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The CDPH 283 A form plays a crucial role in ensuring that Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs) in California maintain their essential skills and knowledge necessary for providing quality care. Developed by the California Department of Public Health (CDPH), this form serves as a record for CNAs and HHAs to document their In-Service Training and Continuing Education Units (CEUs). It outlines specific requirements that these professionals must meet, including a set number of hours of training over a two-year certification period. For CNAs, that amounts to forty-eight hours of training, while HHAs are required to complete twenty-four hours. The form highlights the importance of ongoing education and mandates that training be conducted by CDPH-approved providers. It also specifies how various educational achievements, such as nursing courses, can be converted into training hours. The process not only reinforces the need for skilled care in Skilled Nursing Facilities (SNFs) and Intermediate Care Facilities (ICFs) but also ensures ongoing compliance with state legislation. To efficiently process these updates, CNAs and HHAs must attach relevant training certificates when submitting the form, which includes both their social security number and certification details for validation. With the CDPH 283 A form, these dedicated professionals can keep their certifications up to date while enhancing their abilities to serve vulnerable populations in various healthcare settings.

Cdph 283 A Example

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

Form Characteristics

Fact Name Description
Purpose of CDPH 283 A This form is used to document in-service training and continuing education for Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs) in California.
Governing Agency The CDPH 283 A form is managed by the California Department of Public Health (CDPH), specifically the Aide and Technician Certification Section (ATCS).
Training Requirements for CNAs CNAs are required to complete 48 hours of in-service training or continuing education units (CEUs) every two years, with a minimum of 12 hours each year.
Training Requirements for HHAs HHAs must complete 24 hours of in-service training or CEUs within the two-year certification period, with 12 hours required each year. They cannot use online CEUs.
Submission Timeline The completed CDPH 283 A form must be submitted with the renewal application, CDPH 283 C, and should be kept for four years by the CNA/HHA.
Online Training Cap For CNAs, a maximum of 24 of the required 48 hours may be obtained through approved online computer training programs.
CEU Validation When obtaining CEUs, CNAs and HHAs must attach certificates for each course to the CDPH 283 A form for renewal validation.
Social Security Number Requirement The form requires disclosure of the social security number for identification and compliance with various child support and health data regulations.
Retention of Records CNAs and HHAs must retain the completed form and supporting documents for four years for auditing and verification purposes.
Additional Resources Information about approved training providers and services can be found on the CDPH website at www.cdph.ca.gov.

Guidelines on Utilizing Cdph 283 A

When preparing to fill out the CDPH 283 A form, it's important to gather all necessary information related to your training and continuing education. This form is essential for maintaining compliance and validating your certification as a Certified Nurse Assistant (CNA) or Home Health Aide (HHA) in California. Follow the steps below to ensure that your form is completed accurately and efficiently.

  1. Start by entering your Printed Name at the top of the form where indicated for the CNA/HHA.
  2. Next, sign the form in the space labeled Signature of CNA/HHA.
  3. Fill in your Certificate Number, which you can find on your certification card or documents.
  4. Provide your Social Security Number. Ensure that this information is accurate as it is crucial for processing your application.
  5. For the TITLE OF TRAINING OR COURSE, write the name of the training program or course you completed.
  6. If applicable, check the box that indicates if the training was completed Online.
  7. Specify the SNF/ICF/Home Health Agency Name and the CDPH In-Service ID#.
  8. Next, include the DATE OF ATTENDANCE for the training session.
  9. Document the total HOURS OBTAINED during the training.
  10. Finally, ensure that the SIGNATURE OF INSTRUCTOR or CDPH-approved CEU Provider Name and NAC# is included, validating your participation.

If you have attended multiple training sessions, don't forget to repeat these steps in the designated sections provided on the form. Keep a photocopy for your records, as this documentation is essential for your renewal application.

What You Should Know About This Form

What is the purpose of the CDPH 283 A form?

The CDPH 283 A form is used by Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs) in California to report In-Service Training and Continuing Education Units (CEUs). This information helps ensure that personnel in skilled nursing and intermediate care facilities are well-trained and continue to demonstrate competency in their roles.

How many hours of In-Service Training or CEUs are required?

CNAs must complete a total of 48 hours of In-Service Training or CEUs during their two-year certification period. This includes a minimum of 12 hours each year. HHAs are required to obtain 24 hours, with 12 hours per year mandated as well. The specific requirements for training must be met to maintain certification.

Can online training hours count toward the In-Service Training requirements?

For CNAs, up to 24 of the total 48 hours can be obtained through a CDPH-approved online training program. Online CEUs must be validated with certificates attached to the CDPH 283 A form. However, HHAs cannot use online CEUs to meet their training requirements; all hours must be completed through approved in-person training.

What should I do if I complete a licensed nursing program?

If a CNA or HHA completes courses in Licensed Vocational Nurse (LVN), Registered Nurse (RN), or Licensed Psychiatric Technician programs, they can convert the completed units into training hours. Specifically, one semester unit equals 15 hours, and one quarter unit equals 10 hours. Be sure to submit a school transcript to verify enrollment.

Where should completed CDPH 283 A forms be submitted?

Completed CDPH 283 A forms must be submitted alongside the Renewal Application (CDPH 283 C) to the Aide and Technician Certification Section (ATCS) of the California Department of Public Health. Retain a copy of the form for your records for four years.

What information is mandatory on the CDPH 283 A form?

The form requires personal details, including the printed name, signature, certification number, and social security number of the CNA or HHA. It is essential to provide accurate and complete information, as missing details, especially the social security number, can result in the return of the application.

Where can I find more information about approved training programs?

A complete list of CDPH-approved classroom and online CEU providers is available on the California Department of Public Health website at www.cdph.ca.gov. This resource will help you identify suitable training options to fulfill certification requirements.

Common mistakes

Filling out the CDPH 283 A form can be straightforward, but many people still make mistakes that can delay processing or lead to rejection. One common error is failing to include the correct Social Security Number. Since providing this number is mandatory, omitting it will result in the application being sent back. Make sure to double-check this information for accuracy before submitting.

Another frequent mistake is not keeping track of the required continuing education hours. For CNAs, a total of forty-eight hours is necessary, with a minimum of twelve hours completed each year. Failing to meet these requirements can hinder the renewal process. Always confirm that you have fulfilled these hours and have the necessary documentation.

Many applicants also neglect to attach the proper certificates for CEUs obtained. When you receive CEU course certificates, they should be included with the 283 A form. Any discrepancies or missing certificates can jeopardize your renewal application. It’s best to gather all relevant documents beforehand to ensure nothing is overlooked.

Using a training provider that is not CDPH-approved is another critical mistake. Only trainings from providers with a Nurse Assistant Certification Number (NAC#) are accepted. Therefore, verify the eligibility of your training program to avoid unnecessary complications.

Inaccurate information regarding training hours is another issue. When noting the hours obtained, ensure that the data aligns with what your training provider has documented. Mismatching this information can lead to discrepancies that might require additional explanations later.

Many people fail to provide the signature of the instructor or the CDPH-approved provider on the form. This signature is essential as it authenticates the training received. Without it, your application can be considered incomplete, causing delays.

Lastly, some applicants overlook the importance of record retention. It's essential to keep a copy of the submitted form and all supporting documents for at least four years. This can be invaluable if there are questions or issues that arise after submission. Being organized and maintaining records can save you a lot of trouble in the long run.

Documents used along the form

When navigating the certification process for Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs) in California, various forms and documents play crucial roles in ensuring compliance and validation. The Cdph 283 A form is integral, but it often accompanies other essential documents to facilitate the process. Here’s a closer look at these related forms and documents.

  • Cdph 283 C - Renewal Application: This form is necessary for renewing CNA or HHA certificates. It requires detailed information about accumulated In-Service Training hours and CEUs, alongside corresponding signatures and validation of the training completed.
  • CEU Course Certificates: CNAs and HHAs need to attach individual CEU course certificates from approved providers. These certificates serve as proof of completed courses that contribute towards fulfilling continuing education requirements for certificate renewal.
  • Training Program Verification: For HHAs who have completed the 40-hour training program, documentation is needed to verify that part of these hours can count toward CEUs. This ensures the program meets standards set by CDPH.
  • School Transcripts: If CNAs or HHAs enroll in additional nursing programs, they must submit school transcripts. This documentation verifies their compliance with training requirements by converting academic units into training hours.
  • Instructor Signatures: Every In-Service Training session requires an instructor’s signature on the Cdph 283 A form. This signature confirms attendance and verifies that the training meets CDPH standards.
  • Privacy Statement Acknowledgment: Acknowledgment of the privacy statement surrounding the collection of Social Security Numbers (SSNs) is essential. This statement explains the purpose of SSN collection as a condition of application submission.
  • Employers’ Verification: Some facilities may ask for employer verification of employment and training participation. This verification is an additional layer of documentation supporting the In-Service Training claims made by the CNA or HHA.
  • Certification Tracking Form: This document may be used by organizations to track the training hours and CEUs of their staff. It provides an overview to ensure compliance with the training requirements outlined by CDPH.

In summary, knowing the interconnected forms and documents that accompany the Cdph 283 A form is vital for CNAs and HHAs. These documents not only streamline the renewal process but also enhance the quality of care offered in health facilities by ensuring that certified professionals remain well-trained and qualified.

Similar forms

  • CDPH 283 C Form: This form is used for the renewal application for CNAs and HHAs. Like the Cdph 283 A, it ensures compliance with continuing education requirements.
  • Live Scan Fingerprint Form: Similar to the Cdph 283 A, it collects background information for credentialing. Both forms are essential for ensuring qualifications in healthcare settings.
  • Course Completion Certificate: This document verifies completion of training or educational programs, similar to the CEU certificates attached to Cdph 283 A, proving competency in required areas.
  • Employment History Form: This records employment details, much like the Cdph 283 A collects training history. Both help assess the qualifications and experience of healthcare workers.
  • Competency Evaluation Program (CEP) Form: This evaluates skills for CNAs and HHAs, akin to the training verification in Cdph 283 A. Both documents support the professional standards needed in healthcare.
  • CDPH Training Approval Application: This is submitted by training providers to gain CDPH approval for programs. It resembles the Cdph 283 A in ensuring that training aligns with regulatory standards.
  • Disciplinary Action Appeal Form: Used for appealing actions taken against healthcare personnel, this has similar regulatory compliance themes found in Cdph 283 A, emphasizing fairness in certification.
  • Continuing Education Unit (CEU) Log: This form tracks the accumulation of CEUs similar to the Cdph 283 A, both being vital for verifying ongoing education in the healthcare profession.

Dos and Don'ts

When filling out the CDPH 283 A form, here are five important things to remember:

  • Provide accurate information. Always double-check your details to avoid delays.
  • Attach required documents. Include copies of your CEU course certificates or transcripts when needed.
  • Complete all sections. Ensure each part of the form is filled in clearly and completely.
  • Use the correct format for social security numbers. Follow the instructions exactly to prevent issues.
  • Sign your name. Don’t forget to provide your signature at the end of the form.

Here are five things you should avoid:

  • Do not leave blank spaces. Each question must be answered to the best of your ability.
  • Avoid using non-approved CEUs. Only CDPH-approved CEUs will be accepted for renewal.
  • Don't submit without double-checking. Review for mistakes before sending it off.
  • Do not provide incorrect social security numbers. This will delay your application.
  • Refrain from using obsolete forms. Make sure you're using the most current version of the form.

Misconceptions

There are several misconceptions surrounding the California Department of Public Health (CDPH) 283 A form. Understanding these can help ensure compliance with certification requirements for Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs).

  • Misconception 1: Only classroom training counts towards continuing education units (CEUs).
  • Many people believe that only in-person training hours can be counted when completing the required CEUs. However, this isn't entirely accurate. For CNAs, up to twenty-four of the required forty-eight hours can be completed through CDPH-approved online training programs. In contrast, HHAs cannot utilize online CEUs to meet their requirements.

  • Misconception 2: The renewal period for CNAs and HHAs is longer than two years.
  • It is a common misunderstanding that CNAs and HHAs have more time to complete their continuing education requirements. In reality, both certifications must be renewed every two years. During this period, CNAs need a total of forty-eight hours of training, while HHAs need twenty-four hours.

  • Misconception 3: All CEU providers are accepted without restrictions.
  • There is a belief that any continuing education provider will suffice for renewing certification. This is not the case. Only providers approved by the CDPH, possessing a Nurse Assistant Certification Number (NAC#), are eligible for counting CEUs. This ensures that the training received meets the necessary standards.

  • Misconception 4: Social Security numbers are optional on the form.
  • Some individuals may think that providing their Social Security number on the CDPH 283 A form is optional. However, it is mandatory. The CDPH requires this information for various purposes, including verifying applications and ensuring compliance with child support enforcement.

Key takeaways

  • Purpose of the Form: The Cdph 283 A form is used to document in-service training and continuing education units (CEUs) for Certified Nurse Assistants (CNAs) and Home Health Aides (HHAs) in California.

  • Training Requirements: CNAs must obtain a total of forty-eight (48) hours of In-Service Training or CEUs within a two-year certification period, while HHAs need to complete twenty-four (24) hours.

  • It’s important for CNAs to complete at least twelve (12) hours each year, while HHAs must also meet the annual requirement of twelve (12) hours.

  • Online Training Limits: A maximum of twenty-four (24) hours of the required training for CNAs can come from CDPH-approved online computer training programs. HHAs cannot use online CEUs.

  • Course Validation: To validate CEU completion, copies of individual CEU course certificates must be attached to the form. This applies to both training and CEUs.

  • The form also allows CNAs and HHAs who have completed specific vocational nurse or technician programs to convert course units into training hours.

  • Signature Requirement: All training records must include the signature of the instructor or the responsible training provider.

  • This form must be submitted alongside the Renewal Application (CDPH 283 C) and should be retained by the CNA or HHA for four (4) years after submission.