Cal. Code Regs. tit. 22 § 71835

Current through Register 2025 Notice Reg. No. 2, January 10, 2025

Section 71835 - Certification Training and Competency Evaluation Program

(a) A certification training program shall be conducted either directly by a nursing facility or through an agreement with another nursing facility, agency or public educational institution approved by the Department. All providers of certification training and competency evaluation programs shall meet both state and federal requirements.

(b) When a nursing facility provides the certification training program through another nursing facility, agency or public educational institution, there shall be a written agreement signed and dated by the authorized representatives of each party. Agencies and public institutions which use nursing facilities as a clinical skills training site for certification training shall keep a record of each student, the date and the time of the training and the name of the qualified instructor. Agencies and public institutions must develop the training schedule with the nursing facility and provide the above record to the nursing facility. The agency, public educational institution or nursing facility providing the training must retain these records for a period of four (4) years starting from the date each class begins.

(c) A contractor who provides certification training for a nursing facility by agreement shall be responsible for the program in its entirety. This shall include furnishing the staff to teach theory and supervise the clinical training of the program. Nursing facilities shall only contract with Department approved training programs.

(d) Credit for portions of another California approved certification training program completed within the previous two years shall be given. To receive credit for the portion(s) of a training program received in another state or country, a nursing assistant must request the provider in the other state or country to submit an original transcript of the course(s) to the Department at the address specified in Section 71833(b).

(1) Starting from the date the Department receives a request for approval, the applicant shall be informed within 30 days whether the request is complete and accepted for filing or whether the request is deficient and what specific information is needed. A complete request is one that includes an original transcript.

(2) Starting from the date a completed request is received, the Department will make a decision whether to approve or disapprove it within 90 days. The Department's time frames for acting on a request for credit are as follows:

(A) Minimum........................................	30 days.
(B) Median..........................................	60 days.
(C) Maximum......................................	90 days.

(e) The nursing facility, school or agency shall maintain evidence that all health professionals involved in the training program are currently licensed, registered or certified in their area of expertise.

(f) Each student enrolled in a certification training program or competency evaluation program shall have a health examination prior to participating in segments of the program which involve contact with patients in a nursing facility.

(1) This examination shall include:

(A) A medical history and physical examination.

(B) A test for tuberculosis infection that is recommended by the federal Centers for Disease Control and Prevention (CDC) and licensed by the federal Food and Drug Administration (FDA), unless medically contraindicated. If a positive test result is obtained, a chest x-ray shall be taken, unless medically contraindicated.

(2) A report, signed by the physician, physician's assistant or nurse practitioner, shall be provided to the nursing facility. This report shall indicate that the student does not have any health condition that would create a hazard to himself, fellow employees, or patients.

(g) A licensed nurse (or nurses) in a nursing facility may assist the Director of Staff Development in the supervision of students during clinical training. Such nurse(s) shall have no other duties while supervising students for the one hundred (100) hours of clinical training. The 100 hours of supervised clinical training shall be conducted between the hours of 6:00 a.m. and 8:00 p.m.

(h) Application shall be made by the nursing facility, agency or public educational institution to the Department for approval of a certification training program.

(1) Submission of an application shall be considered complete when all of the information required under subsection (i) of this section has been received by the Department.

(2) The Department's maximum time period for processing an application for a certification training program, from the receipt of initial application to the final decision regarding the application shall be ninety (90) days.

(3) No training shall commence until the nursing facility, agency, or public institution receives approval from the Department.

(i) Applications shall contain a sample of four (4) lesson plans which address four (4) different topics in a module specified in section 71835(n). Each lesson plan must include:

(1) The student performance standard.

(2) An outline of content to be provided for that particular lesson with adequate detail (i.e., method, technique, procedure) to discern what is taught.

(3) The method of evaluating knowledge and demonstrable skills.

(4) A sample of the skills return demonstration record used for each trainee which shall include:

(A) A listing of the duties and skills the nurse assistant must learn.

(B) Space to record the date when the nurse assistant performs this duty or skill.

(C) Space to note satisfactory or unsatisfactory performance.

(D) Space to record the initials and title of the licensed nurse evaluator.

(j) The program shall be finished and/or a competency evaluation must be successfully completed within four (4) months of employment.

(k) Each nursing facility, agency or public educational institution shall submit a request for the Department's review and approval thirty (30) days prior to a change in core curriculum content, training hours or contracted services.

(l) All records regarding the program shall be kept available for the Department's inspection for a period of four years from the date the Department approves it. All records pertaining to individuals who have successfully completed the program shall be available for the Department's inspection for period of four (4) years from the date of enrollment. Records of students who have not successfully completed the program may be discarded.

(m) A certification training program shall consist of at least the following:

(1) One hundred (100) hours of clinical training under the immediate supervision of the Director of Staff Development or Instructor. The training shall include demonstration by the Instructor or Director of Staff Development of basic patient care skills based upon the theory and clinical instruction presented in classroom. Return demonstrations by the student are also required and shall be under the immediate supervision of the Instructor or Director of Staff Development or other licensed nurse who has no other responsibilities while supervising students. During clinical training and demonstration of skills, there shall be no more than fifteen (15) students assigned to each instructor at any time. Clinical training shall take place in a nursing facility and shall be conducted in conjunction with classroom instruction. To be counted toward 100 hours of clinical training, the successful performance of a nurse assistant must be verified by the Instructor or the Director of Staff Development.

(2) A minimum of fifty (50) hours of classroom instruction shall be conducted in either a nursing facility, an agency or a public educational institution.

(n) The Department's criterion for approving certification training programs shall be that each program shallow include one hundred (100) hours of supervised clinical training and fifty (50) hours of theory, as specified in the modules and hours stated below. It is not necessary that the modules be presented in the same sequence, as long as the content and hours are the same. Specific theory hours assigned to each module are mandatory. Specific clinical hours for each module are recommended. Prior to any direct contact with a patient, at least a total of 16 hours of training shall be provided in the following areas:

(1) Communications and interpersonal skills.

(2) Infection control.

(3) Safety and emergency procedures including the Heimlich maneuver.

(4) Promoting the independence of patients.

(5) Respecting the rights of patients.

	Theory Hours	Clinical Hours
(1) Module 1. Introduction.	2	0
(A) Role and responsibilities of the Certified Nurse Assistant.
(B) Title 22, division 5, California Code of Regulations, overview.
(C) Requirements for nurse assistant certification.
(D) Professionalism.
(E) Ethics and confidentiality.
(2) Module 2, Patients' Rights.	2	1
Each nursing assistant applicant shall be instructed in patients' right as specified in title 22, California Code of Regulations section 72527 and in sections 1599.1, 1599.2, and 1599.3 of the Health and Safety Code and in Title 42, Code of Federal Regulations Part 483, Sections 483.10, 483.12, 483.13 and 483.15. The provisions of these sections are incorporated by reference into this regulation.
	Theory Hours	Clinical Hours
(3) Module 3. Interpersonal skills.	2	0
(A) Communications.
(B) Defense mechanisms.
(C) Sociocultural factors.
(D) Attitudes toward illness and health care.
(E) Family interaction
(4) Module 4. Prevention and Management of Catastrophe and Unusual Occurrences.	1	1
(A) Emergency.
(B) General safety rules.
(C) Fire and disaster plans.
(D) Roles and procedures for Certified Nurse Assistants.
(E) Patient safety.
(5) Module 5. Body Mechanics.	2	4
(A) Basic rules of body mechanics.
(B) Transfer techniques.
(C) Ambulation.
(D) Proper use of body mechanics and positioning techniques.
(6) Module 6. Medical and Surgical Asepsis.	2	8
(A) Micro-organisms.
(B) Universal precautions for infection control including methods to handle patients, and all materials that are soiled with blood and/or body fluids from patients. The methods prescribed shall be designed to reduce the risk of transmission of potentially infectious etiologic agents from patient to patient and between patients and healthcare workers.
(C) Basic principles of asepsis.
(7) Module 7. Weights and Measures.	1	1
(A) The metric system.
(B) Weight, length and liquid volume.
(C) Military time i.e. a twenty-four (24) hour clock.
(8) Module 8. Patient Care Skill.	14	44
(A) Bathing and medicinal baths which includes substances such as bran, oatmeal, starch, sodium bicarbonate, epsom salts, pine products, tar, sulfur, potassium permanganate or salt.
(B) Dressing.
(C) Oral hygiene.
(D) Hair care, hair shampoo, medicinal shampoo, nail care and shaving.
(E) Prosthetic devices.
(F) Skin care including prevention of decubitus ulcers.
(G) Elimination needs.
(H) Bowel and bladder retraining.
(I) Weighing and measuring the patient.
(9) Module 9. Patient Care Procedures.	7	20
(A) Collection of specimens, including stool, urine and sputum.
(B) Care of patients with tubing to include but not be limited to urinary, gastric, oxygen and intravenous. This care does not include inserting, suctioning or changing the tubes.
(C) Intake and output.
(D) Bedmaking.
(E) Cleansing enemas and laxative suppositories.
(F) Admission, transfer and discharge.
(G) Bandages and nonsterile dry dressings, including the application of nonlegend topical ointments to intact skin surfaces.
(10) Module 10. Vital Signs.	3	6
(A) Purpose of vital signs.
(B) Factors affecting vital signs.
(C) Normal ranges.
(D) Methods of measurement.
(E) Temperature, pulse, respiration.
(F) Blood pressure.
(G) Abnormalities.
(H) Recording.
(11) Module 11. Nutrition.	2	6
(A) Proper nutrition.
(B) Feeding techniques.
(C) Diet therapy.
(12) Module 12. Emergency Procedures.	2	1
(A) Signs and symptoms of distress.
(B) Immediate and temporary intervention.
(C) Emergency codes.
(13) Module 13. Long-Term Care Patient.	2	0
(A) Needs of persons with developmental and mental disorders including mental retardation, Alzheimer's disease, cerebral palsy, epilepsy, dementia and mental illness.
(B) Introduction to anatomy and physiology.
(C) Physical and behavioral needs and changes.
(D) Community resources available.
(E) Psychological, social and recreational needs.
(F) Common diseases and disorders including signs and symptoms.
(14) Module 14. Rehabilitative Nursing.	2	4
(A) Promoting patients' potential.
(B) Devices and equipment.
(C) Activities of daily living.
(D) Family interactions.
(E) Complication of inactivity.
(F) Ambulation.
(G) Range of Motion.
(15) Module 15. Observation and Charting.	4	4
(A) Observation of patients and reporting responsibility.
(B) Patient care plan.
(C) Patient care documentation.
(D) Legal issues of charting.
(E) Medical terminology and abbreviations.
(16) Module 16. Death and Dying.	2	0
(A) Stages of grief.
(B) Emotional and spiritual needs of the patient and family.
(C) Rights of the dying patient.
(D) Signs of approaching death.
(E) Monitoring of the patient.
(F) Post mortem care.

Cal. Code Regs. Tit. 22, § 71835

1. New section filed 7-16-91 as an emergency; operative 7-16-91 (Register 91, No. 46). A Certificate of Compliance must be transmitted to OAL by 11-13-91 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 11-14-91 as an emergency; operative 11-13-91 (Register 92, No. 8). A Certificate of Compliance must be transmitted to OAL 3-12-92 or emergency language will be repealed by operation of law on the following day.
3. Editorial correction of HISTORY 2. filed and new section refiled 5-6-92 as an emergency; operative 5-6-92 (Register 92, No. 20). A Certificate of Compliance must be transmitted to OAL 9-3-92 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 5-6-92 order including amendment of subsections (a), (b) and (d), new subsections (d)(1)-(d)(2)(C), amendment of subsections (f)(1)(B), (f)(2), (i), (i)(1), (l), (m)(1), and (n), new subsections (n)(1)-(5), and amendment of (2), (8)(A), (9)(A)-(B), (13)(A) of Table and NOTE transmitted to OAL 8-27-92 and filed 10-9-92 (Register 92, No. 41).
5. Editorial corrections (Register 95, No. 44).
6. Amendment of subsection (f)(1)(B) and NOTE filed 5-30-2013; operative 5-30-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 22).

Note: Authority cited: Sections 1275, 1338.3, 121357 and 131200, Health and Safety Code. Reference: Sections 1250, 1337.3, 1337.6, 121362, 131050, 131051 and 131052, Health and Safety Code.

1. New section filed 7-16-91 as an emergency; operative 7-16-91 (Register 91, No. 46). A Certificate of Compliance must be transmitted to OAL by 11- 13-91 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 11-14-91 as an emergency; operative 11-13-91 (Register 92, No. 8). A Certificate of Compliance must be transmitted to OAL 3-12-92 or emergency language will be repealed by operation of law on the following day.
3. Editorial correction of History 2. filed and new section refiled 5-6-92 as an emergency; operative 5-6-92 (Register 92, No. 20). A Certificate of Compliance must be transmitted to OAL 9-3-92 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 5-6-92 order including amendment of subsections (a), (b) and (d), new subsections (d)(1)-(d)(2)(C), amendment of subsections (f)(1)(B), (f)(2), (i), (i)(1), (l), (m)(1), and (n), new subsections (n)(1)-(5), and amendment of (2), (8)(A), (9)(A)-(B), (13)(A) of Table and Note transmitted to OAL 8-27-92 and filed 10-9-92 (Register 92, No. 41).
5. Editorial corrections (Register 95, No. 44).
6. Amendment of subsection (f)(1)(B) and Note filed 5-30-2013; operative 5-30-2013 pursuant to Government Code section 11343.4(b)(3) (Register 2013, No. 22).