CNA SKILLS CHECKLIST

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

POSITION*

1.Previous training and experience.*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

2.Assist patient with oxygen or pulse ox*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

3.Knowledge of infection control in home*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

4.Partial bed bath / Shower scrub*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

5.Monitor and record intake and output*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

6.Basic nutrition and meal planning*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

7.Disaster planning and preparedness*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

8.Toileting / Incontinence management*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

9.Cardiac / Diabetic meal planning*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

10.Hair care / Shampoo / Roller sets*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

11.Assist client with medications/reminders*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

12.Abuse and neglect reporting procedure*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

13.Set up enteral or tube feedings*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

14.Knowledge of potential home violence

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

15.Assist client with use of glucometer*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

16.Safely operate the following medical*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

17.Shampoo tray for bed bound client*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

18.Infection control in the home setting: - Hand washing - Protective equipment- Equipment cleaning-Exposure plan*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

19.Wheelchair, semi and electric bed*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

20.Documentation and reporting of client*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

21.Walker / Single point / Quad cane*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

22.Use of shower bench / Chair / bsc*

No previous experience.Previous training, but no personal hands on experiencePrevious training / hands-on experience. Need additional practice with SupervisorPrevious training and experience.

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