Form CDPH 278B at a glance
What it is: CDPH 278B is the In-Service Training Program for Certified Nurse Assistants.
Where and when to file: Submit the completed packet to TPRU@cdph.ca.gov.
To be completed by all skilled nursing and intermediate care facilities.
A filled-in Form CDPH 278B example: a nursing facility lists six courses
How to fill out Form CDPH 278B, box by box
Facility name, county, training number, email and phone
Enter the Facility Name and Address, Facility County, Facility Identification Training Number (F-), Facility Email Address and Facility Phone Number.
Course titles and hours
The facility must provide a minimum of 24 hours of varied in-service training every year.
Under Course Title, list the in-service courses and include time allocated for each topic (Minimum 1 Hour each).
Enter Total Hours.
All in-service courses shall be reviewed for re-approval every two years, 22 CCR, §71847(h).
Each facility is required to complete four hours of instruction on resident abuse every 2 years, (i.e., every renewal period), California Health and Safety Code (HSC) §1337.1(e)(2)
Each facility is required to complete five hours of dementia-specific in-service training every year, HSC, §1263(c).
Lesson plans
Submit two lesson plans from two different course titles listed on this form. The lesson plan must include the following, 22 CCR, §71847(d)(2):
Student performance standards (e.g., Course Objectives).
A description of topics included which provides the Department with adequate detail (e.g., Technique, Method, Procedure) to discern what is taught.
Describe the method of teaching (e.g., Lecture, Skill Demonstration, and Instructor Led Video Lecture).
Describe the method of evaluating the results of the training (e.g., Written Exam, Oral Exam, and Skill Return Demonstration).
When in-service training is provided to each shift
Each nursing facility shall include a schedule to demonstrate how it will make available twenty-four (24) hours of varied in-service training annually, 22 CCR, §71847(e).
Indicate when in-service training will be provided to each shift: AM shift, PM Shift and Night Shift, each with Days and Time.
Signatures, names, emails and dates
By signing, the Facility Administrator, the Facility Director of Nursing (DON) and the Facility Director of Staff Development (DSD) certify, under penalty of perjury under the laws of the State of California, that it is true and correct.
Fill in Facility Administrator Name, Facility Administrator Email Address and Date, and sign on Facility Administrator Signature.
Fill in Facility Director of Nursing (DON) Name, Facility DON Email Address and Date, and sign on Facility DON Signature.
Fill in Facility Director of Staff Development (DSD) Name, Facility DSD Email Address and Date, and sign on Facility DSD Signature.
More rules for Form CDPH 278B
In-service training program sessions shall be made available to all employed certified nurse assistants who shall receive at least the normal hourly wage for attending the program, California Code of Regulations, Title 22 (22 CCR), §71847(e)(1).
The content of the in-service training program shall enhance knowledge and skills learned in the certification training program and shall also address areas of weakness as determined by a nurse assistant's performance reviews, areas of special needs of the patients, including those with cognitive needs, and areas wherein the facility received deficiencies related to patient care following the last licensing survey, 22 CCR, §71847(f).
The in-service training shall include multiple subjects, 22 CCR, §71847(e).
Home/independent study is not conducted for in-services.
In-service schedule, sign-in sheet and record keeping policy
The three-month schedule
Submit a three-month in-service schedule, 22 CCR, §71847(d)(1).
Example: In-service program expires in August; send a schedule for September, October and November.
Do not send schedules for past months.
The topics listed on this form must match the topics that you will list on the proposed schedule.
Make sure to include specific dates, times, and topics for each month on your schedule.
The in-service sign-in sheet
Submit a copy of the in-service sign-in sheet. It must include the following:
Name of the health facility; In-service course title; Date of in-service; In-service start time and end time; Instructor name (typed/printed) and instructor's signature; Participant's name (typed/printed) and participant's signature; Participant's CNA or HHA certification number.
The record keeping policy
Submit a copy of the record keeping policy. It must include the following:
Which in-service records are maintained (sign-in sheets, lesson plans, written exam etc.)? How long (4-year minimum) are the In-service records maintained? Storage location address. How records are stored (hard copy or digital)? The title of the person responsible for the record keeping.
Videos, computer learning and/or tapes are utilized
When in-service or consultant led instruction videos, computer learning and/or tapes are utilized, the instructor is present at all times for discussion and/or demonstration.
Common questions about Form CDPH 278B
Where do I file it?
Submit the completed packet to TPRU@cdph.ca.gov.
Sources
[1] Form CDPH 278B (12/19), California Department of Public Health (the Official source link on this page).