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FIRST AID AND CPR TRAINING APPLICATION
Word DOC File Available Here

Colorado Department of Human Services (CDHS)
Division of Child Care

Thank you for your interest in offering the required First Aid and CPR training to licensed child care providers in Colorado. To be considered as an approved vendor and listed in Colorado’s Directory of Approved First Aid and CPR Training Vendors, please complete the attached application forms (Form A and Form B) and return to us with all required documentation.

FIRST AID TRAINING for infants, children and adults must cover ALL of the topics listed below with recommended instruction time of 2-½ to 3 hours. Applicants must provide the training curriculum for each of these subjects in addition to the information requested on Form B:
Accident Mgmt/Prevention Drowning Poisoning
Allergic Reactions Ear/Eye/Mouth/Nose Injuries Respiratory Problems
Blood Falls Seizures
Burns Fractures Shock
Choking Head Trauma Stings and Bites
Diabetic Emergencies Neck/Spine Injuries Temperature Extremes

CPR TRAINING for infants, children and adults must meet the following guidelines:

• Training must be conducted in accordance with the most recent Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Guidelines that are updated every 5 years, most recently in 2005.
• Recommended instruction time is 3-4 hours depending on individual needs of the student(s).
• Training must include skills demonstration with life-size/age-appropriate mannequins using a recommended ratio of 1:3 (or less).
• Instructors must be trained to teach the most recent international ECC guidelines in CPR and First Aid and must provide a copy of the certification to the CDHS Division of Child Care. The instructor must submit a copy of the certification for each course they will teach. The certification(s) must include the number of years the certification is valid (issue date and expiration date). The instructor must teach only courses approved by the CDHS Division of Child Care to students requiring CDHS certifications.

UNIVERSAL PRECAUTIONS TRAINING that meets the required minimum of one hour and thirty minutes (1½ hours) of instruction may be included with your first aid/CPR training provided these hours are in addition to the recommended times noted above for first aid training and/or CPR training. It is recommended that trainers obtain the instructional manual, Universal Precautions for Child Care Providers, from the Colorado Department of Public Health and Environment (CDPHE) website at:

http://www.cdphe.state.co.us/ps/hcc/univprecautions.pdf

ALL TRAINING MATERIAL SUBMITTED FOR APPROVAL MUST INCLUDE ALL REQUIRED DOCUMENTATION AT THE TIME THE APPLICATION IS SUBMITTED. SUBMISSIONS WILL FIRST BE EVALUATED FOR COMPLETENESS BEFORE BEING REVIEWED FOR CONTENT. INCOMPLETE SUBMISSIONS WILL NOT BE REVIEWED.

Please complete both Form A and Form B and return with all required documentation to:

Debbie Ledsome
Colorado Department of Human Services
Division of Child Care
1575 Sherman Street, 1st Floor
Denver, CO 80203


COLORADO DEPARTMENT OF HUMAN SERVICES
DIVISION OF CHILD CARE
FIRST AID/CPR TRAINING APPLICATION

PLEASE PRINT CLEARLY

DATE _______________________________________________________________________________

NAME & TITLE_______________________________________________________________________

ORGANIZATION_____________________________________________________________________

MAILING ADDRESS__________________________________________________________________

CITY__________________________________________STATE_________________ZIP____________

PHONE (h)__________________________(w)_______________________(fax)___________________
(Please circle the phone number you want listed in the Directory)

E-mail_______________________________________________________________________________

What training is offered?

First Aid?____________CPR?____________Universal Precautions?____________

What is the length of each class?

First Aid __________hours CPR________hours Universal Precautions________hours

What nationally recognized card is issued?

For First Aid____________________ Card is valid for how many years____________________

For CPR________________________Card is valid for how many years____________________

In what counties or area(s) of state is training offered?_________________________________________

Please list names of trainers, card trainer holds, and expiration of their card (attach additional page if necessary):

NAME OF TRAINER CARD TRAINER HOLDS EXPIRATION DATE

__________________________________ _______________________ __________________

__________________________________ ________________________ __________________

__________________________________ ________________________ ___________________
Please include the following documentation with this application:

_____ A training plan /agenda that is a maximum of 4 pages in length that includes
documentation of instruction and length of each class offered

_____ Valid trainer cards for each instructor

_____ Blank copy of card that you issue


FIRST AID TRAINING DOCUMENTATION

Please complete the following index that corresponds to the first aid training curriculum you are enclosing:

SUBJECT/TOPIC
TIME SPENT ON EACH SUBJECT


Accident Mgmt/Prevention

Allergic Reactions

Blood

Burns

Choking

Diabetic Emergencies

Drowning

Ear Injuries

Eye Injuries

Falls

Fractures

Head Trauma

Mouth Injuries

Neck/Spine Injuries

Nose Injuries

Poisoning

Respiratory Problems

Seizures

Shock

Stings and Bites

Temperature Extremes


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