Frequently Asked Questions (FAQs)


A facility that has obtained an accredited California Nurse Assistant Training Program (NATP) through the California Department of Public Health (CDPH). This is reflected via a 280A form designation that the facility is NATP accredited to train CNA’s.

The Facility-Based NATP Approval award is specifically reserved for facilities with newly approved facility-based NATPs in 2023 or later. If your facility meets this eligibility requirement, please share the original 280A form that confirms your 2023 or later approval status. 

To help with the process of establishing a facility-based NATP, we recommend accessing our website’s Employer Resources page:, which hosts a detailed webinar titled, “Development and Approval of a Facility-based NATP Application,” led by our expert vendor, Ken Merchant. This resource provides a guide on establishing a nurse assistant training program within your facility. There are additional valuable resources for your reference on our site as well. 

A school, academy, ROP, etc. that has obtained an accredited California Nurse Assistant Training Program (NATP) through the California Department of Public Health (CDPH). The community based NATP offers theory and clinical training to students and partners with skilled nursing facilities to provide students with the training required for CNA certification. 

A skilled nursing facility (or Intermediate Care Facility) can secure an agreement with an existing CDPH-approved online NATP for theory instruction and conduct the clinical portion themselves, using the same clinical instruction materials and schedule from the contracted online NATP or develop their own. 

Alternative Online NATPs are responsible for all student training records, statistics, and must be able to demonstrate their compliance with all applicable NATP regulations at any time.

An Online NATP is considered a community based NATP. A community based NATP offers theory and clinical training to students and partners with skilled nursing facilities to provide students with the clinical training required for CNA certification.  

Engaging in a community based NATP Earn and Learn program involves your facility collaborating with an approved school (reflected on your 280A form or executed and approved 278C AND 278SC forms). All aspects of the CNA training take place outside of your facility. 

An Online Alternative nurse assistant training program is considered a facility based NATP because the facility holds CDPH approval as a facility based NATP, granting the facility the ability to conduct CNA clinical training “on-site” utilizing facility staff, while partnered with an approved online NATP to complete the CNA’s theory training. There are two options for an Alternative NATP: 

  1. Type I: Your facility chooses to develop the CNA clinical curriculum itself while the online NATP you’ve partnered with provides the theory instruction OR 
  1. Type II: Your facility chooses to utilize the clinical curriculum provided by the NATP for both the theory and clinical component of the CNA training.   

An Online NATP is considered a community based NATP. Engaging in a community based NATP Earn and Learn program involves your facility collaborating with an approved community based NATP school (reflected on your 280A form OR your executed and approved 278C AND 278SC forms). All aspects of the CNA training take place outside of your facility. 

Earn & Learn

An Earn and Learn program is the establishment of a CNA training program, either facility based, or community based, that allows individuals with no prior experience to start their CNA journey while being employed and compensated by the facility throughout the course of their training. 

Yes, if they are your employees and are paid their hourly wages while they’re in school.

Engaging in a facility based NATP Earn and Learn program means that your facility is NATP accredited by CDPH to train new CNA’s (reflected on your 280A form), granting you the ability to conduct new CNA theory and clinical training at your facility. Students must be hired and compensated by your facility throughout the course of their training. Once the student completes their training program and obtains certification through CDPH, they are qualified to begin working their CNA duties at your SNF. All facility based NATPs are by regulation Earn and Learn.

Engaging in a community based Earn and Learn program involves your facility partnering with a CDPH approved community based NATP (online or brick and mortar) where the community based NATP provides CNA theory and clinical training to the individuals that you hire. Once the CNA successfully completes their training program and obtains certification through CDPH, they are qualified to begin working their CNA duties at your SNF.

Yes, participating in an Alternative Online Earn and Learn program implies that your facility holds CDPH approval as a facility based NATP, but in this arrangement, you partner with a CDPH approved online community based NATP to conduct the theory training, while your facility takes responsibility for the clinical training component.

No, you may partner with a community based NATP to provide the training component if you are not a facility based NATP. They will provide the training for the employees that you’ve hired who are “Earn and Learn” students.

To partner with a facility-based NATP “training hub,” or community-based NATP Earn and Learn Program follow these steps:

  1. Submit Required Forms: Submit both the 278C (Facility Declaration of Participation in Approved Training Contract) and 278SC (Option 2 Nurse Assistant Pre-Certification Training Contract) forms to CDPH. These forms reflect your CNA training agreement with your training site, either a regional training hub facility or a community-based NATP. 
  2. MOU: It is necessary to formalize the training agreement with an MOU between the training site facility and the facility sending employees to be trained. You can refer to the provided example for reference/use. (see example)
  3. Send Forms & the MOU to CDPH: Send all forms via email to CDPH at In the email subject line, include the training facility’s name and their training ID number. Use “(F-)” if applicable to facility-based training or “(S-)” if applicable to facilities partnering with a school. (This takes approximately 2 weeks to hear back from CDPH.)
  4. After Approval: Once approved by CDPH, facilities that hire students and send them through training following the Earn and Learn Guidelines, qualify for CNAP Earn and Learn Awards. 

By following these steps, you can partner with a “training hub” facility-based Earn and Learn program or a community-based training program (community colleges or specialty schools.) Your facility may potentially qualify for CNAP Earn and Learn awards.

Creating a facility-based NATP to provide training to your facility and other SNFs in your local area is possible. One SNF is approved by CDPH to serve as the NATP (Training SNF), and the Sister or “Other” SNFs send students there to go through their CNA Training.

Here are some factors that would need to be built into the training model.

  1. The Training SNF would need to have a CDPH approved NATP.
  2. The Sister or “Other” SNFs would need to do the following:
    • Hire Students at the start of training and pay them wages both for time spent training at the Training SNF, and for any hours they spend working at the Sister or “Other” SNF.
    • The Training SNF and the Sister or “Other” SNFs will need to develop a contract that spells out their business relationship (MOU).  This includes payments from Sister or “Other” SNFs to the Training SNF for student tuition.
  3. The Sister or “Other” SNFs will each need to submit the following documents to CDPH:
    • CDPH Form 278C indicating that they are contracting with an outside agency to train their CNAs.
    • CDPH Form 278SC, serving as a contract between the Training SNF and the Student SNF.
    • An MOU/Contract spelling out additional details (see example).
  4. Students will be employees of the Sister or “Other” SNF, but will be Nurse Assistant students (NA) while they are at the Training SNF.
  5. Students may not be counted toward staffing hours by the Training SNF.
  6. Students can be counted toward 3.5 staffing requirements by the Sister or “Other” SNF if they do work there utilizing skills that they have been trained on, and signed off on by the NATP Instructor.

One additional area that should be reviewed is ensuring that this training program is exempt from management by the Bureau for Private Postsecondary Education.  There are at least two categories under which they would qualify for exemption.

Earn and Learn awards will be issued “after” students have become certified. The awards will be granted for those students after documents and reporting submission to CNAP has been completed (within approximately 3 weeks). Awards are issued after you have provided CNAP with a copy of CNA students I-9’s (substantiating that the student was hired and compensated throughout the course of their training), and their certification verification via  is submitted and verified. Additionally, the Facility Reporting form reflecting the entire cohort, and the CNA demographic form for each cohort participant must be completed before disbursement (Access to these forms can be found on the MOU).

The facility reporting form and CNA demographic form are for CNAP Earn and Learn partners to report on their cohort status, such as the number of students accepted into your cohort, the number of students that completed the program, the number of students retained after their certification completion, etc... This basic reporting is required by HCAI, our grant funder. The CNA demographic form can be filled out by either you or the individual student to report on demographics, such as race and ethnicity. Access to these forms can be found on the MOU. 

A “Training Hub” for sponsored students is when a parent organization uses one of more of their facilities as a designated training site that sister facilities send their Earn & Learn students to for CNA training. Yes, if your facility sponsors students to undergo CNA training at a sister SNF, you may qualify for Earn and Learn awards, if your facility has applied and is approved as an Earn and Learn participant of CNAP. 

Yes, a facility can engage in both an Earn and Learn program (facility based OR community based) and host clinical rotations for a community NATP. Hosting clinical hours is a separate opportunity for facilities to provide training sites for students enrolled in community NATPs.  

However, CNAP does not provide funds for both E & L and clinical hosting for the same CNA cohort. 

The Local Workforce Development Boards (“LWDBs”) in California generally do have funds under a program of “On the Job Training” to subsidize wages during a period of learning on the job. Availability and guidelines will vary among LWDBs, so you will need to contact your Local Board for applicable guidelines. CNAP can assist you in connecting with your Local Board.


Yes, a facility can be the clinical hosting site for a community based NATP that the facility also contracts with for their Earn and Learn program; however, CNAP does not provide clinical rotation award funds for hosting the clinical hours of their same Earn and Learn cohort.  

Your facility becomes a clinical rotation hosting site when you partner with a community NATP to host the clinical hours for students enrolled in their program. In this role, your facility serves as the training site, while the community NATP is responsible for supplying the instructor for the clinical training sessions. 

CUSP Upskilling

The CUSP program is an initiative that serves as a career pathway for CNAs. The goal of CUSP is to increase and retain the CNA workforce in the LTC/SNF sector by instituting professional recognition of standardized advanced education and training levels, with statewide recognized advanced experience levels in conjunction with incremental wage increases. It is designed to cultivate a supportive career advancement environment, empowering CNAs with opportunities for personal and professional growth.


NAHCA CNA training level II Preceptor Courses are $99 each (8-10 hours). The RNA modules are $149 each (16 hours). Curriculum and materials with CEUs are included.  

NAHCA Supervisor training level II Preceptor Course and NAHCA Supervisor training level III RNA courses are $99 each. Curriculum and materials with CEUs are included. 

As a CNAP Earn and Learn and/or CUSP partner, you are entitled to two complimentary preceptor courses as part of your one-year complimentary membership through NAHCA. Your complimentary courses may be any combination of the Supervisor Training or CNA training. 


CNA training level IVa: Dementia: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Activities of Daily Living or CNA training level IVb: Behavioral Health: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Serious Mental Illness. Each set of 2 courses is discounted to $159. Curriculum and materials with CEUs are included. (8-10 hours; $159) 

Supervisor training level IVa: Dementia: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Activities of Daily Living or Supervisor training level IVb: Behavioral Health: CARES® Dementia 5-Step Method (pre-requisite course) + CARES® Serious Mental Illness. Supervisor training is discounted to $359 each. Curriculum and materials with CEUs are included. (10-12 hours; $359) 

The CNAP CUSP upskilling and Registry requires that your CNA’s upskill every level through CUSP with CNAP curriculum (Preceptor, RNA, Dementia: 5-Step + Activities of Daily Living and Behavioral Health: 5-Step + SMI) all state approved programs designed specifically to uphold Industry Best Practices.

The registry ensures the CNA’s certificate of level attained is being recorded, is verifiable and accessible by employers and CNAs in the future at QCHF. 

No, it is not a requirement to participate in CNAP or CUSP to use the statewide registry. SNF’s that independently implement CUSP are to utilize the registry to record upskilled CNAs. The Registry fee is $30 per CNA upskilling level. As a CUSP award recipient, this fee is reimbursed to the facility. The statewide registry allows for the verification of CNAs skill levels for future reference. To utilize the statewide registry, you will sign a facility agreement QCHF/CUSP Registry  and submit your registration to QCHF via  

If the awards for the current year are filled, you still have the option to participate in the CUSP CNA upskilling program independently by following the same curriculum as the award recipients. You can apply for CUSP in a new award cycle, and potentially be awarded for the upskilling that you’ve started independently.

The National Association of Health Care Assistants (NAHCA) is a professional association of and for Certified Nursing Assistants that advocates for policies and practices to advance CNAs in their careers as well as their personal lives. CNAP is partnered with NAHCA to provide our CUSP upskilling levels II and III curriculum, and they offer complimentary one-year memberships for Earn & Learn and CUSP participants facilities.

To initiate the CUSP Implementation process, schedule an introductory meeting with NAHCA using this calendar link: During this meeting, come prepared with a list of students selected for the preceptor upskilling course and a supervisor to oversee the program. Provide NAHCA with the email addresses of these individuals so they can be enrolled in the courses via the learning management system.  

Once the supervisor and cohort of students are selected, NAHCA will invoice your facility for the course fees. Upon payment, the supervisor and students will be added to the learning management system and will receive a welcome email with further instructions on how to proceed.  

HealthCare Interactive (HCI) is an organization committed to improving dementia care for people living with Alzheimer’s disease and other progressive dementias. HCI is endorsed by AHCA/NCAL for the CARES online person-centered dementia training program for staff to help safely reduce the off-label use of antipsychotics. 

HCI has developed online education specific to professionals caring for individuals with dementia and serious mental illness. 

About CNAP

Earn & Learn, CUSP upskilling and a limited number of Clinical Host Rotation awards.

Clinical Host Rotation training that surpasses the maximin award number 

It is our obligation to conduct due diligence prior to dispersing state funded awards. The information that will be reviewed is not only from the supporting documentation & 280A form that you submit, but also your application. We recommend that you carefully review our awards page at Each award outlines the criteria and necessary documents needed to submit in conjunction with submitting your application. This will expedite the time in which we can process your award. 

Yes, you can participate on a limited basis. If your SNF currently has a training ban in place, your eligibility for the other CNAP awards is limited as many awards require NATP approval status. Facilities with a training ban can still participate in Earn and Learn awards if they contract with a community based NATP who does both the theory and clinical training off-site. No training can occur at the facility with the training ban. Additionally, training ban facilities can participate in the three tier CUSP program. 

Upon the lifting of the training ban, and should your facility decide to pursue NATP status (Facility, Alternative or Community based) via CDPH, obtaining approval would then make you eligible to apply for additional CNAP award(s) and we would be happy to consider your application.  

*Award cycles will repeat each year through 2027. As your facility becomes eligible for awards, you may apply. 

No, you don’t need to be a member of CAHF. The CNAP program is open for participation to all SNF’s throughout California. 

As a CNAP Earn and Learn and/or CUSP partner, your MOU includes a complimentary one-year membership for NAHCA. This membership offers valuable benefits, including two free preceptor courses that empower CNAs to enhance their skills and expand their roles in resident care. Given that certified nursing assistants (CNAs) provide an estimated 90 percent of the hands-on care in nursing homes, NAHCA’s mission is to elevate their professional standing and performance through recognition, advocacy, education, and empowerment. Health Care providers can maximize the success of their CNAs and ensure higher quality resident care.

The 45 Local Workforce Development Boards (“LWDBs”) throughout California have a pool of individuals who are looking for employment in various sectors and can help with recruitment of new workers. More broadly, these LWDBs can provide wrap around services to participants, including assistance with transportation vouchers, equipment and uniform supplementation, English as a second language, and even emergency housing assistance. They are a valuable additional resource to your facility cost control.

Because you have an Immediate Jeopardy from April, it’s a little odd that you haven’t been subsequently notified of a training ban.  

 Before you initiate a partnership, you might consider a quick email to inquire about what your status is as a CNA training site. You can do this with the Training Program Review Unit (TPRU) (they approve and regulate CNA training programs).   

 You can send a brief inquiry (without going into specifics) inquiring about your status as a CNA training site prior to starting a partnership application with a school or online program. It should take a couple of days for a response. If you get the green light, you can partner with a community or Alternative trainer and then submit the 278C and 278SC to CDPH for authorization. Also: See above question. 

A: CNAP offers various financial awards to support workforce development initiatives in skilled nursing facilities (SNFs). Facilities that are CDPH approved for facility-based CNA training or contracted with community-based CNA training programs may qualify for significant “Earn and Learn” funds. Additional awards are also available. 

While these awards go directly and only to the SNF’s, they indirectly benefit the industry by supporting the CNA training endeavor. Your students could potentially secure employment through a SNF that employs an Earn & Learn training program, or potential programs through a local workforce Development Agency as these facilities are supportive of CNA training endeavors and the CNAP program as community partners. You can review our program at We also offer a career site where your students can post their resumes in a targeted effort to the SNF community. 

You are encouraged to submit your application to CNAP. It is important to provide the most accurate and comprehensive information possible in your application. If your approval is pending, include this information and the submission date on the application. This will allow us to place your facility on our pending list while awaiting CDPH approval documentation. Please maintain communication with CNAP, and immediately submit the approved 280A form or supporting documentation reflecting the applicable awards when obtained. 

No, we specifically work with Skilled Nursing Facility CNA training programs, not Home Health aide programs.


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