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Ca nurse assistant application 2026

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The document is an application form for the Skilled Nursing Facility (SNF) Nurse Assistant Certification Training Program, issued by the California Department of Public Health. It outlines the requirements for training programs, including curriculum content, clinical training supervision, and necessary documentation for approval. The application must include lesson plans, student records, and a training schedule. It emphasizes that all students must be full-time employees and details the instructor-to-student ratio during clinical training.

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Click ‘Get Form’ to open the ca nurse assistant application in our editor.
Begin by filling in the 'Facility Name and Address' section. Ensure that all information is accurate and legible.
Next, provide the 'Provider Identification Training Number' along with the contact details of the SNF Director of Staff Development or Instructor.
Complete the 'Training Schedule' section by checking or circling your preferred training days and hours. Specify whether it will be AM, PM, or weekends.
In the 'Curriculum Used' field, enter the name of the curriculum you will be using for training. This is crucial for compliance with state regulations.
Finally, ensure that you sign and date the application at the bottom to certify its accuracy before submission.

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2014	4.8 Satisfied (83 Votes)

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Ca nurse assistant application 2026

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