Notice
Deficiencies: 0
Nov 19, 2025
Visit Reason
This document serves to inform individuals about the privacy practices of NJDHSS, including how their medical information may be used and disclosed, and their rights related to this information.
Findings
The notice details the types of information covered, reasons for use and disclosure of health information, individuals' rights regarding their health data, and the legal duties of NJDHSS to protect privacy.
Report Facts
Effective date: 2011
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Devon L. Graf | Director, Office of Legal and Regulatory Compliance | Listed as NJDHSS Privacy Officer contact for questions about the notice |
Inspection Report
Routine
Census: 81
Capacity: 89
Deficiencies: 3
Dec 15, 2021
Visit Reason
The inspection was a standard routine survey of 89 residential units to assess compliance with New Jersey Administrative Code 8:36 for licensure of assisted living residences and comprehensive personal care homes.
Findings
The facility was found not in substantial compliance with all standards, with deficiencies in medication administration documentation, controlled substances accountability, and documentation of pneumococcal vaccinations for residents aged 65 or older.
Deficiencies (3)
| Description |
|---|
| Failure to document administration of two newly ordered medications on the medication administration record for Resident #2 as per prescriber's orders. |
| Failure to maintain accountability of controlled substances; discrepancy between actual doses and documented inventory for Resident #1. |
| Failure to provide documentation of pneumococcal vaccination for Residents #1, #3, and #4 aged 65 or older. |
Report Facts
Census: 81
Total Capacity: 89
Sample Size: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Wellness Director | Interviewed regarding medication administration and vaccination documentation deficiencies. | |
| CMA #1 | Certified Medication Aide | Observed and interviewed regarding controlled substances accountability and medication administration. |
| CMA #2 | Certified Medication Aide | Interviewed regarding controlled substances accountability and medication administration. |
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