N.J. Admin. Code § 10:47-3.14

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

Section 10:47-3.14 - Pre-admission

(a) Individual records shall include the following data:

1. The full name and sex of the individual;

2. A copy of the individual's birth certificate or a written statement of the individual's birth date and birth place, including a copy of any guardianship determination made in accordance with N.J.S.A. 30:4-165.5;

3. Documentation of the current custody and legal guardianship; which shall include the name, address, telephone number of the parent(s) or guardian;

4. Consent forms signed by the parent(s) of a minor or court appointed guardian allowing the facility to authorize all necessary medical care, routine tests, immunization, and emergency medical or surgical treatment;

5. Documentation of the existence of a developmental disability prior to the age of 22 (for example, medical diagnosis, psychological evaluation, social history);

6. A social and developmental history;

7. A previous placement history;

8. Behavioral information, including, if applicable, the most recent psychological evaluation, current behavior plan and history of previous attempts to modify the behavior;

9. A psychiatric evaluation, if applicable;

10. A medication history and immunization history;

11. Documentation for known allergies;

12. Seizure records and/or neurological examination;

13. A history of serious illness, serious injury, or major surgery and all hospitalizations;

14. A certificate which certifies that the person is free from contagious disease within 48 hours prior to admission;

15. A summary of the latest physical examination, including Mantoux testing, Hepatitis B status and lead levels;

16. A current audiological evaluation, if available;

17. Vision testing, if available;

18. Dental information, if available;

19. An IHP from the sending agency indicating the individual's programmatic and service needs and corresponding recommendations; and

20. Education records and reports as required.

N.J. Admin. Code § 10:47-3.14

Recodified from N.J.A.C. 10:47-3.15 by R.2007 d.72, effective 3/5/2007.
See: 38 N.J.R. 4352(a), 39 N.J.R. 777(a).
Former N.J.A.C. 10:47-3.14, Admission policies, recodified to N.J.A.C. 10:47-3.13.