Get Ca Cdph 283 C 2024-2025
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How to fill out the CA CDPH 283 C online
Filling out the CA CDPH 283 C form is essential for individuals seeking to renew or reactivate their Certified Nurse Assistant (CNA) or Home Health Aide (HHA) certification in California. This guide provides a step-by-step approach to completing the form online, ensuring that all necessary information is included for a smooth application process.
Follow the steps to complete the CA CDPH 283 C form online
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin with Section I, where you must indicate the type of request: CNA Renewal, HHA Renewal, or CNA Reactivation. Please ensure that you provide the certificate number in the designated field.
- Proceed to Section II, which requires you to fill out your last name, first name, middle initial, public address, city, state, zip code, date of birth, phone number, social security number (SSN) or individual taxpayer identification number (ITIN), and email address. Remember that the public address is required for public records.
- In Section III, answer the questions regarding any convictions or disciplinary actions since your last renewal. Indicate 'Yes' or 'No' and provide the necessary details if applicable.
- If you are applying as an HHA, go to Section IV to confirm that you have completed the required in-service training. If you are a CNA, answer the corresponding question regarding your continuing education units.
- Section V focuses on employment history. Confirm whether you have worked as a CNA or HHA during your certification period. If applicable, provide the employer details including facility name, phone number, employment dates, and address.
- If you are a CNA and did not fulfill the renewal requirements, you will need to complete Section VI to indicate your wish to reactivate your certificate.
- Finally, Section VII requires your signature certifying that all information provided is true and correct. Ensure to date your application.
- Once you have completed the form, you can save changes, download, print, or share the completed form as needed.
Complete your CA CDPH 283 C form online today to ensure your certification remains active.
To transfer your CNA license to California, you need to submit an application, provide your original certification, and meet the requirements outlined by the CDPH. Documentation demonstrating your training and work experience is essential, alongside passing the CA CDPH 283 C competency evaluation if needed. Using UsLegalForms can assist you in gathering and completing the necessary paperwork for a successful transfer.
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