The Training Program Review Unitis responsible for the review, approval/disapproval and continual oversight of Certified Nurse Assistant (CNA), Home Health Aide (HHA), and Certified Hemodialysis Technician (CHT) training, Orientation and In-service programs. (1-833-422-4255). Decrease, Reset The Associate Governmental Program Analyst (AGPA) will be responsible for enforcing licensing and certification standards in accordance with State, Federal, and local laws and regulations. Box 997416 Sacramento, CA 95899-7416 PHONE: (916) 327-2445 FAX: (916) 324-0901 . <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Describe how your education, training, experience, and skills meet the minimum qualifications and qualify you for the position. 678) and any other relevant documents (e.g. It looks like your browser does not have JavaScript enabled. endstream endobj 1559 0 obj <>stream 1555 0 obj <>stream It looks like your browser does not have JavaScript enabled. Training Program Name: NURSE ASSISTANT TRAINING PROGRAM SKILLS CHECK LIST MS 0500 At the California Department of Public Health (CDPH), equity, diversity, and inclusion are at the core of our mission to advance the health and well-being of Californias diverse people and communities. Questions relative to this Users' Manual should be directed to your usual program policy office. Share your form with others Send cdph form 5000 via email, link, or fax. Simply copying and pasting your resume will also not be accepted. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting. j)@@Q"+S3LY4keu(^ i 1540 0 obj <>/Filter/FlateDecode/ID[<21B77C7B2D434A44B1AE3812132A329D>]/Index[1511 45]/Info 1510 0 R/Length 129/Prev 469261/Root 1512 0 R/Size 1556/Type/XRef/W[1 3 1]>>stream PO Box 997377 HtUnH+>$; /"06k",O&?)^"]{ufztOE(-#M Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants. CDPH 931 (PDF) - Verification of Current Nurse Assistant Certification CDPH 5000 (PDF) - Program Flexibility CDPH 5000 A (PDF) - Temporary Permission for Program Flexibility for Increased Patient Accommodations HS 200 (PDF) - Licensure and Certification Application HS 215 A (PDF) - Applicant Individual Information* a hard copy application package may be submitted through an alternative method as explained in the How to Apply section below. We are genuinely and strongly committed to cultivating and preserving a culture of inclusion and connectedness where we can grow and learn together with a diverse team of employees. Health care facilities in California are licensed, regulated, inspected, and/or certified by a number of public and private agencies at the state and federal levels, including the CDPH Center for Health Care Quality (CHCQ) and the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS). Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). Application Packages may be submitted electronically through your CalCareers Account at www.CalCareers.ca.gov. Contact Us WARNING: This is a State of California computer system that is for official use by authorized users and is subject to being monitored and or restricted at any time. This change supports the Department's effortsto promote paperless communication. endstream endobj 1555 0 obj <>/Metadata 119 0 R/OCProperties<>/OCGs[1573 0 R]>>/OpenAction 1556 0 R/Outlines 157 0 R/PageLayout/SinglePage/Pages 1546 0 R/StructTreeRoot 229 0 R/Type/Catalog/ViewerPreferences<>>> endobj 1556 0 obj <> endobj 1557 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1558 0 obj <>stream When submitting your application in hard copy, a completed copy of the Application Package listing must be included. Sacramento, CA 95899-7377, For General Public Information: 3/16/2023, 5:00:00 PM to 3/16/2023, 11:30:00 PM. Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. MS 0500 Please turn on JavaScript and try again. Z,TxoY0t/KJzC8-EeW"hT+%5y-WrA08[!S~"Pk ^&C&;Xp|2z9vH+%WRJ7U]wgBLXc>x|*W*fH^I:|} O^I2N!OSJ63Y1m v yh7y2x [gKARj;xnbX. that are in compliance with licensing rules and can be found in the LSS Group Service Manual, . When submitting your application in hard copy, a completed copy of the Application Package listing must be included. 220 0 obj <>/Filter/FlateDecode/ID[<8057D936990C164CA14321D7DAD250DF><77642FCE50124145A561DCCE9727C949>]/Index[204 23]/Info 203 0 R/Length 80/Prev 97625/Root 205 0 R/Size 227/Type/XRef/W[1 2 1]>>stream All California Department of Public Health (CDPH) employees perform work that is of the utmost importance, where each employee is important in supporting and promoting an environment of equity, diversity, and inclusivity, essential to the delivery of the department's mission. 1-833-4CA4ALL You may submit your application and any applicable or required documents to: Address for Drop-Off Application Packages. endobj 5. manual letter and subsequent community care licensing changes will now be identified by a line in the left margin. 0 l California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device. %PDF-1.6 % Applications received without an SQ may be rejected. Contact Us. Box 997416 Sacramento, CA 95899-7416 (916) 327-2445 FAX (916) 324-0901 NURSE ASSISTANT ORIENTATION PROGRAM CONTENT Restate each question preceding each response. Espaol, - <>>> social security number, date of birth) from your documents prior to submission. *cCIN?3j72*=_=O*,s In addition, CHCQ cooperates with CMS to ensure that facilities accepting Medicare and Medi-Cal (in California, Medicaid is referred to as Medi-Cal) payments meet federal requirements. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. hbbd```b``"@$s0;D2 $#K-+DU'`1d A&$r9*&F-@FQQl@ /B Application packages without this information will experience delayed processing times and your eligibility for this position may be impacted. 0 (916) 558-1784, COVID 19 Information Line: Researches and evaluates laws, policies, and procedures to analyze changes and issues relative to the Licensing and Certification (L&C) Program and makes recommendations to management.
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