Cdph 278B Form PDF Details

In the realm of healthcare, ensuring that staff is regularly trained and up to date with the latest practices is paramount, particularly in skilled nursing and intermediate care facilities. This is where the CDPH 278B form, issued by the State of California Health and Human Services Agency and its California Department of Public Health (CDPH), plays a crucial role. Designed to be completed by such facilities, this form outlines the requirements for an in-service training program that all certified nurse assistants employed by the facility are expected to undertake. The form stipulates a minimum of 24 hours of annual in-service training, which includes at least 5 hours focused specifically on dementia care. This training is not just a repetition of what has previously been learned; instead, it aims to enhance the basic skills of the caregivers based on the specific needs of the facility's residents and addresses any deficiencies noted in the last licensing survey. The document requires a comprehensive listing of the training topics, along with the time allocated for each, and necessitates the signatures of the facility’s administrator, director of nursing, and director of staff development to ensure accountability. Additionally, there are provisions for the submission of lesson plans, a proposed schedule for the training sessions, and methods for including staff across all shifts, underlining the form's integral role in maintaining high standards of care through continuous professional development.

QuestionAnswer
Form NameCdph 278B Form
Form Length2 pages
Fillable?Yes
Fillable fields82
Avg. time to fill out16 min 58 sec
Other names278b, cdph 278c, cdph 278b, cdph 278a and 278b

Form Preview Example

State of California-Health and Human Services Agency

California Department of Public Health (CDPH)

 

Licensing and Certification Program (L&C)

 

Aide and Technician Certification Section (ATCS)

 

MS 3301

 

P.O. Box 997416

 

Sacramento, CA 95899-7416

 

(916) 327-2445 FAX (916) 324-0901

IN-SERVICE TRAINING PROGRAM

(To be completed by ALL skilled nursing and intermediate care facilities)

 

 

See page two for instructions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility name and address:

Provider identification training number:

F

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone: (

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County:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

All Parties Must Sign

 

 

Required Signatures

 

 

Administrator

Signature

Director of Nursing

Signature

Director of Staff Development

Signature

Each nursing facility shall provide 24 hours of in-service training annually which shall be accessible to all certified nurse assistants employed by the facility. The content of the in-service training program shall be an enhancement to the basic training program, consistent with the needs of the facility residents as determined by facility staff and shall also address areas wherein the facility received deficiencies following the last licensing survey. Include 5 hours of dementia specific training per year.

Programs shall be reviewed for reapproval every two years.

Please list the in-service topics below, totaling at least 24 hours: Include time allocated for each topic (minimum 1 hour).

TOPIC

TIME

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Total Hours

TOPIC

TIME

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

Total Hours

California Department of Public Health Use Only

Approved By:

Program Consultant

Date

CDPH 278B (06/11) This form is available on our website at: www.cdph.ca.gov

Page 1 of 2

1.Submit two lesson plans (from two different topics listed) which shall include the following:

a.Student behavioral objectives.

b.Descriptive topic content (technique, method, procedures).

c.Method of teaching.

d.Method of evaluation that indicates that learning has occurred.

2.Submit your proposed three-month schedule calendar of in-service training programs.

3.Indicate your method for including all three shifts for in-service training.

I certify that:

1.When in-service videos and/or tapes are utilized, the instructor is present for discussion and/or demonstration.

2.All records of in-service training programs and attendance records are kept on file for a period of four years.

3.Home/independent study is not done.

Director of Staff Development signature

Date

Before sending to CDPH for review and approval, check the following:

Did you get all required signatures?

Did you include two lesson plans?

Did you include three-month schedule?

Did you indicate how three shifts are in-serviced?

Did you fill in all information on this form?

Original signatures must be submitted. A faxed or scanned copy will not be accepted. Keep copies for your records.

CDPH 278B (06/11) This form is available on our website at: www.cdph.ca.gov

Page 2 of 2

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Tips to fill in form 278a stage 1

2. The next part is usually to submit the next few fields: TOPIC, TIME, TOPIC, TIME, Approved By, Total Hours, Total Hours, and California Department of Public.

Total Hours, Total Hours, and TIME inside form 278a

3. This next part should be fairly simple, Director of Staff Development, Date, Before sending to CDPH for review, Did you get all required signatures, Did you include two lesson plans, Did you include threemonth schedule, Did you indicate how three shifts, Did you fill in all information on, and Original signatures must be - all these blanks needs to be filled out here.

Filling out section 3 of form 278a

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