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CNA Skills Checklist

In order for us to help find the job that is the perfect fit for you, we need to learn more about you.

Please take a few minutes to complete the CNA Skills Checklist.

Name

Phone

Email

1 - No Experience 2 - Limited Experience 3 - Experienced 4 - Highly Skilled 5 - Able to Teach and Supervise

Documentation

Clinical Note *

1

2

3

4

5

Personal Care

Total Bed Bath *

1

2

3

4

5

Tub Bath *

1

2

3

4

5

Shower *

1

2

3

4

5

Sponge Bath *

1

2

3

4

5

Sitz Bath *

1

2

3

4

5

Hair Care *

1

2

3

4

5

Shampoo *

1

2

3

4

5

Nail and Foot Care *

1

2

3

4

5

Skin Care *

1

2

3

4

5

Perineal Care *

1

2

3

4

5

Oral Care *

1

2

3

4

5

Denture Care *

1

2

3

4

5

Shave *

1

2

3

4

5

Assist with Dressing *

1

2

3

4

5

Elimination

Monitor Bowel Movements *

1

2

3

4

5

Measure Output *

1

2

3

4

5

Bedpan *

1

2

3

4

5

Bedside Commode *

1

2

3

4

5

Assist to Bathroom *

1

2

3

4

5

Assist with Bowel Program *

1

2

3

4

5

Assist with Ostomy Change *

1

2

3

4

5

Empty Foley Catheter Bag *

1

2

3

4

5

Empty Drainage Bag *

1

2

3

4

5

Drivers License

Select File

State Certification

Select File

Physical, TB Test, Hepatitis B, Infuenza

Select File

Direct Deposit Information

Select File

Activity

Repositioning *

1

2

3

4

5

Walk with Assistance *

1

2

3

4

5

Walk with Supervision *

1

2

3

4

5

Up in Chair *

1

2

3

4

5

Dangle *

1

2

3

4

5

Walker *

1

2

3

4

5

Passive Range of Motion *

1

2

3

4

5

Active Range of Motion *

1

2

3

4

5

Transfer *

1

2

3

4

5

Hoyer Lift *

1

2

3

4

5

Assist with Exercise Program *

1

2

3

4

5

Observation

Temperature *

1

2

3

4

5

Oral *

1

2

3

4

5

Axillary *

1

2

3

4

5

Tympanic *

1

2

3

4

5

Rectal *

1

2

3

4

5

Respiration *

1

2

3

4

5

Age Appropriate Care

The ability to adapt care to incorporate normal growth and development, adapt method and terminology of client instructions as it relates to the age and comprehension level of the client, and to ensure a safe environment - reflecting specific needs of the client and various age groups.

Newborn (birth-30 days) *

1

2

3

4

5

Infant (30 days - 1 Year) *

1

2

3

4

5

Toddler (1-3 years) *

1

2

3

4

5

Preschooler (3-5 years) *

1

2

3

4

5

School Age (5-12 years) *

1

2

3

4

5

Adolescents (12-18 years) *

1

2

3

4

5

Young Adults (18-39 years) *

1

2

3

4

5

Middle Adults (39-64) *

1

2

3

4

5

Older Adults (64+ years) *

1

2

3

4

5

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CNA Skills Checklist

In order for us to help find the job that is the perfect fit for you, we need to learn more about you.

​

Please take a few minutes to complete the CNA Skills Checklist.

Documentation

Personal Care

Elimination

Activity

Observation

Age Appropriate Care