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How to Become a Nurse Assistant in California

Last Updated on January 18, 2023 by

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3 Easy Steps to Becoming a CNA in California

A certified nursing assistant (CNA) is a health care professional who provides assistance to a registered nurse (RN) or a licensed practical nurse (LPN). A CNA has several responsibilities, including helping patients bathe, dress, and perform basic daily activities.

To work as a certified nursing assistant in California, an individual must complete a state-approved nurse assistant training program that includes at least 100 hours of supervised clinical training and 60 hours of classroom instruction. 

Upon completion of your training program, you’ll need to take the CNA certification test and pass a criminal background check. You must also be at least 16 years old.

​The Professional Certification Branch (PCB), Aide and Technician Certification Section (ATCS) of the California Department of Public Health (CDPH) is responsible for processing and confirming certifications. Becoming a certified nursing assistant in the state of California can be as easy as following these three steps:

1. Fulfill Training Requirements

The individual seeking certification must have at least 60 hours of classroom training. An additional 100 hours of supervised clinical training is also required. The training must take place at a state-approved health care facility or school. If flexibility is needed, seek out programs that offer classroom training in an online format.  

An exception is if you can show you have received equivalent training in another health care related field or setting. For example, if you have received on-the-job health care training, you may be able to use those hours to count towards certification. 

Partial training as a registered nurse, licensed practical nurse, or licensed psychiatric technician, and some military training may also count towards a nursing assistant certification. For partial or military training to count towards certification, you must have received recent pay in the health care field.

Length

Most programs are approximately 12 weeks in length. Depending on where you choose to attend, you may need to complete an interview. Providing proof of current immunizations, negative TB tests, and current CPR certification are also common requests. 

Cost

You should expect to pay between $500 and $1800 for a Certified Nursing Assistant training program. Additional costs include classroom fees, uniforms, and textbooks.

The California Department of Public Health website has a listing of approved CNA programs. The majority of these programs are located at local community colleges, trade schools, or the American Red Cross.

2. Pass the Certification Test

California is one of the 25 states that partners with the National Nurse Aide Assessment Program (NNAAP) to certify nurses. The certification test has two components. A written exam and a clinical skills exam. 

The state of California requires that within two years of completing your training program, you must apply and pass both exams. Failure to do so will result in the need for retraining. Applicants can attempt the test three times within that two-year period.

Pearson VUE administers the test at various locations throughout the state. Testing sites and test schedules are available on the Pearson VUE website.

Bring your completed Certified Nurse Assistant Initial Application and photo identification with you to your scheduled testing time. Consider wearing scrubs and non-skid shoes when it is time to take the clinical skills portion of your exam.

To prepare for your CNA certification test, you might want to take a free practice exam.

Fees

Testing fees may fluctuate but currently, the cost is $100. This fee covers both the written and the clinical skills component.  After completion of the exam, the California Department of Public Health will notify you of your results within 30 days.

3. Undergo a Criminal Background Check

Certified nursing assistant candidates must pass a criminal background check. The check is performed using the Live Scan fingerprinting process. You are responsible for contacting Live Scan to schedule an appointment.

With the exception of minor traffic violations, all offenses will be taken into consideration. Some convictions will automatically disqualify an applicant. If you are disqualified but can obtain an official Certificate of Rehabilitation, your application may be reconsidered.

Once all steps are successfully completed, the California Department of Public Health will issue the candidate an official certificate.

Next Steps After Certification

Certified nursing assistants are eligible for positions in various healthcare facilities.

Hospitals are the most common employer of nursing assistants, but CNAs are also commonly employed at specialty health care facilities such as cancer centers, children’s hospitals, rehabilitation facilities.

Some certified nursing assistants work in environments outside of health care facilities. Assisted living centers and nursing homes commonly hire nursing assistants. Some nursing assistants work as home health aides, providing care in a patient’s home.

The state of California requires you to renew your CNA license every two years. Within two years, you must complete 48-hours of in-service training and provide proof of at least one day of paid service in order to maintain an active status.

Earnings Outlook

The U.S. Bureau of Labor Statistics reports that California has the highest CNA employment, with over 100,000 CNAs currently employed. California CNA wages can start at $40,000 per year and average at $17 per hour, which is among the top 5% in the nation.

A nursing assistant may earn more if they already have significant experience working in a health care environment. For example, a nursing assistant with several years of experience volunteering at a local hospital could possibly earn more than a CNA with no previous health care work experience.       

 

What is a CNA?

Certified Nursing Assistants often have a better understanding of the residents’ needs and requirements than the additional nursing staff. Many will develop ongoing relationships with the patients as they have more one-on-one time with them than any other in the medical staff.

During the course of a shift, they are required to maintain records of all their residents, which are referred to by the nursing staff. They have to be sure to document the correct information, which includes the vital signs and any changes they observe in their condition. It is their job as Certified Nursing Assistants to inform the medical staff if the resident under their observation needs more urgent care.

CNA Programs in California

California’s Certified Nurse Assistants must complete training programs, pass examinations, and receive criminal background clearance. Individuals can be certified as young as age 16.

Certified Nurse Assistant Requirements in California

California’s Certified Nurse Assistants must complete training programs, pass examinations, and receive criminal background clearance. Individuals can be certified as young as age 16.

Educational Requirements

A prospective CNA will complete an approved program unless he or she can demonstrate equivalent training in another healthcare field. Approved California programs include at least 60 hours of classroom instruction and 100 hours of supervised training. Training can be completed in a regular employment context if it meets the requirements of state code. A list of approved CNA programs can be found on the Department of Public Health website

Equivalency: A prospective CNA may meet equivalency requirements on the basis of partial completion of an LPN or RN nursing program or Licensed Psychiatric Technician (LPT) program. A healthcare worker may also qualify based on military training.

In most cases, equivalency candidates must demonstrate recent paid employment in the field. This requirement does not apply to nursing graduates who received their degrees within the previous two years.

Candidates applying on the basis of equivalent training are directed to contact the Department of Health at 916-327-2445.

Requirements In California 

  1. Be at least 16 years old
  2. Be in good physical health
  3. Up-to-date immunization records
  4. Have a high-school diploma or GED
  5. Pass a criminal background check
  6. Graduate from a Certified Nursing Assistant School in California
  7. Pass the State Exam
  8. Become a Certified CNA

Examination Requirements

California is among the 25 states that use the National Nurse Aide Assessment Program (NNAAP) for certification purposes. Candidates must pass knowledge and skills tests; the knowledge test is available in written and oral formats. The oral test includes ten word recognition/ reading comprehension questions in addition to 60 oral questions.

The examination is administered by Pearson VUE. Applicants will find resources on the ‘California Nurse Aide’ page of the Pearson VUE site (http://www.pearsonvue.com/ca/nurseaides/). Applicants who are unsure which format to choose may do the self-assessment in the candidate bulletin.

Applicants seeking certification based on equivalency must obtain Department of Public Health approval before registering for an examination.

Scheduling is done through regional testing centers. There are multiple examination sites in both the Northern (http://missioncollege.org/depts/HWI/regional_testing.html) and Southern (http://www.regionaltestingcenter.org/) regions. The Northern and Southern California testing centers have each provided a list of test sites and upcoming examination dates, as well as links to other certification resources.

The Northern Region Testing Center can be reached at (408) 855-5203. The Southern Region Testing Center can be reached at (714) 895-8708. A third regional site, for Central California, can be reached at (805) 965-0581

Test takers can reschedule one time free of charge provided that they call at least two business days before the scheduled test..

The fee is $90 for test takers who opt to do the knowledge exam in a written format, $105 for those who opt for the oral version.

Fees for re-examination are as follows:

  • Written $35
  • Oral $50
  • Skills $55

Candidates are expected to pass the knowledge and skills examinations within two years of program completion/ approval by the Department of Health. Otherwise, they will need retraining. Pearson VUE notes that three attempts are allowed during the two-year period.

Criminal Background Checks

California requires criminal background checks; the agency uses a Livescan (digital) fingerprinting process. The applicant will need to fill out form BCIA 8016, a request for Livescan services (http://ag.ca.gov/fingerprints/forms/BCIA_8016.pdf) Applicants may contact Live Scan operators for fingerprinting appointments. The Southern Regional Center has provided contact information for operators in the region (http://www.regionaltestingcenter.org/livescan.html).

The credentialing agency will review all criminal offenses except minor traffic violations. The application packet includes a list of convictions that are automatically disqualifying. An applicant may be granted reconsideration in some cases despite a disqualifying conviction; an applicant with a disqualifying felony conviction would need a Certificate of Rehabilitation.

The Application Process

An in-state trainee will submit an application and Livescan fingerprint request before beginning the patient-care portion of the program; in some cases, the program will submit it on behalf of the student.

Application forms are available on the Department of Health website (https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx). Applicants for initial nurse assistant certification will select form CDPH 283 B.

An applicant who is applying on the basis of recent in-state CNA training will need a signature from the registered nurse who supervised the training program. There is no required application fee.

An equivalency candidate will use the same application as an examination candidate, but will not enter information in all sections. The Board has provided a sample, with pertinent information highlighted (https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/CNA.aspx). The Board has also recently put together an application packet that includes supporting documentation necessary for equivalency applicants.

An equivalency applicant will document training through an official transcript or a letter on official school letterhead. Documentation must include completion date. An individual applying on the basis of nursing education must have, at the minimum, a course in Fundamentals of Nursing.

An individual with military training may instead include a copy of his or her DD-214.

Reciprocity/ Transfer

CNAs who are registered and in good standing in other states may be placed on the California Nursing Assistant Registry by reciprocity. The applicant will need to submit a copy of the out-of-state certificate to the California Aide and Technician Certification Section (ATCS) and submit a ‘Verification of Current Nurse Assistant Certification’ form (CDPH 931) to the current state of certification.

A reciprocity candidate will use the same initial application form that an examination candidate uses. The applicant may download a reciprocity packet and a “How to Complete Your Reciprocity Application” PDF file from the ACTS webpage; the PDF highlights the information that must be included on the form.

An out-of-state CNA who received an initial certificate more than two years in the past will submit a pay stub or other evidence of employment providing nursing-related services.

Certified Nursing Assistant Programs in California

MiraCosta College

The CNA program at MiraCosta College in Oceanside admits students on a first-enrolled, first-admitted basis. Additionally, students must enroll in Nursing 160 to be considered for admission. Other prerequisites are completion of an English course (or passing an English placement test) and proof of CPR certification. MiraCosta College offers students this program in two formats. One option, which is offered twice a semester, has students completing coursework 23 hours a week in an accelerated eight-week program. The second option has students completing coursework 32 hours a week for six weeks during the summer. The curriculum consists of 79 hours of theory and 105 hours spent in long-term care facilities obtaining hands-on training. The college also offers an eight-week HHA class for CNAs who want to expand their knowledge and career options.

Pasadena City College

The five-credit hour nursing assistant program at this Pasadena-based school lasts six weeks and trains the aspiring CNA to work with patients as part of a healthcare team. Students complete 54 hours in the classroom covering the basic principles of nursing and 108 clinical hours gaining hands-on experience. This class, offered during the winter and summer semesters, is graded on a pass or no pass basis. Applicants must be at least 16 years old and qualified to perform CPR by the American Heart Association.

Rio Hondo College

Whittier-based Rio Hondo College offers a nursing assistant pre-certification program that prepares students to care for geriatric patients in long-term care facilities. Applicants must complete reading assessment tests, be at least 16 years old and have a valid social security number. The one-semester, 16-week program consists of 64 hours of theory-based courses and 120 hours of clinical education. Topics of study include patient care skills, emergency care procedures, patient rights, medical and surgical asepsis, vital signs, death and dying, patient care procedures and long-term care patients.

American River College

American River College in Santa Clara has a nurse assistant training program that limits its class size to 15 students. Before students can begin this program, they must attend a mandatory orientation session. By combining theory knowledge with hands-on clinical training, students learn to care for and assist patients with their daily care needs. Topics of study include infection control, patient care skills, residents’ rights and effective communication. Applicants must take a required English class or show proof of a completed assessment test.

Bakersfield College

Located in Bakersfield, this school offers a six-unit nursing assistant program. Students learn to collect specimens, take and document vital signs, document patient information and perform basic hygiene on patients. Other topics of study include residents’ rights, healthcare safety and the role of the caregiver. Upon completion of all training, students are prepared to take the American Red Cross competency exam for CNAs. Students must provide valid social security cards.

School Comparison: At a Glance

School NameSchool Type and SettingNursing Assistant Programs OfferedProgram Costs (2018-2019)
American River CollegeTwo-year, public; large suburbNurse assistant program$46/unit, in-state; $317/unit, out-of-state*
Bakersfield CollegeTwo-year, public; ruralCertified nurse assistant program$46/unit
College of the SequoiasTwo-year, public; midsize cityNursing assistant program$46/unit, in-state; $271/unit, out-of-state*
Hacienda La Puente Education Center< Two-year, public; large suburbNurse assistant – CNA program$1,110 estimated total program cost*
MiraCosta CollegeTwo-year, public; large suburbCertified nursing assistant program$600 estimated total program cost*
Pasadena City CollegeTwo-year, public; midsize cityCertified nursing assistant program$46/unit, in-state*
Rio Hondo CollegeTwo-year, public; large suburbNursing assistant pre-certification program$46/unit, in-state; $265/unit, out-of-state*
San Diego Continuing Education< Two-year, public; large cityNursing assistant programFree tuition*

What Does a Certified Nursing Assistant Do?

Certified nursing assistants work under the supervision of licensed nursing professionals. They care for patients who are infirm, ill, injured, disabled and otherwise unable to care for themselves. In many settings, CNAs are the health professionals whom patients encounter most often. A CNA performs a variety of basic duties that are important for the patient’s comfort and recovery. These tasks vary depending on the employment setting.

What Are the Roles & Duties of Certified Nursing Assistants?

The roles and duties of CNAs can include the following:

  • Turning or repositioning bedridden patients
  • Taking patients’ temperature, blood pressure and other vital signs
  • Answering patient calls
  • Documenting patients’ health issues and reporting to nurses
  • Feeding patients, measuring and recording their food and liquid intake
  • Cleaning rooms and bed linens
  • Helping with medical procedures
  • Dressing wounds
  • Gathering supplies for the RN or MD
  • Bathing patients
  • Combing hair, shaving, caring for nails and brushing teeth
  • Stocking supplies
  • Preparing rooms for admissions

How Training Programs Work

To start a CNA training program, you need to be at least 16 years old with a high school diploma, or the equivalent. Next, you will need to find accredited CNA classes in California, these programs must include a minimum of 60 hours of classroom instruction and 100 hours of supervised training. Some training programs are offered during employment, if they meet state code.

The California Department of Public Health offers a list of certified nursing assistant training in California. The majority of these programs can be found at local community colleges, trade schools, or even the American Red Cross. You can find local CNA classes near you as well as CNA classes online.  

California requires 150 hours of training for CNAs, the highest hours of CNA training required in the nation. The program can be completed in 6-15 weeks and requires 50 hours of classroom training and 100 hours of clinical training, that will be under the direct supervision of a Licensed Practical Nurse (LPN) or a Registered Nurse (RN). Some accelerated programs offer 4-week CNA classes as well.

Once the training is complete, you are eligible to apply for CNA certification, which allows you to sign up to take the official CNA examination. It’s recommended you take a free CNA practice exam to prepare.

You must take the exam at a certified testing center such as the American Red Cross or the National Nurse Assistant Training and Assessment Program (NNAAP).

Career Requirements

To work as a certified nursing assistant or aide (CNA) in California, an individual must complete a state-approved nurse assistant training program that includes at least 100 hours of supervised clinical training and 50 hours of classroom instruction. Students must also pass the National Nurse Aide Assessment Program (NNAAP) examination. The exam consists of an oral or written test and a hands-on practical examination.

California also requires that prospective CNAs pass a physical examination, fingerprint scan and criminal background check prior to certification. Students may also be required to have cardiopulmonary resuscitation (CPR) certification. CNAs must complete 48 hours of continuing education every two years to maintain certification status. The 10 education centers and 2-year colleges outlined below offer state-approved CNA courses or programs that prepare students for the state exam.

CNA Specialty Certification

While general CNA certification is required in each state, you can also choose to earn additional certification in specialized areas. The additional credentials can help expand your opportunities in an area of interest and potentially help you qualify for higher pay.

Earning a specialty or advanced credential typically requires education and experience beyond your initial CNA certification. The organization responsible for each credential determines these requirements. Some common CNA specialty certifications and their certifying organizations include:

Name of Specialty Certification

Certifying Organization

CNA II

Offered by some state boards to CNAs with specified advanced training and/or experience

Certified Alzheimer Caregiver

National Certification Board for Alzheimer Care

Certified Hospice and Palliative Nursing Assistant

Hospice and Palliative Nurses Association

Certified Wound Care Associate

American Board of Wound Management

Medication Aide Certification

National Council of State Boards of Nursing Inc.

Certified Nursing Assistant Salary & Employment

As the baby boomer population ages, there will be an increased demand for preventive medical care. The growth rate over the next decade for a certified nursing assistant shows an estimate of 9% according to the United States Bureau of Labor Statistics (BLS), and 2018 showed a surge of over one million jobs in this field.

According to the BLS, the median average annual salary for certified nursing assistants in 2018 was $28,530. It is important to note that this does vary depending on the setting. See our insights into a CNA salary.

For increased salary and employment growth options consider a CNA to RN program.

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