Get Ca Cdph 276e 2019-2025

The CA CDPH 276E form is essential for obtaining clinical training site approval for Nurse Assistant Training Programs and Home Health Aide Programs within California. This guide provides clear and user-friendly instructions on how to complete the form effectively online.

Follow the steps to successfully complete the CA CDPH 276E form.

1. Click ‘Get Form’ button to access the CA CDPH 276E and open it for editing.
2. Fill out the name and address of the nursing facility. Ensure accuracy as this information is pivotal for identification.
3. Enter the name and address of the Nurse Assistant Training Program (NATP) or Home Health Aide Program (HHP). This section should match the program you are representing.
4. Provide the names and signatures of both the nursing facility administrator and the NATP/HHP owner/administrator. This indicates mutual agreement to the terms outlined in the form.
5. Complete the date fields to ensure all parties are aligned on the timeline of approval.
6. Check the appropriate box to indicate whether the application is for NATP or HHP approval.
7. Sign and date where indicated for the Nursing Facility Director of Nursing and the NATP/HHP Program Director, RN, ensuring all required signatures are present.
8. Review the completed form to ensure all information is correct before submission. Misentries can cause delays in processing.
9. Once you are satisfied with the accuracy of the information, you can save changes, download, print, or share the form as necessary.

Complete your CA CDPH 276E form online today to ensure timely approval for your training program.