All nursing home administrators shall report CEU programs or courses with a “Continuing Education Form” provided by the board by stating the following:
- (a) The name and home address of the nursing home administrator;
- (b) The home phone number of the nursing home administrator;
- (c) The nursing home administrator’s place of employment, employment address, and work phone number;
- (c) The date, topic, and sponsoring organization of course attended;
- (d) Number of CEU clock hours;
- (e) A copy of the certificate of attendance for each course; and
- (f) The applicant’s dated signature attesting that there are no willful misrepresentations in or falsifications of the information provided.
Source. #7663, eff 3-19-02, EXPIRED: 3-19-10 New. #9830-B, eff, 12-10-10; ss #12690, eff 12-19-18