Form preview

Get the free APPLICATION FOR NURSING HOME ADMINISTRATOR STATE EXAMINATION AND LICENSE - cdph ca

Get Form
This application form is for individuals seeking to apply for the Nursing Home Administrator state examination and license in California. It requires personal information, eligibility details, and
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign application for nursing home

Edit
Edit your application for nursing home form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your application for nursing home form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing application for nursing home online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the steps below to use a professional PDF editor:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit application for nursing home. Rearrange and rotate pages, add new and changed texts, add new objects, and use other useful tools. When you're done, click Done. You can use the Documents tab to merge, split, lock, or unlock your files.
4
Get your file. Select the name of your file in the docs list and choose your preferred exporting method. You can download it as a PDF, save it in another format, send it by email, or transfer it to the cloud.
With pdfFiller, it's always easy to work with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out application for nursing home

Illustration

How to fill out APPLICATION FOR NURSING HOME ADMINISTRATOR STATE EXAMINATION AND LICENSE

01
Obtain the application form from the state regulatory board or their official website.
02
Read the instructions carefully to ensure you understand the requirements.
03
Complete the personal information section, including your name, address, and contact information.
04
Provide your educational background, including degrees and training relevant to nursing home administration.
05
List your work experience in long-term care or related fields, including job titles and duration of employment.
06
Prepare and attach any required documentation, such as transcripts, proof of work experience, and background checks.
07
Pay the applicable application fee as specified by the state regulatory board.
08
Review the application thoroughly for accuracy before submission.
09
Submit the completed application form and all required documents to the state regulatory board by the deadline.

Who needs APPLICATION FOR NURSING HOME ADMINISTRATOR STATE EXAMINATION AND LICENSE?

01
Individuals seeking to become licensed nursing home administrators.
02
Those who have completed the necessary education and training requirements in nursing home administration.
03
Candidates preparing to take the state examination for nursing home administrators.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.5
Satisfied
61 Votes

People Also Ask about

All states require nursing home administrators to be licensed. There are three national licenses to choose from, and your pick might depend on where you work. Consider earning a certification.
To become a certified RCFE Administrator, you must be at least 21 years of age, completed high school or have a GED, complete the 80 hour RCFE Certification class, pass the State exam (100 questions, open book to DSS materials), pass a background check and pay the State $100 for the RCFE certificate application.
All nursing home administrators must be licensed, but each state has its own requirements. The National Association of Long Term Care Administrator Boards (NAB) is governed by state boards and offers three licenses for nursing home administrators, plus continuing education courses.
Average base salary The average salary for a nursing home administrator is $106,113 per year in California. 364 salaries taken from job postings on indeed in the past 1 months (updated May 30, 2025).
NHA, RCAL, & HCBS Exams – Each line of service exam has 60 scored/15 pretest questions/ 75 total questions. Seat time 90 minutes.
Nursing home administrators get to be the “face” of a nursing home, adult care community, or other long-term care facility. Administrators get to work with many people and teams. They are typically paid well and in high-demand, while also making a positive difference in the long-term care sector.
To become licensed as a nursing home administrator, applicants must: Be at least 18 years old; Be a citizen of the United States or legal resident of reputable and responsible character; Pass the nursing home administrator license examination, which consists of a written state exam and an on-line national exam;

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The APPLICATION FOR NURSING HOME ADMINISTRATOR STATE EXAMINATION AND LICENSE is a formal request submitted by individuals seeking to take the licensing examination required to become a licensed nursing home administrator in their respective state.
Individuals who wish to become licensed nursing home administrators are required to file this application. This typically includes those who have completed the necessary education and training requirements for nursing home administration.
To fill out the APPLICATION FOR NURSING HOME ADMINISTRATOR STATE EXAMINATION AND LICENSE, applicants must provide personal information, educational background, work experience in healthcare, and any relevant certifications. The application may also require fingerprints and a background check.
The purpose of the application is to assess the qualifications and readiness of individuals to take the state examination for nursing home administrators, ensuring they meet state regulations and standards necessary for licensure.
The information usually required includes personal identification details, educational history, professional experience in nursing home settings, certifications related to healthcare administration, and any disciplinary actions taken against the applicant in previous roles.
Fill out your application for nursing home online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.