cleaning] crews and maintenance personnel work during the off-hours during the week and maintenance personnel [including the refrigeration staff] work on the weekends and holidays. The facility employees approximately 615 people at this location. IACCIDENT FINDINGS NA I COMPLAINT/REFERRAL FINDINGS NA I UNUSUAL CIRCUMSTANCES -- :- ...... ··1 . . - - - -. .ll.!2Lstrict Supervisor Ricardo Cruz-Segarra receiv!M!l!ld a hone call on December 9, 2010, from _ in 2010 and were concerned ab~ _ regarding two injuries, see 7x and 7y below, medIcal care being provided to employees in regard to wor p ace injuries. District Supervisor Ricardo CruzSegarra and Bureau Chief Tim Childers expanded the scope of the in 'on to include the OSHA 300 L~ . . n December 9, 2010, and met with_ obtain information about the two cases. 2) The employer did not record any days away from work on the OSHA 300 Logs for 2008 or 2009 when employees experienced work related amputations and fractures. 3) The employer placed employees who experienced work related injuries on light duty. However, employees who experienced non-related injuries were told there were no light duty jobs available for them. 4) Unusual circumstances on the 1st Aid Log, such as multiple visits to see Plant Medic without being sent to an outside HCP, are contained in Appendix A. (Rev 8/05) Page 9 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 5) Many of the Form 19's had incorrect dates and times of injuries, and incorrect dates and times for return to work. 6) had work related in uries in 2008/2009 that were not ogs or those years. owever, uld not provide the names of documented on the OS produce a medical file for those doctors they visited in most cases. In addition, when the emp employees, they could not produce one. Therefore, due to the lack of information the investigation on the claim could not be pursued. 7) In reviewing the records, the inspectors identified the following unusual circumstances: a) On or about A oat Room Cle s written up for but the form was n anyone. sent a letter ce asp stating the employee ;s responsible for the ER visit bill because~ent date to the hospital on_own free will. However, the employer sent the employee to Burke Occupational Health on 5/1/08 fOrtlie same injury and it was considered work related. The employee was taken to Grace Hospital mber 2, 2008, Cleaner, discharged home and instructed to be out of work for 3 days. After the instructed by the employer to visit Burke Occupational Health, where. light duty. c) On or about May 13, 2008, Shou~ndinitis due to overexertion from cutting chicken shoulders: The employee first visited _ o n 3/12/08, according to the 1st Aid Log, but was not sent to an outside HCP until 6/10/08. There were 23 entries on the 1st Aid Log in 2008 for this employee, however, no entries were recorded for May which is the date of injury. d) On or about September 15, 2008, Cutter, Rupture of the flexor tendon to the left ring finger with a 4 month delay in treatment: The employer reco e to Workers' Com den the claim an was p ys a ow up a In 3-5 days. The employee was never sent to Mountain Orthq by the employer. The employee did not work on 9/17 or 9/18 but the pay code for those days was log ed as The employee was not sent to a hand specialist, Carolina Ortho, until 1/20/09 Carolina Ortho on 1/22/09 and told them this is not a Workers' the medical bills. The employ~e was terminated on 6/7/09 due to failure to return was based on the injury that occurred at work. The Carolina Ortho notes from 1/27/09 state I!~ have called us and informed us in no uncertain terms that ~t" back on the job until~and is fixed." The Carolina Ortho notes from 2/17/09 state s1ilrnot been able to get any satisfaction from the clma n y . _ aM,rentlY placed _ on a job which requ~g chicken breast off of the bone, whic caniiOt"'do"With and the way it is riQbl.now ... _ needs to g e _ p st cI~rified. The time a IX this was to the emergency room a~ back when.first got hurt in Septemberwh_took Hospital. Subsequent to that they were seen b~.company doctor, whose name that do not know_ was placed on a job that was not damar. to~and. Now, the company has t o l d _ h a s to do the job pulling chicken breast off, whic cannot do, because of lack of strengt~and and pain." II " e) On or about January 5, 2009, Cutter, Tendi!ll'nitis in the ri ht hand from worki~on the cuttin line: The and then employee received in-house treatment from until 2/17/09 per were e employee requested to see an outside HCP. The employee went to race Hospital ER on 2 was placed on restricted work activity for 2 weeks and instructed to follow-up ~ina Ortho in 5-7 days. The employer sent the emp~ to Burke Occupational Health on 2 / 1 8 , _ was placed on light work 2/18 - 2/26. However_states the employee was terminated on 2/6/09 for poor work performance (this date was verified with H . . shows the e was on 2/18 sta suspend . n note by Id not d job to Thought that hand hurt was reporting it as an njury .... urke OccupationaL" The note was Signed by (Rev 8/05) Page 10 Fri May 6, 2011 3:32PM Case Farms Processing, Inc. Inspection Nr. 315114611 f) On or ~ry 3, 2008, Cutter, G.n lion cyst on the right wrist: The Mountain O~notes from right wrist for approximately two years now_ noticed a 5/9 state_complaint of pain of Jar aspect a wrist.-.stated over the past couple of years this has lump/cyst over the radi . The increased in size causi are pain." The employeehad surgery on 6/25/08 to excise the 6/25 state "no work until follow up on 3" was discharge instru . . to the hospital for the surgery an was present accompanied by on ntain Crtho sent a fax to Case F e employee at discharge. However, worked 8 may work 1 hour daily only. However, the employee's time card shows time had an hours per day the em agreement our per ay because employee ed the employee duty job for 1 hour per day was cleaning didn't want to m 5S the cafeteria. However, per oyee's time card for weekending 7/5, it states "transfer to coat room all week". Off Employee, partial amputation to the right index fing came into work the day of surgery, 6/4, to clock in and then was rned to light duty work in the cafeteria the day after surgery. h) On or a~, 2009, Line Cutter, slip on the wet floor resulting in a sprain of the right ankle .. ment 12/10 - 12/20. On 12/20 the hand: P e r _ t h e employee s.el:,.ced out of work until 12/22. employee visited Caldwell Memorial Hospital The employer sent the employee to Burke Occu re_was placed on light work. i) On or about January 14, 2010, Cutter, Neck and back strain: The employee went to Grace Hospital ER on 1/15 and was instructed not to . r n to work for 2 days. The employee was sent by the employer to was placed on light duty. The employee did not work on 1/15 and Burke Occupational on 1/15 where received an excused absence from the employer per her time card, however, the lost day was not recorded on the OSHA 300 Log. j) On or about January 21, 2010, ac, Tendon laceration from scisso the employee , 1/22, to clock in clocked in at 7: and out at 5:10 PM. 'd not work on the day of surgery. There was a e employee's file for date of service 1/22. The statement was k) On or about July 8, 2010, Sanitation Trainee, Fall resulting in, a '!!!itt knee s rain and various contusions: was placed out of work 7/12 The employee visited Cleveland Regional ER on 7/12 at 8:58PM and 7/13. The employee did not work on 7/13 and received an unexcuse absence from the employer. I) On or about January 10, 2008, Cutter, Gan lion on the right wrist from employee received in-house treatment fro includ 3/11. There were 57 entries on the 1st Aid ain Ortho _ h a s had this pain over the dorMal as ect right wrist for approximately six months ~n artho notes from 5/5 state waul to go forth wit~._ scheduled this for Wednesday, Ma 21,20 at Valdese Hospital." Pe_t~ did not have surgery at eithe . s. Mountain Ortho also has no record of the why th have and surgery. CSHO Branch aske what happened after the 5/5 ponded membe left and went back didn't have the surge donlt know didn't go back to the he employee s not terminated until 6/2 he employer has no 1/08 and 6/29/09. record of what happened between I m) On or about February 12, 2008, Chicken Hanger, Cre the employee was transferred to in the left wrist from repetitive motion: Per however, there is no (Rev 8/05) Page 11 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 documentation of the transfer in _ file. Once employee was placed in that Department it was a permanent transfer. The only ~ is a 1st Report of Injury (Internal Form) and a 301. No other information was available. Pe~ the employee was not sent to an outside H diagnosis of crepitus in the left Wrist seems to be outside the scope for a diagnosis from n) On or about March 12, 2008, Cutter, Ganglion cyst on the ri employee received 4 months of in-house treatment from HCP. There were 46 entries on the 1st Aid Log for 2008. hand from repetitive motion: The before being sent to an outside 0) On or about November 28,2009, Maintenance, Disc herniation on the left side at L5-S1 covers on the ice auger: The employee was sent to Burke Occupational on 11/30 out of work from 11/30 to 12/4. The employee left the office at 12:39 PM. At 2: 14 P faxed a revised Progress Note stating light work from 11/30 to 12/4, sit/standlwalk at intervals, cold pack hourly x 15 minutes, sedentary work. ange the note. stated the employee requested to work and asked t the employee returned terminated before being released to regular duty. Pe p) On or about August 5, 2009, Driver, taken to Rutherford Hos for e in er injury from a driving "accident: The =rTlln.r1o"== s excused from work 8/5 - 8/10. Per on uty the employee requested to be pia Ing 0 wo so urke Occupational for a second opinion on 8/5. Burke Occupational placed the employee on light work 8/5 - 8/12 with the following limitations: no prolonged walking/standing, no kneeling/squatting, no left arm, no operation around movi no use arm. loyee worked in machine no drivi light duty the employee was tOl"rnln'~TO, ng re . The oyee received a traffic citation for the driving q) On or about June 2, 2009, Grading, Strain to left wrist from overexertion: According to.the employee was hired on 5/6 and terminated on 6/4 for excessive absenteeism. According to the employee's HR file, the only absences..a,ad were late more than 2 hours on 5/26 and an excused absence on 6/3 for court. Although, the empTQYer states the employee was terminated on 6/4, the employee's time card shows an unexcused absence on 6/5. r) On or about March 30, 2009, Cutter, Lateral epicondyliti~pulling tenders: The date of injury documented is 3/30, however, the employee went t o _ T a b l e Rock Family Medical, 3/26 for the condition. The empl provided with the progress notes from the doctor regarding ",r.r\rUf,r.,., The progress notes does a lot of he which I think is contributory. a rather pronou . s) On or about January 16, 2009, Chicken Catcher, Lateral epicondylitis of the right elbow from catchin chi yee visited Table Rock Fam~edical on 1/16 for the condition The ~ress notes state . .is voluntarily going to a take a wee vaca ooses to not do this"should be-"'l.light duty for 1 week and I thin~will be back to normal s ortly,." Per the employee's time cards. .worked instead of taking vacatio'n,1iowever, the time card shows.worked as a chicken catcher. Table Rock Family Medical has no notes for any follow-up visits (Rev 8/05) Page 12 Case Farms Processing, Inc. after 1/16. The employee.quit to Fri May 6, 2011 3:32PM Inspection Nr. 315114611 on 2/27 p e r _ t) On or about February 23, 2009, Maintenance, Strain to right shoulder from falling in manhole: The employee was taken to Grace Hospital ER on was instructed not to return to work for 1 day. After the ER visit, the employer took the emplo Occupational for a second opinion on 2/23, ~was instructed to go home on 2/23 and return to regular work on 2/24. Then Burke Occupational sent a progress note to the employer on 2/23 with an addendum stating "Patient may return to work on 2/23/09 with no use of right shoulder. 1I u) On or about January 23, 2009, Cutter, Ganglion cyst and carpal tunnel syndrome from the right wrist: The first documentation of the employee seeing an outside HCP is on 5/21 sent to Mountain Ortho and assessed with right arm pain and scheduled for a nerve condu MRI. On 5/21 the employee returned to Mountain Ortho for a follow-up visit an at Carolina Ortho for treatment of carpal tunnel. The employee was seen 0 contacte~ lion and carpal tunnel syndrome. On to get authorization for 9/2 appointment. uld not authorizetlie' use t employer wants a 3rd opinion. On 3/18/10 the em ~s sent to Carolina the 3rd opinion. The progress notes f is visit state "It is worse when. .works and sleeps does relate this to t~use hand at work. The work is highly repetitive_ has rea ad no treatment at a l l . ' _ diagnosed the employee with work-related tendinitis iriTFleright han caus~'ng seconda carpal tunnel syndrome and stenosing tenosynovitis of the right middle finger. In addition wrote in the progress notes: "In y OpinIOn, this is very straightforward. The patient has tendinitis due to overuse. Thii.Jlils put pressure on the median nerve causing pain that goes into the hand and also radiates up" arm. . I would recommend the patient go into _ has a trigger finger related to the iiWae pathoRo ~at. wears at night and when_drives, can wear it at work, it might be helpful. An anti-inflammatory such as Naprosyn woul e e p ul. If this did not work, a steroid injection into the carpal tunnel would be helpful. I saw the patient today for a second opinion only. I would agree to see this patient for treatment but I will not do so w~ny limitations on my ability to treat this patient properly. Specifically, this means I will not treat. given restrictions on what that treatment might entail ether ical or non-surgical. lI In an email dated 3/22/11, stated the following when asked about this have appo nts the went to Carolina Hand on 3/18/2010 case: "The only thin.e and was released. had no excisions or surgeries. No further treatment after the ." appointment on 3/1 v) On or about October 28, 2009, Cutter, Slip and fall resulting in spraining left thumb, bruising left forearm and spraining the thoracic cavity: The employee was sent to Burke Occupational on 10/29 where "'was placed on light duty 10/29 -11/5 with the following restrictions: no repetitive bending/stooping, no PLiSf,ing/pulling, no lifting over 5 I limited/no use of back and left arm. The e e s' on 11/4 ast would be 10/30 due The em yee an appea e ap Iman use the employer did not assign claimant wo rdance with medical restriction ... Claimant was not assigned to facility cafeteria during light duty restrictions as indicated by employer, but assigned to work in another production area that required claimant to handle bags with injured forearm and thumb ... The claimant was not disqualified for unemployment benefits." The employee's time card shows_did not work 11/2 - 11/5 and received unexcused absences, however, HR states the termination dre'Was 10/30. w) While reviewing_file the CSHOs found a "Patient Work Status Report" from Carolina Ortho dated 12/8/08 stating not able to return to work, diagnosis of a tendon laceration right hand, and treatment is surgery 12/12/08. Also, in the employee's file was a "Payroll Change Notice" stating the employee voluntarily quit on 12/8108. CSHO Branch visited Carolina Ortho to determine if the surgery was work related and they could not find a file on the employee. The only explanation they could offer was this employee may have been a translatorforthe injured patient and the wrong name was written on the status report. There are no injuries recorded on the OSHA 300 Log for 12/8/08. The employer did not have a medical file for the employee in question. x) During an employee interview on 2/15/11, had gotten a sliver of (Rev 8/05) Page 13 Case Farms Processing, Inc. Fri May 6, 2011 3:32PM Inspection Nr. 315114611 w . ewas cuttin~s knife broke_ an pu~s in. . .~ on a week for 2 an sendWlback to work. Id_needs~ for injury. The employee went to the amaritan Crrnrcsecause_ The Good Samaritan Clinic did not have the capability of examining the eye and sent urox drops i n . eye to numb it, colored rgent Care. At Psalms Urgent uSing pH paper, and looked at it with a black light. there was extra skin rotruding as if it was covering up a foreign body. They then The employee did not visit this facility becaus 0 Branch and Supervisor Ricardo Cruz-Segarra s to Eyecare Specialists on 2/28/11, approximately 9 months a checked. No foreign bodies were found inthe eye. metal from a knife in went to month 2010, Forklift Driver, overturned forklift: . was reported when it h~n'''lcr,cl"1 d to feel the right side and was s Occup was told these ms are normal. Burke lagnose with Bells Palsy an ne strain and sent_for a CT scan. The CT scan was n~ve for abnormal . The employee continued tgJJave multiple neurological issues on the right side o~body and could not close "right ey'e. On 11/8"visited the Good Samaritan Clinic for further treatment. The Good Samaritan crr;;ic sent. for a CT scan of the head and MRI of the brain. The CT scan was ative but the MRI ~hing~against the optic nerve. The employee was sent _ sent to Grace Hospital ER on 11/9 and Grace tr"'lloI"C"t,orr.::lol" due to the unusual situation. he employee ~o all the docto not ave any neurological issues prior to the forklift accident. On 1 1 / 1 0 , _ eye stitched shu Baptist Hospital. The Baptist Hospital notes state "35 yo HM wI right CN VII palsy following a fall at work, found to have abnormality on CT and MRI imaging which is favored to represent fibrous dysplasia and is likely incidental." The employee was admitted to the hospital on 11/10 and discharged 11/12. In speaking with the Workers' Comp ca eny ase on agnos of Be alsy and neck strain. The dates provided by the employer for restricted work activity are 11/4 - 11/11, but the last day the employee worked was 11/5. The e.yee was absent 11/8 -11/29. The absences 1118 -11/12 a coded as unexcused per ime card. All the other absences were coded as excused. Per the employer has not paid any of the medical bills oth~n the visit to Burke Occupationa is still under the treatment of a doctor and does not feel_ well but is working becausell cannot to keep going to the doctor. The injury is recorded on the OSHA 300 Log as a neck strain injury. that occurred on 7/21/08: on 81 . ived a phone ca me that had a large amount 0 sure in better shape h would not have broken. was a person s wondering wou at be a personal thing i f . te shape they was then they wouldn't have broken. Can we get this denied?" aa) In reviewing an employee's HR file it was noted a FMLA notificati to 6/2/08 for an inguinal hernia repair. as that not been in the 4/18/08 was work (Rev 8/05) Page 14 Fri May 6, 2011 3:32PM Case Farms Processing, Inc. Inspection Nr. 315114611 related and the company paid the medical bills_drew a paycheck while out. CSHO Branch visited two different doctor's offices and the local hOSj:)itaiin relation to the hernia but could not find any documentation where the employer paid for the treatment. The only documentation indicating it could possibly be work related was at Cloud Surgical Solutions where a note stated "due to every day activities However, the office did not have any documentation on file that was work related injury and the surgery was billed to the employee's personal insurance. ll • I GENERAL I Due to the number of instances of recordkeeping violations, consideration was given as to whether or not recommended citations should be willful. Following a review of pertinent information and employer responses to the violations it was determined that the violations should not be classified as willful. Determining factors included: 1. The errors made by the employer in recordkeeping were not intentional violations of the standard or plain indifference to its requirements. 2. The major error of not recording an injury on the OSHA 300 logs occurred only 10 instances for calendar years 2008 and 2009, which were out of 100 entries for the combined years. The other entry errors were based on miscalculations and not on omissions. ed hands multiple times since 2008. in July 2009 n August 2009 the spring of 2010 personnel 3 times from 2008 to 2010 In ..... 1"I'!lI,nl"'u:~rI was questioned about specific instances not being recorded or recorded 4. incorre A. B. id not think the lost day was recordable because the company had the employee come clock in ay of surgery so he/she would be paid for the day. C.~id not realize the injury was recordable due to a lack of lost days/restricted days/prescription given. on Violations were observed regarding recordkeeping procedures and citations were issued 2008 and 2010. A cl May 4,2011, calendar to discuss Pl"'ltC'''ltr!:l1 was not In e closing co n 1'o.rcr'\ ..... o' ns an Inet'-:::.nr'o questions could!1 Address Occupation Duration Employer Case Farms Processing, Inc. Frequency . Occupation Duration Employee N arne I -". \: Address Occupation Duration Employee Name Address Phone Phone \ ; L '\ \ \ I Employer Case Farms Processing, Inc. Frequency I Phone I Employer Case Farms Processing, Inc. Frequency I Oracle OSHA.IB/lBIHprint(Rev. 5104) Page 3 Fri May 6, 2011 3:33PM Employee Name Address \ Occupation Duration Employee cName t, ,/ ;, I; t EmJ>loyer Case Farms Processing, Inc. Frequency f', \.,. I ''''l i t / I ~' ~ Occupation Duration Employee Name Address Employer Case Farms Processing, Inc. Frequency ~, ~-! r:r'; r: ; E 1-:. tr. / I I- ; Employer Case Farms Processing, Inc. Frequency t~ " ;' I I ~~t \~ ~., - Occupation Duration Employee Name Address I Phone ~ ~ Employer Case Farms Processing, Inc. Frequency ~:: ~ I l t,. ~, I' 1 I Phone \ ! ''l\\ i\ Occupation Duration Employee Name Address Employer Frequency Case Farms Processing, Inc. I ~;;. f f' \'-. I "I A. Hazard B. E ui ment C. Location D.ln·ury/Illness GBP Good Faith Size History Total Adjustment Factors 0% 0% H-High M-Medium L-Low N-Non serious G- Greater L- Lesser $7000 Admin Repeat Factor E. Measurements Adjustment Factors Penalty Calculations Probability I Phone f, - Instance Descri tion: Severity I Phone \,: ,. I Phone :1 Occupation Duration Employee Name Address I Phone / ~ Occupation Duration Employee Name Address I ./ ; 11 Address Employer Case Farms Processing, Inc. Frequency I \\ I Phone t !" Unadjusted GBP 0% S&H Cooperation 0% 0% Proposed Adjusted Penalty $7,000 Repeat GBP $0 4. Date/Time 11110/10 Oracle OSHA-lB/IBIHprint(Rev. 5/04) Page 4 Fri May 6, 2011 3:33PM 20. Instance Description - Describe the following: a) Hazards-OperationlCondition-Accident: Administrative Violation / The employer failed to record each injury and illness that was work-related on the OSHA 300 Logs. CSHO Branch requested copies of the OSHA 300 Logs for the years of 2008, 2009, and 2010 to review. The entries on the logs were compared with doctor's notes, employee medical records, NCIC Forms, Workers' Compensation Forms, accident reports, pI Aid logs and employee interviews. It was observed there were 8 instances not recorded in 2008 2 instances not recorded in 2009, and 3 instances not recorded in 2010, CSHO Branch ri 1nt''''t"U1J:>11" .. 1)On or about April 25, 2008 aid to . ude prescr.' tion medlc:atlj::ms addition vas placed on restncted work actl for 19 days due to the fall. It was written up for improper footwear on 5/2/08 but the form was not signed by letter dated 5/14/08 to Grace Hospital stating the employee is responsible for the to the hospital own free will. However, the employer sent the employee to Burke on 5/1/08 for the same injury and it was considered work related. on. 2) On or about September 2,2008 was placed on restricted ER on 9 accompanied by the employer 7 days. In addition, the employee was prescribed received medical treatment beyond first aid and The employee was first taken to Grace Hospital llru;trulcte~d to be out of work days. was ptnnIA'\lpp left the instructed duty for nl'l.'icl'I.ninlCT 3) On or about May 13, 2008, and was placed on restricted shoulders. In . to received medical treatment beyond first aid days for tendinitis due to OVI!rexe1rtlCl11 , the employee was prescribed It was noted the employee first , but was not sent to an outside HCP unti16/10/08. were entries on the 1st Aid Log in 2008 for this employee, however, no entries were recorded for May which is the date of injury. 4) On or about March 24, 2008 by a binder. 5) On or about June 26, 2008, from fan. received a dental crown after being hit in the mouth received sutures for a laceration to the head 7) On or about February 8, 2008, was placed on restricted work activity for sedentary work for 2 days due being hit in the head with a metal pole. 8) On or about September 15, 2008, received medical treatment beyond first aid due rmg finger, had 28 days away from work, and was placed on to the rupture of the flexor tendon to restricted work activity for152 days. The employee ruptured the flexor tendon to the left ring finger and had a 4 month delay in treatment: The employer but then lined it off due to Workers' claim. isited Grace ER on 9/16/08 and was out .1"lC"t.... "I'>t".rf to follow up with . Ortha in 3-5 days. The employee was never sent to Mountain Ortho by the employer. The employee did not work on 9/17 or 9/18 but the pay code for those days was as The employee was not sent to a hand specialist, Carolina Ortho, untill /20/09. corltacted Carolina Ortho on 1122/09 and told them this is not a Workers' Comp aIm. paid the medical bills. The employee was terminated on 6/7/09 due to failure to return was based on the injury that occurred at work. The Carolina Ortho notes from 1127/09 state "They have called us and informed us in no uncertain terms that~~ant_ack on the job until_and is fixed." The Carolina Ortho notes from 2/17/09 state~as still not been 11 • ". Oracle OSHA-IBIlBlHprint(Rev. 5/04) Page 5 Fri May 6, 2011 3:33PM able to get any satisfaction fr~pany.!tIpparently placed on a job Whichii!eqUiresulling chicken breast off of the bone,~annot do with left hand the way it ~.t now.. needs to ge~omp status clarified. The time to IX this was back whe rst got Hurt In eptember w h e _ t o o . o the emergency room at Grace Hospital. Subsequent to that they were seen by a company doctor, whose name that do not know_was placed on a job that was no~ hand. Now, the company has t o l d _ has toCiOtlie job pulling chicken breast off, _cannot do. because of lack of strength in ~ and pain. t_ 11 9) On or about September 18, 2009 . due to include a prescription 0 received medical treatment beyond first aid gettmg chIcken grease in the right eye. 10) On or about January 5, 2009 placed on restricted work activity line. The """."nl/,\u"."" received medical treatment beyond first aid to a contusion and sprain of the left foot and toes from 11) On or about June 10. 2010 to include slipping. received medical treatment beyond first due to a fall in the restroom resulting 12) On or about J aid to include in a chipped ical treatment beyond first aid due to and was placed on light duty for 9 days. 13) On or about June 1, 2010 epididymitis to inc b) c) d) e) Equipment: OSHA 300 Logs Location (a-c): Facility Injury IIllness: Administrative Measurements: Review of OSHA 300 logs, 301 forms, Form 19, Medical Records, Management interviews and Employee interviews Location on Video 21. Photo Number 23. Employer Logs in 2010. All of the cases not on an offsite healthcare provider was authorized by had received formal training on OSHA 300 es on the 300 Logs and maintaining the Logs. cOInpJiete:d the incident. All medical treatment to visit gs, Employee medical files, interview forms, ORIA database information, Company osing Conference): lined the entry for because it was denied by Workers' Oracle OSHA-IBIlBIHprint(Rev. 5104) Page 6 Fri May 6, 2011 3:33PM ""....... ·nln·u""rt once the case was o v e r t u r n e d _ stated the reason the injury f o r _ was not recorded on the log was by Case Farms at the time of the injury. 25. Other Employer Information: SEVERITY: PROBABILITY: 26. Classification: Serious Knowledge N Y First Repeat S or 0 Repeat? Willful? N N 0 Second Repeat Repeat Penalty I Oracle OSHA-IB/IBIHprint(Rev. 5/04) N. C. Department of Labc. ;Division of Occupational Safety and Health Worksheet Fri May 6,2011 3:33PM 315114611 031-11 Inspection Number Opt. Insp. Number Establishment Name Case Farms Processing, Inc. Type of Violation N Nonserious Number Exposed 615 No. Instances 1904. 7(b)(3) Std. Alleged Vio. Abatement Completed Code Abatement Documentation Required 01 17 Citation Number Item/Group 002 REC Egre.gious Days to Abate Days Type 5 W Date Abated Date Verified Final Abatement Due Date No MULTISTEP Type Days Due Date Track Completed Code ISubstance Codes IAVD/Variable Information: 29 CFR 1904.7(b)(3): When an injury or illness involved one or more days away from work, the employer did not record the injury or illness on the OSHA 300 log with a check mark in the space for cases involving days away from work and enter the number of calendar days away from work in the number of days column: a) Located at Case Farms Processing, Inc., Morganton. NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2008. 1) On or about December_18, 2008, Mechanic:. an employee slipped andfell into a gearbox and the case was recorded as restricted work activity. when the case resulted in days away from work. The case resulted in 7 days away from work and 173 restricted work days. 2) On or about January 3, 2008, Cutter: an employee developed a ganglion cyst on the right wrist and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 179 restricted work days. 3) On or about May 23,2008, Maintenance: an employee fractured the left pinky finger due to getting it caught in the projections of a wheel and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 8 days away from work and 20 restricted work days. 4) On or about September 3, 2008, Stack Off Employee: an employee caught his finger in a conveyor resulting in a partial amputation to the right index finger and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 62 restricted work days. 5) On or about November 4, 2008, Cutter: an employee received a tendon laceration and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work Oracle OSHA-lBIlBIHprint(Rev. 5104) Page 2 Fri May 6, 2011 3:33PM and 46 restricted work days. 6) On or about October 10, 2008, Cutter: an employee reached in a leg skinner and received a partial amputation of the left index finger and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 16 days away from work and 85 restricted work days. b) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2009. 1) On or about June 13, 2009, Maintenance: an employee received a welding burn to both eyes and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 3 restricted work days. 2) On or about November 19, 2009, Sanitation: an employee received a left hand contusion & abrasion and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 61 restricted work days. 3) On or about December 10, 2009, Line Cutter: an employee slipped on the wet floor resulting in a sprain of the right ankle hand and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 26 restricted work days. 4) On or about March 20, 2009, Cleaner: an employee received a partial amputation of the left index finger from machinery and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 2 days away from work and 42 restricted work days. 5) On or about July 28,2009, Driver: an employee was hit by a forklift resulting in a right wrist sprain, back contusion, and hip contusion and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 2 days away from work and 162 restricted work days. c) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 log for calendar year 2010. 1) On or about January 14, 2010, Cutter: an employee experienced neck and back strain working on the line and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 31 restricted work days. 2) On or about January 21,2010, QC: an employee received a tendon laceration from scissors and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 70 restricted work days. 3) On or about February 23, 2010, Bagger: an employee experienced back strain from lifting a box and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 8 restricted work days. 4) On or about July 8, 2010, Sanitation Trainee: an employee fell resulting in a left knee sprain and various contusions and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 120 restricted work days. 5) On or about August 10, 2010, Lead Person: an employee caught the left index finger in a sprocket on the wing line conveyor resulting in a partial amputation and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 5 days away from work and 42 restricted work days. 6) On or about January 29,2010, Line Cutter: an employee slipped on the stairs resulting in contusions, abrasions, and back strain and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 179 restricted work days. Oracle OSHA-IB/IBIHprint(Rev. 5/04) Page 3 Fri May 6, 2011 3:33PM ,, Employee Exposure: Occupation Duration ~ Employer Case Farms Processing, Inc. I Frequency Employee Name Address I Phone Occupation Employer Duration Employee Name Frequency Address. Case Farms Processing, Inc. I I Phone Occupation Employer Duration Frequency Case Farms Processing, Inc. I Employee N arne ;"' Address Employer Case Farms Processing, Inc. Frequency Occupation Duration Employee Name I ; I Phone Address Occupation Employer Duration Employee Name Frequency Case Farms Processing, Inc. I f I Phone Address IInstance Description: A. Hazard B. Equipment Penalty Calculations Severity H-High M-Medium I Phone .-.~. - L-Low N-Non serious Probability C. Location D. Injury/Illness Adjustment Factors Good Faith Size GBP History Total . Adjustment Factors 0% 0% '--< G- Greater L- Lesser $7000 Admin Repeat Factor E. Measurements Unadjusted GBP 0% S&H Cooperation 0% 0% Proposed Adjusted Penalty $7,000 Repeat GBP $0 4. DatelTime 11/10/10 Rev. 5/04 Page 4 Fri May 6, 2011 3:33PM 20. Instance Description - Describe the following: a) Hazards-OperationiCondition-Accident: Administrative Violation I The employer failed to record each injury and illness that resulted in days away from work on the OSHA 300 Log. CSHO Branch requested copies of the OSHA 300 Logs for the years of 2008, 2009, and 2010 to review. The entries on the logs were compared with doctor's notes, records, NCIC Forms, Workers' Compensation Forms, accident reports, 1Sl Aid logs . It was observed there were 6 instances not recorded in 10. CSHO Branch interv' 5 1) On or about December 18, 2008 slipped and fell into a gearbox and the case was recorded as restricted work acti , when the case in days aw from work. The case resulted in 7 away from work and 173 restricted work days. The employee had on 2/10109 and was placed out of work 2/10 - 2/16. 2) On or about January 3, 2008, developed a ganglion cyst on the right wrist and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 179 restricted work days. The day the employee was out of work was 6125 for the excision of the ganglion cyst. It was noted, the Mountain Ortho notes from 5/9~has a complaint of pain ht wrist for approximately two years now.oticed a lumplcyst over the radial volar aspect o . n s t . stated over the past couple of years this has increased in size causing_more pain. The employee had surgery on 6/25/08 to excise the cyst. The discharge _ on 6/25 state "no work until follow ~ 3".was accompanied b y _ to the hospital for the surgery a n d _ w a s present at discharge. However, at 5:31 PM on 6/25, Mountain Ortho sent a fax to Case F . the employee may work 1 hour daily only. However, the prnf'\ll"\uPp's time card shows time 8 hours per 6/26,6/27 6/30 7/1 7/2 and 7/3. an agreement to I per didn't employee s light duty job for 1 hour per day card for weekending 7/5, it states "transfer to coat room O_.i It 3) On or about May 23, 2008, fractured the left pinky finger due to getting it caught in the projections of a case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 8 days away from work and 20 restricted work days. The employee was out of work 6/4 - 6/11 and had surgery at Grace Hospital on 6/6. The NCIC form 28 (Return to Work) states disability began 6/4/08 and the employee returned to work 7/2/08.Although. the Work Status Report from Carolina Ortho states for the employee to return to light duty work on 6/12. 4) On or about September 3, 2008 resulting in a partial amputation to and the case when the case resulted in days away from work. The case resulted' work days. The employee did not work on the day of surgery 9/4 . • arne in to work on the day of surgery to clock in and then was taken to to light duty work in the cafeteria the day after surgery. received a tendon laceration and the case was 5) On or about November 4, 2008, _ recorded as restricted work a c t i v i t y : - = ' days away from work. The case resulted in 1 day away from work and 46 restricted work days. The employee had a flexor tendon repair on 1116 and did not work this day. 6) On or about October 10, 2008, , reached in a leg skinner and received a partial amputation of the left index finger and the case was recorded as restricted work activity, when the case ~days away from work. The case resulted in 16 days away from work and 85 restricted work days. _ W o r k Status Report notes dated 1I5/~m Carolina OrtIwfate not able to return to work for 2 weeks; return to full duty on 1/19/09. Howeve~ime card showsllllworked. 7) On or about June 13, 2009, received a welding burn to both eyes and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 3 restricted work days. The employee visited Grace ER on 6/14 was instructed not to return to work for 1 day. Rev. 5/04 Page 5 Fri May 6, 2011 3:33PM 8) On or about November 19, 2009, received a left hand contusion & abrasion and the case was recorded as restric work . when the case resulted in days away from work. The case resulted~ay from work and 61 restricted work days. On 11120 the employee was sent to Burke Occupational~as sent home for the day and instructed to return to light duty on 11121. The employee's time card shows.ad an excused absence on both 11120 and 11123. 10) On or about March 20, 2009 received a partial amputation of the left index finger from machinery and the case was reco as work activity, when the case resulted in days away from work. The case resulted in 2 days away from work and 42 restricted work days. The employee had surgery on 3/20.The Return To Work Recommendations from Mountain Ortho dated 3/20 state the employee may return to work with restrictions on 3/23/09. 11) On or about July 28, 2009, was hit by a forklift resulting in a right wrist sprain, back contusion, and hip contusion and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 2 days away fwm work and 162 re~ted work days. The employee visited Grace Hospital ER on 8/11 and given a Work Release Form sta~.could return to work on 8/14. The employee did not work 8/12, 8/13 or 8114 andlltime card shows_had an excused absence from the employer. 12) On or about January 14, 2010, experienced neck and back strain from working on the line and the case was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 31 restricted work days. The employee went to Grace Hospital ER on 1115 and was instructed not to return to work for 2 days. The employee was sent by the employer to Burke Occupational on 1115_ _ was placed on light duty starting on 1116. The Burke Occupational note also says "home today". The employee did not work on 1115 and received an excused absence from the employer per_time card. 13) On or about January 2 1 , 2 0 1 0 , _ , received a tendon laceration from scissors and the case was recorded as restricted wo~e case resulted . The case resulted in I day away from work and 70 restricted work days. Per the employee came into work the day of , 1122, to clock in and for ,clOlck~!d in at 7:51AM out at 5:10 PM. did not work on the day of surgery. The employee was adnlltt(~d hospital at 8:24 post op instructions were to keep right hand elevated on pillows. There was a billing statement from Nurse Anesthesia of NC in the employee's file for date of service 1122. The statement was mailed to the employee's home address. 14) On or about February 23, 2010, experienced back strain from lifting a box and the case was recorded as restricted actIvity, when the case resulted in days away from work. The case resulted~way from work and 8 restricted work days. The employee was sent to Burke Occupational on 2/24 _ w a s placed on light duty 2124 - 3/3. The employee arrived at the appointment at 2:40 PM 's time . at 1:52 PM and clocked out at 3:23 PM. and left at 3:07 PM. The to go home e~ b y . went to tell management. did not asked"hat happened.was told to punch in/out taken to the doctor. 15) On or about July 8,2010, fell resulting in a left knee sprain and various contusions and was recorded as restricted work activity, when the case resulted in days away from work. The case resulted in 1 day away from work and 120 restricted work days. The employee was taken to Grace Hospital ER on 7/8 but there are no detailed discharge instructions. On 7/12, the employee visited Cleveland Regional ER at 8:58PM_was placed out of work 7/12 and 7/13 . •time card show.orked on Rev. 5104 Page 6 Fri May 6, 2011 3:33PM 7/12 but did not work on 7/13 and received an unexcused absence from the employer. caught the left index finger in a sprocket on 16) On or about August 10, 2010, the wing line conveyor resulting in a partial amputatIOn and was recorded as restricted work activity, when the case resulted in days away from work. T h _ away from work and 42 restricted work days. The employee had surgery on 8/11 and _ Report from Carolina Ortho dated 8/10 state to return to one handed work on 8/16. The NCIC form 26A states the employee returned to work on 8/16. The employee's time card showsllwas absent 8/11, 8/12, and 8/13 and these days were counted as excused absences. Per the employee's time carct1llreturned to work on 8/16. 17) On or about January 29, 2010, slipped on the stairs resulting in contusions, as restricted work activity, when the case resulted in days away abrasions, and back strain and was from work. The case resulted in 1 day away from work and 179 restricted work days. The injury happened on a Friday, 1129, and the next Monday, 2/1, the employee did not report to work. Per the employee's time card, the employer counted the day as an excused absence. The employee was sent to Burke Occupational on 2/2. b) c) d) e) Equipment: OSHA 300 Logs Location (a-c): Facility Injury/Illness: Administrative Measurements: Review of OSHA 300 logs, 301 forms, Form 19, Medical Records, and Employee interviews 21. Photo Number Location on Video 23. Employer Knowledge: had received formal training on OSHA 300 Logs in 2010. •are respollS for recording injuries/illnesses on the 300 gs and maintaining the Logs. All of the cases with days away form work not recorded on the OSHA 300 Logs had a Form 19 completed for the" as well as a Form 301. All medical treatment to visit o ffsite are provider during working hours was authorized If the employee went to the ER after working hours, as well as, any discharge instructions. gs, Employee medical files, _ interview forms, ORIA data~ had to count a lost work day had the employee do this so clocked in while_as at the doctor's 25. Other Employer Information: SEVERITY: PROBABILITY: 26. Classification: Serious Knowledge N Y First Repeat S or 0 Repeat? Willful? N N 0 Second Repeat Repeat Penalty Rev. 5/04 N. C. Department of LabG_ Division of Occupational Safety and Health Worksheet Fri May 6, 2011 3:33PM 315114611 031-11 Inspection Number Opt. Insp. Number Establishment Name Case Farms Processing, Inc. T:xpe of Violation N Nonserious Number Exposed 615 No. Instances 1904.7(b)(4) Std. Alleged Vio. Abatement Completed Code Abatement Documentation Required 01 41 Citation Number Item/Group 003 REC Egregious Days to Abate Days Type 5 W Date Abated Date Verified Final Abatement Due Date No MULTISTEP Type Days Due Date Track Completed Code ISubstance Codes IAVD/Variable Information: 29 CFR 1904.7(b)(4): When an injury or illness involved restricted work or job transfer but did not involve death or days away from work, the employer did not record the injury or illness on the OSHA 300 log by placing a check mark in the space for job transfer or restriction and enter the number of restricted or transferred days in the restricted workdays column: a) Located at Case Farms Processing. Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log fqr calendar year 2008. 1) On or about December 4, 2008, Cutter: an employee experienced inflammation in the tendons of the right arm and shoulder from overexertion resulting in 32 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 23 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 2) On or about December 14, 2008, Live Haul Driver: an employee slipped on the edge of the scale and experienced a sprain/tear of the left knee resulting in 101 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. 3) On or about December 5, 2008, Cutter: an employee experienced a laceration to the left thumb resulting in 5 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 3 days. 4) On or about November 24,2008, Trimmer: an employee slipped on the stairs and fractured the tailbone resulting in 41 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 31 days. 5) On or about November 5, 2008, Leg Debone: an employee fell from a platform due to grease on the floor and fractured the left finger resulting in 75 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 43 days. Oracle OSHA-IB/IBIHprint(Rev. 5/04) Page 2 Fri May 6, 2011 3:33PM 6) On or about September 19,2008, Rework: an employee experienced a shoulder contusion from a tote falling on it, resulting in 22 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 18 days. 7) On or about September 15, 2008, Sanitation: an employee fractured the right index finger resulting in 89 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 62 days. 8) On or about May 23, 2008, Catcher: an employee experienced eye irritation from particles in the chicken house, resulting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 9) On or about January 8, 2008, Cutter: an employee experienced a strained neck, right shoulder and right wrist from overexertion resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 154 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 10) On or about June 24, 2008, Shipping: an employee experienced a partial amputation of the left middle finger from a falling pallet, resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 75 days. 11) On or about January 10. 2008, Cutter: an employee developed a ganglion cyst on the right wrist from repetitive motion resulting in 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 139 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 12) On or about February 12,2008, Chicken Hanger: the employee developed crepitus in the left wrist from repetitive motion and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 13) On or about February 6, 2008, Inspector Helper: the employee developed right shoulder strain from repetitive motion and the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). 14) On or about February 27, 2008. Leg Debone: an employee experienced a right 10th rib fracture after slipping on chicken fat, resulting in 21 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 13 days. 15) On or about March 12, 2008, Cutter: the employee developed a ganglion cyst on the right hand from repetitive motion and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 16) On or about December 10, 2008, Maintenance: an employee experienced a crush and wound injury to the left 5th finger, resulting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 17) On or about December 30, 2008,Cleaner: an employee received a laceration to the head from a metal bar, resulting in 13 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. b) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log for calendar year 2009. l) On or about December 1, 2009, Supervisor: an employee experienced an avulsion to the right middle finger from a wing saw resulting in 31 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. 2) On or about February 3, 2009, Chicken Catcher: an employee experienced hand strain from overexertion from catching chickens resulting in 28 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 10 days. In addition, the employer misc1assified the case as an injury (Ml) and it should be classified as an illness (M6). 3) On or about March 16, 2009, Supervisor: an employee experienced an avulsion of the right 4th finger tip resulting Oracle OSHA-lB/lBIHprint(Rev. 5104) Page 3 Fri May 6, 2011 3:33PM in 14 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. 4) On or about May 15, 2009, Maintenance: an employee experienced an avulsion of left index finger from the well house door closing on his finger resulting in 38 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 5) On or about November 14, 2009, Sanitation: an employee experienced a laceration to the right forearm while cleaning the bird washer resulting in 84 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 33 days. 6) On or about August 18, 2009, Mechanic: an employee experienced back strain from changing a drum during a brake job resulting in 46 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 28 days. 7) On or about December 12, 2009, Maintenance: an employee received a laceration to the left forearm after falling in the Chiller resulting in 16 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 8) On or about January 22, 2009, Supervisor: an employee experienced a ganglion cyst to the right hand from overexertion resulting in 18 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 14 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 9) On or about April 8, 2009, Cutter: an employee experienced tendinitis in the right hand overexertion from pulling chicken breasts apart resulting in 55 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 41 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 10) On or about November 28, 2009, Maintenance: an employee experienced a disc herniation on the left side at L5-S1 while installing covers on the ice auger in the Ice House resulting in 95 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 90 days. 11) On or about July 27, 2009, Cutter: an employee fractured the left index finger while working in Stack Off resulting in 14 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. 12) On or about August 5,2009, Driver: an employee sustained a left shoulder injury from a driving accident resulting in 101 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 13 days. 13) On or about November 19,2009, Cutter: the employee developed a strain to the right hand from overexertion from pulling skin off chicken breasts and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 14) On or about October 16,2009, Cutter: the employee developed a ganglion cyst to the right wrist from overexertion and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 15) On or about June 8, 2009. Driver: the employee was stung on the arm by a bee while driving a truck and the employer misclassified the case as an illness (M6) and it should be classified as an injury (Ml). 16) On or about June 2, 2009, Grading: the employee developed a strain to left wrist from overexertion from loading chickens on the coning line and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 17) On or about May 11, 2009, Maintenance: an employee sprained the right middle finger on a coil in the Ice House resulting in 125 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 109 days. 18) On or about April 7, 2009, Cutter: the employee developed tendinitis in his right thumb and wrist from cutting chicken shoulders and the employer misc1assified the case as an injury (Ml) and it should be classified as an illness (M6). Oracle OSHA-lB/lBIHprint(Rev. 5/04) Page 4 Fri May 6, 2011 3:33PM 19) On or about March 30, 2009, Cutter: an employee developed lateral epicondylitis in her right ann from pulling tenders resulting in 18 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 20) On or about January 22, 2009, Chicken Catcher: the employee experienced overexertion to the right hand from catching chickens and the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 21) On or about February 2, 2009, Chicken Catcher: the employee experienced strained rib muscles while catching chickens and the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 22) On or about January 16, 2009, Chicken Catcher: the employee developed lateral epicondylitis of the right elbow from catChing chickens and the employer misclassified the case as an injury (M 1) and it should be classified as an illness (M6). c) Located at Case Farms Processing, Inc., Morganton, NC: The employer did not record the following workplace injuries and illnesses correctly on the OSHA 300 Log for calendar year 2010. 1) On or about November 30,2010, QC: an employee experienced a sprained right ankle from a fall resulting in 22 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 8 days. 2) On or about March 15,2010, Cutter: an employee developed a ganglion cyst on the right wrist from repetitive motion resulting in 53 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 38 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 3) On or about July 6, 2010, Cutter: an employee developed epicondylitis in the right elbow from repetitive motion resulting in 49 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 39 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). Employee Exposure: \ Occupation \ Duration Employee Name Address ,. \ / ,/ Occupation Duration Employee Name Address 1/ Phone I Phone I~ ~ f· I L /'1 ;- Occupation Duration f ;" ! i I E ll1plqyer Case Farms Processing, Inc. Frequency ~; l I Employer Case Farms Processing, Inc. Frequency ? I I I I / I Occupation Duration Employee Name Address EmpJo-'yer Case Farms Processing, Inc. Frequency i Phone " I Employer Case Farms Processing, Inc. Frequency I Oracle OSHA·IB/lBIHprint(Rev. 5104) Page 5 Fri May 6, 2011 3:33PM i Em 10 ee Name Address ! ~r Occu ation Duration Em loyee Name Address l Occu ation Duration I I Phone Ii · I Phone Employer Case Farms Processing, Inc. Frequency Employer Case Farms Processing, Inc. Frequency I I,"{ ~;d::SSee Name ~ t,: /: Occu arion Duration Em loyee Name I : ii ~ i' t, J. Occu ation / '" [ i' Duration Em 10 ee Name ------- Address ...... ..... Occu ation Duration Em 10 ee Name Address Employer Case Farms Processing, Inc. Frequency I i; Address I Phone I Phone Employer Case Farms Processing, Inc. Frequency I ~ ~ i I, ,. I Phone '\ Employer Case Farms Processing, Inc. Frequency /' I I Phone A. Hazard Instance Descri tion: B. E ui ment Probability H-High M-Medium L-Low N-Non serious G- Greater L- Lesser GBP $7000 Admin Unadjusted GBP Repeat Factor D. In'ur /Illness E. Measurements Adjustment Factors Penalty Calculations Severity C. Location Good Faith Size 0% S&H Cooperation 0% 0% History Total Adjustment Factors 0% 0% Proposed Adjusted Penalty $7,000 Repeat GBP $0 4. Date/Time 11/10110 20. Instance Description - Describe the following: a) Hazards-OperationfCondition-Accident: Administrative Violation I The employer failed to correctly record each injury and illness that resulted in restricted work activity and/or job transfer on the OSHA 300 Log. CSHO Branch requested copies of the OSHA 300 Logs for the years of 2008, 2009, and 2010 to review. The entries on the logs were compared with doctor's notes, employee medical records, NCIC Forms, Workers' Compensation Forms, accident reports, 1st Aid logs and employee interviews. It was observed there were 16 Rev. 5104 Page 6 Fri May 6, 2011 3:33PM 1) On or about December 4, 2008, experienced inflammation in the tendons of the right arm and shoulder from overexertlon resultmg III days of restricted work activity. The employer incorrectly recorded the restricted work activity as 23 days. The employee was placed on restricted work activity 12/09/08-1/12/09. In addition, the employer misclassified the case as an injury (M1) and it should be classified as an illness (M6). 2) On or about December 14, 2008, slipped on the edge of the scale and experienced a sprain/tear of the left knee resulting in 101 days of restncted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. The employee was placed on restricted work activity 12/19/08-2/15109 with the following restrictions: no prolon~ walking/standing, no kneeling, squatting or climbing; wear knee brace. The BRHC notes on 2/16109 state. . current work/activity status is limited with restriction of wearing the brace, and no prolonged standing, kneeling, s The was placed back on restricted work activity on 3/9109 4/20/09. recorded the case as medical treatment only because. 3) On or about December 5, 2008, experienced a laceration to the left thumb resulting in 5 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 3 days. The employee was placed on restricted work activity 12/5 - 12/10. 4) On or about November 24, 2008 slipped on the stairs and fractured.ailbone resulting in 41 days of restricted actIvity. The employer incorrectly recorded the restricted work activity as 31 days. The employee was placed on restricted work activity 11125/08 - 115/09. 5) On or about November 5, 2008, fell from a platform in Dept 1145 due to grease on the floor and fractured the left finger resulting in 75 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 43 days. The employee was placed on restricted work activity 1116 - 11111 with limited or no use of the left hand. The employee was placed on restricted work activity 11111108 - 1123/09 with restrictions of no vibration, limit grasp/pinch left hand, and splint while working. 6) On or about September 19, 2008 experienced a shoulder contusion from a tote falling on it, resulting in 22 days of work activity. The employer incorrectly recorded the restricted work activity as 18 days. The employee was placed on restricted work activity 9/21 - 10/12. 7) On or about September 15, 2008, fractured the right index finger resulting in 89 days of restricted work lty. employer incorrectly recorded the restricted work activity as 62 days. The employee was placed on restricted work activity 9/16 - 12/15. 8) On or about May 23,2008, experienced eye irritation from particles in the chicken house, resulting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. The employee was placed on restricted work activity 5/23 - 5/30. 9) On or about January 8, 2 0 0 8 _ experienced a strained neck, right shoulder and right wrist from overexertion resulti~ed work activity. The employer incorrectly recorded the restricted work activity as 154 days. The employee was placed on restricted work activity 3/25 - 10114. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). experienced a partial amputation of the left middle finger from a falling pallet, III 180 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 75 days. The employee was placed onrestricte~/09. The release from restricted work date is the employee's termination date. P e r _ , the employee was terminated before.,as released from restricted work. The last doctor's note in the file was Rev. 5104 Page 7 Fri May 6, 2011 3:33PM dated 8/28/08 with restricted work activity through 9/10108. Per HR, the employee voluntarily quit. 11) On or about January 10, 2008, developed a ganglion cyst on the right wrist from repetitive motion resulting in 180 days 0 restricted work activity. The employer incorrectly recorded the restricted work activity as 139 days. In addition, the employer misclassified the case as a~ it should b e " Joyee received in-house treatment f r o m _ t o inc were 57 entries on the 1st Aid Log. The Mountain Ortho notes from state had this pain over the dorsal aspect of_right wrist for approximately six months now. Ortho notes from 5/5 state.would like to go forth with excision of this cyst...We have scheduled this for Wednesday, May 21,2008. at Valdese Hospital." Per Blue Ridge Healthcare the patient did not have surgery or Grace Hospitals. Mountain Ortho also has no record of the surgery. CSHO Branch asked did not have ur er and what happened after the 5/5 r's visit. remember left and went back don't know It have the on't know wliy Idn't go back to the HR the employee was not terminated until employer • has no record of what happened between 5/21/08 and 6/29/09. The restricted work activity days were capped at 180 because the employer cannot provide a release to regular work date or any other information regarding the case. developed crepitus in the left wrist (M 1) and it should be classified from repetitive motion and the case as an as an illness (M6). Per the ee was transferred t o _ b y . _ however, there IS no transfer in file. Once employee - = = d in that a ermanent as transfer. The employer recorded 9 days of restricted work activity on the log. Department i _ w was a 1st Report of Injury (Internal Form) and a 301. No other information was The only thing in available. Pe the employee was not sent to an outside HCP. However, the diagnosis of crepitus in the left wrist seems to be outside the scope for a diagnosis f r o m _ T h e r e was not enough infonnation to verify the case was recorded correctly, as far as, the ~ted work activity days. 80 13) On or about February 6, 2008, developed right shoulder strain from repetitive motion and the employer misclassified the case as an injury eM1) and it should be classified as an illness (M6). 14) On or about February 27, 2008, experienced a right 10th rib fracture after slipping on chicken fat, resulting in 21 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 13 days. The employee was placed on restricted work activity 2/28 - 3/20. According to the Payroll Change Notice, the employee did not return to work following the incident on 2/27. The employee was tenninated on 3/10. The employee was scheduled to follow up with Mountain Ortho on 3/20 but there is no record of the visit. developed a ganglion cyst on the right hand from 15) On or about March 12, 2008, repetitive motion and the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). It was also note, the employee received 4 months of in-house treatment from before being sent to an outside HCP. There were 46 entries on the 1st Aid Log for 2008. 16) On or about December 10, experienced a crush and wound injury to the left 5th finger, resulting in 7 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. The employee was placed on restricted work activity 12/11 - 12/17. 17) On or about December 1, 2009, experienced an avulsion to the right middle finger from a wing saw resulting in 31 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. The employee was placed on restricted work activity 12/1 - 12115 with no use of the left hand. The activity 12/18 - 1/31 with limit use ofleft hand, and keep clean and dry. Per miscalculated the number of days to record on the log. Rev. 5/04 Page 8 Fri May 6, 2011 3:33PM 18) On or about February 3, 2009, overexertion from catching chickens resultmg recorded the restri~days. The . The days on 2/16; then f r o m _ o n 3/16; and from of job transfer would be 2/16 - 3/18. In add~r the case as an injury (Ml) and it should be classified as an illness (M6). P e r _ t h e employee was not sent to an outside HCP. 19) On or about March 16, 2009 experienced an avulsion of the right 4th finger tip resulting in 14 days of restricted activIty. incorrectly recorded the restricted work activity case as a medical treatment case on the log. The employee was placed on restricted work activity 3/24 - 4/7 with a restriction to keep clean and dry and protect areas. 20) On or about May 15, 2009 experienced an avulsion of the left index finger from the well house door closing days of restricted work activity. The employer incorrectly recorded the restricted work activity as 5 days. The employee was placed on restrictions of maintain dressing at all times, keep clean and dry, no use of left hand from 5/15 to 5120. The employee was placed on estricted work .. 5/20 - 6/23 with restrictions of splint to protect, minimal use, keep clean and dry . • stated 5 days were recorded on the log because after 5 days the employee had the StItc es taken out and returned to regular work. ~ 21) Onor about November 14, 2009 experienced a laceration to the right forearm while cleaning the bird washer m restncted work activity. The employer incorrectly recorded the restricted work activity as 33 days. The employee was placed on restricted work activity 11/24 12/16 with restrictions to protect the area. The employee was placed on restricted work activity 12/16 - 12/29 with limited use of right hand. The employee was placed on restricted work activity 114 - 2/16 with restrictions to limit grasp and repetition of the right hand. 22) On or about August 18, 2009, experienced back strain from changing a drum during a brake job resulting in 46 restricted work activity. The employer incorrectly recorded the restricted work activity as 28 days. The employee was placed on restricted work activity 11/19/09 - 1/4110 with limitations of no . bending/stooping, no pushinglpulling, and no straining over 121bs. According the employee did not report the injury until November 2009. The employee appointments between 12/4 and 114. 23) On or about December 12, 2009. received a laceration to the left forearm after resulting in 16 days of restricted work activity. The employer incorrectly recorded the . The employee was placed on restricted work activity 12/12 - 12/29. Per miscalculated the days when recording them on the log. 24) On or about January 22,2009, experienced a ganglion cyst to the right hand from overexertion resulting in 18 days of restricted work activity. The employee was on restricted work activity 1/26 - 2/13. The employer incorrectly recorded the restricted work activity as 14 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 25) On or about April 8, 2009, experienced tendinitis in the right hand from overexertion from pulling chicken apart days of restricted work activity. The employer incorrectly recorded the restricted work activity as 41 days. Grace Hospital placed on restricted work activity 4/12 - 4/19. Then the employee was sent to Burke Occupational and was placed on restricted work activity 4/13 - 5/6. The employee was then sent to Mountain Ortho_was placed on restricted work activity 5/22 - 6/3. The last note in the files is from 6/10 and it says contmue restricted work activities. Per HR, the employee was terminated on 6/3 for falsifying a statement on the job application. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). an employee experienced a disc 26) On or about November 28, 2009, herniation on the left side at L5-S1 while installing covers on the ice auger in the Ice House resulting in 95 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 90 days. The employee was on restricted work activity 11130109 - 3/4110. It was noted, the employee was sent to Burke Rev. 5104 Page 9 Fri May 6,2011 3:33PM Occupational on 11130_was placed out of work from 11/30 to 12/4. The employee left t~e office at 12:39 PM. At 2: 14 PM, Burke Occupational faxed a revised Progress Note stating light work from 11130 to I" • • II ns: sit/stand/walk at intervals, cold pack hourly x 15 minutes, sedentary work. ed the employee requested to work and asked the doctor to change the note. , the was terminated before being released to regular duty. ~tated the employee returned The employee's termination date was 3/4/10. iii •• \ 27) On or about July 27.2009, fractured the left index finger while working in Stack Off reSUlting in 14 days of aCtIVIty. The employer incorrectly recorded the restricted work activity as 5 days. The days counted for restricted work activity were 7/27 - 8/12 because the ER notes state ~stricted work activity and to follow . _ w a s terminated on 7/31. 28) On or about August 5, 2009, resulting in 101 days of restricted as 13 days. The employee was placed on sustained a left shoulder injury from a driving accident incorrectly recorded the restricted work activity rpctrtf""tpr1 work activity 8/5 - 11/16. The employ~ 1.t1l1thp'rTl'\lrr1 ~l'\cr'1t'''31 • • was excused from work 8/5 - 8/10. Pe~ the employee requested to be placed on light duty instead Burke Occupational for a second opinion on 8/5. Burke Occupational - 8/12 with the following limitations: no prolonged walking/standing, PW5hlltlg1PUI with left arm, n o ' " ~se of left arm. the employee worked _ l i g h t duty job. the employee was ter:miIlatt~d on 8/24 due to maxing out points on driving record. The employee recel a traffic citation for the driving accident and this was the reason for _termination of employment. However, the doctor's notes state restricted work activity until 11116. 29) On or about November 19, 2009, overexertion from pulling skin off chicken and it should be classified as an illness (M6). developed a strain to the right hand from and the employer misclassified the case as an injury (Ml) 30) On or about October 16,2009 developed a ganglion cyst to the right wrist from overexertion and the employer mlsclassified the case as an injury (Ml) and it should be classified as an illness (M6). 31) On or about June 8, 2009, was stung on the arm by a bee while driving a truck and the employer misclassified the case as an illness (M6) and it should be classified as an injury (M 1). 32) On or about June 2,2009, developed a strain to left wrist from overexertion from loading chickens on the coning line and the ~loyer misclassified the case as an injury (M 1) and it should be classified as an illness (M6).According to. . the employee was hired 0~6 and terminated on 6/4 for excessive absenteeism. According to the employee's HR file, the only absences.had were late more than 2 hours on 5/26 and an excused absence on 6/3 for court. Although, the employer states the employee was terminated on 6/4, the employee's time card shows an unexcused absence on 615. 33) On or about May 11, 2009, an employee sprained the right middle finger on a coil in the Ice House resulting in 125 days of restricted work act~vity. The employer i n c o r , _here t'c work activity as 109 days. The days of restricted work activity are 5/11-9/14. P e r _ this was an in-house transfer from the 15t doctor's visit until the last doctor's visit. inll 34) On or about April 7, 2009 developed tendinitis right thumb and wrist from cutting chicken shoulders and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). developed lateral epicondylitis in1lright arm from 35) On or about March 30, 2009 pulling tenders resulting in 18 days 0 restricted work activity. The employer incorrectly recorded the restricted work activity as 15 days. The employee was on restricted work activity 4/6 - 4124. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). It was also noted, the Rev. 5/04 Page 10 Fri May 6, 2011 3:33PM date of injury documented is 3/30, however, the employee went to 126 for the condition. The provided with the Table R~ notes f r o m _ in . nl'('\(fl'#"'CS k Family Medical employee's limitations on 4/6. On 417, the was placed duty. T~ returned COI1ld.lu,on. At this .. .ved _ was told Again, the employee to Burke Occupational on 4114 for a second opinion was diagnosed with the light duty was continued. The employee received a Form the NCIC for t h e ' Workers' C~ted 4/14. The employee signed'a "Light Duty Policy" form on 4/16, however,' it was signed b y _ o n 417. The employer cannot provide any information following 4/24. The employee had an appointment with Burke Occupational on 4124 but did not show up for it. The employer stated the employee returned to regular work but has no documentation to verify the claim and no release from the doctor. Burke Occupational and Table Rock Family Medical have no notes after 4/14. 36) On or about January 22,2009 from catching chickens and the ptT\'nlnupr miscl,assitie:d as an illness (M6). experienced overexertion to the right hand case as an injury (M1) and it should be classified 37) On or about February 2, 2009, muscles while catching chickens and the employer misclass classified as an illness (M6). . experienced strained rib (M 1) and it should be 38) On or about January 16, 2009, developed lateral epicondylitis of the right elbow from catching chickens and the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6).T!S0yee visited Table Rock Medical on 1116 for the condition. ~~ing chickens for The progress notes state volu~ goin~ a take a weeks vacation_ chooses to not do thi should be on light duty or week_thi~i1l be back to normal shortly. " Pe~irne cardsllworked instead of taking vacation, however, the time card showsavorked as _ . Table Rock Family Medical has no notes for any follow-up visits after 1116. The employee quit to return home on 2/27 per HR. FWil 39) On or about November 30, 2010, a sprained right ankle from a fall employer mcorrectly recorded the restricted work activity resulting in 22 days of restricted work aCtivIty. as 8 days. The days of restricted work activity were 11130 - 12/22. 40) On or about March 15, 2010, developed a ganglion cyst on the right wrist from repetitive motion resulting in 53 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 38 days. In addition, the employer misclassified the case as an injury (M!) and it should be classified as an illness (M6). 41) On or about July 6, 2010, epicondy litis in the right elbow from repetitive motion resulting in 49 days of restricted work activity. The employer incorrectly recorded the restricted work activity as 39 days. In addition, the employer misclassified the case as an injury (Ml) and it should be classified as an illness (M6). 42) 17) On or about December 30, 2008 received a laceration to the head from a metal bar, resulting in 13 days of restricted work activity. The employer incorrectly recorded the restricted work activity case as a medical treatment case on the log. The employee was placed on restricted work activity 119 - 1/22. b) Equipment: OSHA 300 Logs Rev. 5/04 Page 11 Fri May 6, 2011 3:33PM c) d) e) Location (a-c): Facility Injury/Illness: Administrative Measurements: Review of OSHA 300 logs, 301 forms. Form 19, Medical Records, and Employee interviews I 21. Photo Number Location on Video 23. Employer Knowledge: had received formal training on OSHA 300 Logs in 20l0.are responsible recordmg ses on and maintaining the Logs, All of the cases with restricted work activity and/or job transfer misrecorded on the OSHA 300 Logs had a Form 19 completed for the mC;ldtmt~ to visit an offsite healthcare provider during working hours was author' If the employee went to the ER after working hours, as \yell as, any discharge instructions. 1st Aid Logs Employee medical files, interview forms, aRIA database informatIon, Company 24. Comments (Employer, Employee, Closing Conference): 25, Other Employer Information: SEVERITY: PROBABILITY: 26. Classification: Serious Knowledge N Y First Repeat S or a Repeat? Willful? N N 0 Second Repeat Repeat Penalty Rev. 5104 N. C. Department of Labc Division of Occupational Safety and Health Worksheet Fri May 6, 2011 3:34PM Inspection Number 315114611 031-11 Opt. Insp. Number Establishment Name Case Farms Processing, Inc. Type of Violation Number Exposed Std. Alleged Via. N Nonserious Citation Number 615 No. Instances 1904.29(b) (3) Abatement Completed Code Abatement Documentation Required 01 Item/Group 004 6 REC Egregious Days to Abate Days Type 5 W Date Abated Date Verified Final Abatement Due Date No MULTISTEP Type Days Due Date Track Completed Code ISubstance Codes IA VD/Variable Information: 29 CFR 1904.29(b)(3): The employer did not enter each recordable injury or illness on the OSHA 300 log within seven (7) calendar days of receiving information that a recordable injury or illness had occurred. a) Located at Case Foods, Inc., Morganton: The employer failed to completely record injuries/illnesses on the OSHA 300 Log within 7 days for calendar year 2010. 1) On or about September 23, 2010, Chicken Catcher: the employer did not have any days recorded in columns K or L for this case. This case resulted in both days away from work and restricted work days. 2) On or about October 21, 2010. Stack Off: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 3) On or about September 21,2010, Sanitation: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 4) On or about November 3, 2010, Stack Off: the employer did not have any days recorded in column L for this case. This case resulted in restricted work days. 5) On or about November 2, 2010, Forklift Driver: the employer did not have any days recorded in columns K or L for this case. This case resulted in both days aw~y from work and restricted work days. 6) On or about November 30,2010. Mechanic: the employer did not have any days recorded in column L for this case. This case resulted in both days away from work and restricted work days. Oracle OSHA-IB/IBIHprint(Rev. 5104) Page 2 Fri May 6, 2011 3:34PM Case Farms Processing, Inc. Duration Em 10 ee Name Address Occu ation Duration Em Joyee Name Address Phone IInstance Description: A. Hazard B. Equipment Probability H-High M-Medium L-Low N-Non serious D. Injury/Illness E. Measurements Adjustment Factors Penalty Calculations Severity C. Location GBP Size Good Faith History Total Adjustment Factors G- Greater L- Lesser Admin $7000 Repeat Factor Proposed Adjusted Penalty 0% S&H Cooperation 0% 0% 0% 0% $7,000 Repeat GBP Unadjusted GBP $0 4. Date/Time 11110/10 20. Instance Description - Describe the following: a) Hazards-OperationJCondition-Accident: Administrative Violation / The employer failed to record injuries on the OSHA 300 Log within 7 days. CSHO Branch requested copies of the OSHA 300 Logs for the years of2008, 2009, and 2010 to review on about November 10,2010. The employer supplied one copy of the 2010 log in November and a different version of the log in December. There were 6 entries on the 2010 log SUt)plled in December that did not have the L completed. CSHO Branch 'nterviewed in reference the missing data. on. 1) On or about September 23, 2010, the log did not have any days recorded in columns K or L for this case. This case resulted III both days away from work and restricted work days. The employee was injured on a Thursda~ out of work the following Monday, 9/27. The employee was sent to Burke Occupational on 9129 _ w a s placed on restricted work activity until 10115. 2) On or about October 21, 2010, column L for this case. This case ,"oc<,"lt""rt the employer did not have any days recorded in resltncted work days. 3) On or about September 21,2010 in column L for this case. This case the employer did not have any days recorded in restricted work days. 1\...:1II.1Il.\..,\1.1 employer did not have any days recorded in 4) On or about November 3,2010, column L for this case. This case resulted in restricted work days. 5) On or about November 2, 201 the employer did not have any days recorded Rev. 5104 Page 3 Fri May 6,2011 3:34PM in columns K or L for this case. This case resulted in both days away from work and restricted work days. 6) On or about November 30, 2010 in column L for this case. This case res b) c) d). e) the employer did not have any days recorded m both days away from work and restricted work days. Equipment: OSHA 300 Logs Location (a-c): Facility Injury/Illness: Administrative Measurements: Review of OSHA 300 logs, 301 forms, Form 19, Medical Records, and Management interviews I 21. Photo Number Location on Video 23. Employer Knowledge had received formal training on OSHA 300 Logs in 2 0 1 0 . are respons for unes ses on the 3 and t h e . All medical treatment to visit an offsite healthcare provide~ hours was authorized by If the employee went to the ER after working hours, _ w a s provided with a copy any discharge instructions. gs, Employee medical files, interview forms, ORIA daltao,ase mtlornlatIOn, campan, 24. Comments (Employer, Employee, Closing Conference): 25. Other Employer Information: SEVERITY: PROBABILITY: 26. Classification: Serious Knowledge. N Y First Repeat Sora Repeat? Willful? N N a Second Repeat Repeat Penalty Rev. 5104 N. C. Department of LabG. Division of Occupational Safety and Health Worksheet Fri May 6, 2011 3:34PM Inspection Number Opt. Insp, Number Establishment Name 315114611 031-11 Case Farms Processing, Inc. N Nonserious Citation Number 615 No. Instances 1904.30(a) Type of Violation N umber Exposed Std. Alleged Vio. Abatement Completed Code OOS 01 Item/Group 3 REC Egregious Days to Abate Days Type I Corrected During Inspection (CSHO Observed Abatement) Final Abatement Due Date W Abatement Documentation Required Date Abated Date Verified No MULTISTEP Type Days Due Date Track Completed Code ISubstance Codes IAVD/Variable Information: 29 CFR 1904.30(a): The employer did not keep a separate OSHA 300 Log for each establishment that was expected to be in operation for one year or longer: a) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2008. b) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2009. c) Located at Case Farms Processing, Inc., Morganton, NC: The employer failed to keep a separate OSHA 300 Log for each establishment for calendar year 2010. Employee Exposure: Occupation Duration Employee Name Address Instance Descri tion: x, :f~r Employer Frequency I /-:~~- . :~ :,... "; ,r':)' I ../.;;.' , , ..... Phone ", A. Hazard B. E ui ment C. Location J D, In'ury/Illness E. Measurements Oracle OSHA-IB/IBIHprint(Rev. 5/04) Page 2 Fri May 6, 2011 3:34PM Penalty Calculations Severity Adjustment Factors GBP Probability Size Good Faith H-High History Total Adjustment Factors 0% 0% M-Medium L-Low G- Greater N-Non serious L- Lesser Admin $7000 Repeat Factor 0% S&H Cooperation 0% 0% Unadjusted GBP Proposed Adjusted Penalty $7,000 Repeat GBP $0 4. Date/Time 11/10/10 20. Instance Description - Describe the following: a) Hazards-OperationiCondition-Accident: Administrative violation/ The employer failed to maintain a separate OSHA 300 Log for each business establishment expected to be in operation one year or longer. CSHO Branch requested copies of the OSHA 300 Logs for the years of 2008, 2009, and 2010 to review. The logs the employer provided to CSHO Branch on or about November 10, 2010, had 3 separate locations recorded on one log. The separate locations included the Processing Plant in Morganton, the Hatchery in Glen Alpine and the Feed Mill in Shelby. b) Equipment: OSHA 300 Logs c) Location (a-c): Facility d) Injury/Illness: Administrative e) Measurements: Review of OSHA 300 logs, Management Interviews 121. Photo Number Location on Video had received formal traini~OSHA 300 and maintaining the Logs.~ere aware 23. Employe~ledge: Logs in 201 O_are respons 3 separate locations were recorded on one OSHA 300 Log. 1st Aid Logs, Employee medical flIes, _ interview forms, ORIA data~ 24. Comments (Employer, Employee, Closing Conference): 25. Other Employer Information: SEVERITY: PROBABILITY: 26. Classification: Serious Knowledge N Y S or 0 0 Repeat? Willful? N N Rev. 5104 Page 3 Fri May 6, 2011 First? Repeat Second Repeat Repeat Penalty Rev. 5/04 w, 1 9 Mid??s?? as? Ere-l, Appendix A First Aid Log 1. a. b. 68 entries on the 2008 log but no medical file in the box P e r " - no Workers' Comp file and in-house treatment only a. b. 18 entries on 2008 log 11 entries on 2009 log a. b. 17 entries on 2008 log for wrist pain Pe~nlY received in-house treatment 2. 3. 4. log for wrist pain nly received in-house treatment 5. a. b. c. 46 entries on 2008 log (Jan - July) for wrist pain The medical file provided by employer is for a shoulder injury from 2007 (Note: which is not recorded on the 2007 OSHA 300 log). There was a Form 19 completed. Did not receive any information relating to wrist pain a. b. 13 en t ries on 2008 log for hand/wrist (July - Aug) P e r _ d i d not go to outside HCP a. b. 12 ~008 log for wrist Pe~ did not go to outside HCP a. b. 26 entries on 2008 log for multiple reasons P e r _ a l l in-house treatment 6. 7. 8. 9. log for wrist pain oes not have a Workers' Comp file 10. a. b. 47 entries on 2008 log for back, cut on finger, eyewash (Feb - Oct) P e r _ personal back injury a. b. 17 entries on 2008 nurse's log for wrist P e r _ did not go to outside HCP 11. Appendix A First Aid Log 12. a. h. 17 entries on 2008 log in March for wrist P e r _ , in-house treatment only a. b. 27 entries on 2008 log for finger and thumb pe~ersonal issue a. b. 31 entries on 2008 log 1. 4 months of visits for a cut finger P e r _ bandaged the finger from an old injury a. b. 26 entries on 2008 log Please provide a medical file 13. 14. 15. 16. a. b. 17. - There are multiple n the 2008 log (clock numbers 40 entries on the 2008 log for multiple injuries to the wrist, finger and foot(Apr - Sept) a. b. 11 entries on 2008 log for wrist pain P e r _ no Workers' Comp file and in-house treatment only a. b. 70 entries on 2008 log for shoulder and wrist (Jan - Sept) 001 1/8/08 recorded on 300 log a. b. c. d. 23 entries on 2008 log in March and April st 1 sent to outside HCP 6/10 Illness not recorded on 300 log Employee had tendonitis of the right hand 18. 19. APPENDICES a) OSHA 300 Logs for 2007,2008,2009 & 2010 b) OSHA 301 Forms for 2008,2009 & 2010 c) 1 st Aid Logs for 2008,2009 & 2010 d) 2008 Employee Roster f)_ e) Company Policies g) Interview Forms Interview Forms h)_Interview Forms i) Interview Forms j) ORIA Database Information for 2008 & 2009 k) Employee Medical FileONFIDENTIAL