Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX:

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1 Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX: Davie Campus: 1205 Salisbury Road, Mocksville, NC Telephone: FAX: TO: FROM: SUBJECT: Persons Interested in the Nursing Assistant II Program Joey Goodman, Program Director Health and Public Safety Course Announcement DATE: April 25, 2016 Davidson County Community College will offer an NA II class in the Fall 2016 at the Davidson campus in Lexington. The class is scheduled for September 6 December 10, The course will be offered as a hybrid class, meaning part of the work is completed online with labs/skills completed at the campus. The online information will be assigned each week. Students will find the assignments on Moodle. Lab time is scheduled for Tuesday and Thursday evenings from 6:00 p.m.-9:00 p.m. in Briggs Technology room 223. Clinical will consist of 88 hours on Saturday and Sunday, with various locations. See attached schedule. Successful completion of the course means students will be eligible to apply for listing as a Nurse Aide II with the North Carolina Nurse Aide II Registry. The registration fee will be $ (based on current rates). Other fees will include insurance: $9.25, technology fee: $5.00. Your textbook and lab kit will be available in the bookstore one week prior to class for approximately $180. To be eligible to register for this class, the following information must be submitted prior to receiving registration information. The enrollment for this class will be on a first come basis until all seats are filled. There will be a maximum of 10 seats for this class. You must pay the registration fee to reserve your space seats cannot be held without payment. Information required prior to class registration: Documentation of High School diploma /GED Proof of Nursing Assistant I training at state accredited program Current NC Nurse Aide I Registry listing copy Current CPR certification valid through the end of the class Acceptable College Accuplacer reading test score or college credit for English Program Interest Form Students interested in this course should complete the process listed on the enclosed Program Interest Form. Return completed forms and program documentation to office 112 in the Public Safety Building on the Davidson campus. Once the application file is complete, you will be given the course ID number and will be eligible to register for the class. Please feel free to contact us if you have questions at , or via diane_hedgecock@davidsonccc.edu.

2 Immunizations: Must be submitted to Verified Credentials, Inc. no later than the 1 st day of class. Students not completing immunizations will not be allowed clinical placement and cannot continue in the program. Students will be dropped from the class and will not be entitled to a full refund. 2 MMRs or titers (Measles, Mumps, Rubella) 2 doses, 4 weeks apart OR positive serum titers for each disease Tetanus Booster (Tdap) A Tdap booster within the last 10 years Chicken Pox (Varicella) immunization or titer 2 doses, 4 weeks apart OR positive serum titer. History of the disease is not acceptable. Start of Hepatitis B immunization or titer 3 doses over a 6-month period Dose #2 one month after dose #1, dose #3 approx. 5 months after #2 2 TB skin tests completed within 1-3 weeks or Chest X-ray or Quantiferon Gold titer Seasonal Flu Background Check and 12-Panel Drug Screen: Must be submitted to Verified Credentials, Inc. no later than the 1 st day of class. Students not completing background check and drug screen will not be allowed clinical placement and cannot continue in the program. Students will be dropped from the class and will not be entitled to a full refund. Students will receive additional information on Verified Credentials and how to proceed once they meet the requirements and are eligible to enroll in the NAII program. Thank you for your interest.

3 Nursing Assistant II (NAII) Program Interest Form Please complete this form and submit it to Health & Public Safety. Davidson County Community College, PO Box 1287, Lexington, NC Date Date of Birth: Print Your Name: Address City State Zip Home Phone No. Work Cell Address Date Packet Picked Up: How did you hear about this class? NOTE: An NAI skills competency test will be given at the first class. Failure to complete NAI skills proficiently may result in the inability to proceed in NA II. For College Use Only File Completion Date : Checklist of NAII items Required for Admission High School / GED / Adult High School Diploma Transcripts College credit for English or provide documentation of one of the following listed below: Accuplacer (57) NCDAP (136) Compass (63) ACT (22) SAT (500) Asset (34) Exemption form from Enrollment Services Copy of current CPR certification good through end of course Current NC Nurse Aide I Registry listing copy Proof of Nursing Assistant I training at state approved program Applicant Certification of Understanding

4 Nursing Assistant II (NAII) Applicant Certification of Understanding Please complete this form and submit it to the program coordinator. This form must be on file with the Health and Public Safety Office as part of your Program Interest packet. Name DATE Address City State Zip Code Address Home Phone Work: Cell: Davidson County Community College has provided me with information regarding the immunization requirements for the NAII program including the background check and urine drug screen requirements. To complete this process, I authorize Davidson County Community College to release the last four digits of my social security number to Verified Credentials, Inc. I understand that if I do not turn in all of the required immunization records on or by the first day of class, as well as complete the urine drug screen and criminal background check by the first day of class, I will be dropped from the class and will not be entitled to a full refund. Submission of background check and urine drug screen is required for clinical. Clinical sites may or may not allow you to complete clinical based on your criminal background and/or drug screen results. If any facility refuses to allow the student to participate in the clinical experience at that agency as a result of those findings, the student will not be able to progress in the program. Inability to progress will result in failure of the course and removal from the program. A full refund of tuition and fees is granted when the student officially withdraws from a class prior to the first class meeting or when the College cancels the class. A student who officially withdraws from a class prior to the ten percent date of the class will receive a 75% tuition refund, but fees will not be refunded. No refunds after ten percent date. Print Name Signature Last 4 digits of Social Security # Date

5 Nursing Assistant II CID Fall /6 12/10/16 Modules listed indicate coursework to be completed online Wk Sunday Mon Tues Wed Thurs Saturday Clinical sites: PRHR Pine Ridge Health & Rehab; TMC Thomasville Medical Center; OF - Oak Forest Health & Rehab; DH Davie Hospital (old location); LMC Lexington Medical Center. 88 total hours of clinical will be completed.

6 Nursing Assistant II CID Fall /6 12/10/16 (Clinical hours: 7am-3pm) (Briggs 223 unless o/w listed) (Briggs 223 unless o/w listed) (Clinical hours: 7am-3pm) 1 (Module 1) 9/6 6p-8p 2 (Module 3 & Module 4) 9/13 6p-9p 9/15 6p-9p 3 (Module 9) 9/20 6p-9p 9/22 6p-9p 4 (Module 8) 9/27 6p-9p 9/29 6p-9p 5 (Module 8 cont.) 10/4 6p-9p 10/6 6p-9p 6 (Module 7 & Module 12) 10/11 6p-9p 10/13 6p-9p 7 (Module 2 and Module 5) 10/22 Clinical ( ) 10/18 6p-9p 10/20 6p-9p 8 10/23 Clinical (7a-3p) (Module 6) 10/29 Clinical ( ) ( ) 10/25 6p-9p 10/27 6p-9p 9 10/30 Clinical ( ) (Module 10 & Module 11) 11/5 Clinical ( ) 11/1 6p-9p 11/3 6p-9p 10 11/6 Clinical ( ) 11/8 6p-8p 11/12 Clinical ( ) 11 11/13 Clinical ( ) 11/19 Clinical ( ) 12 11/20 Clinical ( ) 11/26 Thanksgiving Holiday 13 11/27 Thanksgiving Holiday 12/3 Clinical ( ) 14 12/4 Clinical ( ) 12/8 6p-8p Review 15 12/10 8a-5p (1 hour lunch) Competency Skills and Written Clinical sites: PRHR Pine Ridge Health & Rehab; TMC Thomasville Medical Center; OF - Oak Forest Health & Rehab; DH Davie Hospital (old location); LMC Lexington Medical Center. 88 total hours of clinical will be completed.