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How to Become a Certified Nursing Assistant (CNA) in California

A certified nursing assistant (CNA) is a healthcare professional who provides hands-on care to patients under the supervision of a registered nurse or licensed practical nurse. CNA's can have many different responsibilities, including taking vital signs, administering medication, feeding patients meals, turning or repositioning patients who are bedridden, and helping patients perform basic daily activities such as bathing and getting dressed. Although working as a CNA can be demanding it’s a stable job and there are plenty of job opportunities available.

In order to become a CNA in California you must first satisfy the following three threshold requirements: 1) you must be at least 16 years old; 2) you must pass a physical health exam; and 3) you must pass a criminal background check.

If you satisfy these three threshold requirements, the next step is to complete a nursing assistant training program that has been approved by the California Department of Public Health (CDPH). The state of California requires these nursing assistant training programs to consist of at least 100 hours of supervised clinical training and 60 hours of classroom instruction.

However, the training program requirement may be waived in the following circumstances: 1) you have undergone similar training in the military; 2) you have a CNA license from another US state or foreign country; or 3) you are enrolled in or have completed a program to become a registered nurse, licensed vocational nurse, or licensed psychiatric technician.

For individuals who don’t waive out of the nursing assistant training program requirement you can choose from among two different types of programs: school nurse assistant certification training programs (non-facility) and skilled nursing facility nurse assistant certification training programs (facility). Each approved school will have a contract with a long-term care facility where students obtain their clinical training, while those who participate in a facility-based program complete their clinical training on-site.

A list of approved training programs (both facility and non-facility) can be found at There are hundreds of CNA schools throughout California, so there’s a good chance you can find a program nearby.

After finishing the nursing assistant training program or being waived out of this requirement the next step is to pass an exam, which is designed to evaluate your knowledge, skill, and ability after completing the nursing assistant training program. This exam must be taken within two years of completing the nursing assistant training program.

However, if you already obtained a CNA certification in another state there is no need to undergo additional CNA training or take the competency evaluation exam. In this case, all you need to do is provide the CDPH with proof that you were paid to provide nursing or nursing-related services to facility residents within the last two years.

For those who must take the exam there are two different exams to choose from: the National Nurse Aide Assessment Program (NNAAP) exam administered by Pearson VUE and the California Nurse Assistant Competency (CNAC) exam administered by the American Red Cross.

The NNAAP exam consists of two parts—a written or oral exam plus a skills evaluation. The written portion of the NNAAP exam consists of 70 multiple-choice questions. Individuals who have difficulty reading English can take an oral examination in lieu of the written examination. The oral exam consists of 60 multiple-choice questions and 10 multiple-choice reading comprehension questions. The skills portion of the NNAAP exam requires you to perform five randomly selected nursing assistant skills within 25 minutes.

The American Red Cross CNAC exam also has two parts—a written exam consisting of 60 multiple-choice questions plus a skills exam where you must demonstrate four skills you’re your knowledge of the six principles of care (dignity, infection control, safety, communication, independence, and privacy).

If you pass both parts of either exam and have passed the criminal background check you will receive a CNA certificate from the CDPH. After becoming certified you must renew your CNA certification every two years, and as a requirement for renewal you must complete 48 hours of continuing education during each two-year period.

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