State of California—Health and Human Services Agency
California Department of Public Health
CDPH 181 Communication Notice Classroom
CEU Provider for CNA's and HHA's
Aide and Technician Certification Section (ATCS), MS 3301, 1615 Capitol Avenue, P.O. Box 997416, Sacramento, CA 95899-7416
(916) 552-8811 Fax (916) 324-0901
181 (6/17CM) Internet Address: www.cdph.ca.gov
TO:
NAC #:
Telephone Number:
County:
This CEU provider applicati
on/renewal:
☐ Has been approved/re-approved through:
☐ Has not been approved (Resubmission deadline is 90 days
from receipt of this notice.)
Check marks below indicate incomplete or unsatisfactory items.
For specific information, see comment box on the right:
☐ List of courses were not submitted or do not meet
requir
ements. (Courses must be relevant to patient care skills
and expand on information taught in the
basic pre-certification
training.)
☐ Courses/topics are not applicable to the duties
of the Certified
Nurse Assistant (CNA) or Home Health Aide (HHA).
☐ Lesson Plans, Course Outlines, Sample Tests.
☐ Course outline does not contain specific detail necessary to
support
# of CEU hours or for Department staff to make a
determination.
☐ Instructor documents are missing, and/or
the applicant is not approved.
☐ Description of classroom requirement not met.
☐ Record-keeping policy requirements were not met.
☐ Other:
Comments:
C Martin, RN, HFEN
(916) 552-8879
This approval is for classroom instruction and not for
online or home study courses.
See page 2-3 of CDPH
192 form for list of currently approved courses and
instructors.
Los Angeles County + University of Southern California
Medical Center and Los Angeles County College of
Nursing and Allied Health
1237 N. Mission Road
Los Angeles, CA 90033
The Department has approved the
courses and instructors as listed on
the attached course and instructor
lists.
The course titled "NA Seminar 2017
#1 was not approved; however each
course was approved and may be
taught for credit. A separate
certificate of completion must be
issued for each course.
Please call to discuss if questions.
