Get Cdph 501 Fillable Form

The Cdph 501 Fillable Form is an essential document for the Nursing Home Administrator Program evaluation. This guide will walk you through the process of completing the form online, ensuring that you accurately provide all necessary information.

Follow the steps to successfully complete the Cdph 501 Fillable Form.

1. Click ‘Get Form’ button to access the form and open it in the editor.
2. Begin with the AIT's name section. Input the last, first, and middle names of the Administrator-in-Training, ensuring correctness to avoid delays.
3. Next, fill in the AIT number, preceptor's information, facility details, and contact numbers. Confirm that all information matches official records.
4. For the first quarter, record the total AIT training hours, start date, end date, and actual hours per week. Document any program changes that occurred and attach supporting documentation if necessary.
5. Rate the AIT's attendance on a scale from excellent to poor, and specify the personal training hours you provided, including any additional assistance from others.
6. List the training topics covered during the quarter and indicate whether you recommend the AIT progress to the next training quarter. Provide reasoning if the answer is 'no.'
7. Ensure you obtain signatures from both the preceptor and the AIT, along with the corresponding dates.
8. Proceed to repeat the filling process for the second, third, and fourth quarters, closely following the same structure and providing all requested information.
9. Finally, review the entire form for accuracy. Save changes, download, or print the completed document as needed for your records or submission.

Complete your documents online with confidence and ensure timely submission to the relevant authorities.