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Licensing and Certification

Orientation and In-service Program Requirements

In-service and Orientation programs are required for all Skilled Nursing Facilities (SNF) and Intermediate Care Facilities (ICF). 

​Initial Application:

The following items must be submitted for application consideration:

  • Nurse Assistant Orientation Program Content (CDPH 278A) (PDF) (Revised 12/19)
    • Submit a lesson plan for a direct patient care skill that is taught during supervised clinical training included in the first 8 hours of the orientation.
    • Submit a copy of the orientation skills return demonstration record used to document the basic patient care clinical training from first 8 hours of the orientation.
  • In-Service Training Program (CDPH 278B) (PDF) (Revised 12/19)
    • Submit two lesson plans from two different topics listed that you listed on your CDPH 278B form.
    • Submit a three-month in-service schedule for future months.
    • In-service Training for Certified Nurse Assistants Attendance Sign-in Sheet (CDPH 278D) (PDF) (Revised 02/22)
    • If your facility uses its own sign-in sheet, submit a copy. It must include the following:
      • Name of the health facility
      • In-service course title
      • Date of in-service
      • In-service start time and end time
      • Instructor name (typed/printed) and instructor's signature
      • Participant's name (typed/printed) and participant's signature 
      • Participant's CNA or HHA certification number
  • Submit a copy of the record keeping policy.  It must include the following:
    • Which in-service records are maintained (sign-in sheets, lesson plans, written exam etc.)?
    • How long (4-year minimum) are the In-service records maintained?
    • Storage location address.
    • How records are stored (hard copy or digital)?
    • The title of the person responsible for the record keeping.
  • Facility Declaration of Participation in Approved Training Programs (CDPH 278C) (PDF) (Revised 01/20) - Required for SNF and ICF only
  • Director of Staff Development Application (CDPH 279) (PDF) (Revised 11/22)
    • Important Update:  There must be a valid resume on file with the Department for all Department approved Director(s) of Staff Development or training program Instructors.
  • Contact Information Form (CDPH 193) (PDF) (Revised 12/19)
  •  Copy of Department issued facility license.
  • If your facility is unable to meet the Orientation requirements listed in 22 CCR §71833(e), submit Temporary Permission for Program Flexibility and for Emergencies (CDPH 5000A) (PDF) (Revised 07/20) to request program flexibility.

Renewal Application:

The following items must be submitted for renewal of SNF and ICF related programs.  Please follow the instructions listed in the Combined Renewal Application for SNF/ICF (CDPH 278R). 

Note:  Your facility may submit an initial Nurse Assistant Training Program (NATP) application with an Orientation and In-service Program update or renewal (CDPH 278R). Please visit the NATP webpage for all items needed for consideration of an initial SNF/ICF NATP application.

Orientation Program Updates (CDPH 278R Section A):

In-Service Training Program Renewal (CDPH 278R Section B):

  • Submit a three-month in-service schedule for future months.
  • In-service Training for Certified Nurse Assistants Attendance Sign-in Sheet (CDPH 278D) (PDF) (Revised 02/22)
  • If your facility uses its own sign-in sheet, submit a copy. It must include the following:
    • Name of the health facility
    • In-service course title
    • Date of in-service
    • In-service start time and end time
    • Instructor name (typed/printed) and instructor's signature
    • Participant's name (typed/printed) and participant's signature 
    • Participant's CNA or HHA certification number
  • Submit one in-service lesson plan from the Course Titles listed on your three-month in-service schedule.

Declaration of Participation in Approved Training Programs (CDPH 278R Section C):

Nurse Assistant Training Program Renewal for SNF/ICF (CDPH 278R Section D):

If your facility conducts its own Nurse Assistant Training Program (NATP), submit the following for renewal with the CDPH 278R:


How to submit your application:

Email: TPRU@cdph.ca.gov
Fax: 916-636-6760
Do NOT send by mail.
Visit the TPRU Website for more information.


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