New Jersey Administrative Code › Title 10 - HUMAN SERVICES › Chapter 47 - STANDARDS FOR PRIVATE LICENSED FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES › Subchapter 3 - ADMINISTRATION › Appendix - APPENDIX

Current through Register Vol. 56, No. 14, July 15, 2024
APPENDIX
DDD CLASSIFICATION OF INCIDENT
						  CATEGORIES
Primary
Reporting
Type
						  Code
Category
DHS Community Incident
						  Category List
Level
AB116
ABUSE
Physical (alleged) -- to
						  Service Recipient --
A+
Major Injury
AB114
ABUSE
Physical (alleged) -- to
						  Service Recipient --
A
Moderate Injury
AB112
ABUSE
Physical (alleged) -- to
						  Service Recipient --
B
Minor Injury
AB110
ABUSE
Physical (alleged) -- to
						  Service Recipient --
B
No Injury (Community only)
AB220
ABUSE
Emotional (DYFS & IA
						  Only) Substantiated
A+
AB210
ABUSE
Emotional (DYFS & IA
						  Only) Risk of
A
AB310
ABUSE
Verbal/Psychological/Mistreatment
						  (alleged)
B
AB420
ABUSE
Sexual (alleged) -- to
						  Service Recipient --
A+
penetration/genital contact, oral sex
AB410
ABUSE
Sexual (alleged) -- to
						  Service Recipient --
A
all other forms of sexual contact or
situations
AS116
ASSAULT
Physical -- SR to SR --
						  Major Injury
A
AS114
ASSAULT
Physical -- SR to SR --
						  Moderate Injury
B
AS126
ASSAULT
Physical -- SR to Staff
						  -- Major Injury
A
AS124
ASSAULT
Physical -- SR to Staff
						  -- Moderate Injury
B
AS136
ASSAULT
Physical -- SR to Other
						  -- Major Injury
A
AS134
ASSAULT
Physical -- SR to Other
						  -- Moderate Injury
B
AS316
ASSAULT
Physical -- Other to SR
						  -- Major Injury
A
AS314
ASSAULT
Physical -- Other to SR
						  -- Moderate Injury
B
CR400
CRIMINAL
Suspected or alleged; SR
						  (on or off site)/
A
ACTIVITY
Staff or Other; on site and/or on
						  duty,
considered to be potentially newsworthy and
not in violation of SR confidentiality.
(Community only)
DL010
DANIELLE'S
Medical emergency:
						  life threatening situation
A
LAW
911 called
DL011
DANIELLE'S
Medical emergency:
						  life threatening situation
A
LAW
911 not called. DDD/TBI only
DL020
DANIELLE'S
Other than medical:
						  life threatening
A
LAW
situation. 911 called
DL021
DANIELLE'S
Other than medical:
						  life threatening
A
LAW
situation. 911 not called
DT110
DEATH
Expected: due to medical
						  condition, disability
A
or end stage disease/illness
DT210
DEATH
Unexpected: Sudden [i.e.
						  due to suspected
A+
choking, medical incident (suspected heart
attack)
DT310
DEATH
Unexpected:
						  Suicide
A+
DT320
DEATH
Unexpected:
						  Accidental
A+
DT410
DEATH
Unexpected: Undetermined
						  manner (This code to
A+
be used for follow up/findings only)
EL110
ELOPEMENT
SR with KROL, IST,
						  NGRI, Detainer, Megan's
A+
Law/Sex offender status (Also see Walkaway
category)
EL120
ELOPEMENT
SR from a designated
						  screening center if not
A
returned within 2 hours. (Community only)
EX110
EXPLOITATION
of SR: Improper use
						  of SR by staff.
A
EX130
EXPLOITATION
of SR: Improper use
						  of SR's funds by staff,
A
value is equal to or above $ 500 (Community
only)
EX140
EXPLOITATION
of SR: Improper use
						  of SR's funds by staff,
B
value is below $ 500 or undetermined
(Community only)
IN116
INJURY
Accidental -- Service
						  Recipient -- Major
A
IN114
INJURY
Accidental -- Service
						  Recipient - Moderate
B
IN216
INJURY
Self-injurious behavior --
						  Major
A
IN214
INJURY
Self-injurious behavior --
						  Moderate
B
IN226
INJURY
PICA -- ingestion of
						  foreign object after
A
PICA behavior has been identified resulting
in major injury
IN224
INJURY
PICA -- ingestion of
						  foreign object after
B
PICA behavior has been identified resulting
in moderate injury
IN316
INJURY
Unknown origin: SR,
						  Major
A
IN314
INJURY
Unknown origin: SR,
						  Moderate
B
IN426
INJURY
Staff: Work related: (not
						  due to assault) --
A
Major (i.e. broken bones)
IN436
INJURY
Staff, Non-work related
						  [but occurring on
A
campus/site] (not due to assault)-Major
IN516
INJURY
Restraint
						  Related
Major injury
A
IN514
INJURY
Restraint
						  Related
Moderate injury
B
IN510
INJURY
Restraint Related Minor
						  injury (Community
B
only)
MD110
MEDICAL
Disease/Illness -- Single
						  incident of disease
B
that is reportable to DHSS.
MD120
MEDICAL
Disease/Illness --
						  Outbreak of a communicable
A
disease that impact on the operation of the
program.
MD220
MEDICAL
Medication/Treatment
						  Error -- Any deviation
A
from prescribed orders that results in serious
effects requiring medical intervention
MD212
MEDICAL
Medication/Treatment
						  Error -- Any deviation
B
from prescribed orders that has the
potential
for serious effects as determined by a
qualified medical professional (i.e. --
doctor, pharmacist) (Community only)
NE216
NEGLECT
With major
						  injury
A
NE214
NEGLECT
With moderate
						  injury
B
NE212
NEGLECT
With minor
						  injury
B
NE213
NEGLECT
With No injury (but
						  incident resulted in risk
B
to SR) Examples include but are not limited
to inadequate food, clothing or supervision.
(Community only)
OP310
OPERATIONAL
Environmental
						  incidents -- Spills, illegal
A
dumping
OP430
OPERATIONAL
Fire -- Major event
						  -- resulting in damage
A+
which renders facility or part thereof,
unusable or resulting in any injuries to staff
or service recipients
OP420
OPERATIONAL
Fire -- Moderate
						  event -- requiring outside
A
assistance to extinguish or contain
OP410
OPERATIONAL
Fire -- Minor event
						  -- extinguished or
B
contained using facility staff/Fire personnel
OP590
OPERATIONAL
Media interest: When
						  no other incident
A+
category applies.
OP540
OPERATIONAL
Unexpected Staff
						  Shortages -- Which may pose
A
a threat to life/safety or impact on facility
operations
OP530
OPERATIONAL
Public Safety Issues:
						  Posing immediate threat
A+
to life/safety (i.e. natural disaster, hostage
taking, terroristic threats)
OP520
OPERATIONAL
Mass Disturbances
						  (i.e. riot) involving 5 or
A+
more people (staff or SR)
OP510
OPERATIONAL
Operational breakdown
						  Any utility outage or
A
loss of use of equipment which may cause a
threat to life or safety and impact on
facility operations
OP500
OPERATIONAL
Unannounced/Unexpected
						  site visit for any
B
purpose at a facility/school by any
regulatory/investigatory/inspection unit.
Examples: CMS, DOH, JCAHO, DEP, Public
Advocate, Child Advocate, DOJ, Prosecutor's
Office or similar agency/office.
OP745
OPERATIONAL
Loss: SR(s) funds or
						  property value
B
(individual or aggregate) over $ 200.
(Community only)
OP740
OPERATIONAL
Theft: SR(s) funds or
						  property value
A
(individual or aggregate) over $ 200.
(Community only)
RE111
RESTRAINT
Restraint implemented
						  on a SR without an
B
USE
order or approved behavior plan or in
violation of an approved plan. (Community
only)
RE120
RESTRAINT
Restraint to remove SR
						  from harm. (Community
B
USE
only)
RG210
RIGHTS
Alleged act challenged by
						  legal or advocacy
A
VIOLATION
group
RG110
RIGHTS
Alleged act not
						  challenged
B
VIOLATION
SA200
SEXUAL
Involving SR as Victim or
						  Perp With or
A+
ASSAULT
Without Injury
SX110
SEXUAL
SR to SR
						  (nonconsensual)
B
ASSAULT
SX120
SEXUAL
SR to Staff or
						  Other
B
ASSAULT
SX310
SEXUAL
Other to SR
A
ASSAULT
SX400
SEXUAL
Inappropriate Sexual
						  Conduct (i.e. exposing
B
ASSAULT
one's self to another, public
						  masturbation)
No physical contact with another person but
occurring in a public setting.
SU116
SUICIDE
Resulting in major
						  injury
A+
ATTEMPT
SU114
SUICIDE
Resulting in moderate
						  injury
B
ATTEMPT
SU113
SUICIDE
Resulting in minor injury
						  (Community only)
B
ATTEMPT
WK410
WALKAWAY
SR Dangerous to self or
						  others (violence) but
A+
[No Criminal
no criminal status
Status]
WK320
WALKAWAY
SR at risk due to
						  disability (medical or
A
[No Criminal
cognitive) [i.e. may need
						  medication such
Status]
as insulin] or due to extreme weather
						  or
environmental conditions
WK310
WALKAWAY
SR at risk due to age
						  (18 or younger) or 60+
A
[No Criminal
Status]
EE110
ERROR CODE
Community Incident
						  report entered in error
B
(Community only)