Deficiencies per Year
4
3
2
1
0
Unclassified
Census Over Time
Notice
Deficiencies: 0
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 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
Abbreviated Survey
Census: 76
Deficiencies: 0
Apr 28, 2022
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with infection control regulations and CDC recommended practices related to COVID-19.
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
Abbreviated Survey
Census: 79
Deficiencies: 1
Jan 15, 2022
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted to assess compliance with infection control regulations and CDC recommended practices related to COVID-19.
Findings
The facility failed to implement an infection prevention and control program ensuring staff appropriately used personal protective equipment (PPE) between resident care, with 3 of 5 direct care staff observed not wearing required PPE, risking transmission of COVID-19 and other infections.
Deficiencies (1)
| Description |
|---|
| Failure to implement infection prevention and control program ensuring appropriate use of PPE between resident care. |
Report Facts
Sample size: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| RN #1 | Registered Nurse | Observed not wearing full required PPE while providing care to residents on precautions |
| CM #1 | Care Manager | Observed wearing two surgical masks instead of required N95 and not wearing full PPE while providing care |
| CM #2 | Care Manager | Observed failing to wear gown as part of full PPE when providing care to resident on precautions |
| Executive Director | Interviewed and confirmed staff noncompliance with PPE use; stated staff 'knew better' and had been trained multiple times | |
| Director of Nursing | Interviewed and confirmed facility status related to COVID-19 positive staff and residents; confirmed training and PPE requirements |
Inspection Report
Abbreviated Survey
Census: 83
Deficiencies: 1
Oct 8, 2021
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with infection control regulations and CDC recommended practices related to COVID-19.
Findings
The facility was found not in compliance with infection prevention and control standards, specifically failing to perform proper handwashing techniques according to CDC guidelines and facility policy, as observed in 3 of 4 staff members including a CNA, Housekeeper, and Activities Director.
Deficiencies (1)
| Description |
|---|
| Failure to perform handwashing technique in accordance with CDC and facility policy by 3 of 4 staff members observed. |
Report Facts
Staff members observed for handwashing: 4
Staff members failing proper handwashing: 3
Census: 83
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nursing Assistant (CNA) | Observed failing to wet hands before applying soap and washing for less than recommended time; unable to explain handwashing process. | |
| Housekeeper | Observed washing hands for 8 seconds without soap; no documented infection control education upon hire. | |
| Activities Director (AD) | Observed performing proper handwashing for 20 seconds and had attended handwashing in-service. | |
| Executive Director (ED) | Acknowledged handwashing concerns and lack of documented education for some staff; responsible for infection control policy and education. | |
| Registered Nurse (RN) | Acknowledged handwashing concerns during surveyor interview. |
Inspection Report
Abbreviated Survey
Census: 73
Deficiencies: 1
Jan 27, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with infection control regulations and CDC recommended practices related to COVID-19.
Findings
The facility was found not to be in compliance with infection control regulations as two dietary aides were observed not wearing hair restraints in the kitchen, potentially affecting all 73 residents receiving food from the kitchen.
Deficiencies (1)
| Description |
|---|
| Facility staff failed to ensure staff wore hair restraints in the kitchen for 2 of 2 Dietary Aides observed not wearing hair restraints while preparing or serving food. |
Report Facts
Sample size: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Server #1 | Dietary Aide | Observed not wearing hair restraint while preparing resident food |
| Server #2 | Dietary Aide | Observed not wearing hair restraint upon entering kitchen |
| Dietary Supervisor | Dietary Supervisor | Interviewed regarding hair restraint policy and compliance |
| Director of Nursing | Director of Nursing | Accompanied surveyor during kitchen tour |
Inspection Report
Routine
Census: 69
Deficiencies: 0
Nov 18, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the State Agency to assess compliance with infection control regulations and CDC recommended practices related to COVID-19.
Findings
The facility was found to be in compliance with the New Jersey Administrative Code 8:36 infection control regulations and CDC recommended practices for COVID-19 preparation.
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