Deficiencies per Year
4
3
2
1
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
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, NJDHSS Privacy Officer | Listed as contact person for privacy practices and rights |
Inspection Report
Complaint Investigation
Census: 135
Deficiencies: 0
Mar 5, 2024
Visit Reason
The inspection was conducted as a Commissioner's Complaint survey identified by complaint number NJ00171273.
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 based on this complaint survey.
Complaint Details
Complaint number NJ00171273 was investigated and the facility was found to be in substantial compliance.
Report Facts
Sample size: 4
Inspection Report
Routine
Census: 117
Deficiencies: 0
Dec 9, 2023
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.
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.
Inspection Report
Complaint Investigation
Census: 122
Deficiencies: 2
Aug 18, 2022
Visit Reason
Complaint survey conducted due to complaint NJ156409 regarding failure to ensure safe usage and maintenance of personal medical equipment for Resident #1.
Findings
The facility failed to develop and implement policies and procedures to ensure safe usage and maintenance of a mechanical lift used by Resident #1. Resident #1 sustained a fall during transfer with the lift, resulting in traumatic intracranial injury and subsequent death. The facility did not conduct an assessment to ensure the lift was appropriate and in good working order, and there was no policy regarding assessment or maintenance of resident-owned equipment.
Complaint Details
Complaint #NJ156409 regarding unsafe use and maintenance of a mechanical lift for Resident #1, who fell during transfer and later expired due to injuries sustained.
Deficiencies (2)
| Description |
|---|
| Failure to ensure development and implementation of policies and procedures for safe usage and maintenance of personal medical equipment. |
| Failure to conduct assessment for use of mechanical lift to ensure safety and operability for Resident #1. |
Report Facts
Census: 122
Sample size: 1
Date of incident: May 12, 2022
Date of death: May 12, 2022
Date of survey: Aug 18, 2022
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Certified Nurse Aide #1 | CNA | Assisted with transferring Resident #1 during fall incident; provided detailed interview about transfer and equipment use. |
| Director of Nursing | DON | Provided information about facility policies, resident care, and assessment practices; interviewed regarding Resident #1's care and equipment. |
| Resident #1's Private Duty Aide | PDA | Provided care and assisted with transfers for Resident #1; interviewed about training and transfer incident. |
| Home Health Agency Director of Nursing | HHA DON | Provided information about home health agency services and training related to Resident #1's care and transfer. |
| Administrator | Facility Administrator | Provided information about facility policies, resident equipment, and understanding of responsibilities related to Resident #1. |
| RN #1 | Registered Nurse | Home health agency nurse who visited Resident #1 and reported concerns about mechanical lift. |
| HHA #1 | Home Health Aide | Reported issues with mechanical lift and provided information about replacement equipment. |
Inspection Report
Abbreviated Survey
Census: 120
Deficiencies: 0
Jul 13, 2021
Visit Reason
A Covid-19 Focused Infection Control Survey was conducted by the State Agency on 7/13/2021 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.
Inspection Report
Abbreviated Survey
Census: 116
Deficiencies: 0
Dec 3, 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.
Inspection Report
Routine
Census: 117
Deficiencies: 0
Nov 21, 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 New Jersey Administrative Code 8:36 infection control regulations and CDC recommended practices for COVID-19 preparation.
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