Form CDPH 283 A at a glance
What it is: Form CDPH 283 A is the Certified Nurse Assistant (CNA) / Home Health Aide (HHA) In-Service Training / Continuing Education Units (CEUs) form.
Who signs: Enter the Signature of Applicant (Required) and the Date (Required).
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 the CDPH website. Online CEU certificates must be attached to this form for validation. Please visit cdph.ca.gov for a complete listing of CDPH-approved classroom and online computer CEU providers. If the CDPH-approved HHA Training Program (40-hour program) was completed during the certification period, twenty-six (26) hours of the forty (40-hour) training program may count towards CEUs. Training less than 50 minutes increments cannot be counted towards the CEU/In-Service training renewal requirement. 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 renewal requirement). C) CNA & HHA: Follow section A and B to renew both certificates. D) Continuing Education: CEUs must be obtained only through a CDPH-approved provider with a valid NAC#. Courses taken for credit must enhance the knowledge and skills of the CNA/HHA and enhance the skills in the employer-based healthcare settings. E) Continuing In-Service Training: This training must be provided by a department-approved provider that is a health facility where the CNA/HHA has been employed within the most recent certification period. Printed name, signature and title of the instructor responsible for training is required.
A filled-in Form CDPH 283 A example: a CNA logs two courses
How to fill out Form CDPH 283 A, box by box
First year of my certification period, name and certificate number
Under First year of my certification period, enter From and To.
Enter the Printed Name of CNA/HHA (Required), the Social Security Number (Required) and the Certificate Number.
Columns A to E, the training
For each course, enter the Title of training/course, the SNF/ICF/Hospice/Home Health Agency name and CDPH in-service ID# or CDPH-approved provider name and NAC#, the Date of attendance (MM/DD/YY) and the Hours Obtained.
Training obtained from: Sections to be completed on Form CDPH 283A. Skilled Nursing/Intermediate Care Facility: Complete column A, B, C, D and E. Hospice: Complete column A, B, C, D and E. Home Health Agency: Complete column A, B, C, D and E. CDPH-approved providers with a NAC# (In-class and Online): Complete column A, B, C and D.
Licensed Vocational Nurse/Registered Nurse/Licensed Psychiatric Technician programs: Complete column A, B, C and D.
Printed name, signature and title of instructor responsible for training (for instructor use only).
Each training row has a check box for Online Training.
Total Hours
Enter the Total Hours.
I certify under penalty and perjury
By signing you certify under penalty and perjury under the applicable state and federal laws that the information contained in this application and supporting documents, is true and correct, and that you understand any false, incomplete, or incorrect statements may result in denial of this application.
More rules for Form CDPH 283 A
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 on this form 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.
The initial CNA/HHA certificate is issued for two birthdays, not two calendar years, and will expire on your birthday. Each year of the certification period will be from one birthday to the following birthday. Any additional time from the effective date until the first birthday after certification will be counted towards the first year of the certification period.
Certificates of completion must be submitted for renewal validation.
Example: Effective Date - 03/20/24 Expiration Date - 05/15/26 Birthday - 05/15/XX First year of certification period - 03/20/24 - 05/15/25 Second year of certification period - 05/16/25 - 05/15/26 From the expiration date on, it will expire every two years for timely renewals Next certification period: First year of certification period - 05/15/26 - 05/15/27 Second year of the certification period - 05/16/27 - 05/15/28 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.
If your situation is different
Licensed Vocational Nurse, Registered Nurse or 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.
A copy of your school transcripts must be attached to this form to verify enrollment and completion of this coursework.
Second year of my certification period
Log your second year of CEUS and In-Service training, and enter the From and To of the Second year of my certification period.
Common questions about Form CDPH 283 A
Where do I file it?
Mail or submit application Online: California Department of Public Health (CDPH) Healthcare Workforce Branch (HWB) MS 3301, P.O. Box 997416 Sacramento, CA 95899-7416 Phone: (916) 327-2445 Submit application Online: cdph.ca.gov/Programs/CHCQ/LCP/Pages/Online-Submission-Page.aspx#
Sources
[1] Form CDPH 283 A (5/2024), Certified Nurse Assistant (CNA) / Home Health Aide (HHA) In-Service Training / Continuing Education Units (CEUs), California Department of Public Health (the Official source link on this page).
