N.J. Admin. Code § Tit. 10, ch. 47, subch. 3, app APPENDIX

Current through Register Vol. 57, No. 1, January 6, 2025

Appendix - APPENDIX

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)

N.J. Admin. Code Tit. 10, ch. 47, subch. 3, app APPENDIX

Repeal and New Rule, R.2007 d.72, effective 3/5/2007.
See: 38 N.J.R. 4352(a), 39 N.J.R. 777(a).
Section was "DDD CLASSIFICATION OF INCIDENT CATEGORIES".