This is a summary of staff and administrator training requirements. This information is intended as an overview only; CALA members can access detailed compliance information on our Implementation Plans webpage.
All RCFE Employees
In an effort to promote well-qualified employees and support the welfare of residents, all RCFE employees must meet specific foundational requirements:
- All employees must pass a criminal background check and be cleared by the Department of Social Services (DSS) and the FBI.
- All employees must be in good health and physically and mentally capable of performing assigned tasks.
- All employees must be trained upon hire and annually on the community’s emergency preparedness plan.
- All employees must participate in a quarterly emergency preparedness drill.
All RCFE Caregivers
Before working with residents, staff members assisting with activities of daily living are instructed on a variety of subjects. In addition to required first aid training, all direct care staff members receive 40 hours of initial training* and 20 hours each year** on the following topics:
- The aging process, physical limitations, and special needs of the elderly
- The importance and techniques of personal care services, including, but not limited to: bathing, grooming, dressing, feeding, toileting, and universal precautions
- Residents’ rights and personal rights
- Medication policies and procedures
- Psychosocial needs of the elderly (e.g. recreation, companionship, independence, etc.)
- Recognizing the signs and symptoms of dementia in individuals
- Building and fire safety and appropriate response to emergencies
- Cultural competency and sensitivity in issues relating to the underserved aging LGBT community
Dementia care training (12 hour initial training: 6 hours before working independently with residents, remaining 6 hours within the first four weeks of employment*):
- Recognizing the effects of medications commonly used to treat the symptoms of dementia, the use and misuse of drugs such as antipsychotics, and special needs of persons with Alzheimer’s disease
- Nonpharmacologic, person-centered approaches to dementia care
- Skin care
- Therapeutic activities
- Behavioral changes
- Assisting with activities of daily living
- Recognizing symptoms that may create or aggravate dementia behaviors
- Responsiveness to the general security and supervision of dementia residents
An additional 8 hours of in-service training per year**. Topics include:
- Effects of medication on the behavior of residents with dementia
- Common problems such as wandering, aggression, and inappropriate sexual behavior
- Positive therapeutic interventions and activities such as exercise, sensory stimulation, activities of daily living, and social, recreational, and rehabilitative activities
- Communication skills and resident/staff relations
- Promoting resident dignity, independence, individuality, privacy, and choice
- End of life issues, including hospice
Hospice care training
- Postural supports, restricted conditions, and hospice care (4 hours of initial training* and 4 hours of ongoing training per year**). This training must include:
- 4 hours on the care, supervision, and special needs of those residents prior to providing direct care
- 4 hours ongoing annual training
Employees who care for residents with specialized needs such as oxygen administration or incontinence must complete training provided by a licensed professional. This hands-on training to address general and resident-specific procedures must be completed before employees work directly with residents.
Staff Caring for Residents Receiving Hospice Services
Staff caring for a resident on hospice are required to have additional training beyond the four initial and on-going hours that all direct care staff must receive on postural supports, restricted conditions, and hospice care. The hospice agency will provide training specific to the current and ongoing needs of each individual resident receiving hospice care. Staff must receive this specified training before hospice services begin.
Some of the needs covered in hospice training include, but are not limited to:
- Incontinence care to prevent skin breakdown
- Proper hydration
- Infection control
At least one CPR-trained staff must be on duty and on the premises at all times. This staff person is not required to provide CPR, allowing for DNRs to be honored.
Staff Assisting with Medications – Increased in 2016
In keeping with the importance of proper medication management, staff members who assist with medication receive specialized training. Specifically:
- In a community licensed for 16 or more persons, employees must complete 24 hours of initial training within the first two weeks of employment and pass a test of the required subjects.
- In a community licensed for 15 or fewer persons, employees must complete 10 hours of initial training within the first two weeks of employment and pass a test of the required subjects.
In addition, employees must receive 8 hours of in-service training on medication-related issues in each succeeding 12-month period.
Activity Program Staff
Staff members are responsible for managing the activities that bring enjoyment to residents’ days, maintaining and developing their fullest potential for independent living. Experience and training is required to help assure engaging, enjoyable and safe activities for residents with varied interests.
- Communities licensed for 16–49 residents must have at least one staff member responsible for activity programs. This person must have:
- At least six months’ experience providing planned activities; or
- Have completed or be enrolled in an education or training program
- Communities licensed for 50 or more residents must have one staff member with full-time responsibility for activity programs. This person must have:
- At least one year of experience; and
- Be knowledgeable in:
- Evaluating resident needs
- Supervising other employees
- Training volunteers
Food Service Employees
As in any residence, enjoyable food and good service are highly valued in communities. Employees responsible for food planning, preparation, and service are trained to strive for resident satisfaction.
- Communities licensed for 16–49 residents must have one person who has primary responsibility for food planning, preparation, and service.
- This person shall be provided appropriate training.
- Communities licensed for 50 or more residents that provide three meals per day must have a full-time employee qualified by formal training or experience to be responsible for food service.
- The employee must be a nutritionist, dietician, or home economist, or a provision shall be made for regular consultation from a nutritionist, dietician, or home economist.
- All communities must employ sufficient numbers of appropriately trained food service personnel to meet the needs of residents.
Administrator Requirements and Training
From overseeing resident care to managing staff and regulatory compliance, the responsibilities of RCFE administrators are broad and require state certification. These requirements for administrators include an 80-hour, DSS-approved Initial Certification Training Program and passing a written test of 100 questions administered by DSS. At least 60 hours must be conducted in-person and up to 20 hours can be taken online.
Administrators are required to stay current by completing at least 40 classroom hours of continuing education during each two-year certification period; 8 of those hours must be related to serving residents with Alzheimer’s disease and other dementias.
Administrators must also have at minimum:
- Knowledge of the requirements for providing care and supervision appropriate to the residents
- Knowledge of and ability to conform to the applicable laws, rules, and regulations
- Ability to maintain or supervise the maintenance of financial and other records
- When applicable, the ability to direct the work of others
- Good character (including a criminal record clearance through the Department of Justice)
- A high school diploma or equivalent
- Proof that they are at least 21 years of age
The size of the community also triggers additional requirements for administrators:
- The administrator in a community of 16 to 49 residents must have:
- Passed at least 15 college or continuing education semester or equivalent quarter units; and
- Have at least one year’s experience providing residential care to the elderly; or
- Equivalent education and experience as approved by DSS.
- The administrator in facilities licensed for 50 or more residents must have:
- Completed two years of college; and
- At least three years of experience providing residential care to the elderly; or
- Equivalent education and experience as approved by DSS.
Finally, the administrator is responsible for having the personal characteristics, physical energy, and competence to provide care and supervision and, where applicable, to work effectively with social agencies.
In support of required training, CALA provides ongoing education programs throughout the year. In addition to keeping our members informed, we promote best practices and innovation to continue meeting the needs of our state’s growing, changing population of older adults.
*Training may be done using a variety of methods, such as lectures, instructional videos, and interactive online courses. 20 of the 40 hours of initial training must be completed before working independently with residents. Of the remaining 20 hours, 16 must be hands-on training.
** Annual training options include on the job training, a classroom setting, or both, and may include online training.