
State of California-Health and Human Services Agency. California Department of Aging. CDA 278 (New 05/02 formerly IMS 31). ADMINISTRATOR AND .
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How to fill out the Cda 278 online
Filling out the Cda 278 form online is a vital step for individuals seeking licensure in health services in California. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.
Follow the steps to complete the Cda 278 form online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering your licensee name and the center name in the designated fields. Clearly indicate your position by selecting either Administrator or Program Director.
- Provide your identifying information including your name, birthdate, address, and gender. Also, include any other names you have used and your social security number and driver's license number in the specified sections.
- Fill out the education section by listing the name and location of the college you attended, your course of study, the years completed, and the degree obtained.
- In the civil record section, answer the questions regarding any convictions, judgments, or commitments. Attach an explanatory sheet if you answer 'Yes' to any of these questions.
- List your references in the designated field, ensuring that they are individuals knowledgeable about your ability to provide care or manage a facility.
- Complete the business experience section by indicating if you have owned or operated any businesses and provide details about your role and the organization.
- Fill in your employment summary for the last ten years, ensuring that all items on your resume are included. If there were periods of unemployment, make sure to account for those in your summary.
- Review all of your entries for accuracy and completeness before finalizing your form.
- Once complete, save changes, download the form for your records, and consider printing or sharing it as needed.
Start filling out your Cda 278 form online today to ensure a smooth application process.
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