Cdph 283 A Form PDF Details

In California, the demand for qualified nursing assistants and home health aides remains consistently high to meet the needs of individuals requiring care in skilled nursing facilities, intermediate care facilities, and home health settings. The Certified Nurse Assistant (CNA) / Home Health Aide (HHA) In-Service Training / Continuing Education Units (CEUs) Form (CDPH 283 A) serves as a critical tool in ensuring that these healthcare professionals continually update their skills and knowledge base. Facilitated by the California Department of Public Health (CDPH), the form is a cornerstone of the state’s efforts to maintain a well-informed and competent healthcare workforce. It outlines the requirements for CNAs and HHAs to undergo specific hours of in-service training and continuing education within their certification period. The Legislature has underscored the importance of participation in approved training programs to assure the availability of trained personnel, with the form specifying that all training and CEUs must be obtained from CDPH-approved providers. This document is not only pivotal for the renewal of CNA and HHA certifications but also ensures that healthcare professionals are compensated for their training hours and remain updated on best practices and emerging healthcare trends. The stipulations include a mix of classroom and online training options, with clear guidelines on the amount of CEUs required, the validation process, and the implications for those who also complete Licensed Vocational Nurse, Registered Nurse, or Licensed Psychiatric Technician programs. As these roles are critical in providing frontline patient care, the CDPH 283 A form plays an integral role in promoting ongoing education and competency among CNAs and HHAs throughout California.

QuestionAnswer
Form NameCdph 283 A Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namescna renewal form california, cdph 283 a 3 15, cna form, form cdph 283a

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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) 552-8785 cna@cdph.ca.gov

CERTIFIED NURSE ASSISTANT (CNA) / HOME HEALTH AIDE (HHA)

IN-SERVICE TRAINING / CONTINUING EDUCATION UNITS (CEUs)

Printed Name of CNA/HHA

Signature of CNA/HHA

Certificate Number

*Social Security Number

To assure the availability of trained personnel in Skilled Nursing (SNF) and Intermediate Care Facilities (ICF), the Legislature intends that all such facilities in California participate in approved training programs. All approved In-Service Training programs are specified to enhance the knowledge and skills, assure continuing competency, and address performance issues one may be experiencing as a CNA/HHA. CNAs are to receive the normal hourly wage for attending the In-Service on their regularly scheduled shift or during another shift. Only CDPH-approved In-Service Training Programs and CDPH-approved CEU providers with a Nurse Assistant Certification Number (NAC#) are accepted. CNAs and HHAs that are employed in a SNF, ICF, or Home Health Agency will submit the information below to ATCS for validation of the renewal requirements. CNAs or HHAs that obtain CEUs from CDPH-approved CEU providers must attach a copy of each individual CEU course certificate for renewal validation to this form.

A)CNAs: Must obtain forty-eight (48) hours of In-Service Training/CEUs within the certification period. A minimum of twelve (12) of the forty-eight (48) hours shall be completed in each year of the two (2) year certification period. A maximum of twenty-four (24) of the forty-eight (48) hours may be obtained only through a CDPH-approved online computer training program listed on our website. Online CEU certificates must be attached to this form for validation. Please visit www.cdph.ca.gov for a complete listing of CDPH-approved classroom and online computer CEU providers. If the HHA Training Program (40-hour program) was completed during the certification period, twenty-six (26) of the forty (40-hour) training program may count towards CEUs.

B)HHAs: Must obtain twenty-four (24) hours of In-Service Training/CEUs within the certification period. Twelve (12) of the

twenty-four (24) hours are required in each year of the two (2) year certification period (HHAs may not use online CEUs to meet the requirement).

C)CNA & HHA: Follow section A to renew both certificates.

D)Continuing Education: CEUs must be taken with CDPH-approved providers only with a NAC#. These courses are designed to enhance the knowledge and skills of the CNA/HHA and enhance the skills in the employer-based healthcare settings.

E)Licensed Vocational Nurse / Registered Nurse / Licensed Psychiatric Technician programs: CNA/HHA certificate holders will receive

In-Service Training/CEUs for completion of these courses by converting the units into hours as follows: one (1) semester unit = fifteen (15) hours, one (1) quarter unit = ten (10) hours. You must submit a copy of your school transcript to verify your enrollment.

TITLE OF TRAINING OR COURSE

☒(Check box for Online Training)

SNF/ICF/Home Health Agency Name

 

 

 

and CDPH In-Service ID#

DATE OF

HOURS

SIGNATURE OF INSTRUCTOR

Or CDPH-approved CEU Provider Name and NAC#

ATTENDANCE

OBTAINED

RESPONSIBLE FOR TRAINING

 

 

 

 

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This record shall be submitted with the Renewal Application (CDPH 283 C) and retained by the CNA/HHA for a period of four (4) years.

CDPH 283 A (03/15)

This form is available on our website at: www.cdph.ca.gov

Page 1 of 2

TITLE OF TRAINING OR COURSE

☒(Check box for Online Training))

SNF/ICF/Home Health Agency Name

and CDPH In-Service ID#

Or CDPH-approved CEU Provider Name and NAC#

DATE OF

ATTENDANCE

HOURS

OBTAINED

SIGNATURE OF INSTRUCTOR RESPONSIBLE FOR TRAINING

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Please copy this page if additional pages are needed.

TOTAL HOURS:

This record shall be submitted with the Renewal Application (CDPH 283 C) and retained by the CNA/HHA for a period of four (4) years.

INFORMATION COLLECTION AND ACCESS-PRIVACY STATEMENT

*Social Security Number Disclosure: Pursuant to Section 666(a)(13) of Title 42 of the United States Code and California Family Code Section 17520, subdivision (d), the California Department of Public Health (CDPH) is required to collect social security numbers from all applicants for nursing assistant certificates, home health aide certificates, hemodialysis technician certificates or nursing home administrator licenses. Disclosure of your social security number is mandatory for purposes of establishing, modifying, or enforcing child support orders upon request by the Department of Child Support Services and for reporting disciplinary actions to the Health Integrity and Protection Data Bank as required by 45 CFR §§ 61.1 et seq. Failure to provide your social security number will result in the return of your application. Your social security number will be used by CDPH for internal identification, and may be used to verify information on your application, to verify certification with another state's certification authority, for exam identification, for identification purposes in national disciplinary databases or as the basis of a disciplinary action against you.

CDPH 283 A (3/15)

This form is available on our website at: www.cdph.ca.gov

Page 2 of 2

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