Get Nc Dhsr/ac 4605 2021-2025

Filling out the NC DHSR/AC 4605 form, also known as the Medication Administration Skills Validation Form, is an essential step for ensuring competency validation among unlicensed staff performing medication aide duties in adult care homes. This guide provides clear instructions to help you complete the form accurately and effectively.

Follow the steps to complete the NC DHSR/AC 4605 form online.

1. Press the ‘Get Form’ button to access the Medication Administration Skills Validation Form and open it in the provided editor.
2. Enter the name of the employee and the adult care home at the top of each page of the form, ensuring this information is clearly visible. Remember that this form is not transferable.
3. Complete all required documentation in ink. Items marked with an asterisk (*) must be checked off only by a registered nurse, confirming their authority.
4. As the instructor, when the employee has demonstrated competency for a task or skill, record the 'Satisfactory Completion Date' and sign your initials in the designated block.
5. If further training is required for any tasks, mark 'Needs More Training' and provide your initials and signature in the appropriate section.
6. Complete Sections 1 through 14 for each unlicensed staff member, documenting observations of their performance, unless otherwise specified.
7. The employee must demonstrate skills or competencies through practical observation or verbal demonstration as outlined in the guidelines.
8. Once all tasks have been completed, both the employee and the instructor must sign and date the form to validate the completed training.
9. If additional tasks are validated after the initial completion, these can be checked off and initialed by the instructor, and both parties should sign and date again in the 'Comment' section.
10. Utilize the 'Comment' section for any extra notes or documentation as necessary, ensuring all information is comprehensive.
11. Finally, ensure the completed form is securely stored and maintained within the facility as per regulatory requirements.

Complete the required documentation online to ensure compliance with North Carolina's regulations and enhance the quality of care provided in your facility.