How to Complete Your Reciprocity Application Package​

In order to transfer your out-of-state certificate to California, you must complete and submit the following to CDPH:

• Certified Nurse Assistant Equivalency/Reciprocity Application (CDPH 283E, PDF)
• Obtain your fingerprints either one of the two methods below:
  
• Electronic Fingerprints
• Obtain your fingerprints in California utilizing a Live Scan Agency and submit a copy of the completed Request for Live Scan Service (BCIA 8016, PDF). Please also download the Request for Live Scan Service Sample (BCIA 8016 Sample, PDF), which will show you how to correctly complete the BCIA 8016 form.
• Fingerprint Cards 
• Applicants residing out of state may complete the fingerprint card (FD-258) and submit two completed cards to the department. Fingerprint cards (FD-258) must be accompanied by a $32.00 check or money ​order made payable to “The Department of Justice.” Please refer to the DOJ’s website (PDF) for instructions on how to correctly complete the fingerprint card (FD-258).
• A copy of your out-of-state CNA certificate.
• Proof of work showing that you provided nursing or nursing-related services in a facility to residents for compensation under the supervision of a licensed health professional within the last two (2) years. Acceptable forms of proof of work are a copy of a paystub or W2. If you have received your initial out-of-state CNA certificate within the last two (2) years, you do not need to submit proof of work. Staffing agencies are not an acceptable work setting to qualify for reciprocity to California. You must submit proof of work from a skilled nursing facility in which you worked. If you work in a facility but are paid through a staffing agency you may submit a letter from the facility stating that you have worked there under the supervision of a licensed health professional.

• The Verification of Current Nurse Assistant Certification (CDPH 931, PDF). Part I of the CDPH 931 is to be completed by the applicant and Part II is to be completed by the endorsing state agency (the state you are coming from). If the state you are transferring your certificate from does not endorse these forms, please provide a screenshot of the online registry indicating your certificate is active.

State and Federal Requirements

• Certified Nurse Assistant Regulations California Health and Safety Code Section 1337-1338.5
• California Code of Regulations (CCR), Title 22, Division 5
• Code of Federal Regulations (CFR) Section (d) 5

Certified Nurse Assistant Forms

• BCIA 8016 (PDF) Request for Live Scan Service
• BCIA 8016 Sample (PDF) Sample Request for Live Scan Service form for Certified Nurse Assistants
• CDPH 283E (PDF) Certified Nurse Assistant Equivalency/Reciprocity Application
• CDPH 929 (PDF) Request for Name/Address Change and/or Duplicate for CNA Certificate
• CDPH 318 (PDF) Report of Misconduct