PO Box 997377 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. California Department of Public Health (CDPH) Licensing and Certification Program (L&C) Aide and Technician Certification Section (ATCS) Training Program Review Unit (TPRU) MS 3301, P.O. hb```f``Qg`e` B@16`Q1yjW+; Please reference. The Supplemental Questionnaire serves as a documentation of each candidates ability to present information clearly and concisely. Simply copying and pasting your resume will also not be accepted. Espaol, - You may submit your application and any applicable or required documents to: Address for Drop-Off Application Packages. 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). The incumbent works under the direction of the Staff Services Manager I (SSM I). 1-833-4CA4ALL The Supplemental Questionnaire is a narrative writing that individually answers each of the questions below. I..vy5E~U,/sTa?|[bi[6YE]e1z}/E mX"Tw\|V5:"w&o^cel~M;O:~ lsp%!\6%"Q3&gO\#D@|BiPQ8L ' {^&[]\5|;Pp! 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. California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) State Oversight: CDPH Licensing and Certification (L&C) Headquartered in Sacramento, CA 18 district offices >600 health facility evaluator nurses (HFEN) Licenses facilities to operate in California, including General acute care hospitals (GACH) Skilled nursing facilities (SNF) Federal Oversight: Centers for Medicare and Medicaid Services (CMS) An error occurred during your request. If you believe that this page should be taken down, please follow our DMCA take down process, 17 Station St., Ste 3 Brookline, MA 02445. Share your form with others Send cdph form 5000 via email, link, or fax. Please turn on JavaScript and try again. Licensing, Certification and Other Credentials; Certificates, Licenses, Permits and Registrations; Health Care Facility Licenses; Health Care Professionals; Laboratory; Medical Waste; . hmo0?n:D*+PR)xm$?C j)@@Q"+S3LY4keu(^ i Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting. At the California Department of Public Health (CDPH), equity, diversity, and inclusion are at the core of our mission to advance the health and well-being of Californias diverse people and communities. All employees are 1571 0 obj <>/Filter/FlateDecode/ID[<229AD8CC74FBF740881CE5C81D10DED6>]/Index[1554 28]/Info 1553 0 R/Length 96/Prev 530017/Root 1555 0 R/Size 1582/Type/XRef/W[1 3 1]>>stream PDF Nurse Assistant Orientation Program Content Please describe your experience using those skills. The incumbent will develop expertise in a number of program areas and will analyze and research issues, work closely and cooperatively with others and in teams, and prepare responses to controlled and other program correspondence on a variety of subjects. 1-833-4CA4ALL 01. CDPH 2388 Duty Statement Template - calcareers.ca.gov Type text, add images, blackout confidential details, add comments, highlights and more. Primary care clinics are required to be licensed through the authority of the California Department of Public Health (CDPH) Licensing & Certification Program (L&C). The Training Program Review Unit is responsible for the review, approval/disapproval and continual oversight of Certified Nurse Assistant (CNA), Home Health Aide (HHA), and Certified Hemodialysis Technician (CHT) training, Orientation and In-service programs. com EMAIL info passport-visa-service. HQK0+.y+BXL HM>&8mqu-pITSid/%IdV}!L$!d+ endstream endobj 435 0 obj <>stream A completed State application (STD. Please try again. endstream endobj 1512 0 obj <>/MarkInfo<>/Metadata 65 0 R/OCProperties<>/OCGs[]>>/Outlines 85 0 R/Pages 1509 0 R/StructTreeRoot 90 0 R/Type/Catalog>> endobj 1513 0 obj <>/ExtGState<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 1514 0 obj <>stream hUYO@+%) T *aq`mp hb```%B }r ga`w $Kux~pI-ky,-H}.Ri s)1@"wR @;::`#,fstt`u2b5B3'130axq2E7S+1\ce|TpQ=f65j,dX } Health care facilities in California are licensed, regulated, inspected, and/or certified by a number of public and private agencies at the state and federal levels, including the CDPH Center for Health Care Quality (CHCQ) and the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS). Adhere to the instructions below to fill out Cdph 5000a online quickly and easily: Benefit from DocHub, the most straightforward editor to promptly manage your documentation online! (916) 558-1784, COVID 19 Information Line: It looks like your browser does not have JavaScript enabled. System will be down for a scheduled maintenance from. The Centralized ApplicationsBranch provides standardizationand consistency ofstate licensing and federal certification through the application process. Espaol, - policies and procedures. =x4;5*3-=)L:o';-D9+SLj`:?A2(KJvjW ]'nUo,C~`7}-iE9)re6BWl manual letter and subsequent community care licensing changes will now be identified by a line in the left margin. (916) 558-1784, COVID 19 Information Line: For experience/education to qualify during the application screening process, and to ensure that minimum qualifications can be determined, applicants should include all employment history on the Employment Application (STD 678) and/or Resume, including detailed job descriptions,hours worked per week, andstart/end dates (MM/DD/YYYY). HtUnH+>$; /"06k",O&?)^"]{ufztOE(-#M 1554 0 obj <> endobj Electronic (Using your CalCareer Account), Note: documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 0 CHCQ also oversees the certification of nurse assistants, home health aides, hemodialysis technicians, and the licensing of nursing home administrators. CDPH Licensing. for licensing and certification meet the State and Federal requirements. 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. ^YFa5~s@( 9! d!74{d4{@Xfie5SIgPS(.HB_pX@YOL{*S.9V8oVBiZ`tAp|YsSAqCi 3/16/2023, 5:00:00 PM to 3/16/2023, 11:30:00 PM. Individuals who are eligible for a Training and Development assignment may also be considered for this position(s). (1-833-422-4255). When submitting your application in hard copy, a completed copy of the Application Package listing must be included. L)Ba(i"q}3%qAQb K`!9T)CCIpA6R1~W*jOGGhGthRf- endobj Formulates and implements an action plan for issue resolution and presents problem endstream endobj 432 0 obj <>/Metadata 34 0 R/Names 455 0 R/OCProperties<><>]/BaseState/OFF/ON[461 0 R]/Order[]/RBGroups[]>>/OCGs[460 0 R 461 0 R]>>/Pages 429 0 R/StructTreeRoot 51 0 R/Type/Catalog>> endobj 433 0 obj <>stream social security number, date of birth) from your documents prior to submission. Find All Guidance - California Sacramento, CA 95899-7377, For General Public Information: hbbd``b`Z$U7H0w V6"K!ADHmy0f`bdR h' Please remove any confidential information (i.e. It also oversees the approval of the CNA, HHA, and CHT training programs andcontinuing education, and the criminal record clearance of these four health care professional types. Home Health Aide Regulations, Title 22, Division 5, Chapter 6, Article 5. [H:+"yc" 1581 0 obj <>stream Application Packages may be submitted electronically through your CalCareers Account at www.CalCareers.ca.gov. Submitting an electronic application through your CalCareers account is strongly recommended since electronic applications will be received/processed faster than other methods of filing. APPROVED C passport-visa-service. It is an objective of the State of California to achieve a drug-free work place. 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. to Default, Certificates, Licenses, Permits and Registrations, Registered Environmental Health Specialist, California Health Facilities Information Database, Chronic Disease Surveillance and Research, Division of Radiation Safety and Environmental Management, Center for Health Statistics and Informatics, Medical Marijuana Identification Card Program, Office of State Public Health Laboratory Director, Centers for Disease Control and Prevention. %PDF-1.5 to Default, Registered Environmental Health Specialist, California Health Facilities Information Database, Chronic Disease Surveillance and Research, Medical Marijuana Identification Card Program, Office of State Public Health Laboratory Director, Centers for Disease Control and Prevention, Licensing and Certification Program Information. The Human Resources Contact is available to answer questions regarding the application process. SROA and surplus candidates should submit a copy of their letter with their application. unofficial transcript, copy of degree, resume, etc.) %PDF-1.6 % endobj 4 Any applications received thatdo not providea written response to theSQ will notbe scored/reviewed. ?+{ z$Dny}N^0b7A yl `cG/Q*W^ ? &"e$;MHl G!0Q! c&x0 j C9+$`p|B+H,{($Do^[aU+a The Field Operations Branch has regulatory oversight of licensed health care facilities and agencies. Supplemental Questionnaire (SQ) Instructions. This change supports the Department's effortsto promote paperless communication. %PDF-1.6 % Many updates and improvements! Application Analyst, Final Filing Date: that are in compliance with licensing rules and can be found in the LSS Group Service Manual, . CHCQ is responsible for ensuring health care facilities comply with state laws and regulations. Edit your cdph program flex form online. For experience/education to qualify during the application screening process, and to ensure that minimum qualifications can be determined, applicants should include all employment history on the Employment Application (STD 678) and/or Resume, including detailed job descriptions. and indicate the basis of your eligibility in the Examination(s) or Job Title(s) section. 1-833-4CA4ALL `a`zHs10iaCSovp9HY!zYJ 9A b0 M; NO . Home Health Aide regulations, Title 42, Federal Code of Regulations (42CFR), Part 484, CNA Competency Testing Vendor Information, Disqualifying Penal Code Sections (HHA only), Centers for Disease Control and Prevention, Educational Institution Application Requirements, Skilled Nursing Facility & Intermediate Care Facility Application Requirements, In Person Continuing Education Program Requirements, Online Continuing Education Program Requirements. Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Please submit only one application. summary of significant accounting policies is on file in the licensing record. A completed State application (STD. 5. Please turn on JavaScript and try again. Please remove any confidential information (i.e. In recruiting for team members, we welcome the unique contributions that you can bring to us and the work we do. take the place of the Supplemental Questionnaire. . When submitting your application in hard copy, a completed copy of the Application Package listing must be included. Application packages without this information will experience delayed processing times and your eligibility for this position may be impacted. hbbd```b`` AD2*+d|"@d -"A$o ?mX=# / : 226 0 obj <>stream 453 0 obj <>/Filter/FlateDecode/ID[<2D63CCFDFD5B7E46935B63B2B7D57276><8CC1B76A2A16E84A8C51865605C06DC9>]/Index[431 115]/Info 430 0 R/Length 111/Prev 220853/Root 432 0 R/Size 546/Type/XRef/W[1 3 1]>>stream PO Box 997377 The request should be made at the time of contact to schedule the interview. 5/7/2023, https://www.surveymonkey.com/r/CDPHRecruitment. Sacramento, CA 95899-7377, For General Public Information: to the Department's EEO Office. Edit your cdph program flex form online Type text, add images, blackout confidential details, add comments, highlights and more. 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. The L&C Program is comprised of three branches: Centralized Applications Branch, Field Operations Branch, and Professional Certification Branch. HR0!M&p:"Kwv~%Q CCL -08-01 Effective 3/5/08 Page 6 4 0 obj PDF South Dakota Department of Social Services CERTIFICATE OF LICENSE as a What skills do you believe are most critical to be successful in this position? Cdph 5000: Fill out & sign online | DocHub endstream endobj 434 0 obj <>stream Resumes, letters, Statement of Qualifications, transcripts, degrees, your state application, cover letters and other materials. If you are unable to submit your application electronically through your CalCareers account, please email. hb```b``Nc`a``} @q@QIP@ID-0Oaa(sAA0Ll #F#Xz&>P]`>}K Yf[W;@g2KbGY L1dV'f(JXRV,#WMo>)4:dm3Q]+=cOEvUo7\Y@6JuQ,'Vmnv@LwmI !:tLZ6Xd:-b[ Nh^V(u0LJ TVbF3Qb\++a|Ly1F3 z |cw$TQHQj n i> D3Fn&~Hz-te;}>>F?2'z@p:{6f+ >-ge3 E+8D]!je - 431 0 obj <> endobj endstream endobj startxref PDF State and Federal Regulatory Requirements By using this site you agree to our use of cookies as described in our, cdph licensing and certification policy and procedure manual. The branch administers thelicensing and regulation of nursing home administrators (NHAs). Send cdph form 5000 via email, link, or fax. Espaol, - (1-833-422-4255). DocHub v5.1.1 Released! 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* Teleworking may be available for this position, in accordance with CDPHs Telework Policy and Procedures. Describe your ability to handle multiple assignments at one time, prioritize your workload, and manage deadlines. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below: Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. We review, analyze, and evaluate requests for facility licensure, certification, and other license-associated transactions submitted by facility providers for approval. <> *cCIN?3j72*=_=O*,s We apologize for any inconvenience. Submit a CDPH form 5000 for non-COVID-19 related requests to your local district office; Submit COVID-19 related requests to Centralized Program Flex Unit 01. to Default, Registered Environmental Health Specialist, California Health Facilities Information Database, Chronic Disease Surveillance and Research, Medical Marijuana Identification Card Program, Office of State Public Health Laboratory Director, Orientation and In-serviceProgram Requirements, Hemodialysis Technician Training Program Requirements, 120 Hour Home Health Aide (HHA) Training Programs (HHP), Training Program Review Unit News & Updates, Certified Nurse Assistant Regulations, California Health and Safety Code Section 1337 - 1338.5, Certified Nurse Assistant Training Regulations, California Code of Regulations, Title 22, Division 5, Chapter 2.5, Article 1-5, Certified Nurse Assistant Training Federal Regulations, Title 42 Code of Federal Regulations, 483.75 and 483 Subpart D, Home Health Aide regulations, California Health and Safety Code Section 1725-1742 (1736-1736.7). 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. 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 The incumbent will have frequent contact with health care providers, other State and Federal entities, city and/or county agencies, other division/sections within the Department, and the Office of Legal Services. hbbd```b``"oH= &+jlV0i&IU0yD=;EXLA$XDr!4`v5HW{NI$+X/{$g k Restate each question preceding each response. 03. 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. Select 'Stay Logged In' below to resume your activity. <> Staff Qualifications - 67:42:07:02, 67:42:07:07 A. social security number, date of birth) from your documents prior to submission. ]_h_'=S(; 40`/!iXL:|MX]:oIs m=e}wdSY)Sa1n_W?P0;K^O B(xj*Jt\o5!@k2S#lMW~VMcS7N{W^:=gU=V=> :c\!p? Program Director : YES . TN",MgR:lvCbOjt8l~E8a3/}:#BQ0tRVt-U[Fi]k2T/ F);$%U.'g(O&OP]eb)G Please referenceJob Control # (367337)and indicate the basis of your eligibility in the Examination(s) or Job Title(s) section. HS]O0}_qdAy@D$44nY; d$*O.K{j%\*M@BN"\"s`n,C: 7hyS3? Job Posting: m? W5O)DH$/c Our survey teams also consider compliance with federal statutes if the facilities receive Medicare or Medi-Cal reimbursement. (1-833-422-4255). for assistance and a CDPH Human Resources Division staff member will contact you to assist with the online application process or. The Hiring Unit Contact is available to answer questions regarding the position. endstream endobj startxref It looks like your browser does not have JavaScript enabled. MS 0500 When submitting your application in hard copy, a completed copy of the Application Package listing must be included. NEW: Effective January 1, 2022, all training program applications and documents must . Application packages without this information will experience delayed processing times and your eligibility for this position may be impacted. The Health Program Specialist 1 examination will be unavailable for maintenance after 5/4/2023 and will be available again on 5/9/2023. Please let us know how you heard about our position by taking this brief survey: You will find the Minimum Requirements in the Class Specification. In recruiting for team members, we welcome the unique contributions that you can bring to us and the work we do. The incumbent will conduct research utilizing various databases to ensure compliance with State and Federal statutes. CPaXp"r.8H. Training Program Name: NURSE ASSISTANT TRAINING PROGRAM SKILLS CHECK LIST 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. 0tt e -*`#T84`gy52wp6PPFA40t102(5 Decrease, Reset Forms: Licensing and Certification Program - California N.>nO a hard copy application package may be submitted through an alternative method as explained in the How to Apply section below.
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