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ADULT DAY HEALTH SERVICES - JOB DESCRIPTION

Department: Adult Day Health / Direct Care Services
Employment Status: Full-Time / Part-Time / PRN
Classification: Direct Care Staff

POSITION SUMMARY

The Certified Nursing Assistant (CNA) provides direct personal care, assistance with activities of daily living, observation, supervision, and supportive services to participants attending the Adult Day Health Center.

The CNA works under the direction and supervision of licensed nursing personnel and center management and provides services according to each participant's Individual Plan of Care, center policies and procedures, assigned duties, training and competency, and applicable requirements.

The CNA is responsible for promoting participant health, safety, dignity, independence, comfort, choice, and participation while promptly reporting changes in participant condition to the Registered Nurse or other appropriate licensed nursing personnel.

The CNA shall not independently perform nursing assessments, diagnose medical conditions, develop nursing plans of care, administer medications, or perform other functions reserved for licensed nursing personnel unless specifically authorized by applicable law and the individual's credentials.

ESSENTIAL DUTIES AND RESPONSIBILITIES

1. Activities of Daily Living

Provide or assist participants with activities of daily living according to their Individual Plan of Care, including:

• Toileting and continence care.
• Personal hygiene.
• Handwashing.
• Oral care.
• Grooming.
• Dressing.
• Eating and drinking.
• Mobility and ambulation.
• Transfers.
• Positioning.
• Wheelchair assistance.
• Rest periods.
• Other assigned personal-care activities.

Encourage participants to perform as much of their own care as safely possible to promote independence and maintain functional abilities.

1. Participant Supervision and Safety

The CNA shall:

• Provide appropriate supervision of assigned participants.
• Maintain awareness of participant locations and activities.
• Protect participants from injury and unsafe conditions.
• Follow participant-specific safety precautions.
• Observe participants identified as fall, wandering, elopement, choking, aspiration, seizure, or other safety risks.
• Immediately report unsafe conditions.
• Never leave participants unattended when supervision is required.
• Follow the participant's Individual Plan of Care and staff instructions.
• Assist the center in maintaining appropriate direct-care staffing coverage.

1. Observation and Reporting

The CNA plays an important role in recognizing changes in participant condition.

The CNA shall observe participants for changes involving:

• Mental status.
• Alertness.
• Behavior.
• Mobility.
• Balance.
• Skin condition.
• Eating and drinking.
• Toileting.
• Bowel or bladder patterns.
• Pain or discomfort.
• Breathing.
• Weakness or fatigue.
• Swelling.
• Falls or injuries.
• Confusion.
• Functional ability.
• Other unusual signs or symptoms.

The CNA shall promptly report significant observations or changes to the RN or other appropriate licensed nursing personnel.

The CNA shall not independently diagnose or treat a participant's medical condition.

1. Vital Signs and Routine Measurements

When trained, competent, assigned, and permitted by center policy, the CNA may obtain and document routine measurements such as:

• Temperature.
• Pulse.
• Respirations.
• Blood pressure.
• Weight.
• Other routine measurements authorized within the CNA's role.

Abnormal findings or significant changes must be promptly reported to licensed nursing personnel.

The CNA shall not independently interpret findings or make clinical treatment decisions.

1. Mobility, Transfers and Positioning

The CNA shall:

• Assist participants with walking and mobility.
• Assist with wheelchair use.
• Assist participants with transfers according to established care instructions.
• Use gait belts or other approved equipment when trained and required.
• Follow participant-specific transfer precautions.
• Assist with repositioning when indicated.
• Encourage safe mobility and independence.
• Use proper body mechanics.
• Request additional staff assistance when a participant requires a two-person transfer or other additional support.
• Never attempt an unsafe one-person lift or transfer.

Any significant decline in mobility or ability to transfer safely must be reported to licensed nursing personnel.

1. Meals, Snacks and Hydration

The CNA shall:

• Assist participants with meals and snacks.
• Set up meals when needed.
• Assist with feeding when assigned and trained.
• Encourage appropriate fluid intake.
• Follow participant-specific dietary instructions.
• Follow identified swallowing and aspiration precautions.
• Observe participants for difficulty chewing or swallowing.
• Immediately respond to and report coughing, choking, difficulty swallowing, or other feeding concerns.
• Document intake when required by the participant's plan.
• Report poor food or fluid intake to licensed nursing personnel.

1. Toileting and Continence Care

The CNA shall:

• Assist participants to the restroom.
• Provide continence care.
• Assist with changing clothing or protective garments when necessary.
• Maintain participant privacy and dignity.
• Follow infection-control procedures.
• Observe and report unusual urine, bowel patterns, diarrhea, constipation, bleeding, pain, or other concerns.
• Document toileting assistance when required.

1. Skin Care and Positioning

The CNA shall:

• Observe exposed skin during routine personal care.
• Assist with positioning and repositioning as directed.
• Keep participants clean and dry.
• Immediately report redness, bruising, swelling, wounds, pressure areas, skin tears, or other skin concerns to licensed nursing personnel.
• Follow established skin-care instructions.

The CNA shall not independently diagnose or treat wounds unless authorized, trained, and acting within the individual's lawful scope of practice.

1. Activities and Social Engagement

The CNA shall:

• Encourage participant involvement in scheduled activities.
• Assist participants traveling to and from activity areas.
• Assist activity staff as needed.
• Provide individual support to participants requiring additional assistance.
• Encourage appropriate social interaction.
• Promote participant choice and independence.
• Observe participant responses to activities.
• Report significant changes in participation or behavior.

1. Medication Safety

The CNA shall follow the center's medication-management policies.

The CNA shall:

• Immediately report medication concerns to licensed nursing personnel.
• Never independently change a participant's medication.
• Never borrow or share participant medications.
• Never conceal a medication error.
• Immediately report suspected medication errors or adverse reactions.

Medication administration or assistance may only be performed when specifically permitted by applicable law, the CNA's credentials and training, and center policy.

When uncertain, the CNA must obtain direction from the RN before performing a medication-related task.

1. Infection Prevention and Control

The CNA shall consistently follow infection-control practices, including:

• Hand hygiene.
• Standard precautions.
• Appropriate use of gloves and other PPE.
• Bloodborne-pathogen precautions.
• Safe handling of bodily fluids.
• Proper disposal of contaminated materials.
• Cleaning and disinfecting participant-care equipment as assigned.
• Following isolation or infection-control instructions provided by licensed nursing personnel.
• Reporting exposure incidents promptly.

1. Participant Rights
2. Documentation

The CNA shall accurately complete assigned documentation, which may include:

• ADL assistance.
• Toileting assistance.
• Food and fluid intake.
• Vital signs.
• Weight.
• Mobility assistance.
• Activity participation.
• Behavioral observations.
• Changes in condition.
• Skin observations.
• Incidents and accidents.
• Daily service documentation.
• Other documentation required by the Individual Plan of Care or center policy.

Documentation must be factual, timely, accurate, complete, and legible.

The CNA shall never falsify, improperly alter, backdate, or intentionally omit required documentation.

1. Emergency Responsibilities

The CNA shall:

• Recognize and promptly report medical emergencies.
• Immediately obtain assistance from the RN or other appropriate personnel.
• Call 911 when directed or when emergency circumstances require immediate emergency assistance.
• Perform CPR and First Aid when trained, certified, and indicated.
• Follow emergency-response procedures.
• Assist with fire, severe-weather, disaster, and evacuation procedures.
• Assist ambulatory and non-ambulatory participants during evacuation according to training and assigned responsibilities.
• Participate in required emergency drills.

1. Transportation and Community Activities

When assigned, the CNA may:

• Assist participants entering and exiting vehicles.
• Assist with wheelchairs and mobility devices.
• Ensure participants are safely seated.
• Assist with participant counts before departure and after arrival.
• Supervise participants during community activities.
• Follow participant-specific safety precautions.
• Immediately report transportation or community-outing incidents.

Participants shall never be left unattended in a vehicle when supervision is required.

1. Communication and Teamwork

The CNA shall:

• Communicate respectfully with participants, coworkers, supervisors, nurses, families, and other professionals.
• Promptly communicate participant concerns to licensed nursing personnel.
• Participate in shift reports and care coordination.
• Attend required staff meetings.
• Follow supervisory instructions.
• Work cooperatively with DSP/Direct Care Staff.
• Maintain appropriate professional boundaries.
• Notify management promptly regarding absences or delays.
• Assist in maintaining safe participant coverage.

MINIMUM QUALIFICATIONS

The CNA must:

• Maintain current certification/registry status as required for the position.
• Meet applicable Georgia Nurse Aide Registry requirements.
• Be qualified by education, training, competency, and experience to perform assigned duties.
• Successfully complete required background and registry screenings.
• Meet applicable pre-employment health requirements.
• Complete required orientation.
• Complete required ongoing staff training.
• Demonstrate competency in assigned participant-care duties.
• Be able to communicate effectively with participants and staff.
• Be able to read, understand, and follow participant care instructions and emergency procedures.

Preferred Qualifications

• High school diploma or GED.
• Previous adult day health, geriatric, long-term care, home health, assisted living, developmental-disability, or direct-care experience.
• Experience assisting individuals with mobility limitations, dementia, chronic health conditions, or disabilities.
• Current CPR and First Aid certification.

PHYSICAL REQUIREMENTS

The CNA position requires the physical ability to safely provide direct personal care and participant assistance throughout the workday, with or without reasonable accommodation.

The CNA must be able to:

• Stand and walk for extended periods.
• Sit, bend, stoop, squat, kneel, reach, turn, and perform repetitive movements.
• Assist participants with toileting, grooming, dressing, hygiene, feeding, and other personal-care activities.
• Assist participants with walking, transfers, positioning, and mobility.
• Push, pull, and maneuver occupied and unoccupied wheelchairs and other mobility equipment.
• Assist participants entering and exiting vehicles when assigned.
• Use hands and fingers effectively for participant care and documentation.
• Respond promptly to falls, medical emergencies, fire alarms, and evacuation situations.
• Perform CPR and First Aid when trained and required.
• Hear participant requests, alarms, emergency announcements, and safety-related communications.
• Observe changes in participant appearance, skin condition, mobility, behavior, breathing, and functioning.
• Assist with emergency evacuation according to the center's emergency plan and assigned responsibilities.
• Work in an environment where exposure to blood, bodily fluids, infectious materials, cleaning products, and other conditions associated with direct personal care may occur.
• Wear required PPE and follow infection-control procedures.

ATTENDANCE AND RELIABILITY

Because the CNA provides direct participant care and may be included in required direct-care staffing coverage, dependable attendance is an essential job responsibility.

The CNA must:

• Report to work as scheduled.
• Arrive on time.
• Remain at the assigned work area unless properly relieved.
• Follow established call-out procedures.
• Notify management promptly of absences or delays.
• Never abandon assigned participants.
• Obtain authorization before leaving the center during an assigned shift.
• Cooperate with staffing assignments necessary to maintain participant safety.

CONFIDENTIALITY

The CNA must protect all participant medical, personal, behavioral, financial, and family information.

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