Inspection Reports for
Pines Village
509 County Rd 530, Manchester Township, NJ 08759, United States, NJ, 08759
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Notice — Nov 20, 2025
State
Date: Nov 20, 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 — Dec 15, 2021
Abbreviated Survey State
Date: Dec 15, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted to assess compliance with New Jersey infection control regulations and CDC recommended practices during the COVID-19 pandemic.
Findings
The facility failed to maintain proper sanitizing solution concentration and ensure dietary staff performed hand hygiene between tasks, risking food-borne infection spread. Observations showed sanitizing solutions with zero PPM concentration and staff failing to change gloves or perform hand hygiene after contamination.
Deficiencies (2)
Failure to ensure sanitizing solution used in cleaning food preparation surfaces was of appropriate concentration in parts per million (PPM).
Failure of dietary staff to perform hand hygiene between tasks, including failure to change gloves after contamination.
Report Facts
Sanitizing solution minimum PPM: 150
Sanitizing solution concentration recorded: 0
Sample size: 5
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Cook #1 | Observed failing to perform hand hygiene and glove changes while preparing food | |
| Dietary Aide #1 | Observed using sanitizing solution with zero PPM concentration | |
| Utility Aide #1 | Observed failing to perform hand hygiene after adjusting mask and handling ready-to-use cooking pots and plates | |
| Dietary Supervisor (DS) | Tested sanitizing solutions and acknowledged deficiencies | |
| Licensed Nursing Home Administrator (LNHA) | Interviewed regarding infection control breaches affecting residents | |
| Infection Control Preventionist (ICP) | Provided infection control training and education to dietary staff |
Inspection Report — Aug 10, 2021
Annual Inspection State
Date: Aug 10, 2021
Visit Reason
The inspection was a standard annual licensure survey of the assisted living facility to assess compliance with New Jersey Administrative Code 8:36 standards for licensure of Assisted Living Residences, Comprehensive Personal Care Homes and Assisted Living Programs.
Findings
The facility was found not in substantial compliance due to failure to conspicuously post required notices including the last annual licensure inspection survey report and complaint deficiencies, business hours of the facility, and names and contact information of the owner/governing authority. These deficiencies had the potential to affect all residents.
Deficiencies (3)
Failure to post a notice that a copy of the last annual licensure inspection survey report and the list of deficiencies from any complaint investigation during the last 12 months was available.
Failure to post a notice of the business hours of the facility.
Failure to post the names of, and a means to formally contact, the owner and/or members of the governing authority.
Report Facts
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Assisted Living Manager | Confirmed with surveyor the absence of required posted notices |
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