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Certified Nursing Assistant Skills Checklist
Please rate your experience / frequency within the last year
0 = No Experience / Observed Only
1 = Limited Experience / Rarely Done (<6 times/year)
2 = May Need Some Review / Occasionally Done (1 - 2 times/month)
3 = Experienced / Frequently Done (daily or weekly)
AGE OF PATIENTS CARED FOR
GENERAL SKILLS
Activities of Daily Living
WOUND/SKIN-Care of Patient with:
ADDITIONAL SKILLS-Care of Patient With
INFECTIOUS DISEASE - Care of the patient with
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