3.1 California CNA Scope of Practice
Key Takeaways
- A CNA provides delegated direct care under licensed nurse supervision.
- CNAs observe, assist, measure, record, and report; they do not diagnose or create care plans.
- Medication administration, sterile procedures, catheter insertion, and independent treatment decisions are outside normal CNA scope.
- Facility policy can be more restrictive than state training, so follow both.
- When unsure, stop and ask the nurse before acting.
What A California CNA Does
The CNA role is direct resident care under supervision. You help residents with daily life, collect basic information, protect safety, and report changes to licensed staff.
Typical CNA tasks include:
- Bathing, dressing, grooming, toileting, and feeding assistance.
- Ambulation, transfers, positioning, and range of motion.
- Measuring temperature, pulse, respirations, blood pressure, height, weight, and output.
- Observing skin, mood, appetite, mobility, and comfort.
- Documenting care accurately.
- Reporting changes to the nurse.
Outside CNA Scope
| Outside-Scope Action | Why It Is Not A CNA Task |
|---|---|
| Giving medication | Requires licensed authorization or special medication role |
| Changing oxygen flow | Requires order and licensed judgment |
| Diagnosing infection | Diagnosis is not CNA scope |
| Inserting a catheter | Invasive procedure |
| Sterile dressing change | Sterile technique and nursing judgment |
| Creating care plan | Requires licensed assessment |
| Teaching new medical instructions | Licensed staff responsibility |
Scope On The Exam
Many wrong answers are outside scope. The CNA may notice a change, report it, keep the resident safe, and provide routine care. The CNA does not independently treat a new condition.
Example: a resident has new swelling in one calf. The CNA should report it to the nurse, not massage the calf, apply heat, or tell the resident it is probably a muscle strain.
When Delegated A Task
Before accepting a task, ask:
- Is it allowed for a CNA?
- Have I been trained and checked off?
- Is the resident condition stable enough?
- Were instructions clear?
- Is help available if needed?
A professional refusal is appropriate when a task is unsafe, outside scope, or outside training. Use the chain of command rather than arguing.
Which task is outside normal CNA scope?
A resident has sudden one-sided weakness. What should the CNA do?