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 explains the types of information covered, reasons for use and disclosure of health information, individuals' rights to access and control their information, 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
Complaint Investigation
Census: 5
Deficiencies: 3
Mar 27, 2024
Visit Reason
The inspection was conducted due to a complaint (Complaint #: NJ00155997) regarding failure to provide a safe environment and failure to follow the facility's 'Staff to Resident Abuse' policy.
Findings
The facility was found not in compliance with New Jersey Administrative Code standards for Dementia Care Homes, specifically failing to provide a safe and decent living environment for residents and failing to report abuse as required. Deficiencies included failure to prevent unauthorized staff access to a resident's apartment and incomplete medical record retention for a discharged resident.
Complaint Details
Complaint #: NJ00155997. The complaint was substantiated as the facility failed to provide a safe environment and failed to report abuse according to policy. Two caregivers involved in the incident resigned or were removed pending investigation.
Deficiencies (3)
| Description |
|---|
| Failure to provide a safe environment for 1 of 4 residents reviewed for abuse and failure to follow 'Staff to Resident Abuse' policy by not reporting an incident. |
| Failure to prevent two staff members from accessing a resident's apartment without approval or physician order for restraints. |
| Failure to retain a complete medical record for a discharged resident. |
Report Facts
Census: 5
Sample: 4
Inspection Report
Abbreviated Survey
Census: 9
Deficiencies: 0
Jan 27, 2021
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with New Jersey Administrative Code 8:37 infection control regulations and CDC recommended practices for COVID-19 preparation.
Findings
The facility was found to be in compliance with the infection control regulations and CDC recommended practices for COVID-19.
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