Complete Care At West Caldwell Llc

The surveyor was not able to find the ISC in the investigation documents.

The LNHA stated that she started to work as the LNHA in the facility in June of 2025 and she was not aware of or if an ISC was made and submitted by the previous administrator who resigned from the facility before June of 2025.

The surveyor reviewed the facility's ID.

There was no facility ISC nor staff statements in the documents received by the surveyor.

Statements received by the surveyor were VWSs taken by the local police.On [DATE] at 1:16 PM, the LNHA provided the surveyor of a document titled, Summary of Investigation (SOI).

The SOI indicated under Issue/Concern: On [DATE] at approximately 120 [1:20 am] [Resident #5] was found lying next to [their] bed with a garbage pail at the top of her head.

Under Action/Intervention: Staff immediately began CPR [cardiopulmonary resuscitation] and called 911.Under Conclusion/Plan: There is no evidence of abuse or neglect .Team has concluded .It is most likely the resident [Resident #5] suffered a fatal seizure and rolled off the bed onto the floor and [their] head hit the bedside garbage pail.A review of the facility's Abuse, Neglect, and Exploitation with a Reviewed/Revised date of [DATE] revealed under Policy Explanation and Compliance Guidelines: 1.

The facility will develop and implement written policies and procedures that .b.

Establish policies and procedures to investigate any such allegations.

Under Investigation of Alleged Abuse, Neglect, and Exploitation: B.

Written procedures for investigations include:

• Identifying staff responsible for the investigation .4.

Identifying and interviewing all involved persons, witnesses, and others who might have knowledge of the allegations; .6.

Providing complete and thorough documentation of the investigation.NJAC 8:39-4.1(a)5

Facility ID: