Uniform Employment Application for Nurse Aide Staff

(a) The application described in OAC 310:2-15-3 is required for use pursuant to Title 63 O.S. Section 1-1950.4. (b) The uniform employment application shall be used in the hiring of nurse aide staff by a nursing facility or a specialized facility as such terms are defined in the Nursing Home Care Act, a residential care home, as such term is defined by the Residential 1 June 25, 2007 OAC 310:002 OKLAHOMA STATE DEPARTMENT OF HEALTH Care Act, an assisted living center as such term is defined by the Continuum of Care and Assisted Living Act, a continuum of care facility as defined by the Continuum of Care and Assisted Living Act, a freestanding hospice or program providing hospice services as such terms are defined by the Hospice Licensing Act, an adult day care center as such term is defined by the Adult Day Care Act, and a home care agency as defined by the Home Care Act. Such uniform application shall be used as the only application for employment of nurse aides in such facilities on and after January 1, 2001. [63:1-1950.4] (c) The uniform employment application for nurse aide staff requires the following: (1) personal information; (2) employment desired; (3) U.S. military record; (4) prior work history; (5) educational background; (6) certification; (7) references; (8) background information; (9) applicant’s employment application certification and agreement; (10) (11) previous certified nurse aide training; (12) applicant's signature certifying no previous conviction and authorizing criminal history record checks; and (13) Any additional information needed to answer all questions fully. 2 June 25, 2007