Allan Hancock College Spring 2016 Certified Nursing Assistant/Acute Care Aide Program Application Application Period: October 1st November 1st, 2016

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Spring 2016 Certified Nursing Assistant/Acute Care Aide Program Application Application Period: October 1st November 1st, 2016 Application and all supporting documents are due in the Health Sciences office by November 2, 2016, 12:00pm. Thank you for your interest in the Allan Hancock College Certified Nursing Assisting (CNA) Program. We are pleased that you are exploring nursing as a profession. Nursing is a demanding discipline and the course of study is challenging as well as rewarding. There are two application periods per year, each May and October. Seating is based on the waitlist and you must re-apply every application period to remain on the waitlist. Please review the contents of this application packet thoroughly prior to submitting your application and supporting documents. If you have questions regarding the CNA Program and/or specific questions about the application process contact the Health Sciences Department at 805-922-6966 ext. 3384. PROGRAM The state approved program is the core class of the Nursing Assistant Series and a requirement for entrance into the LVN Program. Certification as a Nursing Assistant is mandatory to work in a long-term care setting, and in most acute care hospitals. The Certified Nursing Assistant is vital in the care of the elderly and the chronically ill and the need for CNAs is projected to increase as the population continues to age. Physical care, communication, and psychosocial concerns are some of the areas covered. Upon successful completion of this course, students will be qualified to take the State Board examination (written and skills) to become a CNA. This program is offered in the spring and fall semesters. 15 Students will be placed in Santa Maria and 15 students will be in Lompoc for clinical. All 30 students will do classroom days in Santa Maria. EMPLOYMENT OPPORTUNITIES The demand for health care professionals is high in all areas. This need is projected to increase for at least the next 30 years and has resulted in higher wages and more diverse job opportunities for Nursing Assistants. The following courses provide an opportunity for upward mobility, entrance into the LVN Program, and an increase pay. Certificates of completion are awarded for all the Nursing Assistant classes. Wages can be researched on many websites such as Bureau of Labor Statistics, for a Certified Nursing Assistant (CNA) and Certified Home Health Aides. CERTIFICATION OF COMPLETION TOTAL OF 16 UNITS NURS 300 Certified Nursing Assistant/Acute Care Aide ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics. 1

Spring 2016 Certified Nursing Assistant/Acute Care Aide Program Application Application Period: October 1st November 1st, 2016 APPLICATION AND ADMISSION To apply for the CNA Program, you must submit a completed application form and all supporting documents. Incomplete applications will not be accepted. Upon receipt of your completed application, you will be eligible to participate in the randomized lottery (new applicants only) that will take place November 5 th, 2016. The first 30 seats from the waitlist are accepted into the program. A waitlist will be maintained throughout the year, and all students who did not get a seat in the program will need to reapply every application period to retain their waitlist status. FINANCIAL AID Assistance with registration fees may be available by the Board of Governors (BOG) Waiver. Contact the Financial Aid Office at (805) 922-6966 ext. 3216 (Santa Maria) ext. 5249 (Lompoc) or the E.O.P.S. Office at ext. 3214 for more information. If calling from Lompoc or Santa Ynez areas, call toll free at: 800-338-8732, then the extension number. ELIGIBILITY CRITERIA: Must be 18 years of age or older to be in the program Must be a U.S. high school graduate or have a GED (General Educational Development) or CHSPE (California High School Proficiency Examination) certificate. Completion of ENGLISH 101 with a grade of C or better OR show equivalency OR show that course is in progress at time of application period. Valid social security card (you must present original social security card to sit for state board exam). COMPLETED APPLICATION CONSISTS OF: Completed Program Application Form Proof of completion of ENG 101: A print out of your AHC unofficial transcripts (found on the myhancock portal, under Student Tab, link labeled non-official transcript ) OR proof that you are currently enrolled. If you completed ENG 101 elsewhere, all official transcripts from other colleges must be turned in to the Admissions and Records Department. Allow 15 business days to be transcribed. Official transcripts must be sealed from the issuing institution ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics. 2

Spring 2016 Certified Nursing Assistant/Acute Care Aide Program Application Application Period: October 1st November 1st, 2016 ONCE ACCEPTED INTO THE PROGRAM Students will be notified via EMAIL as to their status by the end of the day, November 6, 2015. Accepted students will receive their information packets at this time via email. It is very important that you write legibly on the application or let the office know of any changes to your email address as this is our resource to contact you for acceptance into the program. If you do not receive an email by the end of the day, please check your junk mail then contact the Health Sciences Department. Items such as, Background Check, Immunizations, Physical Form, Drug Screening, CPR, that are contained within the information packet will be required to be completed and handed into the Health Sciences Office (M- 132) by the date given on the packet. Accepted students must attend the mandatory Registered Students Orientation (Information packet will include date and time). This orientation is only for the students given seats in the program. INFORMATION PACKET WILL CONSIST OF: The information packet will be emailed out to accepted students only. The packet will include information/forms for the following: Background Check Dress Code Drug Screening Reference for Student Homework Assignments Social Security card information Drug Screening Consent and Risk Form Physical Form and Immunizations Identification Name Badge ABSENT AND TARDY POLICY The first three weeks of CNA requires 100% attendance to meet state mandated curriculum requirements before patient contact may take place. It is also mandatory to attend each facility orientation day (to meet state requirements that must be met by the facilities). One (1) day absence is allowed after the first 3 weeks for the CNA portion. A makeup day is REQUIRED BY STATE MANDATE for the day missed during CNA. If you are not present when roll is called, you are tardy. More than 30 minutes late is considered a full day s absence. Missing 30 minutes or more during ANY part of class is considered a full day s absence. Three (3) tardies is considered a full day s absence. One (1) day absence is allowed for Acute Care Aide (last five weeks). Make sure you have backup childcare and transportation. Do not make appointments during class time. There is no such thing as an excused absence. Not meeting required State mandated hours is the number 1 reason for being dismissed from class DRESS CODE Your appearance reflects the hospital and college standards and indicates to patients and co-workers your pride and interest in your profession. These standards are maintained by personal neatness and cleanliness, by wearing only the authorized uniform and by avoiding the use of elaborate jewelry and cosmetics. Details will be included in the information packet once you are accepted. ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics. 3

CERTIFIED NURSING ASSISTANT PROGRAM ESTIMATED STUDENT FEES Registration Cost TUITION (16 units @ $46/unit for residents) $736.00 PARKING $20.00 AHC STUDENT ID CARD WITH PICTURE $2.00 HEALTH FEE, STUDENT CENTER FEES PLUS STUDENT REPRESENTATION FEE ($19+$10+$1) $30.00 Mandatory Item Costs Total is estimated $790.00 BACKGROUND CHECK Corporate screening $48.00 DRUG SCREENING Roblar $30.00 PHYSICAL EXAMINATION - FAMILY DOCTOR IMMUNIZATIONS Hep B Series, Varicella, DPT, MMR, Flu Vaccine, TB CPR CARD CPR for healthcare providers EMS 306 (½ unit) + $4 material fee + $15 textbook (AHC) UNIFORMS (4 tops, 4 bottoms, 1 pair of shoes) Variable Cost Variable Cost $42.00 (AHC) $250.00 (est) IDENTIFICATION NAME PIN $6.00 WATCH (Not digital-must have second hand) $30.00 REQUIRED TEXTBOOK NURSING ASSISTANT BUNDLE (TEXT/WORKBOOK) MISCELLANEOUS SUPPLIES (2 binders, notebooks, pens, pencils, highlighter, paper, scissors, scantron, small dictionary, bandage scissors (highly recommended) Due 5 th Week of School CNA testing (NATAP) State Board Exam Cashier s check or Money Order ONLY Made out to MISSION COLLEGE $135.00 (est.) $40.00 (est) Total is estimated excluding variable costs $580.00 $90.00 Total is estimated excluding variable costs $90.00 TOTAL ESTIMATED CNA PROGRAM COSTS $1,500.00 (excluding variable costs) Prices are subject to change 4

Spring 2015 Certified Nursing Assistant/Acute Care Aide Program Application Application Period: October 1st November 1st, 2015 Application due by November 2, 2015, 12:00 pm Full Name: Last First Middle Mailing address: Street City Zip Primary Phone # Secondary Phone# Social Security # Birth Date AHC Student # Email Address (Mandatory) Waitlist Number (if applicable) Please check that you have read and understood the following: I have read this application packet carefully and agree to comply with the standards and rules detailed within. I understand that there are state/federal mandated items and fees required for the CNA Program and that failure to follow procedures and meet deadline schedules may result in being dropped from the CNA Program. I understand that I must have a valid for employment social security card in order to enter into the CNA Program. This is a state requirement and is necessary for the DHS to track certifications and those enrolled in training programs. It is also necessary to show the social security card when taking the required state board examination. This is not an Allan Hancock College requirement. Neither your federal tax ID#, nor student ID number can be used as a valid replacement for the social security number. I have read and understand the completed application consists of portion of this application I understand that I will be notified by email as to my status by the end of the day November 6 th, 2015. It is my responsibility to write my email clearly, and check my spam/junk mail. If given a seat, the information packet will be emailed to the email address I have provided. I understand, once I am accepted into the program, the physical, proof of immunizations, background check and drug screening are required by the facilities and not by Allan Hancock College. Infractions, probations or pending court cases showing up on the background check and/or a positive drug screen test may result in non-admittance to or dismissal from the program. I understand, once I am accepted into the program, the mandatory items packet must be submitted to the Health Sciences Office on the date set on the packet, failure to do so will result in being dropped from the program. If on the waitlist, I understand that I can be contacted via EMAIL as seats become available. I will have a 24 hour period to respond. It is my responsibility to complete the packet within the timeframe specified upon notification. I certify that the statements made in this application are true and complete to the best of my knowledge and that any false or misleading information I may give may be cause for denial for admittance. There are two application periods per year, each May and October. Seating is based on the waitlist and you must re-apply every application period to remain on the waitlist. Signature Date You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA 93454. Please slide under the door if the door is closed. 5

Certified Nursing Assistant/Acute Care Aide Program Application For Office Use New Reapplied WL# Name AHC Student # H Application and Prerequisites Completed: Completed Program Application ENG 101 completed Currently enrolled Semester Waitlist Number/New: Waitlist Number Notes