Certified Nursing Assistant Program Contents

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1 Certified Nursing Assistant Program Contents FALL 2018 Course Dates 1 Becoming a CNA 2 Estimated Costs 2 Managing Costs 2 Background Check Information 3 CNA Program Application 5 Memorandum of Understanding 7 Checklist Before you register: Take a placement test to demonstrate necessary English and Math proficiency (Cost: $18, Schedule: ). Check with advisors to use previous credits or test scores. Meet with an advisor regarding registration approval and submit: Completed application Memorandum of Understanding Photo Release Form When you register: Register for the 6-credit course. Check academic calendar for registration dates. FALL 2018 Course Dates HCA A105-6cr Class and Lab: September 17 November 19, Mondays, 9am - 3pm, and Fridays 9am - 3pm Clinicals: November 26, 27, 28, 29, and December 3, and 4 7am 7pm After you register: Prior to: Monday, September 3 Meet with Nancy Johnson and submit your Background Check information, as well as your credit card payment for processing. Mail KBC advisor-approved background check packet to the State Meet with employee health nurse at SPH to determine immunization status Pay for classes UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www. alaska.edu/nondiscrimination.

2 Becoming a CNA General Information To become a Certified Nurse Aide you must: Pass a two -stage background check Successfully complete an approved course that prepares you to sit for the State of Alaska Licensing Exam Successfully complete the State of Alaska Certified Nurse Aide Competency Licensing Exam High School Graduation or GED equivalent is not required for state licensing but may be required for employment! Approved Courses Courses approved by the State of Alaska include a minimum of 60 hours of classroom and lab instruction and 80 hours of clinical experience. Kachemak Bay Campus s HCA A105 is an approved course that prepares you to sit for the Sate of Alaska licensing exam. Estimated Costs Payable To: Item: Estimated Cost: Kachemak Bay Campus Tuition & Fees $ Kachemak Bay Campus Books $ Subtotal $1609 State of Alaska Certified Finger printer Fingerprint cards (2 sets) $25.00 State of Alaska Background check #1 $72.00 Subtotal $97.00 State of Alaska Fingerprint processing $60.00 State of Alaska State Testing Fee $50.00 State of Alaska Non-refundable Application Fee $50.00 State of Alaska Certification Fee $ Subtotal $ Estimated Grand Total $ Managing Costs Financial assistance may be available to help you manage the costs of the course. Ask your advisor to help you determine which programs you may be eligible for. Resources include: Department of Labor Job Services, Department of Vocational Rehabilitation, ext. 227 or South Peninsula Hospital Foundation Scholarships Application included in this packet South Peninsula Hospital School-to-Work Program, South Peninsula Hospital Tuition Reimbursement Program, UAA payment plan for tuition and fees Ask about options at the KBC registration desk

3 Background Check Information Students must complete two background checks! Check page one for the deadline to submit the application paperwork. Students who are not cleared by the background check will not be allowed to participate in the clinical portion of the class. Without the clinical instruction, students cannot pass the class or sit for the State of Alaska CNA licensing exam. Background check #1 The first background check must be complete before the first day of class. This check provides clearance to participate in the clinical portion of KBC s course. Important Note: KPC does not refund tuition for students who are ineligible for the clinical portion of the course. Make an appointment with an advisor: Obtain fingerprints (2 sets) from Paw Prints ( ) in Homer or another fingerprint service certified by the State of Alaska. Bring Completed BCP Packet to the appointment Credit card, for making an online payment to the State of AK BCP. Mail one set of fingerprints with Release of Information and Background Check forms to: State of Alaska / Dept. of Health & Social Services Division of Public Health Background Check Unit 4601 Business Park Blvd, Bldg. K Anchorage, AK General Information Background check #2 The second background check is conducted by the AK Board of Nursing as part of the licensing process, when applying to take the state exam. Important Note: KPC does not refund tuition for students who are ineligible to take the state exam or who are ineligible for licensing due to a criminal background or history of substance abuse. Complete instructions will be provided by your instructor. You w ill be asked to: Answer questions relating to professional conduct and personal history pursuant to AS Provide a set of fingerprint cards Background Check Questions? Not all offenses bar an individual from participating in clinicals or licensure. Crimes that are considered barriers are listed on the State of Alaska Barrier Crime Matrix Questions about licensing requirements or background barriers should be addressed prior to registering for HCA A105. Inquiries should be made to the Alaska Board of Nursing at (907) The State of Alaska Department of Commerce, Community, and Economic Development Division of Corporations, Businesses and Professional Licensing Nurse Aide Registry page has complete information.

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5 Certified Nursing Assistant Program Application Name: Address: City: State: Zip: Are you a United States citizen? yes no Application Packet Semester you plan to take CNA training: Year: Reason for applying? Do you have a high school diploma or GED? List of schools you have attended: yes no

6 Reason reason for taking this class: If you have difficulty or problems with walking or standing for prolonged periods of time, including stooping and sitting, please explain. Application Packet I am currently taking courses towards a degree. I am not currently taking courses towards a degree. List any other classes you are planning to take while taking HCA 105 I am currently BLS-CPR certified. I am not currently BLS-CPR certified. Print and sign. Bring the completed form with you to your advising appointment. All information contained in this application is complete and accurate to the best of my knowledge. Signature Date Office use only Placement: Writing Reading Math Notes:

7 Memorandum of Understanding I fully understand that I am responsible to follow the provisions and conditions set forth during course. I am expected to pick up and pay for the required textbooks/workbooks prior to the start of classes. I am expected to complete all reading/workbook assignments. I am expected to supply a copy of my American Heart Association BLX or First Certification (if one exists) to my instructor. It is my understanding that the BLS/First Aid Certification required must include 2-person, infant, child and adult resuscitation techniques. Attendance requirements and absentee policies are strictly adhered to. A student cannot miss more than 12 total hours of class time, including time missed due to tardiness. Absolutely NO clinical time can be missed. I will be expected to complete all written quizzes and the final tests. I am expected to maintain a minimum average grade of C on all graded assignments. I am expected to be able to move or lift 50 lbs. or 25% of my body weight, whichever is less, and be able to lift over my head. I am expected to assume responsibility for my own learning with guidance from the instructor. Application Packet I am expected to wear clean, comfortable and appropriate clothing to class. When in clinical training I will wear the designated clothing. If I use alcohol or drugs during the training or when caring for an individual I will not be allowed to attend this program. (Use of alcohol or drugs is unacceptable behavior when I am caring for others.) I am expected to wear scrubs in class labs, and at South Peninsula Hospital and other clinical training sites. I understand it is my responsibility to verify with the Alaska State Board of Nursing, whether I am eligible to apply for certification through the State of Alaska as a nursing assistant; and to become certified I must personally submit state test, application and certification fees currently totaling $260. I understand that being convicted or a crime does not prevent me from registering for the class, but may prevent me from attending the clinical portion of the course; and that it could therefore keep me from being able to complete the course and from being certified as a nurse aide by the State. I understand that no refund will be given for students who have taken the course but are ineligible for state licensing or examination, or are unable to complete the class due to criminal history. I understand that I must drop this course before the official drop date in order to receive a 100% refund. After the drop date, there will be no refund.

8 The campus assumes no responsibility for illnesses and injuries experienced by students in conjunction with their CNA clinical experience; students who are injured while completing clinical assignments are responsible for all associated medical costs. It is strongly recommended that students maintain personal medical insurance. Students may purchase student insurance through UA s Student Health Service. Students are not covered by workers compensation through the University or medical facilities. I have read the attached CNA Eligibility criteria and application requirements. I give my permission for representatives of Kachemak Bay Campus to release my name to the press upon completion of the CNA course. I also understand that my name will appear in the printed commencement program. Print and sign this page and bring it with you to your advising appointment. Application Packet Signature Date For your information: The Division of Occupational Licensing, the State of Alaska, asks the following questions in its application for nurse aide certification that you must complete to be approved to take the examination. Has a certificate ever been denied, revoked, suspended, on probation, or disciplined in any jurisdiction? Have you been under treatment for mental illness in the last five years? Have you had any problems related to habitual use of drugs or alcohol within the last five years? Do you have any physical disability which may impair or interfere with your ability to practice as a nurse aide? Have you ever been convicted of any criminal offense other than minor traffic violations?

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