Average — CMS composite of the measures below.
A standard survey is most likely before around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Goldwater Care Princeton during CMS and state inspections, most recent first.
The facility failed to maintain a full-time DON after the previous DON resigned, leaving the position vacant for several weeks while 76 residents remained in the facility. The facility’s own assessment and DON job description documented that a DON was needed to provide resident care support, communicate care expectations, and oversee nursing operations. During surveyor visits, staff confirmed there was no DON on duty, and a resident reported that there was currently no DON and expressed uncertainty about whom to approach for nursing concerns, indicating they would likely go to the administrator instead.
Bed rail assessments and consent were incomplete for multiple residents. Five residents had care plans identifying quarter rails, half rails, or halos, but the assessments did not document required elements such as diagnoses, prior interventions, risks, benefits, or conditions posing a risk. One resident with a hx of falls, femur fx, anticoagulant use, and morbid obesity also had bed rails observed in place without a consent form, and staff reported a 5-inch gap with spacers between the rail and mattress.
Failure to Maintain Ordered Continuous Oxygen: A resident with COPD and respiratory failure was ordered continuous O2 via NC, but staff found the tubing disconnected and later removed the oxygen during transport and returned the resident to bed without it. An RN did not assess for respiratory distress after being notified the O2 was off, and another RN reapplied oxygen without assessment even though the resident appeared anxious, SOB, and using accessory muscles.
Two residents, both with dementia and behavioral risks, were involved in a physical altercation in which one resident, unable to stand or transfer independently, was struck by another resident who was known to have aggressive tendencies. Staff responded to calls for help and witnessed the incident, confirming the physical abuse occurred.
The facility failed to provide bedtime snacks to all residents, as required by their policy. Several residents reported not being offered snacks, despite the Dietary Manager stating that snacks are sent out with drinks for CNAs to distribute. The Director of Nursing confirmed that CNAs are responsible for offering snacks and documenting acceptance or refusal, but the survey revealed inconsistencies in providing snacks to the 66 residents.
The facility failed to maintain proper kitchen cleanliness and food handling procedures, affecting 66 residents. Observations showed significant cleanliness issues, such as burnt crumbs and greasy substances in the kitchen. A cook used gloved hands instead of tongs for serving food. The Dietary Manager and Administrator confirmed the absence of a cleaning schedule.
The facility failed to follow its Water Management Program, neglecting essential maintenance to prevent Legionella growth, potentially affecting all 66 residents. Additionally, proper transmission-based precautions were not implemented for a resident with a Foley catheter, and infection control practices were compromised during wound care for another resident, as observed by surveyors.
The facility failed to ensure residents were informed about the grievance process, including the identity of the Grievance Official and how to file a grievance. During a survey, residents expressed a lack of knowledge about these procedures, and the Social Service Director acknowledged the need for more frequent communication and education on the grievance process.
The facility failed to ensure proper storage and labeling of medications, affecting 28 residents. An LPN did not check or record the medication refrigerator's temperature, and an undated, partially used Tuberculin bottle was found. The DON confirmed missing temperature records from January to June, indicating a lapse in adherence to storage policies.
A facility failed to maintain a resident's dignity during a transfer, as a CNA was observed transporting a resident on a shower chair with her dress pulled up, leaving her exposed. The resident confirmed this was a common occurrence and expressed discomfort. The CNA acknowledged the resident should have been covered with a bath blanket.
The facility failed to conduct PASARR rescreens for two residents with newly diagnosed severe mental illnesses. One resident was admitted with Bipolar Disorder, but no rescreen was done despite previous indications of behavioral health symptoms. Another resident had a history of severe mental illness, including Major Depression and Anxiety, but the initial PASARR screen showed no severe mental illness. The facility did not perform the required rescreens upon admission.
A resident with chronic diastolic congestive heart failure was not weighed daily as ordered by the physician, despite the importance of weight monitoring for managing her condition. The resident's MAR showed inconsistent documentation of daily weights over several months. Both the DON and Administrator acknowledged the failure to perform daily weights consistently.
The facility failed to implement safety interventions for two residents, including improper transfer techniques and lack of required safety equipment. Additionally, the facility did not adhere to its elopement policy for a resident at high risk of wandering, with missing documentation and untested door alarms.
A resident with significant weight loss was not provided with the necessary nutritional support as ordered. Despite being severely cognitively impaired and requiring assistance with eating, the resident's health shake remained unopened on her meal tray on multiple occasions. Staff did not assist the resident in consuming the shake, which was part of her dietary plan to address weight loss. A CNA noted the shake was frozen and was unsure about obtaining another, while an LPN did not mix the shake with milk as usual. This lack of intervention contributed to the deficiency in maintaining the resident's health.
A facility failed to consistently monitor a resident's respiratory status, who was receiving oxygen therapy for COPD. Despite the facility's policy requiring ongoing assessments using a pulse oximeter, the resident's medical records showed sporadic documentation of SPO2 levels. The DON confirmed that the resident received continuous oxygen therapy, but staff did not consistently monitor SPO2 levels until a later date.
A facility failed to assess a resident's dialysis fistula as ordered, with inconsistent documentation and reports from the resident indicating assessments were not conducted as required. The physician's order required checking the bruit and thrill of the fistula every shift, but many assessments were marked 'No,' and the resident stated the assessments were not always done.
The facility failed to ensure residents on psychotropic medications had supporting diagnoses and identified targeted behaviors with monitoring. A resident was prescribed Seroquel and Olanzapine without documented alternate therapies or target behaviors, and the DON could not confirm the diagnoses. Another resident on Risperdal lacked documentation for targeted behaviors or non-pharmacological approaches, and a third resident on Haldol and Quetiapine also had no such documentation. Observations showed these residents calm and without noted behaviors.
Failure to Maintain a Full-Time Director of Nursing
Penalty
Summary
The deficiency involves the facility’s failure to staff a full-time Director of Nursing (DON) as required. The facility’s own Facility Assessment Tool dated 1/21/26 identified the need for a DON to provide support and care for residents and to communicate expectations of care and provide oversight to ensure those expectations are met. The DON job description, created 5/2/17, documented that the primary purpose of the position is to plan, organize, develop, and direct the overall operation of the nursing department in accordance with applicable regulations to ensure the highest degree of quality care. The resident room roster dated 4/23/26 showed that 76 residents were residing in the facility at the time of the survey. Surveyors confirmed through observation, interview, and record review that the facility had been without a DON for several weeks. The human resources manager stated upon survey entry on 4/23/26 that the facility did not have a DON and that the last DON had quit on 3/31/26, noting they had been without a DON for about three weeks. The former DON’s employee file showed a hire date of 6/30/25 and a resignation letter dated 3/16/26 with a termination date of 3/31/26. During the survey dates and times listed, there was no DON available in the facility. A resident reported awareness that there was no DON and expressed uncertainty about whom to approach for nursing issues, indicating they would probably go to the administrator. The administrator confirmed that the DON had resigned effective 3/31/26 and acknowledged that the position had not yet been filled, though interviews were ongoing.
Bed rail assessments and consent were incomplete for multiple residents
Penalty
Summary
The facility failed to assess residents for entrapment risk and to use alternatives before applying bed rails for five of five residents reviewed. The Side Rails/Bed Rails policy dated 10/24/22 states that alternatives should be attempted before installation of bed rails, and that the facility should assess the resident’s diagnosis, behaviors, size and weight, medications, toileting ability, cognition, communication, mobility, and fall risk, then obtain informed consent and document the use in the medical record. The report states that bed rail assessments were not either completed and/or accurately completed, and that nurses and CNAs did not document gap assessments or bed rail condition assessments. R4 was admitted with a history of falling, fracture of the lower end of the left femur, orthopedic aftercare, long-term anticoagulant use, and morbid obesity. R4’s care plan documented a need for right and left quarter bedrails, but the Side Rail Assessments dated 3/28/25 and 6/5/25 documented that R4 did not have siderails attached to the bed and the assessment was not completed. On 8/12/25, 8/13/24, and 8/14/25, R4’s bed was observed with right and left quarter bedrails in the up position, and the record did not contain an Acknowledgement of Restraint/Device Use consent form. R5, R9, R46, and R64 also had care plans identifying bed rail use, but their assessments did not document required elements such as diagnoses, prior interventions attempted, risks, restrictions, benefits, or conditions posing a risk. R5 was admitted with cerebral palsy, stroke, schizoaffective disorder, bipolar type, muscle wasting and atrophy, cognitive communication deficit, anticoagulant use, and osteoarthritis; R9 had an acquired absence of the left leg below the knee, mood disorder, insomnia, major depressive disorder, osteoarthritis, and malaise; R46 had cognitive impairments, osteoarthritis, diabetic neuropathy, major depressive disorder, acquired absence of the right great toe, and anxiety disorder; and R64 had osteomyelitis of the vertebra and sacral region, severe morbid obesity, and osteoarthritis. The Administrator and Maintenance Director also stated that R46’s bed rails had spacers between the rail and mattress and that the gap measured 5 inches, and the Administrator stated that bed rail assessments were conducted quarterly and that assessments were not documented.
Failure to Maintain Ordered Continuous Oxygen
Penalty
Summary
The facility failed to ensure oxygen was administered as ordered for one resident with COPD and respiratory failure who was ordered continuous oxygen at 1-4 LPM via nasal cannula. The resident’s care plan stated she used continuous oxygen and that, if she was eating, oxygen still had to be given in a different manner and then returned to the usual delivery method after the meal, with monitoring for signs and symptoms of respiratory distress. The Oxygen Concentrator policy described the concentrator as a device used to provide oxygen therapy. On 08/12/2025 at 10:30 AM, the resident’s oxygen tubing was observed on the floor and not plugged into the concentrator. At 10:35 AM, an RN was notified that the oxygen was off and the tubing was on the floor, but the RN did not assess the resident for respiratory distress. Later that day, the resident was observed in the dining room with oxygen and a concentrator, and a CNA removed the oxygen, transported the resident to her room, and returned her to bed without oxygen. At 1:18 PM, an RN entered the room with the concentrator and reapplied oxygen without assessing for respiratory distress. The resident appeared anxious, short of breath, and using accessory muscles to breathe. The RN later confirmed the resident was supposed to be on continuous oxygen and appeared to have signs of respiratory distress during transport, and the resident stated she was short of breath without oxygen and felt afraid. The DON stated the facility did not have portable oxygen tanks and staff had to push oxygen concentrators down the hall to the dining room and back to residents’ rooms.
Failure to Prevent Resident-to-Resident Physical Abuse
Penalty
Summary
The facility failed to protect two residents from resident-to-resident physical abuse. One resident with a history of dementia, mood disturbances, and anxiety was identified as being at moderate risk for abuse and neglect. The care plan for this resident included interventions to ensure safety and to report any incidents of abuse. Another resident, also with dementia and a history of agitation and aggressive behavior, was care planned for the potential to be physically and verbally aggressive due to poor impulse control and ineffective coping skills. On the date of the incident, staff responded to calls for help and found one resident standing over another, hitting him while he was in bed. Multiple staff members witnessed the altercation, and it was documented that the resident being attacked could not stand or transfer independently. The aggressor claimed that the other resident had pulled him out of bed, although staff verified this was not possible due to the victim's physical limitations. The incident was documented in progress notes and an initial abuse investigation report, and all required parties were notified.
Failure to Provide Bedtime Snacks to Residents
Penalty
Summary
The facility failed to provide bedtime snacks to all residents, as required by their policy. The policy states that between-meal snacks should be available to residents according to the planned menu or resident preference, and that bedtime snacks should be sent to nursing stations in bulk to be offered to each resident. However, during a survey group meeting, several residents reported not being offered any bedtime snacks. One resident mentioned being informed by a nurse that they should receive a snack at bedtime, but had not seen any snacks available. The Dietary Manager stated that snacks are sent out with drinks around 7 or 7:30 pm for bedtime, and that kitchen staff deliver trays to the halls for CNAs to distribute. The Director of Nursing confirmed that CNAs are responsible for offering and passing out the snacks, and that acceptance or refusal should be documented as per policy. Despite these procedures, the survey revealed that the facility did not consistently provide bedtime snacks to its 66 residents, as evidenced by the residents' testimonies.
Deficiencies in Kitchen Cleanliness and Food Handling
Penalty
Summary
The facility failed to implement proper cleaning procedures and schedules for the kitchen, as well as failed to use appropriate utensils during food service, potentially affecting 66 residents. Observations revealed significant cleanliness issues in the kitchen, including black burnt crumbs on the floor of ovens and steamers, brown greasy substances on oven doors, and a brown greasy buildup on the ventilation hood. Additionally, the wall behind the dishwasher had brown/black streaks, and there was a black crumbly substance on the floor and wall under the dishwasher, along with a brown fuzzy substance on the covering above the dishwasher. During food service, a cook was observed using gloved hands instead of tongs to handle dinner rolls, acknowledging the mistake. The Dietary Manager admitted to not knowing the last time the kitchen was cleaned and was unable to provide a cleaning schedule. The Administrator confirmed the absence of a cleaning schedule for the kitchen. These deficiencies were identified during a survey, with the facility's application for Medicare and Medicaid documenting 66 residents residing in the facility.
Infection Control and Water Management Deficiencies
Penalty
Summary
The facility failed to adhere to its Water Management Program for the Prevention of Legionella Growth, which is crucial for preventing the growth and spread of Legionella bacteria. The Maintenance Director admitted to not performing the required preventative maintenance protocols, such as verifying and documenting the temperature settings of the domestic hot water boiler storage tanks and the water entering the circulating system at the mixing valve. Additionally, the ice machines were not inspected and cleaned as required, and the weekly sanitizing of medical devices was neglected. This oversight has the potential to affect all 66 residents residing in the facility. The facility also failed to implement proper transmission-based precautions for residents requiring such measures. For one resident with an indwelling Foley catheter, the facility did not place appropriate signage on the door to indicate the category of transmission-based precautions and instructions for PPE. Furthermore, during wound care for another resident, a CNA did not fully don the required Personal Protective Gown, and a box of gloves was improperly handled, compromising the cleanliness of the supplies used for wound care. These lapses in infection control practices were observed during the survey, highlighting deficiencies in the facility's adherence to its own policies.
Lack of Resident Awareness of Grievance Procedures
Penalty
Summary
The facility failed to ensure that residents were informed about the grievance process, including the identity of the Grievance Official, how to file a grievance, and the location of grievance forms. This deficiency was identified during a survey group meeting with four residents, all of whom expressed a lack of knowledge regarding the grievance procedures. The facility's grievance policy, revised in 2017, outlines the residents' right to voice grievances without fear of reprisal and specifies that grievances can be filed orally, in writing, or anonymously. However, the residents involved in the survey were unaware of these procedures, indicating a gap in communication and education regarding their rights. The Social Service Director, who is designated as the Grievance Officer, acknowledged that while new residents are informed about the grievance process, there was no ongoing discussion or reinforcement of this information in Resident Council meetings. The Resident Council minutes from the past year did not include any discussions on how to file a grievance, further highlighting the lack of awareness among residents. The Social Service Director admitted to not being aware of the residents' lack of knowledge and recognized the need for more frequent communication and education on the grievance process.
Medication Storage and Labeling Deficiency
Penalty
Summary
The facility failed to ensure proper storage and labeling of medications, which has the potential to affect all 28 residents currently residing in the facility's Safe Unit. The facility's policy on medication storage, revised on July 2, 2019, directs staff to ensure proper storage, labeling, and expiration dates of medications and biologicals. However, during an observation on June 10, 2024, a Licensed Practical Nurse (LPN) was found to have not checked or recorded the temperature of the medication refrigerator, which contained a thermometer iced to the shelf. Additionally, an undated and partially used bottle of Tuberculin was found, indicating a failure to follow the policy of recording the date opened on medication containers with shortened expiration dates. Further review revealed that the facility's Back Hall Medication Refrigerator had missing temperature records for several months, from January to June 2024. The Director of Nurses (DON) confirmed that the refrigerator's temperature was supposed to be checked daily by the night shift nurse, and acknowledged the undated Tuberculin solution and the missing temperature records. This oversight in medication storage and labeling practices highlights a significant deficiency in the facility's adherence to its own policies and procedures, potentially impacting the safety and well-being of the residents.
Failure to Maintain Resident Dignity During Transfer
Penalty
Summary
The facility failed to uphold the resident's right to personal dignity during a transfer, as observed in the case of one resident among a sample of 49. The facility's Dignity policy, revised in April 2028, emphasizes promoting care that maintains or enhances each resident's identity and respect. Additionally, the Resident Rights policy underscores the right to privacy and confidentiality of personal and medical records. However, on June 10, 2024, a Certified Nursing Assistant was observed pushing a resident down the hall on a shower chair with the resident's dress pulled up to her upper waist, leaving her upper thighs and buttocks uncovered. The following day, the resident confirmed that she is rarely covered when being transported to the shower room and expressed her discomfort with this practice. The Certified Nursing Assistant acknowledged that the resident should have been covered with a bath blanket during the transport.
Failure to Conduct PASARR Rescreens for Residents with Severe Mental Illness
Penalty
Summary
The facility failed to perform a PASARR rescreen for two residents after the emergence of newly diagnosed severe mental illnesses. Resident 59 was admitted with a diagnosis of Bipolar Disorder, but the PASARR screen from a previous facility indicated only low-level behavioral health symptoms. Despite the requirement for a status change and a new Level 1 screen if symptoms did not improve within 30-60 days, the facility did not conduct a rescreen upon admission, as confirmed by the Director of Social Services. Resident 61 was admitted with a diagnosis of Severe Major Depression with Anxiety and Suicidal Intent. Despite having a long history of severe mental illness, the initial PASARR Level 1 screen indicated no severe mental illness. The resident's medical records, including progress notes and physician orders, documented multiple severe mental health diagnoses and the use of psychotropic medications. The facility administrator acknowledged that a new PASARR should have been conducted for this resident.
Failure to Perform Daily Weights for Resident with CHF
Penalty
Summary
The facility failed to perform physician-ordered daily weights for a resident with chronic diastolic congestive heart failure, as part of their Congestive Heart Failure Program. The resident, who was supposed to be weighed daily, reported that she was not weighed every day as ordered and occasionally had to weigh herself. The resident's Medication Administration Record (MAR) showed significant inconsistencies in the documentation of daily weights over several months, with many days missing recorded weights. This inconsistency in monitoring the resident's weight is critical given her medical condition, which requires close monitoring to manage her heart failure effectively. The resident's medical history includes an acute exacerbation of congestive heart failure, dyspnea, and hypoxia on exertion, with a noted weight fluctuation from 268.8 pounds to 256.4 pounds during a hospital stay. The Director of Nursing and the Administrator both acknowledged that the daily weights were not being done consistently as ordered. The resident's condition, including edema and frequent changes in diuretics due to kidney and heart concerns, underscores the importance of adhering to the physician's orders for daily weight monitoring to manage her health condition effectively.
Failure to Implement Safety Interventions and Elopement Protocols
Penalty
Summary
The facility failed to implement necessary interventions to prevent falls and ensure safe transfers for two residents. One resident, diagnosed with severe vascular dementia and other conditions, was identified as high risk for falls. Despite this, staff attempted to transfer the resident without using a gait belt or non-skid socks, causing the resident to express pain. The mechanical lift, which was part of the care plan, was not initially used, and the resident was improperly handled by being grabbed under the arms, leading to discomfort and potential harm. Another resident, with diagnoses including severe unspecified dementia and conversion disorder with seizures, was observed without a required helmet while out of bed. The facility's policy required the helmet to be worn to prevent injury, and any refusal to wear it should have been documented. However, there was no documentation of refusal, and staff were unaware of the resident's non-compliance, indicating a lapse in communication and adherence to safety protocols. Additionally, the facility failed to follow its elopement policy for a resident at high risk of wandering. The resident was not wearing the required wander alarm device, and there were multiple instances of missing documentation verifying the device's presence and functionality. The facility's logs also lacked evidence of door alarm tests on weekends, as required by policy. Staff were unaware of their responsibilities regarding the testing of elopement devices, leading to a significant oversight in ensuring the resident's safety.
Failure to Provide Nutritional Support for Resident with Weight Loss
Penalty
Summary
The facility failed to ensure that a resident with significant weight loss was provided with the necessary nutritional interventions as ordered. The resident, who is severely cognitively impaired and requires assistance with eating, was observed on multiple occasions with an unopened health shake on her meal tray. Despite the presence of the health shake, staff did not assist the resident in consuming it, which was a part of her dietary plan to address her weight loss. The facility's Nutrition Intervention Program policy indicates that residents with significant weight loss should receive additional nutritional interventions, which can be initiated by the food service manager, dietician, or nursing staff. On two separate occasions, the resident's health shake remained unopened on her meal tray, and staff did not make attempts to offer or assist her with it. A CNA mentioned that the health shake was frozen, and they were unsure if they could obtain another one. Additionally, an LPN confirmed that they did not mix the health shake with the resident's milk, which was a usual practice to encourage consumption. The lack of staff intervention and assistance in ensuring the resident consumed the health shake contributed to the deficiency in providing adequate nutrition to maintain the resident's health.
Failure to Monitor Resident's Respiratory Status
Penalty
Summary
The facility failed to perform an ongoing assessment of a resident's respiratory status, specifically for a resident with Chronic Obstructive Pulmonary Disease (COPD) who was receiving oxygen therapy. The facility's policy required licensed nurses to conduct ongoing assessments for oxygen administration using a pulse oximeter to determine oxygen saturation levels. However, the resident's medical records showed sporadic documentation of SPO2 levels, with recorded levels on only a few dates in May and June 2024. The Medication Administration Records for these months also lacked documentation of the resident's SPO2 levels. The Director of Nurses confirmed that the resident was admitted to the facility and received continuous oxygen therapy at 3 liters, but staff did not monitor the resident's SPO2 levels consistently until June 10, 2024.
Failure to Properly Assess Dialysis Fistula
Penalty
Summary
The facility failed to properly assess a resident's dialysis fistula as ordered, which was a requirement for one of the residents reviewed for dialysis care. The physician had ordered that the bruit and thrill of the dialysis fistula in the resident's left forearm be checked every shift to ensure proper blood flow. However, the documentation in the Electronic Medical Record was inconsistent, with many assessments marked as 'No,' making it unclear whether the assessments were conducted as ordered or if 'No' referred to the absence of a bruit or thrill. The Assistant Director of Nursing confirmed that the order required a behavior observed assessment, which should be marked 'yes' for a positive thrill and bruit and 'no' for a negative thrill and bruit. Despite this, the Medication Administration Record showed that a significant number of assessments were documented as 'No,' and the resident reported that the fistula was assessed maybe once a day, not twice as required. This inconsistency in documentation and the resident's statement indicate that the facility did not adhere to the physician's orders for monitoring the dialysis fistula.
Deficiency in Psychotropic Medication Management
Penalty
Summary
The facility failed to ensure that residents on psychotropic medications had supporting diagnoses and identified targeted behaviors with monitoring. For Resident R26, the Physician Order Sheet documented orders for Seroquel and Olanzapine related to unspecified dementia with severe agitation and major depressive disorder. However, the care plan did not include any alternate therapies or identified target behaviors. Observations showed R26 sitting quietly without any noted behaviors, and the Director of Nursing was unable to confirm the accuracy of the diagnoses or provide documentation for targeted behaviors or alternate therapies. Similarly, Resident R33 was prescribed Risperdal for paranoid schizophrenia and dementia, but the care plan lacked documentation for specific targeted behaviors or non-pharmacological approaches attempted before starting the medication. Observations showed R33 calmly interacting with others. For Resident R44, prescribed Haldol and Quetiapine for mood disorder, anxiety, and dementia, the care plan also did not document targeted behaviors or alternate therapies. Observations showed R44 calm and engaged in conversation. The Director of Nursing confirmed the absence of documentation for targeted behaviors or alternate therapies for both R33 and R44.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Princeton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Manor Court Of Princeton | 0.6 mi | ★★★★★ | 1 | 0 |
| Goldwater Care Spring Valley | 13.2 mi | ★★★★★ | 1 | 0 |
| Allure Of Walnut | 14.9 mi | ★★★★★ | 0 | 0 |
| Manor Court Of Peru | 17.1 mi | ★★★★★ | 11 | 1 |
| Allure Of Peru | 17.1 mi | ★★★★★ | 4 | 0 |
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