Profile - NA.00802067 | |
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Name | Deidre T Dimino-Santistevan |
Credential | NA.00802067 |
Healthcare Profile - Certified Nurse Aide Location of Practice | |
Healthcare Professions Profile | Location of Practice |
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Are you currently practicing in the healthcare profession associated with this profile?
For more information about what must be reported, review Director Policy #3. |
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No |
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Healthcare Profile - Certified Nurse Aide Education and Training | |
Healthcare Professions Profile | Education and Training |
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Please select the highest level of education received as it pertains to your profession. If your degree is not listed, please select "Foreign Trained" for education outside of the United States or "Other" for a United States degree that is not included.
For more information about what must be reported, review Director Policy #3 . |
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Training Program |
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Healthcare Profile - Certified Nurse Aide Other Licenses | |
Healthcare Professions Profile | Other Licenses |
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Have you ever held, or do you currently hold any other licenses in this profession from any other state, country or province?
For more information about what must be reported, review Director Policy #4. |
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No |
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Healthcare Profile - Certified Nurse Aide Business Ownership | |
Healthcare Professions Profile | Business Ownership |
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Do you have a current business ownership interest in any healthcare-related business?
For more information about what must be reported, review Director Policy #4. |
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No |
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Healthcare Profile - Certified Nurse Aide Employer | |
Healthcare Professions Profile | Employer |
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Do you have an employer in the profession in which you are licensed or are applying for a license?
For more information about what must be reported, review Director Policy #3. |
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No |
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Healthcare Profile - Certified Nurse Aide Employment Contracts | |
Healthcare Professions Profile | Employment Contracts |
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Do you have a contract with any business whose mission relates to healthcare services or products where the value is greater than $5000 annually?
This does not include contracts with insurance providers. Any contract with a hospital, durable medical equipment company or pharmaceutical company must be reported.
For more information about what must be reported, review Director Policy #4. |
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No |
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Healthcare Profile - Certified Nurse Aide Disciplinary Actions | |
Healthcare Professions Profile | Disciplinary Actions |
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Have you ever had public disciplinary action taken against your license by any board or licensing agency in any state or country?
For more information about what must be reported, review Director Policy #5. |
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No |
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Healthcare Profile - Certified Nurse Aide Restrictions and Suspensions | |
Healthcare Professions Profile | Restrictions and Suspensions |
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Have you ever entered into any agreement or stipulation to temporarily cease your practice or had a board order issued restricting or suspending your license?
For more information about what must be reported, review Director Policy #5. |
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No |
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Healthcare Profile - Certified Nurse Aide Termination of Employment | |
Healthcare Professions Profile | Termination of Employment |
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Have you ever been terminated by an employer for a reason that would be considered a violation of your profession's practice law?
For more information about what must be reported, review Director Policy #5. |
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No |
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Healthcare Profile - Certified Nurse Aide Convictions | |
Healthcare Professions Profile | Convictions |
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Since you were issued a license to practice your profession in any state or country, have you had any final criminal conviction(s) or plea arrangement(s) resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction?
For more information about what must be reported, review Director Policy #6. |
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No |
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Healthcare Profile - Certified Nurse Aide Optional Narrative | |
Healthcare Professions Profile | Optional Narrative |
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Please provide any information regarding awards and/or recognitions you have received, or charity care you have provided that directly relate to your profession. Please be aware that the Director may remove any information that is not pertinent or may be considered inappropriate. | |
Healthcare Profile - Certified Nurse Aide Attestation | |
Healthcare Professions Profile | Attestation |
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By submitting this Healthcare Professions Profile to the Division of Professions and Occupations you are attesting that:
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Enter today's date: | |
Expanded Scope of Practice - Stimulation | |
Certified Nurse Aide Expanded Scope of Practice | Stimulation |
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Have you been deemed competent to perform digital stimulation, insertion of a suppository, or the use of an enema, or any other medically acceptable procedure to stimulate a bowel movement for clients/patients with stable health conditions and are not considered high risk? | |
Expanded Scope of Practice - Stimulation if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Stimulation |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |
Expanded Scope of Practice - Gastrostomy | |
Certified Nurse Aide Expanded Scope of Practice | Gastrostomy |
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Have you been deemed competent to perform gastrostomy-tube and jejunostomy-tube feedings for clients/patients with stable health conditions and are not considered high risk? | |
Expanded Scope of Practice - Gastrostomy if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Gastrostomy |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |
Expanded Scope of Practice - Medication | |
Certified Nurse Aide Expanded Scope of Practice | Medication |
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Have you been deemed competent to perform placement in a client's mouth of presorted medication that has been boxed or packaged by a Registered Nurse, a Licensed Practical Nurse, or a Pharmacist for clients/patients with stable health conditions and are not considered high risk? | |
Expanded Scope of Practice - Medication if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Medication |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |
Expanded Scope of Practice - Medication Minor | |
Certified Nurse Aide Expanded Scope of Practice | Medication Minor |
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Have you been deemed competent to perform placement in a minor's mouth presorted medication that has been sorted by the minor?s parent or guardian? | |
Expanded Scope of Practice - Medication Minor if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Medication Minor |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |
Expanded Scope of Practice - Oxygen | |
Certified Nurse Aide Expanded Scope of Practice | Oxygen |
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Have you been deemed competent to administer oxygen authorized by a health care provider to clients? | |
Expanded Scope of Practice - Oxygen if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Oxygen |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |
Expanded Scope of Practice - Ostomy | |
Certified Nurse Aide Expanded Scope of Practice | Ostomy |
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Have you been deemed competent to change ostomy bags? | |
Expanded Scope of Practice - Ostomy if Yes | |
Certified Nurse Aide Expanded Scope of Practice | Ostomy |
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The full name (first and last) of the RN that deemed you competent: | |
The license number of the RN that deemed you competent: | |
The date you were deemed competent or deemed to have continued competence: | |