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State of California—Health and Human Services Agency
California Department of Public Health

AFL 07-05
February 16, 2007

All Skilled Nursing Facilities (SNFs)
All Intermediate Care Facilities (ICFs)
All CNA Continuing Education Programs

Implementation of On-line In-Service and Continuing Education Training For Certified Nurse Assistants (CNAs)

AMENDMENT: Assembly Bill 1235 (AB 1235), Chapter 615, Statutes of 2005, amends Section 1337.6 of the California Health and Safety
Code (CHSC). It allows CNAs who are renewing their certification to obtain twenty-four (24) of the required
forty-eight (48) hours of in-service training through an on-line computer training program approved by the California Department of Health Services (CDHS), Licensing and Certification Program. 

It also requires vendors of on-line programs for continuing education to ensure that each on-line course contains all of the following:

(i) An interactive portion where the participants receive feedback, through on-line communication, based on input from the participant.

(ii) Required use of a personal identification number or personal identification information to confirm the identity of the participant.

(iii) A final screen displaying a printable statement, to be signed by the participant, certifying that the identified participant completed the course. The vendor shall obtain a copy of the final screen statement with the original signature of the participant prior to the issuance of a certificate of completion. The signed statement of completion shall be maintained by the vendor for a period of three (3) years and shall be made available to the CDHS upon demand. Please note: Title 22, California Code of Regulations (CCR) section 71845(d) requires approved providers of continuing education to maintain the program and attendance records of all students for a period of four (4) years from the starting date of each class. Title 22, CCR section 71847(i) requires a nursing facility to keep all records of in-service training programs on file for a period of four years starting from the date the first classes were offered.


AUTHORITY: All on-line training programs submitted to CDHS for approval must meet the conditions of the law and all the requirements of existing training program regulations.

  • Title 42, Code of Federal Regulations (42 CFR) 483.75(e)(8), and 483 Subpart D 
  • CHSC Section 1337.6
  • Title 22, CCR, Division 5, Chapter 2.5

Title 22, CCR section 71839 permits completion of a total of
twenty-four (24) hours of in-service training or continuing education per year, for a total of forty-eight (48) hours, in a
two-year renewal period.

DEFINITIONS: The following definitions apply to the terms used in this AFL.

“In-Service Training Program” means a CDHS-approved structured program established for CNAs and provided by a nurse facility employer of nurse assistants. In-service training programs shall take place in a nursing facility. In-service training program sessions shall be made available to all employed CNAs who shall receive at least the normal hourly wage for attending the program. 

“Continuing Education” means provision of structured courses for CNAs by an agency, a public educational institution, or in a health care setting other than the nursing facility where the CNA is employed. 

“Hour” means fifty (50) minutes of participation in an organized learning experience. Each hour of classroom theory shall be accepted as one (1) hour of certification training, in-service training or continuing education.

REVIEW: The CDHS, Licensing and Certification Division, Training Program Review Unit (TPRU) reviews and approves CNA in-service and/or continuing education training programs for skilled nursing facilities, intermediate care facilities, community colleges, regional occupational programs, adult education programs, and proprietary schools. Prior to the approval and renewal of a training program, CDHS staff ensures that systems are in place to authenticate a tester through visual confirmation, signature and follow-up or
re-evaluation of performance. 

If you have any questions regarding this statutory amendment or the on-line training application process, please contact Richard Maes, Supervisor, Training Program Review Unit at: (916) 552-8872 or email



Original Signed by Kathleen Billingsley, R.N.

Kathleen Billingsley, R.N.
Deputy Director


cc: Mary Philip, Chief
California Department of Health Services
Licensing and Certification Program
Professional Certification Branch
MS 3300
P.O. Box 997416
1615 Capitol Avenue
Sacramento, CA 95899-7416

Mike Strunk, R.N., Chief
California Department of Health Services
Licensing and Certification Program
Aide & Technician Certification Section
MS 3301
P.O. Box 997416
1615 Capitol Avenue
Sacramento, CA 95899-7416

Angela Chung, M.S., RN, Director
American Red Cross
CEP Department
5051 E. Third Street
Los Angeles, CA 90022

California Community Colleges
Chancellor’s Office
1102 Q Street
Sacramento, CA 95814

Albert L. Tweltridge III, Administrator
California Department of Education
Regional Occupational Center and Programs
1430 N Street, Suite 4503
Sacramento, CA 95814

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