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 Cdph 278b 2011-2023

Cdph 278b 2011-2023

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Two for instructions Facility name and address F Provider identification training number Phone County All Parties Must Sign Required Signatures Administrator Signature Director of Nursing Director of Staff Development Each nursing facility shall provide 24 hours of in-service training annually which shall be accessible to all certified nurse assistants employed by the facility. The content of the in-service training program shall be an enhancement to the basic training program consistent with...
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The licensure and certification application form HS 200 is a multi-purpose form used for all facility types that are licensed by the Department of Public HEvalth centralized applications ranch the HS 200 is a four-page form broken up into sections application information licensee information facility agency or clinic information and property information each section is required to be filled out and the information is used by the provider to report to the centralized applications branch the type of application being submitted for processing during this instruction I will provide an overview of the information required for each section I will use the term facility when also referring to a clinic or agency I will also use the term cab when referring to the centralized applications branch let's begin page 1 you will notice in the top right corner of page 1 there is a box that states for departmental use only please do not enter any information in this box section an application information

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