Evaluation Worksheet for Certificate		Adult Ed: Personal Care Attendant
SID:	________________________________	Certificate of Completion - 5113
		Effective: Fall 2019
		College Skills
Name:	________________________________	(707) 521-7962

REQUIREMENTS: Complete 0.0 units Adult Ed: Personal Care Attendant - complete 0.0 units Course Description Units Completed In Progress Comments ADLTED 737.1  Personal Care Attendant 1: Basic Care 0.0       ADLTED 737.2  Personal Care Attendant 2: Dementia and End of Life Care 0.0       ADLTED 737.3  Personal Care Attendant 3: Practicum 0.0       ADLTED 730  First Aid, CPR, AED and Bloodborne Pathogens 0.0

	Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.
	Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________ Units in progress:    __________ Total:    __________

Requirements Completed     Pending (work in progress)     Requirements Not Completed

Comments

Date: ________________________   By: ____________________________________________