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 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: 117
Deficiencies: 2
Jul 22, 2025
Visit Reason
The inspection was conducted as a complaint investigation based on Complaint # NJ00188196 to determine compliance with New Jersey Administrative Code standards for assisted living residences.
Findings
The facility was found not in substantial compliance with standards, specifically failing to ensure a safe environment for residents and failing to develop a required Health Service Plan for a resident. The investigation included interviews, observations, and record reviews related to an incident involving Resident #2.
Complaint Details
Complaint # NJ00188196 triggered the investigation. The complaint was substantiated as the facility failed to ensure safety and proper health service planning for Resident #2.
Deficiencies (2)
| Description |
|---|
| Failure to ensure a safe environment for Resident #2 as evidenced by an incident involving access to a locked bistro kitchenette. |
| Failure to develop a Health Service Plan (HSP) for Resident #2 with a history of specific behaviors. |
Report Facts
Sample Size: 3
Completion Date: Aug 22, 2025
Follow-up Revisit Date: Aug 21, 2025
Inspection Report
Routine
Census: 114
Deficiencies: 0
Jan 2, 2024
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency on 1/2/2024 to assess compliance with infection control regulations and CDC recommended practices.
Findings
The facility was found to be in compliance with the New Jersey Administrative Code 8:36 infection control regulations standards for licensure of assisted living residences and CDC recommended practices to prepare for COVID-19.
Report Facts
Sample Size: 3
Inspection Report
Complaint Investigation
Census: 125
Deficiencies: 0
Mar 15, 2022
Visit Reason
The inspection was conducted as a complaint investigation combined with a COVID-19 focused infection control survey.
Findings
The facility was found to be in substantial compliance with New Jersey Administrative Code Chapter 8:36 standards for licensure of assisted living residences and infection control regulations, including CDC recommended practices for COVID-19 preparation.
Complaint Details
Complaint number NJ146111 was investigated and the facility was found to be in substantial compliance.
Report Facts
Sample Size: 6
Inspection Report
Complaint Investigation
Census: 120
Deficiencies: 0
Jun 4, 2021
Visit Reason
The inspection was conducted as a complaint investigation based on complaint number NJ00141192.
Findings
The facility was found to be in substantial compliance with New Jersey Administrative Code, Chapter 8:36, Standards for Licensure of Assisted Living Residences, Comprehensive Personal Care Homes, and Assisted Living Programs.
Complaint Details
Complaint investigation for complaint number NJ00141192; facility found in substantial compliance.
Report Facts
Sample size: 3
Inspection Report
Routine
Census: 109
Deficiencies: 1
Jan 25, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency on 1/25/2021 to assess compliance with New Jersey Administrative Code 8:36 infection control regulations and CDC recommended practices for COVID-19 preparation.
Findings
The facility staff failed to perform handwashing techniques in accordance with CDC and facility policy for 2 of 2 staff observed (Certified Nurse Aide and Dietary Staff). Observations showed handwashing durations less than the required 20 seconds, and interviews confirmed staff were confused or rushed.
Deficiencies (1)
| Description |
|---|
| Facility staff failed to perform handwashing technique in accordance with CDC and facility policy for 2 of 2 staff observed. |
Report Facts
Census: 109
Sample Size: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nurse Aide | CNA #1 | Observed performing handwashing for 11 seconds, less than required 20 seconds |
| Dietary Staff | DS #1 | Observed performing handwashing for 5 seconds after glove removal |
Inspection Report
Routine
Census: 106
Deficiencies: 0
Nov 20, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with New Jersey Administrative Code 8:36 infection control regulations and CDC recommended practices for COVID-19 preparation.
Findings
The facility was found to be in compliance with the applicable infection control regulations and CDC recommended practices for COVID-19.
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