CA CDPH 276A 2018-2025 free printable template
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CDPH 276A 12/18 This form is available on our website at California Department of Public Health MODULE 5 Body Mechanics 4 Clinical Hours 1 General use of gait belt 2 Assist patient up to head of bed with two assistants 3 Turn and position the patient Supine Side-lying Use of lift sheet 4 Assist transfer from bed to chair or wheelchair 6 Use of mechanical lift MODULE 6 Medical and Surgical Asepsis 1 Hand washing 2 Proper handling of linen 3 Use of standard precautions Gloving Gowning Applying...
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How to fill out CA CDPH 276A
How to fill out CA CDPH 276A
01
Obtain the CA CDPH 276A form from the California Department of Public Health website or your local health department.
02
Begin filling out the 'Applicant Information' section with your name, address, and contact information.
03
Fill out the 'Facility Information' section with details about the facility, including name, address, and license number.
04
Complete the 'Owner Information' section if applicable, providing the owner's name and contact details.
05
In the 'Type of Service' section, indicate the services offered by the facility.
06
Provide any additional information or documentation requested in the 'Attachments' section.
07
Review the form thoroughly for accuracy before signing and dating it.
08
Submit the completed form to the appropriate department or address indicated in the instructions.
Who needs CA CDPH 276A?
01
Individuals or entities applying for a license or renewal in California health facilities, including child care centers, residential facilities, and certain health service providers.
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What is CA CDPH 276A?
CA CDPH 276A is a form used by healthcare providers in California to report certain communicable diseases and conditions to the California Department of Public Health.
Who is required to file CA CDPH 276A?
Healthcare providers, including physicians, hospitals, and laboratories, are required to file CA CDPH 276A when they identify cases of reportable diseases.
How to fill out CA CDPH 276A?
To fill out CA CDPH 276A, practitioners must provide patient information, the disease or condition being reported, the date of diagnosis, and any other relevant clinical details as specified in the instructions.
What is the purpose of CA CDPH 276A?
The purpose of CA CDPH 276A is to facilitate surveillance of communicable diseases in California, enabling public health officials to monitor and respond to disease outbreaks and trends.
What information must be reported on CA CDPH 276A?
The information that must be reported on CA CDPH 276A includes the patient's name, date of birth, address, the disease or condition diagnosed, laboratory results, and the healthcare provider's contact information.
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