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Request for Nurse Assistant Training Program or Home Health Aide program clinical site approval

Request for Nurse Assistant Training Program or Home Health Aide program clinical site approval 2026

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The document outlines the requirements and procedures for obtaining clinical training site approval for Nurse Assistant Training Programs (NATP) and Home Health Aide Programs (HHP) in California. It specifies the responsibilities of NATP and HHP, including compliance with state regulations, training hours, and student supervision. Additionally, it details the obligations of nursing facilities hosting these training programs, ensuring adherence to legal standards and maintaining staff levels during training.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name and address of the nursing facility at the designated section. Ensure accuracy as this information is crucial for approval.
Next, provide the name and address of the NATP/HHP. This identifies who is requesting the clinical site approval.
Fill in the Nursing Facility Administrator's name and signature. This confirms that they agree with the terms outlined in the form.
Complete the section for NATP/HHP Owner/Administrator details, including their printed name and signature, along with the date.
Indicate whether you are applying for NATP or HHP by checking the appropriate box.
Finally, ensure all required signatures are obtained before submitting your form through our platform for processing.

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