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CNA Skills Assessment

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Name *

First

Last

Email *

Select one of the following for each section - A: No Experience, B: Training/Minimal Experience, Needs Supervision, C: Adequate Experience, D: Sufficient Skill To Perform Without Supervision, E: Proficient In Performing Skill *

I Agree

Personal Hygiene *

A
B
C
D
E

Oral Hygiene *

A
B
C
D
E

Denture care *

A
B
C
D
E

Specimen collection *

A
B
C
D
E

Urine *

A
B
C
D
E

Stool *

A
B
C
D
E

Sputum *

A
B
C
D
E

BP *

A
B
C
D
E

Weight *

A
B
C
D
E

Intake and output *

A
B
C
D
E

Measure intake *

A
B
C
D
E

Measure output *

A
B
C
D
E

Nutrition *

A
B
C
D
E

Feeding *

A
B
C
D
E

Signs / Symptoms of dysphagia *

A
B
C
D
E

Dressings *

A
B
C
D
E

Binders *

A
B
C
D
E

Bandages *

A
B
C
D
E

Therapeutic stocking *

A
B
C
D
E

Activity *

A
B
C
D
E

Dangle *

A
B
C
D
E

Assist to chair / commode *

A
B
C
D
E

Ambulation *

A
B
C
D
E

Walker *

A
B
C
D
E

Cane *

A
B
C
D
E

Wheelchair *

A
B
C
D
E

Braces *

A
B
C
D
E

Transfers *

A
B
C
D
E

Weight bearing *

A
B
C
D
E

Non-weight bearing *

A
B
C
D
E

Exercise and positioning *

A
B
C
D
E

Range of motion *

A
B
C
D
E

Bath *

A
B
C
D
E

Bed *

A
B
C
D
E

Shower *

A
B
C
D
E

Tub *

A
B
C
D
E

Backrub *

A
B
C
D
E

Skin / Decubitus care *

A
B
C
D
E

Hair care *

A
B
C
D
E

Bedmaking *

A
B
C
D
E

Unoccupied bed – linen change *

A
B
C
D
E

Turn patient *

A
B
C
D
E

Bowel and bladder elimination *

A
B
C
D
E

Bedpan / Urinal *

A
B
C
D
E

Care of incontinent patient *

A
B
C
D
E

Stoma care (Colostomy / Ileostomy) *

A
B
C
D
E

Bladder / Bowel training *

A
B
C
D
E

Maintenance programs *

A
B
C
D
E

Catheter care - Urinary *

A
B
C
D
E

Closed system *

A
B
C
D
E

Empty drainage bag *

A
B
C
D
E

Perineal hygiene *

A
B
C
D
E

External catheter *

A
B
C
D
E

Care of the dying patient *

A
B
C
D
E

Prosthesis care *

A
B
C
D
E

Limbs *

A
B
C
D
E

Eye *

A
B
C
D
E

Hearing aid *

A
B
C
D
E

Dentures *

A
B
C
D
E

Documentation *

A
B
C
D
E

Recognizes / Reports condition change *

A
B
C
D
E

Isolation *

A
B
C
D
E

Tracheostomy care *

A
B
C
D
E

Blood glucose testing *

A
B
C
D
E

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