§ 71833. Orientation Program.

(a) An orientation program shall be provided by each nursing facility. Each nursing facility must submit for the Department's approval a written plan describing its orientation program. Facilities which already have a written plan approved by the Department shall be required to only submit changes for approval when these occur. To be considered complete, any new program plan shall include the following:

(1) An orientation schedule indicating the time, date of presentation and the number of hours in which orientation is provided.

(2) A lesson plan which includes a student performance standard and a detailed outline of content for each lesson. The topic content must provide the Department with adequate detail (i.e., method, technique and procedure(s)) to discern what is taught. The lesson plan must describe the method of teaching, and the method of evaluating the students' knowledge and clinical skills.

(3) Core curriculum.

(b) New orientation program plans or changes to those plans shall be submitted to the Department for approval at the following address: Department of Health Services, Licensing and Certification Program, Nurse Assistant Certification Unit, 1800 Third Street, Suite 200, P.O. Box 942732, Sacramento, CA 94234-7320.

(c) Upon receipt of the program plan, the Department shall inform the applicant in writing within 30 days of the date received whether the program plan is complete and accepted for consideration or that the request is deficient and what specific information or documentation is required to be changed or added.

(d) The Department's time frames for approving or denying a program plan from the date a complete application is received are as follows:

(1)	Minimum	30 days.
(2)	Median	60 days.
(3)	Maximum	90 days.

(e) Certified and noncertified nurse assistants shall receive sixteen (16) documented hours of orientation. The orientation shall be completed during the first forty (40) hours of employment.

(1) The first eight (8) hours of orientation shall be conducted prior to providing direct patient care. Orientation related to the following facility-specific subjects shall be provided at the facility where the certified or noncertified nurse assistant is to be employed:

(A) A tour of the nursing facility, including a description of the patient population, description of the daily routine for patients and demonstration of the use of equipment including the call cord and intercommunication system.

(B) Instruction in the prevention and management of a catastrophe and other unusual occurrences, including but not limited to emergency procedures related to fire and disaster preparedness.

(C) Introduction to basic patient care which includes supervised clinical training prior to a patient care assignment. This training shall be the responsibility of the Director of Staff Development or other licensed nurse who is free of other responsibilities during the time he/she is providing the clinical training.

(2) The remaining eight (8) hours of the orientation program shall be presented within the next thirty-two (32) hours of employment. Facilities which are under common ownership or belong to one corporation may provide this portion of the orientation in a central location other than the one where the nurse assistant is employed. During this final eight (8) hours of orientation, the following topics must be included:

(A) Administrative structure.

1. Organization of staff.

2. Services offered.

3. The role of nurse assistants, including job description, team approach, attitudes and approaches to patients.

4. Personnel policies, including appearance and grooming.

(B) The facility's philosophy of patient care.

(C) Patients' rights.

(D) Legal and ethical considerations of health care.

(E) Patient care policies and procedures including but not limited to bathing, bedmaking, transfer techniques, positioning and turning.

(F) Patient comfort and patient environment.

(G) The role of Federal and State regulations in the provision of care.

(H) Instruction in the relief of choking.

(f) After completing sixteen (16) hours of orientation and prior to beginning a certification program, noncertified nurse assistants shall provide patient care only in areas of skill where they have received orientation and training and have demonstrated that they are competent through performance evaluations completed and signed by the Director of Staff Development or Instructor.

(g) A licensed nurse shall be responsible for the written evaluation of each clinical skill demonstrated by noncertified nurse assistants and shall determine their ability to provide patient care. During the evaluation, the licensed nurse shall be free from other responsibilities.

HISTORY

1. New section filed 7-16-91 as an emergency; operative 7-16-91 (Register 91, No. 46). A Certificate of Compliance must be transmitted to OAL by 11- 13-91 or emergency language will be repealed by operation of law on the following day.

2. New section refiled 11-14-91 as an emergency; operative 11-13-91 (Register 92, No. 8). A Certificate of Compliance must be transmitted to OAL 3-12-92 or emergency language will be repealed by operation of law on the following day.

3. Editorial correction of History 2. filed and new section refiled 5-6-92 as an emergency; operative 5-6-92 (Register 92, No. 20). A Certificate of Compliance must be transmitted to OAL 9-3-92 or emergency language will be repealed by operation of law on the following day.

4. Certificate of Compliance as to 5-6-92 order including amendment of subsections (a) and (a)(2), new subsections (b)-(d) and relettering of former subsection (b) to (e), amendment of subsections (e)(1) and (e)(2)(E), relettering of former subsections (c) and (d) to (f) and (g), abd repealer of subsections (e) and (f) transmitted to OAL 8-27-92 and filed 10-9-92 (Register 92, No. 41).

Note

Note: Authority cited: Sections 208(a), 1275 and 1338.3, Health and Safety Code. Reference: Section 1337.3, Health and Safety Code.