Inspection Reports for The Delaney of Bridgewater
901 Frontier Rd, Bridgewater, NJ 08807, United States, NJ, 08807
Back to Facility ProfileDeficiencies per Year
4
3
2
1
0
Unclassified
Census Over Time
Census
Capacity
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 legal duties of NJDHSS to protect privacy.
Report Facts
Effective date: 2011
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Devon L. Graf | Director, NJDHSS Privacy Officer | Contact person for privacy practices and rights |
Inspection Report
Complaint Investigation
Census: 65
Deficiencies: 3
Aug 29, 2024
Visit Reason
Complaint investigation related to failure to notify the New Jersey Department of Health of an elopement incident involving Resident #2 in the secured memory care community.
Findings
The facility was found not in substantial compliance with New Jersey Administrative Code standards due to failure to notify the state of an elopement incident involving Resident #2, failure to update Resident #2's health service plan to reflect individual needs and behaviors, and failure to maintain a safe environment for Resident #2 who demonstrated unsafe behaviors. A plan of correction was required and later verified as implemented during a revisit survey.
Complaint Details
Complaint #NJ00171737 regarding failure to notify the state of an elopement incident involving Resident #2. An Imminent Danger was identified related to this incident.
Deficiencies (3)
| Description |
|---|
| Failure to notify the New Jersey Department of Health of an elopement incident involving Resident #2. |
| Failure to review and revise Resident #2's Health Service Plan to reflect individual needs, behaviors, and response to interventions. |
| Failure to maintain a safe environment for Resident #2 who demonstrated unsafe behaviors. |
Report Facts
Census: 65
Sample Size: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Assistant Director of Nursing/Registered Nurse (ADON/RN) | Wrote progress notes related to Resident #2's elopement and care. | |
| Executive Director (ED) | Interviewed regarding awareness of the elopement incident and reporting decisions. | |
| Licensed Practical Nurse (LPN) | Interviewed about Resident #2's elopement and care. | |
| Director of Health Services (DHS) | Provided information about Resident #2's service plan and care. |
Inspection Report
Complaint Investigation
Census: 66
Deficiencies: 3
Jul 11, 2024
Visit Reason
The inspection was conducted as a complaint investigation (Complaint #: NJ00174450) due to concerns about the facility's enforcement of policies regarding the use of restraints and seclusion for residents.
Findings
The facility was found not in substantial compliance with New Jersey Administrative Code standards, specifically failing to enforce its policy prohibiting restraints and seclusion for Resident #2. The facility used a restraining device without a physician's order and failed to provide a safe environment for the resident. A removal plan was implemented and confirmed during a follow-up survey.
Complaint Details
Complaint #: NJ00174450. The complaint involved the use of restraints and seclusion on Resident #2 without proper authorization and failure to provide a safe environment. The complaint was substantiated by interviews, medical record review, and facility document review.
Deficiencies (3)
| Description |
|---|
| Failure to enforce the policy titled 'Use of Restraints and Seclusion' for Resident #2. |
| Failure to ensure Resident #2's right to be free from chemical and physical restraints without proper authorization. |
| Failure to obtain a physician's order for the use of a restraining device for Resident #2. |
Report Facts
Census: 66
Sample Size: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Director of Health Services | Registered Nurse | Wrote progress notes regarding Resident #2 and was interviewed about the use of restraints. |
| Executive Director | Interviewed regarding the facility's policy on restraints and seclusion. |
Inspection Report
Routine
Census: 28
Deficiencies: 0
Jan 27, 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.
Inspection Report
Original Licensing
Capacity: 97
Deficiencies: 1
May 26, 2021
Visit Reason
Initial inspection of a newly constructed assisted living facility with 88 residential units (56 Assisted Living and 32 Memory Care units) to assess compliance with New Jersey standards for licensure.
Findings
The facility was found not in substantial compliance due to failure to provide proper fire sprinkler coverage in all areas, specifically the absence of a fire sprinkler in the Electrical Room on Level 2, which is a fire safety hazard.
Deficiencies (1)
| Description |
|---|
| Failure to provide proper fire sprinkler coverage in the Electrical Room on Level 2 as required by New Jersey Uniform Construction Code and NFPA 13 standards. |
Report Facts
Residential units: 88
Total licensed beds: 97
Census: 0
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Executive Director | Present during entrance conference | |
| Corporate Senior Director of new development | Present during entrance conference | |
| Director of Plant Operations | Present during entrance conference and interviewed about fire sprinkler absence | |
| Construction Supervisor | Present during building tour and confirmed absence of fire sprinkler in Electrical Room |
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