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Licensing and Certification Program

Training Program Review Unit

The Training Program Review Unit is responsible for the review, approval/disapproval and continual oversight of certified nurse assistant (CNA), home health aide (HHA), and certified hemodialysis technician (CHT) training, orientation and in-service programs.

Nurse Assistant Training Program Applicants

Thank you for your interest in establishing a Nurse Assistant Training Program (NATP). The California Department of Public Health (CDPH), Aide and Technician Certification Section (ATCS), Training Program Review Unit (TPRU) oversees NATPs in California.  Applications are processed in the order of date received.  In order to expedite processing, we prefer that all applications be submitted to TPRU@cdph.ca.gov. The State and Federal training program Requirements links on the right should be referenced as part of the application process.  For additional information, see Approval Guidelines below:

Application Submission Requirements

When submitting CDPH forms, use the current version downloaded from the Department website.  Submit documents in the order listed below.

Additional Training Program Requirements

Home Health Aide Training Program (HHP) Applicants

Thank you for your interest in establishing a Home Health Aide Training Program (HHP) in California. The California Department of Public Health (CDPH), Aide and Technician Certification Section (ATCS), Training Program Review Unit (TPRU), oversees the Home Health Aide Training Programs.  All program applicants may submit applications for 120 Hour Home Health Aide (HHA) Training Programs. Links to regulatory references and Instructions for applicants have been provided on this page.

Applications are processed in the order of date received. The Department will make a decision whether to approve or disapprove each application within 90 days and will notify the applicant in writing. A thoroughly completed application which includes the required documents is essential for program approval. Incomplete applications will be disapproved and reasons for disapproval will be provided. When completed, mail your application via regular U.S. mail to the address listed in the top right-hand corner of the forms being submitted, or email it to TPRU@cdph.ca.gov. The HHA Training Program must be approved by the TPRU Representative before training can commence.

Information regarding the 120 hour Home Health Aide Training Program (HHP):

Requests for initial approval of the 120 hour home health aide training program may be submitted by home health agencies, public education institutions and agencies. The requirements for home health aide training programs are found in Title 22, California Code of Regulations (CCR Section 74747), Code of Federal Regulation (CFR 484.36) and Health and Safety Code 1736.6(a)(4)(b). The basic training program for HHA certification requires a minimum of 120 hours of training.

Application Submission Requirements (120 Hour) Home Health Aide Training Program (HHP)

The following items must be submitted for application consideration.

Information regarding the 40 hour Home Health Aide Training Program (HHP):

Only individuals with a current Certified Nurse Assistant (CNA) certificate may enroll in a 40 Hour HHA Training Program (HHP) to become a certified Home Health Aide (HHA). The Department may allow individuals who have successfully completed the 160 hour Nurse Assistant Training Program (NATP) to enroll in a 40 Hour HHA Program if the school/provider has a "separate and consecutive" program.

Such NATP programs may end the NATP training one day and begin the HHP the next day. If a training provider is running a separate and consecutive training program, then they must do the following:

  • Ensure the NATP and HHP are offered as separate programs.
  • The NATP program must follow the NATP curriculum and approved schedule, (including clinical hours).  Training to be provided by NATP approved instructor at approved classroom and clinical locations. 
  • Begin HHP training only after successful completion of the NATP training.  The separate HHA training must follow the HHP curriculum including clinical hours.  Only Department approved HHP Instructors will provide HHA training at approved classroom and clinical locations.
  • Each NATP and HHP has its own start and end date and is advertised as two separate classes.
  • Submit a separate Initial Application (CDPH 283B) be sent to ATCS for each separate program.
  • Upon enrollment in the NATP course, notify future HHP students that an HHA certificate will not be issued by the state until they have passed the CNA Competency Examination given by a state approved testing vendor.

Application Submission Requirements (40 Hour HHP)

The following items must be submitted for application consideration.

Approved Training Providers

Approved Continuing Education Providers

Approved Testing Providers 

Training Program Review Unit Forms  

Nurse Assistant Training Program

Certified Hemodialysis Technician

  • CDPH 283F (PDF) Certified Hemodialysis Technician Initial Application
  • CDPH 391 (PDF) Hemodialysis Technician/Patient Care Technician Training Program Application

Home Health Aide 

In-service and Orientation

 Continuing Education

  • CDPH 192 (PDF) Application for Initial or Renewal Approval as a Continuing Education Provider
  • CDPH 192B (PDF) Application for Initial or Renewal Online Continuing Education Provider

The provider identification training number will be assigned once the program is approved. Each provider identification number is approved for use only at the approved location using the approved training schedule. Each classroom training location or training schedule will constitute a distinct training program. A new application, Department approval, and provider ID is required for each additional training schedule and/or classroom location.
Applicants may not submit multiple applications at one time. Providers Identification Numbers are non-transferable. 

Lesson Plans

Lesson plans covering 4 of the 16 modules must be submitted. Include Module 8, “Patient Care Skills” plus any three of the remaining modules. Each lesson plan must include all topics for the entire Module and shall include learning objectives, content outline, method of teaching and method of evaluation.

Nurse Assistant Training Program Skills Check List (CDPH 276A)

The NATP is required to provide 100 hours of clinical training under the immediate supervision of the Instructor. The training shall include demonstration of basic patient care skills by the Instructor. The demonstration is to be based upon the theory and clinical instruction presented in the classroom. Return demonstrations by the student are also required and shall be under the immediate supervision (present when student is performing the skill) of the Instructor and shall be done in the clinical setting with residents (patients).

The Nurse Assistant Training Program Skills Check List (CDPH 276A) is a sample which may be copied and used for each student in the NATP. Use of this form will ensure the program meets the requirements for documentation of clinical skills training. Applicants may develop a skills check list, however it must include the minimum skills listed on the Department’s Nurse Assistant Training Program Skills Check List (CDPH 276A). This Skills Check List shall include a listing of the duties and skills the nurse assistant must learn, space to record the date when the nurse assistant performs this duty or skill, space to note satisfactory or unsatisfactory performance, and space to record the initials and title of the Department approved instructor who witnessed the return skill demonstration.

This record serves as the primary documentation for the clinical hours and skills that must be implemented in the NATP, and is the fundamental resource that the RN Program Director uses to ensure that the 100 hours and skill performance has been met for each individual student. Approved NATPs must keep accurate, complete and ethical documentation.

A note of importance:  After the completion of the NATP training, the RN Program Director must attest on the Initial Application (CDPH 283 B) with the completion signature, that the student has met all the clinical and classroom training requirements.

Daily Nurse Assistant Training Program Schedule (CDPH 276B)

A day to day schedule must be submitted. This schedule must list all training including 60 hours of classroom theory and 100 hours of clinical training. All required Modules, components, and skills are to be included. Please give considerable attention to the required training program schedule, as it must be detailed enough for the TPRU representative to determine what is being taught on what day and time. A complete training program schedule, will address all the topics and subtopics on the Nurse Assistant Certification Training Program Individual Student Record (CDPH 276C) and all the skills on the Nurse Assistant Training Program Skills Check List (CDPH 276A). Theory topics must be taught prior to skills training for that topic. For example, theory for infection control and hand washing must be taught prior to clinical skills training on that topic.

Lab hours, aka “Skills Lab” may be included the curriculum, but cannot be counted towards the classroom or clinical hour requirements. Any additional hours of training must be included on the training program schedule. It is recommended that lab hours be added to the curriculum to allow for skill demonstration practice prior to the clinical training.

  • Make-up time must be included in the training schedule, and any missed theory training must be made up by the student prior to clinical instruction. Make-up time is made up hour for hour, and must be overseen by the instructor. The make-up must cover the same content that was missed, following the Module lesson plan. The NATP must create a policy that limits the amount of absence and makeup that will be allowed.
  • Once the training schedule is approved by the Department, this is the only schedule that the NATP can use. If the NATP desires to change the schedule (sequence of modules or provide the training at a different time (weekend vs. days), then the Training Program must submit the new training schedule to the Department for approval prior to implementing the change in the schedule. Once reviewed and approved, the updated schedule will be replaced with the previously approved schedule.
  • During any onsite visits, the Department will make a determination if the school is implementing the approved training schedule. There is only one approved training schedule for each provider identification number assigned to each NATP.

A Sample Daily Nurse Assistant Training Program Schedule (CDPH 276B Sample) which shows the formatting for training schedule development has been provided. This sample provides detail for classroom and clinical training over several days. The schedule submitted by the NATP applicant must cover the entire NATP. Please note that lunch and break times are not included in training time and should be subtracted from total program hours.

The NATP schedule must contain all the required content areas listed in CCR, Title 22, Division 5, Chapter 2.5, Section 71835(n). There are 16 hours of state and federal required training in the following areas prior to any direct contact with a resident:

  1. Communication and interpersonal skills
  2. Infection control
  3. Safety and emergency procedures including the Heimlich maneuver
  4. Promoting the independence of patients/residents
  5. Respecting the rights of patients/residents

This requirement is met if all theory components of the following modules are taught prior to clinical training; Modules 1,2,3,4,5,6,12,14.  The students may then begin the clinical portion of the NATP. The remainder of the classroom theory modules must be taught in conjunction with the clinical training. A NATP may choose to teach all 60 hours of theory at the beginning of the program. This can be done if significant laboratory skills’ training is provided in conjunction with the theory training. Clinical training for 100 hours may then follow. Laboratory time does not count as part of the required 160 training hours.

Nurse Assistant Certification Training Program Individual Student Record (CDPH 276C)

The Nurse Assistant Certification Training Program Individual Student Record (CDPH 276C) is the Department form for documenting the student's theory classroom training (minimum 60 hours). The form may be copied and used for each student in the NATP. Use of this form ensures compliance in documentation for all hours, modules and components of classroom theory training.

The Nurse Assistant Certification Training Program Individual Student Record (CDPH 276C) serves as the primary documentation for the theory/classroom hours that must be implemented in the NATP, and is the fundamental resource that the RN Program Director uses to ensure that the 60 hours and classroom theory training Modules and components have been met for each student. Approved NATPs must keep accurate, complete and ethical documentation.

Instructor Application (CDPH 279)

Each instructor must be approved by the Department prior to providing training for each NATP. The Program Director must be a Registered Nurse and is an approved instructor for this NATP. Instructor approval may be prior to or concurrent with the Program Director designation.

NATP Instructor Requirements

  • Valid nursing license (RN or LVN).
  • 2 years of nursing experience [RN, LVN].
  • 1 year verifiable experience as a licensed nurse providing care and services to chronically ill or elderly patients in in an acute care hospital, skilled nursing facility, intermediate care facility, home care, hospice care, or other long-term care setting.

PLUS

Must have ONE of the following:

  • [Verifiable] completion of a course in teaching adults; OR
    • Completion of a 24-hour course in “Planning, Implementing and Evaluating Educational Programs in Nursing” satisfies this requirement.
    • Completion of a course approved by the Board of Registered Nursing (BRN) or by an accredited educational institution satisfies this requirement.
    • A BRN continuing education course certificate used to meet this requirement must comply with the requirements found in 16 CCR, §§1450 et seq.
  • [Verifiable] experience in teaching adults; OR
  • [Verifiable experience] supervising nurse aides.


Nursing Facilities are required to employ a Director of STAFF development (DSD). The DSD is often the Instructor for SNF owned and operated NATPs.

Agencies and Public Institutions do not typically employ a DSD, so the NATP is taught by an Instructor or Program Director, RN.

The Program Director, RN Requirements

  • Must have a valid RN license.
  • Must be a Department-approved NATP Instructor or facility DON in a facility-based program who meets the requirements found in 42 CFR 483.152(a)(5). The facility DON is prohibited from performing the actual training [theory and clinical].
  • The Program Director RN is responsible for the general supervision of the NATP in a non-SNF owned NATP. The general supervision should include, but is not limited to oversight of instructors, curriculum, verification of student training, and signing of CDPH 283B after the student successfully completes the NATP (attesting that all state and federal training requirements are met).
  • In order to be approved as the Program Director for the NATP, the RN must be approved as an Instructor for the NATP. See DSD/Instructor requirements above. Additionally, the NATP must submit the CDPH 276 form which designates the Program Director. The CDPH 276S or CDPH 276F must be submitted in order to designate an approved Instructor as the RN Program Director for the NATP.

Clinical Site Agreement

The NATP must provide 100 hours of clinical training in a Department approved long-term care facility.  There must be a written agreement between the NATP and the long-term care clinical facility where the training is provided.  The agreement must be approved by the Department prior to clinical training taking place.  This form is not required for programs conducted directly by nursing facilities.

The NATP applicant must have a written agreement with the long-term care clinical facility where they will provide the required 100 hours of clinical training for students.  The required clinical training must be provided in the approved SNF between 6:00 a.m. and 8:00 p.m.

The facility must be in good standing with the Centers for Medicare and Medicaid Services (CMS) and not have any training enforcement restrictions. If the facility has a two-year Nurse Assistant Training Program ban, the clinical site agreement will be void and the NATP will not be allowed to conduct training in the facility. Programs should consider having more than one clinical site training agreement; in the event a facility comes under sanctions by CMS. This agreement must be developed jointly with the clinical facility and signed by both parties. The agreement period shall correspond with the NATP approval expiration date will be for a maximum of two years.  The Department CDPH 276E form may be submitted for approval or the clinical site contract between the parties may be submitted, but the agreement shall state the responsibility of the NATP to the facility and the facility to the NATP and shall include:

Nurse Assistant Training Program (NATP) Responsibilities:

  1. Prior to direct patient contact in the facility, the student must receive the federally mandated 16 hours of training regarding specific topics.
  2. Provide all clinical training and will provide immediate and direct supervision of students.
  3. Student to instructor ratio shall not exceed 15 students per Instructor.
  4. Provide facility with a list of names of all students along with the training schedule that will be followed.
  5. Provide all clinical training in the Department approved facility, by a Department approved instructor, while following the NATP schedule.
  6. Provide notice to the facility, that all students have had the physical examination, test for TB (not less than 90 days prior to patient contact) and criminal screening (upon enrollment to the NATP).
  7. Training will be provided between the hours of 6 a.m. and 8 p.m.
  8. Training will provide a minimum of 100 hours of clinical training in the facility.

Facility Responsibilities:

  1. Facility staff may not be used to proctor, shadow, or teach the NATP students.
  2. Facility nursing staff will not be decreased because students are training in the facility.

Both parties agree to:

  1. Provision for adequate notice of termination.
  2. Both entities must agree to comply with all local, state and federal laws and regulations.
  3. Names and addresses of both parties, including signatures and dates.

Clinical Site Contracts

A Skilled Nursing Facility (SNF) that hires nurse assistants, but does not provide in- house NATP training, must contract with a Department approved NATP to provide the required training to its nurse assistant employees. The contract must have adequate provisions to describe the responsibilities of the Department approved NATP to the SNF, and must be approved by the Department. The elements of a contract are similar to the components of the clinical site agreement noted above, except that the NATP will provide all classroom and clinical training. The contract must describe the address/location where the classroom training will occur. If the classroom training will occur at the SNF location, then the contract must also specify the area of the facility which will be used for the instruction.  A copy of the lease/rental agreement for the facility space must be submitted. The area must not be licensed as resident space and must have a separate entrance and egress for students. This area must not infringe on resident privacy. The Department will determine if the space can be approved for classroom student use.

The NATP shall not use facility personnel as preceptors or instructors.  NATP instructors must not be employees of the facility while teaching.  The SNF DSD may teach an evening or weekend class for the NATP school if not employed during those hours with the SNF. The Director of Nursing (DON) in the SNF may not be a NATP instructor, since the DON of a facility is employed full-time and has a twenty-four (24) hour responsibility to the SNF.

Administrative Policies and Procedures Manual

Per California Code of Regulations, Title 22 (22 CCR), §71828, Nurse Assistant Training Program providers must develop and implement written administrative and management policies governing the program.  The Department has developed a template (CDPH 276P form), for Nurse Assistant Training Program providers, which includes the policies and procedures that are minimally required per regulation.  Each Nurse Assistant Training Program applicant must complete the template and sign the attestations as part of their application package.

 

Nurse Assistant Training Program applicants must also develop and submit an organizational chart, job descriptions for training program staff and a checklist for the required Instructor monitoring, as per 22 CCR, §71828.  The instructor monitoring checklist should provide for verification that the program is conducted in accordance with the approved plan.  Examples of items to be included in the instructor monitoring checklist are; "teaches according to the approved training schedule", "provides the required clinical training at the approved clinical training site", etc.  In accordance with best practices, applicants will want to develop additional policies and procedures as needed, to cover student enrollment, criminal background clearances, student health examinations, student testing, etc.

Additional Training Program Requirements

Certified Nurse Assistant Application and Live Scan

Upon enrollment in a NATP for nurse assistant certification, a candidate for training shall submit a training and examination application along with the proof of Live Scan fingerprinting to the Department. The application and Live Scan must be submitted prior to any direct patient contact with residents.

Physical Health Examination

​Each student enrolled in the certification program shall have a health examination which includes a medical history and physical examination, a purified protein derivative, intermediate strength intradermal skin test for tuberculosis, unless medically contraindicated. If a positive reaction is obtained, a chest x-ray shall be taken, unless medically contraindicated. A report signed by the examiner shall indicate that the student does not have any health condition that would create a hazard to themselves, fellow employees, or patients. This examination shall be completed and documented prior to the student having direct patient care contact in the clinical setting. This information shall be provided to the nursing facility prior to patient contact. The physical health examination must be done within 90 days prior to clinical training/direct patient contact.

Home Health Aide Training Program (HHP) Applicants

Application Submission Requirements (120 hour) Home Health Aide Training Program (HHP)

Application (CDPH 191) 120 Hour Home Health Aide (HHA) Training Program

Each applicant must submit a CDPH 191 Application for the 120 Hour Home Health Aide Training Program. The form must be complete and address all fields on the form. The person designated as RN Program Director for the HHA Training Program must have the same qualifications as an Instructor and must be approved as an Instructor prior to or concurrent with being designated as the RN Program Director for the training program. Additional forms and documents must accompany the application as listed.

  • CDPH 191 (PDF) 120 Hour Home Health Aide Training Program Application

Curriculum Acknowledgment (CDPH 191A) 120 Hour Home Health Aide (HHA) Training Program

This curriculum includes the five topics listed below required in accordance with state and federal regulations, including the minimum number of class hours and clinical practice hours. These topics are found at CCR, Title 22, Section 74747 and CFR, Section 484.36:

a) Introduction to the Aide and Agency Role
b) Interpretation of Medical and Social Needs of People Being Served
c) Personal Care Services
d) Nutrition
e) Cleaning and Care Tasks in the Home

Per federal regulations, 16 hours of federal classroom instruction must be provided prior to patient contact. These topics include: infection control, patient rights, communication, safety and emergency services, and promotion independence of patients. These topics can be taught separately as a sixth topic, or they may be included in the five topics above (a-e).

Total training may not be less than 120 hours. Classroom hours may not exceed 75 hours and the recommended minimum number of hours for clinical is 61 hours. Lab hours are recommended, but are not counted towards required hours. A copy of the 120 Hour Home Health Aide (HHA) Training Program Curriculum (CDPH 191A) outlines all components of classroom and clinical training, including assignments and methods of evaluating student learning (tests, skill demonstration, etc.).

  • CDPH 191A (PDF) 120 Hour Home Health Aide (HHA) Training Program Current Curriculum

Lesson Plans

One lesson plan for each of the five topics must be submitted. Each lesson plan must include student learning objectives, content outline, method of teaching and method of evaluation (testing).

Sample Student Record

Submit a copy of the forms that will be used to document and validate the classroom and clinical curriculum to include skill demonstration and evaluation. The student record will include the date and hours of instruction, date and skill of demonstration or evaluation, and the name of the instructor performing the skill evaluation. Records will be maintained for a four-year period, and will be made available to the Department for review upon request.

Instructor Approval

Each instructor must be approved by the Department prior to teaching. Previously approved instructors are required to submit a new application and obtain approval for each specific training program. HHA Instructors must be Registered Nurses (RNs) with at least two years of RN nursing experience, to include one year of employment by a Home Health Agency, providing direct patient care. Licensed Vocational Nurses (LVNs) are not eligible to be approved as HHA Training Program Instructors.
Each applicant must complete the CDPH 191B form and include a resume and copy of the active RN license with the application. The resume must include month/year to month/year of nursing experience, name, address, and phone number of employer and the name of the supervisor. Resumes that lack verifiable information will not be approved.

  • CDPH 191B (PDF) 120 Hour Home Health Aide (HHA) Training Program Faculty Information

Clinical Site Agreement(s)

HHA Training Programs must provide clinical training for students in a health facility setting to ensure that students have the opportunity to practice and demonstrate nursing and home care skills with direct patient contact. The health facility types that are approved by the Department to be clinical sites are licensed as Home Health and Hospice Agencies, Acute Care Hospitals, and Skilled Nursing Facilities (SNF). The training focus shall be on delivery of care and services in the home environment, and not in an institutionalized setting. The clinical site facility must comply with state and federal regulations and must not have a Department imposed two year Training Program ban secondary to enforcement actions.

An applicant may choose to submit a Clinical site agreement other than the CDPH 276E clinical site agreement.  If an alternate document is submitted, it must contain the following components:

  1. Separate responsibilities for the Training Program and the health facility. 
  2. Include the name and address of the parties, and be signed by the facility administrator and training program Owner or Administrator.
  3. The agreement must be a closed-ended contract with a specific expiration date of two years or less.
  4. Both parties must agree to follow all local, state and federal laws and regulations.
  5. The training program (school) must be responsible for all training in its entirety and cannot allow facility staff to train, teach, monitor, shadow, or proctor students. The Department approved RN Instructor(s) must provide direct and immediate supervision of the students at all times.
  6. Skills must be performed on residents in the clinical setting, evaluated by the Instructor, and then recorded on the student record.
  7. The school must work collaboratively with the facility to establish a clinical schedule that includes specific training dates and times.
  8. The school must provide the facility with a list of student names and training schedule which indicates dates and times of training.
  9. The school will ensure that the students have had the following, prior to direct care in the clinical setting:
    • Criminal screening which must be completed upon student enrollment.
    • Physical examination to include tuberculin (TB} skin test (PPD) or chest x-ray.
    • Examination results signed by the individual doing the examination. Results must indicate that the student does not have any health condition that would interfere with the students' ability to perform care duties, and that the student is free from signs and symptoms of infectious disease.

It is the responsibility of the school to provide documentation that the students in the clinical setting do not pose a health risk to patients/residents. The Training Program must supply a list of student names to the facilities that have met the above criteria.

Policy and Procedures Manual

Each applicant must develop and submit a policy and procedure manual that details the administrative and management policies (rules) governing the program. The manual is to be written for HHP employees in order to inform them of the rules governing the HHP. Each policy should include a policy statement, purpose statement, scope, responsibility statement and specific procedure steps. Procedural steps must include sufficient detail and identify who, what, when, were and how each step will be carried out. Policies covering each of the following categories should be included:

  1. Staffing - Job Descriptions, qualifications and duties for all HHP staff must be included.  Each HHP must include information for the RN Program Director, HHP Instructor, and program Administrator/Owner roles.  Indicate HHP Instructor and RN Program Director qualifications, approval process and license requirements.
  2. Organizational Chart - This policy should include information on how the organization chart will be developed and updated.  Who will make updates and when. Describe the revision process. The organizational chart must be submitted with this policy and must indicate lines of authority. Job titles on the organizational chart must match job titles listed in P&P and include Administrator/Owner, RN Program Director and Instructor job titles.
  3. School Advertising - The policy must include a statement that a NATP shall not make false or misleading claims or advertisements regarding training. Include the person responsible for monitoring and compliance of advertising. Describe how and when monitoring is to be performed.
  4. Student Enrollment – P&P must detail initial application process at time of enrollment, including submission of CDPH 283B CNA/HHA application form and Live Scan BCIA8016 form to the Department’s Aide & Technician Certification Section Registry upon student enrollment. The criminal background clearance requirement and process must be addressed. Include requirement for all students to complete Live Scan fingerprinting upon enrollment and prior to beginning clinical training or direct contact with patients. The Health requirements for physical examination and tuberculosis testing process must be included. A determination that the individual is free of active tuberculosis disease per tuberculin infection must be made using testing method(s) recommended by the Federal Centers for Disease Control and Prevention (CDC) and licensed by the federal Food and Drug Administration (FDA).
  5. Training Requirements - Ensure that the Training Program will meet all federal and state requirements regarding curriculum, clinical topics and required hours of training. All theory classroom training must be completed prior to the clinical instruction for that topic being taught. All clinical training must be completed at the Department approved clinical training facility. P&P to include the clinical training site approval process and clinical training requirements. Student to instructor ratio not to exceed fifteen to one (15:1) and the Instructor must have no other duties while providing immediate and direct supervision of students. P&P must address procedure to ensure compliance.
  6. Attendance - Student absenteeism and makeup policy must be clearly stated. Makeup is “hour for hour”, and covers same Modules, components and content as originally missed. Makeup instruction must follow the approved curriculum and lesson plans. Instructor must be present and available for questions during all training; including makeup.
  7. Program Monitoring – Each training program must be monitored for regulatory compliance and to verify that it is operating within the program requirements as per the policy and procedure manual. Monitoring criteria and specific details regarding the monitoring process should be included. A monitoring tool or checklist must be developed and included in the “Form” section, in the P&P.
  8. Recordkeeping and form retention – Policy must identify all program related documents to be retained by the training program. Details must include the timeframe for keeping records, the locked location where records will be stored and how recordkeeping is accomplished.

Application Submission Requirements (40 Hour HHP)

Application CDPH (171) 40 hour Home Health Aide Training Program

Each applicant must submit a CDPH 171 Application for the 40 Hour Home Health Aide Training Program. The form must be complete and address all fields on the form. The person designated as RN Program Director for the HHA Training Program must have the same qualifications as an Instructor and must be approved as an Instructor prior to or concurrent with being designated as the RN Program Director for the training program. Additional forms and documents must accompany the application as listed.

  • CDPH 171 (PDF) 40 Hour Home Health Aide (HHA) Training Program Application

Curriculum Acknowledgement (CDPH 171A) 40 hour Home Health Aide Training Program Application

Twenty (20) hours of HHA curriculum are in the classroom and twenty (20) hours are clinical, which are performed and monitored by the HHA RN Program Director in a clinical setting (Home Health Agency, Skilled Nursing Facility or Acute Care Hospital). The applicant, who is approved to implement a 40 Hour HHA Training Program, will abide by the regulations at CCR, Title 22, Section 74747(e), instructor requirements at Section 74747(d) and CFR, at Section 483.36; as well as maintain accurate students' records for a period of four (4) years.

  • CDPH 171A (PDF) 40 Hour Home Health Aide (HHA) Training Program Current Curriculum

Sample Student Record

Submit a copy of the forms that will be used to document and validate the classroom and clinical curriculum; including skill demonstration and evaluation. The student record will include the date and hours of instruction, date and skill of demonstration or evaluation, and the name of the instructor performing the skill evaluation. Records will be maintained for a four-year period, and will be made available to the Department for review upon request.

Instructor Approval

Each instructor must be approved by the Department prior to teaching. HHA Instructors must be Registered Nurses (RNs) with at least two years of RN nursing experience, to include one year of employment by a Home Health Agency, providing direct patient care. Licensed Vocational Nurses (LVNs) are not eligible to be approved as HHA Training Program Instructors.

Each applicant must complete the CDPH 171B form and include a resume and copy of the active RN license with the application. The resume must include month/year to month/year of nursing experience, name/address/phone number of employer and the name of the supervisor. Resumes that lack verifiable information will not be approved.

  • CDPH 171B (PDF) 40 Hour Home Health Aide (HHA) Training Program Faculty Application

Clinical Site Agreement(s)

HHA Training Programs must provide clinical training for students in a health facility setting to ensure that students have the opportunity to practice and demonstrate nursing and home care skills with direct patient contact. The health facility types that are approved by the Department to be clinical sites are licensed as Home Health and Hospice Agencies, Acute Care Hospitals, and Skilled Nursing Facilities (SNF). The training focus shall be on delivery of care and services in the home environment, and not in an institutionalized setting. The clinical site facility must comply with state and federal regulations and must not have a Department imposed two year Training Program ban secondary to enforcement actions.

An applicant may choose to submit a Clinical site agreement other than the CDPH 276E clinical site agreement.  If an alternate document is submitted, it must contain the following components:

  1. Separate responsibilities for the Training Program and the health facility. 
  2. Include the name and address of the parties, and be signed by the facility administrator and training program Owner or Administrator.
  3. The agreement must be a closed-ended contract with a specific expiration date.  The agreement is valid for a maximum two-year period.
  4. Both parties must agree to follow all local, state and federal laws and regulations.
  5. The training program (school) must be responsible for all training in its entirety and cannot allow facility staff to train, teach, monitor, shadow, or proctor students. The Department approved RN Instructor(s) must provide direct and immediate supervision of the students at the facility during the clinical training.
  6. The skills must be evaluated in the clinical setting with patients and recorded on the student record.
  7. The school must work collaboratively with the facility to establish a clinical schedule that includes specific training dates and times.
  8. The school will furnish the facility with a list of student names including dates and times of the training schedule.
  9. The school will ensure that the students have had the following, prior to direct care in the clinical setting:
    • Criminal screening which must be completed upon student enrollment.
    • Physical examination to include tuberculin (TB) skin test (PPD) or chest x-ray.
    • Examination results signed by the individual doing the examination. Results must indicate that the student does not have any health condition that would interfere with the students' ability to perform care duties, and that the student is free from signs and symptoms of infectious disease.

The Training Program must supply a list of student names to the facilities that have met the above criteria. It is the responsibility of the school to provide documentation that the students in the clinical setting do not pose a health risk to patients/residents.

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