Skip Navigation LinksContinuing-Education-Program-Applicants

Licensing and Certification

Continuing Education Program Applicants

In-person Continuing Education Applicants

Submit the following documents, if you are applying for the in-person continuing education program:

  • Application for Initial or Renewal Approval as a Continuing Education Provider (CDPH 192) (PDF) (Revised 10/15)
    • A minimum of four (4) lesson plans (from course list on page 2 of CDPH 192) with a copy of the posttest.
      • The lesson plan must have course objectives, method of teaching, method of evaluation and content outline.
      • The content outline must be 1 page per 1 hour of Continuing education
    • A copy of each instructor's resumes and his or her current professional license or certification
    • Important Update: There must be a valid resume on file with the Department for all Department approved training program Instructors.
    • A copy of current city/county business license or copy of health facility license. If the applicant is an educational institution (college/university), a business license is not required.
    • A copy of attendance sign-in sheet used for each classroom course. It must include:
      • Name of CE program/ health facility
      • Course title
      • Date of Course
      • Course Start time and end time                                       
      • Instructor name (typed/printed)
      • Instructor's signature
      • Participant's name (typed/printed)
      • Participant's signature 
      • Participant's CNA or HHA certification number     
    • A copy of CE Course Certificate. It must include
      • The participant's name and CNA/HHA certification number
      • The name of the course   
      • The date and hours attended
      • The name, address, and phone number of the organization or individual providing the training.
      • The name, professional title, and signature of the Director of Staff Development or CE Provider Instructor.
      • The Provider Identification Number issued by CDPH, (NAC #)
      • The following statement, "This record shall be retained by the CNA or HHA for a period of four (4) years starting from the date of enrollment."
    • A written description of classroom characteristics and equipment used.
      • Example of what needs to be included: Size of the classroom, equipment (chairs, table, whiteboard, computers etc.).
    • The CE program record keeping policy. It must include:
      • Which CE records are maintained (sign-in sheets and certificates)?
      • How long (4 year minimum) are the CE records maintained.
      • Storage location address.
      • How records are stored (hard copy or digital)?
      • The title of the person responsible for the record keeping.
    •  Contact Information Form (CDPH 193) (PDF) (Revised 12/19)

Online Continuing Education Applicants

Submit the following documents, if you are applying for an online continuing education program:


How to submit your application:

Fax: 916-636-6760
Do NOT send by mail.
Visit the TPRU Website for more information.

Page Last Updated :