Evaluation Worksheet for Certificate		Adult Ed: Introduction to Medically Fragile Infant Care
SID:	________________________________	Certificate of Completion - 5105
		Effective: Fall 2018
		College Skills
Name:	________________________________	(707) 521-7962

REQUIREMENTS: Complete 0.0 units Adult Ed: Introduction to Medically Fragile Infant Care - complete 0.0 units Course Description Units Completed In Progress Comments ADLTED 736A  Medically Fragile Infants--Part 1 0.0       ADLTED 736B  Medically Fragile Infants--Part 2 Practicum 0.0       Complete any combination totaling at least 0.0 units from the following: Complete 1 course           Complete any combination totaling at least 0.0 units from the following: ADLTED 730  First Aid, CPR, AED and Bloodborne Pathogens 0.0       ADLTED 734A  Youth in Out-of-Home Care 1 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: ____________________________________________