The following definitions apply to this chapter:

(1) "Activities of daily living" means self-care abilities related to personal care such as bathing, eating, using the toilet, dressing, medication assistance, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.

(2) "Applicant" means:

(a) An individual who is applying for an adult family home license;

(b) An individual with an ownership interest in a partnership, corporation, or other entity that is applying for an adult family home license; or

(c) An individual who is applying for an enhanced services facility license.

(3) "Capable caregiving training" ((is the name of))means the DSHS developed training curricula in dementia and mental health that will be available in three class levels. The level one series of the class in both dementia and mental health meets the requirements ((provided in))under RCW 18.20.270 and 70.128.230 for specialty training. The level two and level three capable caregiving classes, when developed, in both topics may be completed for continuing education credits.

(4) "Care team" includes the resident and everyone involved in his or her care. The care team may include family, friends, doctors, nurses, long-term care workers, social workers, and case managers. The role of the care team is to support the resident's well-being. However, the resident directs the service plan when able.

(5) "Challenge test" means a competency test taken for specialty training without first taking the class for which the test is designed.

(6) "Competency" ((defines))means the integrated knowledge, skills, or behavior expected of a long-term care worker after completing the training in a required topic area. Learning objectives are associated with each competency.

(7) "Competency testing" including challenge testing, evaluates a student to determine if they can demonstrate the required level of skill, knowledge, and behavior with respect to the identified learning objectives of a particular course.

(8) "Core basic training" is the portion of the seventy-hour long-term care worker basic training that covers the core competencies and skills that long-term care workers need in order to provide personal care services efficiently and safely. The core basic training hours also includes hours devoted to student practice and demonstration of skills.

(9) "Date of hire" for determining timeframes related to training and certification, means the day an individual was first hired as a long-term care worker as determined by the department according to WAC 388-112A-0115.

(10) "DDA" means the developmental disabilities administration.

(11) "Designee" means a person in an assisted living facility or enhanced services facility who supervises long-term care workers and is designated by an assisted living facility administrator or enhanced services facility administrator to take the trainings in this chapter required of the facility administrator. An assisted living facility or enhanced services facility administrator may have more than one designee.

(12) "Direct care worker" means a paid individual who provides direct, personal care services to persons with disabilities or the elderly requiring long-term care (see also the definition of long-term care worker, which includes direct care workers).

(13) "Direct supervision" means oversight by a person who has demonstrated competency in basic training and if required, specialty training, or has been exempted from the basic training requirements, and is on the premises and quickly available to the caregiver.

(14) "DSHS" or "department" ((refers to))means the department of social and health services.

(15) "Enhancement" means additional time provided for skills practice and additional training materials or classroom activities that help a long-term care worker to thoroughly learn the course content and skills. Enhancements may include new student materials, videos or DVDs, online materials, and additional student activities.

(16) "Entity representative" means the individual designated by an adult family home provider who is or will be responsible for the daily operations of an adult family home.

(17) "Guardian" means an individual as defined in chapter 11.88 RCW.

(18) "Home" ((refers to))means adult family homes, enhanced services facilities, and assisted living facilities.

(19) "Home care aide certified" or "home care aide" means a person who obtained and maintains a home care aide certification through the department of health.

(20) "Indirect supervision" means oversight by a person who has demonstrated competency in basic training and if required, specialty training, or was exempted from basic training requirements, and who is quickly and easily available to the long-term care worker, but not necessarily on-site.

(21) "Learning objectives" ((are))means measurable, written statements that clearly describe what a long-term care worker must minimally learn to meet each competency. Learning objectives are identified for each competency. Learning objectives provide consistent, common language and a framework for curriculum designers, the curriculum approval process, and testing.

(22) "Long-term care worker" ((includes))means:

(a) All persons who provide paid, personal care services for the elderly or persons with disabilities, including but not limited to individual providers of home care services, direct care workers employed by home care agencies, providers of home care services to persons with developmental disabilities under Title 71A RCW, all direct care workers in state-licensed assisted living facilities, adult family homes, respite care providers, community residential service providers, and any other direct care staff who provide home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

(b) Long-term care workers do not include:

(i) Persons employed by the following facilities or agencies: Nursing homes subject to chapter 18.51 RCW, hospitals or other acute care settings, residential habilitation centers under chapter 71A.20 RCW, facilities certified under 42 C.F.R., Part 483, hospice agencies subject to chapter 70.127 RCW, adult day care centers, and adult day health care centers; or

(ii) Persons who are not paid by the state, by a private agency, or facility licensed by the state to provide personal care services.

(23) "Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living, which is provided to meet the resident's care needs.

(24) "Provider" means any person or entity licensed by the department to operate an adult family home, enhanced services facility, or assisted living facility, or any person or entity certified by the department to provide instruction and support services to meet the needs of persons receiving services under Title 71A RCW.

(25) "Resident" means a person residing and receiving long-term care services at an assisted living facility, enhanced services facility, or adult family home. As applicable, "resident" also means the resident's legal guardian or other surrogate decision maker.

(26) "Resident manager" means a person employed or designated by the provider to manage the adult family home who meets the requirements in WAC 388-76-10000 and this chapter.

(27) "Routine interaction" means regular contact with residents.

(28) "Seventy-hour long-term care worker basic training" means the seventy-hours of required training that a new long-term care worker must complete within one hundred and twenty days of hire. It has three components: Core competencies, practice of skills, and population specific topics, which may include specialty and nurse delegation training.

(29) "Special needs" means a resident has dementia, developmental disabilities, or mental illness.

(30) "Specialty training" ((refers to))means curricula that meets the requirements of RCW 18.20.270 and 70.128.230 to provide basic core knowledge and skills that caregivers need to learn and understand to effectively and safely provide care to residents living with mental illness, dementia, or developmental disabilities. The specialty training curricula may be DSHS developed or DSHS approved and must be based on the competencies and learning objectives in WAC 388-112A-0430, 388-112A-0440, or 388-112A-0450.

(((30)))(31) "Training entity" means an organization, including an independent contractor, who provides or may provide training under this chapter using approved curriculum.

(1) The following chart provides a summary of the training and certification requirements for volunteers and long-term care workers in adult family homes and adult family home providers:

(2) The following chart provides a summary of the training and certification requirements for adult family home applicants prior to licensure and adult family home resident managers prior to assuming the duties of the position:

(3) The remainder of this chapter describes the training and certification requirements in more detail.

(4) The following training requirements are not listed in the charts in subsections (1) and (2) of this section but are required under this chapter:

(a) First aid and CPR under WAC 388-112A-0720;

(b) Nurse delegation under WAC 388-112A-0500 and 388-112A-0560; and

(c) Adult family home (AFH) administrator training under WAC 388-112A-0810.

(1) The following chart provides a summary of the training and certification requirements for volunteers and long-term care workers in assisted living facilities and assisted living administrators or administrator designees:

(2) The remainder of this chapter describes the training and certification requirements in more detail.

(3) The following training requirements are not listed in the charts in subsection (1) of this section but are required under this chapter:

(a) First aid and CPR under WAC 388-112A-0720;

(b) Nurse delegation under WAC 388-112A-0500 and 388-112A-0560;

(c) Assisted living facility (ALF) administrator training under WAC 388-78A-2521.

(1) The following chart provides a summary of the training and certification requirements for applicants, administrators or their designees, volunteers, and long-term care workers in enhanced services facilities:

(2) The remainder of this chapter and chapter 388-107 WAC describes the training and certification requirements in more detail.

(3) The following training requirements are not listed in the chart in subsection (1) of this section but are required under this chapter:

(a) First aid and CPR under WAC 388-112A-0720; and

(b) Enhanced services facility (ESF) administrator training under WAC 388-112A-0800.

The following long-term care workers are exempt from the seventy-hour long-term care worker basic training requirement:

(1) An ((applicant for an adult family home license on or before January 6, 2012 who met the basic training requirements in effect at the time of application;

(2) A person))individual employed as a long-term care worker on January 6, 2012 who ((completed))complied with the basic training requirements in effect on the date of his or her hire;

(((3) A person employed as a long-term care worker on January 6, 2012 who completed within one hundred twenty days of hire the basic training requirements in effect on the date of his or her hire;

(4) A person))(2) An individual previously employed as a long-term care worker who completed the basic training requirements in effect on the date of his or her hire and was employed as a long-term care worker at some ((point))time between January 1, 2011 and January 6, 2012;

(((5) Washington state department of health))(3) Registered nurses, licensed practical nurses, and advanced registered nurse practitioners licensed under chapter 18.79 RCW;

(((6) Washington state department of health))(4) Nursing assistants certified under chapter 18.88A RCW and persons in an approved training program for certified nursing assistants under chapter 18.88A RCW provided that they complete the training program within one hundred twenty days of the date of hire and the department of health has issued them their nursing assistant certified credential within two hundred days of the date of hire;

(((7)))(5) A home health aide who was employed by a medicare certified home health agency within the year before the ((home health aide))individual was hired as a long-term care worker and who has met the requirements of 42 C.F.R. Sec. 484.36; ((and))

(((8)))(6) An individual with special education training with an endorsement granted by the Washington state superintendent of public instruction as described in RCW 28A.300.010; and

(7) Home care aides (HCAs) certified under chapter 18.88B RCW.

Before hiring a long-term care worker, the home must review and verify the following training and certification information. The home must verify the highest level of training or certification achieved by the individual.

(1) When the individual is a home care aide certified under chapter 18.88B RCW, the home must:

(a) Verify that the individual's home care aide certification is current and in good standing;

(b) Confirm the individual has completed continuing education as required under WAC 388-112A-0610, 388-112A-0611, or 388-112A-0612; and

(c) When specialty training is required, confirm the training was completed as required under WAC 388-112A-0495.

(2) When the individual is exempt from the seventy-hour long-term care worker training and certification requirements under WAC 388-112A-0090, the home must review and verify the following:

(a) Documents demonstrating that the individual is exempt from training and certification which may include:

(i) Washington state provider credential number, showing that the individual's license or certification is current and in good standing;

(ii) A letter from a former or current employer documenting work history during the exemption period described in WAC 388-112A-0090;

(iii) Employment history records from the Washington state employment security department documenting work history information during the exemption period;

(iv) Federal tax statements documenting work history information during the exemption period; or

(v) Documents showing completion of the basic training as required under WAC 388-112A-0090;

(b) Compliance with continuing education requirements as required under WAC 388-112A-0610, 388-112A-0611, or 388-112A-0612; and

(c) Compliance with specialty training if required under WAC 388-112A-0495.

(3) Individuals who have worked as long term care workers in the past, but who do not complete the training or certification that was required at the time, may be eligible to have their date of hire reset in accordance with this section and WAC 388-112A-0110. 

(a) Individuals who are eligible to reset their date of hire under WAC 388-112A-0110 must submit a new application and fee to the department of health in accordance with WAC 388-112A-0110, and adhere to the training or certification requirements under this chapter.

(b) Individuals who are not eligible to reset their date of hire as provided in WAC 388-112A-0110 must not be paid to provide personal care assistance until they complete required training and become certified as a long term care worker.

(4) The home must comply with continuing education documentation requirements under WAC 388-112A-0620.

(a) Individuals who worked in a long term care setting during the previous calendar year are held accountable for their CE completion by their new employer on the date of hire and shall provide at new hire documentation of their continuing education compliance during the calendar year in which they are hired; or

(b) Individuals who work for multiple employers or move between employers shall on the date of hire, provide documentation of continuing education compliance, for the year in which they are hired if hired after their birth date.

Adult family homes.

(1) Adult family home applicants, providers, entity representatives, and resident managers must complete specialty training or developmental disability caregiver training and demonstrate competency before ((the home is licensed or before a new entity representative or resident manager assumes the duties of the position in order to admit))admitting or ((serve))serving residents who have special needs related to mental illness, dementia, or a developmental disability.

(2) If a resident develops special needs while living in a home without a specialty designation, the provider, entity representative, and resident manager have one hundred twenty days to complete specialty training or developmental disability caregiver training and demonstrate competency.

Assisted living facilities.

(3) If an assisted living facility serves one or more residents with special needs, the assisted living facility administrator or his or her designee must complete specialty training or developmental disability caregiver training and demonstrate competency within one hundred twenty days of date of hire.

(4) If a resident develops special needs while living in an assisted living facility, the assisted living facility administrator or his or her designee has one hundred twenty days to complete specialty training and demonstrate competency.

Enhanced services facilities.

(5) Enhanced services facilities applicants, providers, entity representatives, and resident managers must complete dementia and mental health specialty training and demonstrate competency before the home is licensed or before a new entity representative or resident manager assumes the duties of the position in order to admit or serve residents who have special needs related to mental illness, dementia, or a developmental disability.

(6) If a resident develops special needs while living in ((a home))an enhanced services facility without a specialty designation, the provider, entity representative, and resident manager have one hundred twenty days to complete developmental disability specialty training and demonstrate competency.

Adult family homes.

(1) If an adult family home serves one or more residents with special needs, the adult family home must ensure that long-term care workers ((must))employed by the home complete and demonstrate competency in specialty training as described in WAC 388-112A-0400 within one hundred twenty days of hire.

(2) ((During the period to complete the specialty training the))Until a long-term care worker completes the requirements of subsection (1) of this section, the home must not allow the long-term care worker to provide personal care to a resident with special needs without direct supervision ((until that long-term care worker demonstrates competency in specialty training)), unless indirect supervision is allowed under subsection (3) of this section.

(3) The long-term care worker may ((have))provide personal care with indirect supervision if ((the long-term care worker is)) one or more of the following requirements are met:

(a) The long-term care worker is a nursing assistant certified (NA-C) under chapter 18.88A RCW;

(b) The long-term care worker is a certified home care aide (HCA) under chapter 18.88B RCW;

(c) The long-term care worker is a licensed practical nurse (LPN) under chapter 18.79 RCW;

(d) The long-term care worker is a registered nurse (RN) under chapter 18.79 RCW; or

(e) The long-term care worker ((meets the exemption criteria described in))is exempt from the seventy hour basic training under WAC 388-112A-0090.

Assisted living facilities.

(4) If an assisted living facility serves one or more residents with special needs, the assisted living facility must ensure that long-term care workers ((must))employed by the facility complete and demonstrate competency in specialty training within one hundred twenty days of hire. However, if specialty training is not integrated with basic training, the specialty training must be completed within ninety days of completion of basic training.

(5) ((During the period to complete the specialty training, the))Until a long-term care worker completes the specialty training and demonstrates competency as required under subsection (4) of this section, the home must not allow the long-term care worker to provide personal care to a resident with special needs without ((indirect))direct supervision ((until that long-term care worker demonstrates competency in specialty training)).

Enhanced services facilities.

(6) All long-term care workers in enhanced services facilities ((are facilities that serves one or more residents with special needs, and long-term care workers)) must complete and demonstrate competency in mental health and dementia specialty training prior to providing client services.

(((7) Long-term care workers are not required to complete specialty training if the adult family home or assisted living facility has no residents with a special need where the specialty training is required.))

(1) Nurse delegation core and specialized diabetes training may ((occur))be required in the same year as basic training if ((required to be able to perform)) delegated tasks need to be performed. ((The training hours))If completed within one hundred twenty days of hire, the nurse delegation core and specialized diabetes training hours may ((apply to))be counted toward the population specific component of the seventy-hour long-term care worker basic training.

(2) Long-term care workers in enhanced services facilities are not permitted to perform nurse delegated tasks.

(1) Continuing education is annual training designed to promote professional development and increase a caregiver's knowledge, expertise, and skills. DSHS must approve continuing education curricula and instructors.

(2) The same continuing education course must not be repeated for credit unless it is a new or more advanced training on the same topic. However, long-term care workers may repeat up to five credit hours per year on the following topics:

(a) Bloodborne pathogens and infection control;

(b) CPR training;

(c) First-aid training;

(d) Food handling training;

(e) Health insurance portability and accountability act (HIPAA);

(f) Medication assistance;

(g) Disaster preparedness;

(h) Aging sensitivity;

(i) Resident rights as it relates to caregiving issues in chapter 70.129 RCW;

(j) Resident safety;

(k) Abuse and neglect identification and mandatory reporting; and

(l) Topics where the assisted living facility, enhanced services facility, or adult family home can demonstrate a need for retraining.

(((2)))(3) Continuing education must be on a topic relevant to the care setting, care needs of residents, or long-term care worker career development. In addition to the topics listed in subsection (1) of this section, topics or course may include:

(a) Personal care services;

(b) Mental illness;

(c) Dementia;

(d) Developmental disabilities;

(e) Depression;

(f) Communication skills;

(g) Positive resident behavior support;

(h) Developing or improving resident centered activities;

(i) Dealing with wandering or aggressive resident behaviors;

(j) Deescalating challenging behaviors; and

(k) Medical conditions.

(((3)))(4) Nurse delegation core and nurse delegation specialized diabetes training hours when not applied to basic training hours may count towards continuing education.

(((4)))(5) Specialty training, except if completed through a challenge test, may be used to meet continuing education requirements.

(((5)))(6) When hours from a class approved as specialty training are counted toward basic training requirements, the hours must not be counted toward continuing education.

(((6)))(7) Residential care administrator training under WAC 388-112A-0800 may be used to meet the continuing education requirements described in WAC 388-112A-0610 during the year it was completed.

(((7)))(8) Successful completion of a department of health approved home care aide certified alternative bridge program may be applied up to twelve hours of continuing education in the year it was completed.

(1) ((Adult family homes))The continuing education training requirements that apply to certain individuals working in adult family homes are described below.

(a) The following long-term care workers must complete twelve hours of continuing education by their birthday each year:

(i) Certified home care aides ((must complete twelve hours of continuing education by their birthday each year after obtaining certification as required by the Washington department of health as described in RCW 74.39A.341.

(b) If exempt from certification as described in));

(ii) Long-term care workers who are exempt from certification under RCW 18.88B.041, ((long-term care workers must complete twelve hours of continuing education by their birthday each year.

(ii) Continuing education requirements under subsection (1)(b) of this section do not apply to))and WAC 388-112A-0090(1) and (2) because they worked during the exemption period of January 1, 2011 to January 6, 2012, and they completed all of the basic training requirements in effect on the date they were hired;

(iii) Certified nursing assistants, and persons with special education training and an endorsement granted by the Washington state office of superintendent of public instruction, as described in RCW 28A.300.010; and

(iv) Adult family home applicants, home entity representatives, and resident managers as provided in WACs 388-112A-0050 and 388-76-10146.

(((c) For))(b) Long-term care workers ((that)), who are certified ((as a)) home care ((aide or nursing assistant, if the first renewal period is less than a full year from the initial date of certification, no continuing education will be due for the first renewal period))aides, must comply with continuing education requirements under chapter 246-980 WAC.

(c) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section, must complete the annual continuing education requirements for each calendar year in which they performed any work as a long-term care worker.

(d) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section and who have not worked in long-term care during the current calendar year or during one or more of the previous calendar years, are eligible to return to work as a long-term care worker when the continuing education hours required under subsection (1)(c) of this section are completed within the following timeframes:

(f) Continuing education must include one half hour per year on safe food handling in adult family homes as described in RCW 70.128.250 ((when the))for a long-term worker who does not maintain a food handler's permit, and completed their basic or modified basic caregiver training before June 30, 2005. Long-term care workers who completed basic or modified basic training after June 30, 2005 are not required to have a food handler's permit.

(2) ((Assisted living facilities.

(5) One hour of completed classroom instruction or other form of training (such as an online course) equals one hour of continuing education. For online courses, the training entity must establish a way for the long-term care worker to ask the instructor questions))A long-term care worker who does not complete continuing education as required under this chapter must not provide care until they complete the required continuing education.

(3) One hour of completed classroom instruction or other form of training (such as an online course) equals one hour of continuing education. For online courses, the training entity must establish a way for the long-term care worker to ask the instructor questions.

(1) The continuing education training requirements that apply to certain individuals working in assisted living facilities are described below.

(a) The following long-term care workers must complete twelve hours of continuing education by their birthday each year:

(i) Certified home care aides;

(ii) Long-term care workers who are exempt from certification under RCW 18.88B.041, and WAC 388-112A-0090(1) and (2) because they worked during the exemption period of January 1, 2011 to January 6, 2012, and they completed all of the basic training requirements in effect on the date they were hired;

(iii) Certified nursing assistants, and persons with special education training and an endorsement granted by the Washington state office of superintendent of public instruction, as described in RCW 28A.300.010; and

(iv) Assisted living facility applicants, facility representatives, administrators, or the administrator designees must complete twelve hours of continuing education by their birthday each year.

(b) Long-term care workers, who are certified home care aides, must comply with continuing education requirements under chapter 246-980 WAC.

(c) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section, must complete the annual continuing education requirements for each calendar year in which they performed any work as a long-term care worker.

(d) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section and who have not worked in long-term care during this calendar year or during one or more of the previous calendar years, are eligible to return to work as a long-term care worker when the continuing education hours required under subsection (1)(c) of this section are completed within the following timeframes:

(i) On or before their birthday, if their birthday will occur after the date they return to work; or

(ii) Within forty-five calendar days of the date they returned to work, if their birthday occurred on or before the day they returned to work.

(A) If this forty-five calendar day time period allows workers to complete their continuing education in January or February of the following year, the credit hours earned will be applied to the calendar year in which they were hired.

(B) Continuing education requirements for the calendar year after the year they were hired must be completed as required under subsection (1)(a) of this section, even if that means the long-term care worker must complete twenty-four hours of continuing education within a very short period of time.

(e) Following initial certification, as a home care aide or nursing assistants (NA-C), long-term care workers must complete their first annual continuing education hours:

(i) Before their first birthday following certification, if that date is more than twelve months after the date of certification; or

(ii) Before their second birthday following certification, if their first birthday occurred less than twelve months after the date of certification.

(2) A long-term care worker who does not complete continuing education as required under this chapter must not provide care until they complete the required continuing education.

(3) One hour of completed classroom instruction or other form of training (such as an online course) equals one hour of continuing education. For online courses, the training entity must establish a way for the long-term care worker to ask the instructor questions.

(1) The continuing education training requirements that apply to certain individuals working in enhanced services facilities are described below.

(a) The following long-term care workers must complete twelve hours of continuing education by their birthday each year:

(i) Certified home care aides;

(ii) Long-term care workers who are exempt from certification under RCW 18.88B.041, WAC 388-112A-0090 (1) and (2), and WAC 388-71-0839(1) and (2) because they worked during the exemption period of January 1, 2011 to January 6, 2012, and they completed all of the basic training requirements in effect on the date they were hired;

(iii) Certified nursing assistants, and persons with special education training and an endorsement granted by the Washington state office of superintendent of public instruction, as described in RCW 28A.300.010; and

(iv) Enhanced services facility applicants, facility representatives, administrators, or the administrator designees as provided under WAC 388-112A-0070 and 388-107-0630.

(b) Long-term care workers, who are certified home care aides, must comply with continuing education requirements under chapter 246-980 WAC;

(c) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section, must complete the annual continuing education requirements for each calendar year in which they performed any work as a long-term care worker.

(d) Long-term care workers, who are exempt from home care aide certification under either subsection (1)(a)(ii) or (a)(iii) of this section and who have not worked in long-term care during the current calendar year or during one or more of the previous calendar years, are eligible to return to work as a long-term care worker when the continuing education hours required under subsection (1)(c) of this section are completed within the following timeframes:

(i) On or before their birthday, if their birthday will occur after the date they return to work; or

(ii) Within forty-five calendar days of the date they returned to work, if their birthday occurred on or before the day they returned to work.

(A) If this forty-five calendar day time period allows workers to complete their continuing education in January or February of the following year, the credit hours earned will be applied to the calendar year in which they were hired.

(B) Continuing education requirements for the calendar year after the year in which they were hired must be completed as required under subsection (1)(a) of this section, even if that means the long-term care worker must complete twenty-four hours of continuing education within a very short period of time.

(e) Following initial certification, as a home care aide or nursing assistant (NA-C), long-term care workers must complete their first annual continuing education hours:

(i) Before their first birthday following certification, if that date is more than twelve months after the date of certification; or

(ii) Before their second birthday following certification, if their first birthday occurred less than twelve months after the date of certification.

(f) Enhanced services facility certified home care aide staff and nursing assistant certified staff must have ten of their twelve hours of annual continuing education cover relevant education regarding the population served in the enhanced services facility as provided in WAC 388-107-0660.

(g) In addition to the annual continuing education requirements for individual staff, the enhanced services facility must provide three hours of staff education per quarter on topics relevant to the needs of the population served.

(2) A long-term care worker who does not complete continuing education as required in subsection (1)(a) of this section or RCW 74.39A.341 must not provide care until they complete the required continuing education.

(3) One hour of completed classroom instruction or other form of training (such as an online course) equals one hour of continuing education. For online courses, the training entity must establish a way for the long-term care worker to ask the instructor questions.

(1) If a training entity modifies a department developed curriculum in any manner, the training entity must submit the curriculum to the department for approval.

(2) Training must not be offered before receiving department curriculum and instructor approval.

(4)For orientation and safety training:

(a) Submit an outline of what will be covered in each training offered, ((like))including a table of contents or a class syllabus, that shows where the required introductory topics listed in WAC 388-112A-0210 for orientation and WAC 388-112A-0230 for safety training are covered in the training.

(b) Department required orientation and safety training application forms must be submitted to the department at least forty-five days before the training is expected to be offered.

(c) Training cannot be offered before the department approves the curriculum and instructor.

(((3)))(5)For continuing education:

(a) Continuing education curriculum delivery models must only include instructor led, online instructor led (such as a webinar), or online interactive self-paced learning with access to an instructor.

(b) ((Online classes must adhere to the DSHS online class standards in effect at the time of approval. These online standards are posted on the department's web site.

(c))) For continuing education classes, submit on a department developed form a summary of the class that includes the topic, a brief description of what the training will cover, a course outline, the number of training hours, and a description of how the training is relevant to the care setting, care needs of residents, or long-term care worker career development.

(((d)))(c) For online training courses, submit the information requested in (((c)))(b) of this subsection and a description of how the instructor or training will assess that the students have integrated the information being taught.

(((e)))(d) Department required continuing education training application forms must be submitted at least forty-five days in advance of the training. The department must approve the curriculum and instructor before the training may be offered.

(((4)))(6)For core basic training:

(a) If the instructor or training entity uses the DSHS developed revised fundamentals of caregiving learner's guide with enhancements, they must submit the DSHS form with all required information.

(b) If the instructor or training entity does not use a DSHS developed revised fundamentals of caregiving learner's guide with enhancements to teach the seventy-hour long-term care worker basic training, they must submit to DSHS the following for approval:

(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives described in this chapter are located in the long-term care worker materials from the proposed curriculum for that course;

(ii) Any materials long-term care workers will receive, such as a textbook, long-term care worker manual, learning activities, audio-visual materials, handouts, and books;

(iii) The table of contents or curriculum outline, including the allotted time for each section;

(iv) Demonstration skills checklists for the personal care tasks described in WAC 388-112A-0320 (12)(a) and (b) and infection control skills such as hand washing and putting on and taking off gloves; and

(v) The teacher's guide or manual that includes for each section of the curriculum:

(A) The goals and objectives;

(B) Method of teaching, including learning activities that incorporate adult learning principles;

(C) Methods used to determine whether each long-term care worker understands the materials covered and can demonstrate all skills;

(D) A list of the sources or references that were used to develop the curriculum and if the primary source or reference is not a published citation, the instructor must provide detail on how the content is evidence based;

(E) Description of how the curriculum was designed to accommodate long-term care workers with either limited English proficiency, learning disabilities, or both; and

(F) Description and proof of how input was obtained from consumer and long-term care worker representatives in the development of the curriculum.

(c) Curriculum submitted for the core competency section of basic training, called core basic training, as described in WAC 388-112A-0320, must include how much time students will have to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill.

(d) Entities that submit curriculum for the population specific component of the seventy-hour long-term care worker basic training must submit their own list of competencies and learning objectives used to develop the population specific basic training curriculum.

(((5)))(7)For specialty training:

(a) For specialty training that is not the DSHS developed curriculum or another department approved specialty training curriculum, submit the required specialty training application form and any additional learning objectives added to the competency and learning objectives checklist, the enhancements that have been added, and additional student materials or handouts.

(b) To be approved, an alternative curriculum must at a minimum include:

(i) All the DSHS published learning outcomes and competencies for the course;

(ii) Printed student materials that support the curriculum, a teacher's guide or manual, and learning resource materials such as learning activities, audio-visual materials, handouts, and books;

(iii) The recommended sequence and delivery of the material; and

(iv) The teaching methods or approaches that will be used for different sections of the course, including for each lesson:

(A) Learning activities that incorporate adult learning principles and address the learning readiness of the student population;

(B) Practice of skills to increase competency;

(C) Feedback to the student on knowledge and skills;

(D) An emphasis on facilitation by the teacher; and

(E) An integration of knowledge and skills from previous lessons to build skills;

(v) A list of the sources or references, if any, used to develop the curriculum;

(vi) Methods of teaching and student evaluation for students with either limited-English proficiency, learning disabilities, or both; and

(vii) A plan for updating material((; and)).

(((6)))(8) Substantial changes to a previous approved curriculum must be approved before they are used.

An instructor for core basic, population specific, on-the-job, residential care administrator, nurse delegation core, and nurse delegation specialized diabetes trainings must meet the following minimum qualifications:

(1) Twenty-one years of age;

(2) Has not had a professional health care, adult family home, assisted living facility, or social services license or certification revoked in Washington state; ((and))

(3) Meets one or more of the following education or work experience requirements upon initial approval or hire:

(a) Is a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting;

(b) Has an associate degree or higher degree in the field of health or human services and six months professional or caregiving experience within the last five years in a community based setting or an adult family home, enhanced services facility, assisted living facility, supported living through the developmental disabilities administration (DDA), or home care setting; or

(c) Has a high school diploma or equivalent and one year of professional or caregiving experience within the last five years in an adult family home, enhanced services facility, assisted living, supported living through DDA, or home care setting;

(4) Meets one or more of the following teaching experience requirements:

(a) One hundred hours of experience teaching adults in an appropriate setting on topics directly related to basic training or basic training topics that may be offered as continuing education;

(b) Forty hours of teaching basic training while being mentored by an instructor who is approved to teach basic training; or

(c) Instructors with adult family homes, enhanced services facilities, and assisted living facilities ((that))who do not ((meet the criteria))have the experience described in (a) or (b) of this subsection, must have and attest to the following experience and plans in their application:

(i) Forty hours of informal teaching experiences unrelated to basic training topics such as guest lecturing, team teaching, and volunteer teaching with parks, local high schools, 4-H groups, English as a second language (ESL) groups, senior organizations, and religious organizations;

(ii) Three adult learning techniques that the instructor will implement in his or her long-term care worker training; and

(iii) Three ways the instructor plans on improving his or her instructional ((facilitation))skills and the method the instructor will use to measure improvement such as submitting the continuous improvement plan feedback from the DSHS adult education class;

(5) Except for instructors for nurse delegation core and diabetes training, completion of a class on adult education that meets the requirements of WAC 388-112A-1297;

(6) The instructor must be experienced in caregiving practices and ((capable of demonstrating))demonstrate competency ((with respect to))for teaching the course content or units being taught;

(7) Instructors who will administer tests must have experience or training in assessment and competency testing;

(8) Community instructors for nurse delegation core and diabetes training must have a current Washington registered nurse (RN) license in good standing without practice restrictions; and

(9) Facility instructors must be approved and contracted by the department as a community instructor in order to be approved to teach the following classes:

(a) Nurse delegation core;

(b) Nurse delegation diabetes training; or

(c) DSHS adult education training curriculum.

(1) The minimum qualifications for community instructors for mental health specialty training, in addition to the general qualifications in WAC 388-112A-1240 (1) and (2), include:

(a) The instructor must be experienced in mental health caregiving practices and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education, or accredited college classes, in subjects directly related to mental health, including, but not limited to, psychology (one year of education equals twenty-four credits in a semester system, thirty-six credits in a quarter system, or at least eighty hours of seminars, conferences, and continuing education); and

(ii) Successful completion of the mental health specialty training class before the instructor trains others;

(c) Work experience: Two years full-time equivalent direct work experience with people who have a mental illness; and

(d) Teaching experience:

(i) Two hundred hours experience teaching long-term care related subjects;

(ii) Successful completion of an adult education class that meets the requirements of WAC 388-112A-1297;

(iii) Successful completion of the DSHS instructor qualification/demonstration process; and

(iv) The instructor has been approved and contracted by the department as a community instructor;

(e) Instructors who will administer tests must have experience or training in assessment and competency testing; and

(2) Five years of full-time equivalent direct work experience with people who have a mental illness may substitute for either:

(a) The credential described in subsection (1)(b)(i) of this section; or

(b) The one year of education in college classes or eighty hours in seminars, conferences, continuing education described in subsection (((1)(b)(ii)))(1)(b)(i) of this section.

(3) If your status is an approved instructor for mental health specialty training, you may instruct a new mental health specialty training curriculum after submitting to the department a copy of a certificate of completion for that curriculum and a copy of a certificate of completion of an adult education class that meets the requirements of WAC 388-112A-1297.

(1) The minimum qualifications for instructors for dementia specialty, in addition to the general qualifications defined in WAC 388-112A-1240 (1) and (2) include:

(a) The instructor must be experienced in dementia caregiving practices and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education or college classes, in dementia or subjects directly related to dementia, such as, but not limited to, psychology (one year of education equals twenty-four credits in a semester system, thirty-six credits in a quarter system, or at least eighty hours of seminars, conferences, or continuing education); and

(ii) Successful completion of the dementia specialty training, prior to beginning to train others;

(c) Work experience: Two years full-time equivalent direct work experience with people who have dementia;

(d) Teaching experience:

(i) Two hundred hours experience teaching long-term care related subjects;

(ii) Successful completion of an adult education class that meets the requirements of WAC 388-112A-1297;

(iii) Successful completion of the DSHS instructor qualification/demonstration process; and

(iv) The instructor has been approved and contracted by the department as a community instructor; and

(e) Instructors who will administer tests must have experience or training in assessment and competency testing.

(2) Five years of full-time equivalent direct work experience with people who have dementia may substitute for either:

(a) The credential (bachelor's degree, registered nurse, or mental health specialist) described in subsection (1)(b)(i) of this section; or

(b) The one year of education in college classes or eighty hours in seminars, conferences, continuing education described in subsection (((1)(b)(ii)))(1)(b)(i) of this section.

(3) If your status is an approved instructor for dementia specialty training, you may instruct a new dementia specialty training curriculum after submitting to the department a copy of a certificate of completion for that curriculum and a copy of a certificate of completion of an adult education class that meets the requirements of WAC 388-112A-1297.