CNA HHA CHT Report of Misconduct - cdph ca 2026

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The document is a report form for misconduct involving Certified Nursing Assistants (CNA), Home Health Aides (HHA), and Hemodialysis Technicians (CHT) in California, intended for submission to the California Department of Public Health. It outlines the necessary information required from the reporting party, details about the individual being reported, and any actions taken or investigations conducted. The form emphasizes the importance of providing supporting documentation and includes a privacy statement regarding the collection of Social Security numbers.

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Click ‘Get Form’ to open the CNA HHA CHT Report of Misconduct in the editor.
Begin by filling in your personal information as the reporting party, including your name, address, and telephone number. Ensure accuracy for effective communication.
Provide details about the individual being reported, including their name, certification number, and any known aliases. This information is crucial for proper identification.
Indicate whether you wish to remain anonymous by selecting 'Yes' or 'No'. This choice will guide how your report is handled.
In the brief description section, clearly outline the misconduct incident, including dates and times. Use additional sheets if necessary for comprehensive details.
Attach any relevant documentation such as investigation reports or witness statements that support your claim. This strengthens your report.
Complete sections regarding previous incidents and actions taken by employers or law enforcement agencies related to this case.
Review all entered information for accuracy before submitting the form through our platform for a seamless process.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What are the types of complaints reported to CDPH?

CDPH documents every complaint received in an electronic tracking system and assigns it to a health facilities evaluator supervisor, a registered nurse who classifies the allegation. Complaint categories range from resident/patient abuse and quality of care/treatment to dietary services and resident/patient rights.

What happens if you get reported as a CNA?

Disciplinary action includes probation in lieu of suspension (diversion), suspension up to 24 months and denial/revocation of CNA/HHA/CHT certification.

What is CDPH compliance?

CDPH Professionals Provide Many Services: Preventing the spread of diseases like COVID-19, Ebola, flu, mpox and Zika by monitoring and tracking epidemics. docHubing and licensing various health facilities and professionals to ensure individual and community safety.

What are the reporting requirements for a CNA?

Generally, a nursing assistant should report any physical changes in a client that seem unusual or behavior that is out of the ordinary for that person. Examples that require immediate notification to the nurse may include the following: Strong odors from , oral care, or wounds. Reddened, warm, or open skin areas.

How do I report unethical behavior in healthcare?

How to File a Complaint. Complete the complaint form or draft your own and submit via email NHAP@cdph.ca.gov or Fax Number: (916) 636-6108. Please provide the facility name and address, if applicable.

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How do I complain about a CNA in CDPH?

To file a complaint against a certified nursing assistant, home health aide or certified hemodialysis technician, please contact the Aide and Technician Certification Section at (916) 492-8232 or email cna@cdph.ca.gov.

How do I complain about CDPH in California?

CDPH Office of Compliance - Internal Audits The mission of the California Department of Public Health (CDPH), Office of Compliance - Internal Audits (OOC-Internal Audits) is to provide an independent, objective analysis and consulting services designed to add value and improve the Departments operations.

CNA HHA CHT Report of Misconduct - cdph ca 2026

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