N.J. Admin. Code 10:47 app APPENDIX - APPENDIX

Current through Register Vol. 54, No. 7, April 4, 2022

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)

Notes

N.J. Admin. Code 10:47 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".

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