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Follows the resident's plan of care:

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Understands job description and duties:

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Adheres to federal and state regulatory laws/guidelines affecting resident care:

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Understands basic supportive care for residents with multiple medical conditions:

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Maintains knowledge of basic life support, Heimlich maneuver, and AED:

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Follows chain of command for job role:

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Completes inventory of resident's personal belongings and labels them:

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Assists with equipment/room set up:

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Provides the resident orientation to their room:

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Assists resident with personal belongings:

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Assists with transport of resident (e.g., wheelchair):

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Respects cultural and diverse beliefs:

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Adheres to HIPAA laws:

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Understands Resident Rights:

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Provides person-centered care:

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Provides introduction of self to resident and explains all care actions:

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Actively listens to resident concerns:

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Uses English and Metric conversions to calculate measurements:

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Documents care provided within required timeframes:

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Records vital signs:

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Reads and documents time correctly:

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Uses electronic documentation methods (e.g., computer, tablets):

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Uses checklist and flowsheet documentation methods:

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Follows organizational policy and procedure for reporting events (e.g., fall, injury, missing personal items):

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Identifies and reports information that is considered an indicator of abuse or neglect:

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Reports concerns of the resident/family/caregiver per organizational policy and procedure:

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Identifies signs and symptoms of a resident in pain:

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Uses correct procedure to obtain tympanic temperature:

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Performs Flossing:

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Cares for Dentures (Full and Partial):

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Performs Oral Hygiene for Conscious and Unconscious Residents:

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Performs Mouth Care (e.g., Oral Swabs, Lip Lubricant):

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Brushes Teeth:

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Files Nails:

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Observes and Reports Abnormal Findings (e.g., color, texture, bruising):

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Follows Organizational Policy and Procedure for Nail and Foot Care:

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Trims Nails:

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Performs a Complete Bed Bath:

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Assists with Whirlpool Bath:

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Performs a Partial Bed Bath:

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Shampoos Hair (Sink, Tub, Bed):

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Assists with Tub Bath:

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Performs Shower:

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Uses Electric Razor:

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Uses Disposable Safety Razor:

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Checks Resident’s Plan of Care for Bleeding Precautions:

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Provides Privacy During Dressing and Undressing:

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Dresses and Undresses Conscious and Unconscious Residents:

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Dresses and Undresses a Resident with a Weak Side:

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Applies TED/Support Stockings:

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Allows the Resident to Choose Their Clothing:

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Dresses and Undresses a Resident with an Intravenous Line:

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Provides Proper Care of Eyeglasses:

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Provides Proper Care of Hearing Aids and Devices:

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Provides Proper Care of a Prosthetic Eye:

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Provides Proper Care of Contact Lenses:

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Makes Occupied Beds:

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Handles Clean Linens Appropriately:

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Properly Disposes of Soiled Linen:

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Makes Unoccupied Beds:

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Positions and turns the resident to prevent skin problems:

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Uses proper skin care techniques:

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Keeps the skin clean and dry:

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Reports abnormal and new skin problems to the RN/charge nurse:

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Massages the Back:

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Correctly positions the resident during and after feeding:

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Reports abnormal observations (e.g., trouble swallowing, refusal of meals):

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Assists resident with menu selection:

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Follows aspiration precautions:

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Follows the resident's diet listed on the plan of care:

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Understands special diets:

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Prepares food (e.g., opening containers, cutting up food):

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Uses assistive devices properly (e.g., built-up utensils, plate guard):

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Uses proper feeding techniques with and without assistive devices:

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Provides the resident with respect and privacy during toileting and elimination:

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Assists resident using a toilet riser:

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Assists resident with urinal use:

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Empties colostomy bag:

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Provides colostomy care and assistance:

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Follows the bowel and bladder training plan:

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Provides catheter care (e.g., indwelling, condom):

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Provides care to a resident with self-harm behaviors or suicidal ideations:

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Provides end-of-life care for a resident:

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Provides care for resident with DNR order:

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Provides post-mortem care in accordance with cultural and religious considerations/preferences:

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Provides care for a resident with developmental disabilities:

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Provides care for a resident who is combative:

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Provides care for a resident with cancer or other terminal diagnosis:

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Understands and follows chemical storage protocols:

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Understands and follows fire safety protocols:

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Uses a fire extinguisher:

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Understands the importance of disaster preparedness:

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Understands and follows the evacuation plan:

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Reports issues with the resident's room (lighting, furniture, housekeeping):

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Assists with Transport of Resident (e.g., wheelchair):

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Uses support devices (e.g., leg/wrist brace, wedge, elastic stockings):

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Transfers resident using safe transfer techniques:

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Understands and follows aspiration precautions:

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Understands and follows fall precautions:

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Identifies residents using two unique identifiers prior to care:

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Understands and follows suicide precautions:

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Understands and follows bleeding precautions:

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Follows airborne precautions when required:

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Follows contact precautions when required:

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Follows standard precautions at all times:

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Performs hand hygiene:

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Follows droplet precautions when required:

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Uses appropriate PPE (e.g., gloves, gowns, masks, respirators):

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Appropriately applies and removes masks/respirators:

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Appropriately applies and removes protective eyewear/face shields:

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Appropriately applies and removes gloves:

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Appropriately applies and removes gowns/aprons:

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Appropriately applies and removes shoe covers:

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Obtains stool specimen:

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Properly labels specimens:

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Obtains emesis specimen:

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Obtains urine specimen (e.g., clean catch):

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Uses bed alarm, if applicable, per organizational policy:

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Understands the use of therapeutic beds:

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Understands the use of a bed scale:

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Recognizes bed positions:

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Understands the use of therapeutic mattresses:

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Uses adjustable bed properly/appropriately:

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Uses Hoyer lift with proper sling size:

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Uses sit-to-stand lift:

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Adolescent (12-18 years):

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Elderly (>60 years):

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First Name:

Last Name:

Birthdate (MM/DD/YYYY):

Years of Experience in Clinical Specialty:

Most Recent Facility Worked At:

I certify that the information provided accurately reflects my experience within the last 2 years.

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GoMed Healthcare

CNA Self-Assessment

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GoMed Healthcare

CNA Self-Assessment

Section 1: Provision of Care - General (6 Questions)

Section 2: Resident Admission (3 Questions)

Section 3: Resident Discharge (2 Questions)

Section 4: Resident Rights (4 Questions)

Section 5: Communication - Effective Communication Skills (2 Questions)

Section 6: Communication - Documentation (4 Questions)

Section 7: Communication - Methods of Documentation (2 Questions)

Section 8: Communication - Reporting (3 Questions)

Section 9: Communication - Vital Signs (2 Questions)

Section 10: Resident Care - Oral Hygiene (5 Questions)

Section 11: Resident Care - Nail and Foot Care (4 Questions)

Section 12: Resident Care - Bathing Techniques (6 Questions)

Section 13: Resident Care - Shaving Techniques (3 Questions)

Section 14: Resident Care - Dressing and Undressing Techniques (6 Questions)

Section 15: Resident Care - Vision and Hearing Aids (4 Questions)

Section 16: Resident Care - Bedmaking Techniques (4 Questions)

Section 17: Resident Care - Skin Care (5 Questions)

Section 18: Resident Care - Nutrition (9 Questions)

Section 19: Resident Care - Toileting and Elimination (7 Questions)

Section 20: Resident Care - Special Care (7 Questions)

Section 21: Resident Care - Environmental Safety (6 Questions)

Section 22: Resident Care - Mobility and Transfer (3 Questions)

Section 23: Resident Care - Safety Precautions (5 Questions)

Section 24: Infection Control - Standard/Universal Precautions (5 Questions)

Section 25: Infection Control - Personal Protective Equipment (PPE) (6 Questions)

Section 26: Infection Control - Specimen Collection (4 Questions)

Section 27: Equipment - Beds (6 Questions)

Section 28: Equipment - Proper Use of Mechanical Lifts (2 Questions)

Section 29: Age-Specific Care (2 Questions)

Section 30: Summary (6 Items)

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