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Infectious Control 1

Infection control 1

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edward1682
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43 views3 pages

Infectious Control 1

Infection control 1

Uploaded by

edward1682
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NYRequirements.

com
Course and Accreditation provided by CEUFast, Inc.

THIS IS TO CERTIFY THAT

MARY JANE MAGALLANES LADABAN


HAS SUCCESSFULLY COMPLETED

Child Abuse: New York Mandated Reporter Training

New York State Education Department Approved Provider #80870

CONTACT HOURS: 2

CEUFast, Inc. is accredited as a provider of continuing nursing education by the American Nurses
Credentialing Center's Commission on Accreditation.
ANCC Provider number #P0274

The AAFP has reviewed Child Abuse: New York Mandated Reporter Training and deemed it
acceptable for up to 2.00 Enduring Materials, Self-Study AAFP Elective credit. Term of
Approval is from 08/01/2023 to 07/31/2024. Physicians should claim only the credit
commensurate with the extent of their participation in the activity.

03/25/2024

COMPLETION DATE

Julia Tortorice
Julia Tortorice, RN, MBA, MSN, NEA-BC CEO, Lead Nurse Planner CEUfast, Inc.
CERTIFICATE ID

322914

VERIFY AUTHENTICITY

Scan OR code OR visit

nyrequirements.com/verify
Retain this certificate for your records for 4 years. Do NOT send to your licensure board unless requested.
The University of the State of New York
The State Education Department
Certification of Completion
(Coursework/Training in Identification and Reporting of
Child Abuse and Maltreatment)
Updated 2022 to include recent amendments to Social Services Law §413 requiring the addition of Adverse Childhood Experiences
and Trauma, Implicit Bias, and Identification of Child Abuse virtually.
Section I: Trainee Information
Trainee Instructions: Make sure Section I is complete. When you have received this form with a completed Section II from the
coursework or training provider, submit this completed form to the appropriate address at the end of this form. Keep a copy of this
form for your records.
Important Note: Only this completed form can be accepted as sufficient documentation by the Department that you have completed
the required coursework or training. It is your responsibility to ensure all of the appropriate documentation has been received by the
Department (especially in the case of providers that submit certifications to the Department electronically). Failure to do so will result
in not receiving credit for completion of this coursework or training.
1.
Social Security Number
(Leave this blank if you do not have a U.S. Social Security Number)
2. Print Name
Last
LADABAN
First
MARY JANE
Middle
MAGALLANES
3..
Birth Date
OCTOBER 19,1987
4. Telephone/Email Address Daytime Phone
Home or Business +63-9566321679
Licensee business address, phone and email address are public information. Failure to indicate business or home on this form for each item will deem it
public information.
5. Mailing Address
Home or 30-A MABILIS ST. PINYAHAN QUEZON CITY
Business
(You must notify the Department within 30 days of any address or name changes)
Line 1
Area Code +63-9566321679
Phone
Email Address (please print clearly) Home or Business
Line 2 [email protected]
Line 3
City: QUEZON CITY
State Country/ Province: PHILIPPINES
ZIP Code 1100
6. New York State DMV ID Number (Driver or Non-Driver ID)
(Leave this blank if you do not have a New York State DMV ID Number)
7. If you currently hold or are applying for professional licensure, permit or a teacher certification in New York State,
list in what profession(s) or certificate title(s) here: NURSE
8. I hereby attest that the information provided in Section I of this form is true, complete and correct.
Signature
Date
Section II: Certification by Approved Provider
Provider Instructions: Complete Section II. Submit this form to the trainee listed on this form within ten calender days of the
completion of the coursework or training. Important Note: As the provider of this coursework or training, you MUST retain a copy of
the certification of completion provided to this trainee in your files for not less than five years from the date the course was
completed.
Approved Provider Name CEUfast, Inc.
Identification Number
80870
Dates of coursework/training
3/25/2024
Pursuant to Chapter 544 of the Laws of 1988, I certify that the trainee named above has completed the required
coursework or training regarding the identification an reporting of child abuse and maltreatment.
Signature of Authorized Certifying Officer

Julia Tortorice
Date
3/25/2024
If this certification of completion is being submitted in support of an application for New York State Licensure or Permit, Return
Directly to: New York State Education Department, Office of the Professions, Division of Professional Licensing Services, [Be sure to
give name of profession], 89 Washington Avenue, Albany, NY 12234-1000.
If this certification of completion is being submitted in support of an application for reregistration of a New York State license: Make
sure to include this completed form with your reregistration application.
If this certification of completion is being submitted in support of an application for New York State Teacher Certification, Return
Directly to: New York State Education Department, Office of Teaching, 89 Washington Avenue, Albany, NY 12234-1000.
Certification of Completion Form, Revised 8/23

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