California Nursing Home Administrator License Requirements

What it takes to become a licensed nursing home administrator in California: the seven routes, the Administrator-in-Training (AIT) program, the NAB and state exams, CE, renewal, fees and preceptors, with section numbers from the official sources listed below.

nhaexamprep.com · updated September 2026

California at a glance

Who licenses	CDPH’s Nursing Home Administrator Program (NHAP), in the Center for Health Care Quality, Licensing and Certification Program, set up by HSC 1416.1
Basic requirements	18 or older, a U.S. citizen or legal resident, “reputable and responsible character”, and one of seven education and experience routes (HSC 1416.22(a))
AIT requirement	At least 1,000 hours on five of the seven routes. None on the master’s route (a 480-hour internship instead) or reciprocity. Partial waivers are possible (HSC 1416.22(c))
National exams	NAB Core of Knowledge + NHA Line of Service (HSC 1416.20(b)); $480 for the two, paid to NAB
State exam	Required: written, in person, two hours, offered at least four times a year; 75 percent to pass (HSC 1416.34(a)(1); NHAP page) Details ↓
Continuing education	40 hours per two-year license, at least 10 in aging or patient care (HSC 1416.50(c))
License renewal	Every 24 months from your own issue date (HSC 1416.42(a)); $814 on time (fees effective July 1, 2025)
Official sources	cdph.ca.gov (NHAP) · HSC Chapter 2.35 · 16 CCR Division 31 (mirror) · nabweb.org (national exams)

Verified against the sources above, September 2026. Requirements change; the current statute and rules, as applied by CDPH’s Nursing Home Administrator Program, govern, so confirm with NHAP before you apply.

Who licenses you, and the seven routes

California licenses administrators through a health department program, not a separate licensing body: the Nursing Home Administrator Program (NHAP) of the California Department of Public Health (CDPH), set up by HSC 1416.1. The law is the Nursing Home Administrators’ Act, HSC 1416 to 1416.86. Contact: NHAP@cdph.ca.gov, (916) 552-8780, P.O. Box 997416, MS 3302, Sacramento, CA 95899-7416.

Acting as an administrator without a license is a misdemeanor (HSC 1416.6(a)). The NHA regulations are in Title 16, Division 31 of the California Code of Regulations (3100 to 3180, several sections repealed). They predate the 2001 Act; where the two differ, the statute governs. Title 22, Division 5 holds the facility rules, not the license rules.

Beyond the basics in HSC 1416.22(a) (see the table above), NHAP requires the written state exam and the online national exam, a Live Scan criminal history review (HSC 1416.26), the fees, and compliance with any support orders (1416.30).

The routes, HSC 1416.22(a)(1) to (7)

Route	What you need	AIT
(1) Master’s	A master’s in nursing home administration or a related health administration field, with an “internship or residency of at least 480 hours” in a skilled nursing or intermediate care facility	None
(2) Reciprocity	A current valid license in another state, plus the California education standard in force when you were first licensed (a bachelor’s degree if first licensed on or after July 1, 1980)	None
(3) Physician	A doctorate in medicine and a current valid physician and surgeon license	1,000 hours
(4) Bachelor’s	A bachelor’s degree	1,000 hours
(5) Registered nurse	A current RN license and 10 years of recent full-time RN work, the last 5 in a “supervisory or director of nursing position”	1,000 hours
(6) Facility experience	10 years full time in any department of a skilled nursing, intermediate care or ICF/DD facility, the last 5 as a department manager, plus 60 semester (90 quarter) units	1,000 hours
(7) Hospital administration	10 years full time in acute-care hospital administration, the last 5 supervisory, plus 60 semester (90 quarter) units	1,000 hours

NHAP’s AIT form, CDPH 502 (November 2022), lists only the bachelor’s, RN and facility experience routes; the statute (1416.22, 1416.55(d)) and NHAP’s page list all five AIT routes, and the statute governs. A separate religious education waiver (HSC 1416.23) covers members of a 501(c)(3) church running a faith-based SNF: a high school diploma or GED, 10 years of work and the full AIT, for a license limited to that church’s facilities.

The AIT requirement in California

On routes 3 to 7 you complete a “program-approved AIT Program of at least 1,000 hours” (HSC 1416.22(a)(3) to (7)), which NHAP describes as a “1,000-hour training program prepared by the applicant’s preceptor”. The master’s route (with its own 480-hour internship) and reciprocity need no AIT.

Cutting the hours: partial waivers

NHAP “may accept a waiver exception to a portion of the AIT Program” when you and your preceptor give “compelling evidence” that your prior work relates directly to an administrator’s duties (HSC 1416.22(c)). You ask on CDPH 507, Modification of AIT Hours Request, on grounds of education or work experience. The form sets no maximum, and “Requests for reduction in hours will NOT be accepted after the second quarter of training.” Holders of the religious education waiver cannot use it.

How the AIT runs

• Approval first. Apply on CDPH 502 with 502C (preceptor information), 502B (employment history, if needed), 502A (only for the religious education waiver), your preceptor’s week-by-week 1,000-hour outline, Live Scan (BCIA 8016), ID and transcripts; the fee is $439. Allow “approximately 30 days”: “AIT training does not start until the NHAP issues an approval letter.” The regulation asks for the application at least 30 days before your start date (16 CCR 3161(b)).
• 20 to 60 hours a week of direct supervision (HSC 1416.57(f)(2)(A)). By our arithmetic, that is roughly 17 to 50 weeks.
• Your preceptor is the designated administrator of the training facility, and supervises no more than two AITs at once.
• Reports. Evaluations are due “within 10 days of completing each quarter, or every 250 hours”.
• Changes. Changing preceptor or facility, permanently changing your weekly hours, or a hold over two weeks needs NHAP approval first; shorter holds do not. The program runs continuously except for approved absences, and resuming needs approval (16 CCR 3162(d), (e)).

The 19 areas in the statute

Your preceptor’s outline must cover these areas of instruction, HSC 1416.55(a) (labels shortened):

1. Orientation
2. Administration and business office
3. State and federal regulations
4. Residents’ rights and abuse prevention
5. Staffing and workforce retention
6. Nursing services
7. Activities
8. Resident care
9. Social services
10. Dietary
11. Environmental care
12. Financial management
13. General management
14. Government regulations
15. Legal management
16. Personnel and training
17. Consultants and contracts
18. Medical records
19. Public relations and marketing

Who can be your preceptor

Under HSC 1416.57 and NHAP’s preceptor page, a preceptor holds a current, active California NHA license with no pending discipline; has at least 2 years as the designated administrator, or 4 as the designated assistant administrator, of a California licensed nursing home; has experience in all administrative functions; has run facilities with a history “free from major deficiencies”; and has attended NHAP’s preceptor training seminar. Certification is “valid for two years from issuance date” (CDPH 516, revised February 2024), renewed by attending the training again, and costs $250. 16 CCR 3160(b) says three years; the statute (1416.57(a)) says two and governs.

Other states: AIT Hours by State.

The exams you must pass

California’s licensing exam “shall consist of a state and national examination” (HSC 1416.20(b)). The national part is the two exams from NAB, the National Association of Long Term Care Administrator Boards: NAB’s California page lists “NAB NHA & CORE National: Yes”. Figures from NAB’s exam information page:

Core of Knowledge	125 questions (100 scored, 25 pretest), 150 minutes
NHA Line of Service	75 questions (60 scored, 15 pretest), 90 minutes
Scheduling	Through Pearson VUE, (800) 834-1426, once NHAP approves you: “You will be given 60 days to schedule and take the examination” (NHAP page). NHAP calls it the online national examination
National exams first	Be on file with NHAP and send CDPH 503 with “Request National Exam First” checked (CDPH fee page)
Fee and attempts	$480 for Core and NHA together from February 1, 2026, paid to NAB, not CDPH. Since January 1, 2026, up to 4 attempts per cycle, July 1 to June 30
Passing score	HSC 1416.34(a)(1) requires “a score of at least 75 percent” on either the national or state exam. NAB reports its exams as a scaled score from 50 to 150 and designates 113 as passing; ask NHAP how it applies the 75 percent rule to a NAB score
Passed elsewhere	With an endorsement showing at least 75 percent on the national exam, you take only the California state exam (HSC 1416.20(c))

More in NAB Exam Format and The Core Domains Explained.

The California state exam

CDPH gives it no brand name. NHAP’s page calls it the “written state examination”, and you apply on CDPH 503 after the AIT, or CDPH 524. By law the licensing examination, state and national parts together, “shall cover the broad aspects of nursing home administration” (HSC 1416.20(a); 16 CCR 3120).

Format	Written, taken in person. NHAP sends a confirmation letter and email with the date and time, and NHAP staff start checking in test takers “45 minutes before the examination”
Time	“Test takers have two (2) hours to complete the examination” (NHAP page)
How often	“At least four times a year” (NHAP page; HSC 1416.20(b))
Filing	The statute requires the complete package to be received at least 30 days before the exam (HSC 1416.24(b)); NHAP’s exam page says it must be postmarked by the final filing date, and later applications roll to the next exam. The application is “valid for only one year after the date of receipt” (1416.24(d))
Passing score	“At least 75 percent” (HSC 1416.34(a)(1))
Results	By email, not by phone, “not to exceed 90 days from the date of the examination” (HSC 1416.34(c))
Retakes	A failed exam is retaken in full (1416.34(a)(2)); the second and third attempts cost $622 each (CDPH 520). After three failures you must complete NHAP-approved retraining, $439 (CDPH 526), which the statute describes as additional training “from a program-approved preceptor” (1416.34(a)(3))
Fee	$1,540 bundled with CDPH 503 or 524 (fees effective July 1, 2025)

Exam security. You sign a security agreement (HSC 1416.32(a)). “Divulging the content of specific written examination items to examination preparation providers” is grounds to deny or revoke a license (1416.32(b)(3)), and subverting the exam is a misdemeanor (1416.32(c)). So please do not send anyone questions you remember from the exam.

What the state exam covers

CDPH’s pages list no content outline, study guide or reference list for the state exam. The firmest pointer is the AIT curriculum, which must cover “State and federal regulations governing long-term care facilities” (HSC 1416.55(a)(3)).

No official outline. CDPH publishes no question count or topic list for the state exam, so ask NHAP (NHAP@cdph.ca.gov) what it covers.

Our suggested reading list, all public primary text: Title 22, Division 5, Chapter 3 (skilled nursing facilities, 72001 and following), Chapter 2.5 (the certified nurse assistant program) and Chapter 4 (intermediate care facilities); HSC Chapter 2.35 (your license), HSC 1276.65 (staffing) and HSC Chapter 2.4 (1417 and following, citations); and 42 CFR Part 483.

Where the California rules differ from the federal rules

Four places where the California text differs from the federal requirements in 42 CFR Part 483:

Topic	Federal rule (42 CFR 483)	California rule	Section
Nursing staff hours	Staff in “sufficient numbers” (483.35(a)(1)); an RN “for at least 8 consecutive hours a day, 7 days a week” (483.35(b)(1)). No numeric hours per resident day: the 2024 minimums (3.48 total nurse staffing hours per resident day and an RN on site 24/7) were repealed by an interim final rule (90 FR 55687) published December 3, 2025, effective February 2, 2026	At least 3.5 direct care service hours per patient day in a freestanding SNF, of which at least 2.4 by certified nurse assistants, since July 1, 2018. A waiver of the 3.5 or 2.4 hour requirement is possible if the facility still meets 3.2 nursing hours per patient day (the HSC 1276.5 measure, which for skilled nursing facilities counts actual hours worked, without doubling RN or LVN hours), with notice of a pending or approved waiver posted in the facility	HSC 1276.65(c)(1)(B), (C); 22 CCR 72329.2(c); HSC 1276.5
The administrator	“Licensed by the State, where licensing is required” (483.70(d)(2)(i)); Part 483 sets no limit on how many facilities one administrator may run	One administrator may run more than one SNF only if the facilities are in the same geographic area, “within one hour surface travel time of each other” and run by the same governing body; the administrator “shall not be responsible for more than three facilities or a total of no more than 200 beds” and must name a responsible adult in each facility	22 CCR 72513(a)
Reporting abuse	“Not later than 2 hours” if the events involve abuse or result in serious bodily injury, otherwise within 24 hours, to the administrator and the State Survey Agency (483.12(c)(1)); suspected crimes also go to the State Agency and law enforcement within 2 hours if there is serious bodily injury, otherwise 24 hours (483.12(b)(5), section 1150B)	Alleged or suspected abuse goes to CDPH “immediately, or within 24 hours”; WIC 15630 adds a separate track: a verbal report to local law enforcement within two hours, then written reports within 24 hours to the ombudsman, law enforcement and the licensing agency, with a narrower path for some resident-to-resident abuse involving dementia	HSC 1418.91; WIC 15630
Nurse assistant training	“No less than 75 clock hours”, with at least 16 hours of supervised practical training (483.152(a)(1), (a)(3))	“At least 60 classroom hours” plus at least 100 hours of supervised clinical practice: 160 in all	HSC 1337.1

California: HSC, WIC and 22 CCR, mirrors of the official text; CDPH AFL 18-17 confirms the July 1, 2018 start. Federal: eCFR, September 2026. The 3.5 figure is in HSC 1276.65; HSC 1276.5 still sets 3.2 nursing hours per patient day, the floor a waiver must keep. 22 CCR 72329.1 still prints shift ratios, but CDPH says they “did not become operational” (AFL 09-47).

Figures worth knowing, with their conditions

• HSC 1276.65(c)(1)(B), (C)Direct care service hours per patient day in a freestanding SNF, since July 1, 2018, at least 2.4 of them by certified nurse assistants: 3.5
• 22 CCR 72329.2(c); HSC 1276.5Nursing hours per patient day a facility must still meet under a waiver of the 3.5 or 2.4 hour requirement (actual hours worked, with no doubling of licensed nurse hours), with notice of the waiver posted in the facility: 3.2
• 22 CCR 72541; 72513(e)Unusual occurrences (epidemics, poisonings, fires, major accidents, unnatural deaths) to the local health officer and CDPH; the administrator reports by telephone: within 24 hours
• HSC 1416.12; 1424Citations CDPH must report to NHAP, from the state classes AA, A and B: every class AA citation, and three class A citations at one facility under the same administrator within one calendar year
• HSC 1416.6(b)(2), (3)An acting administrator notifies NHAP in writing within 5 days, must have at least 8 hours a week of onsite supervision by a licensed administrator after 10 days, and needs NHAP’s written approval after two months; the longest NHAP can approve: 6 months
• HSC 1253.3No acquiring an ownership interest in, operating or managing an SNF before CDPH review, approval and license: for applications submitted after July 1, 2023

State NHA Exams Explained covers how state exams work in general.

Where to find an AIT program or preceptor in California

Ask NHAP for the preceptor list. CDPH keeps a current list of approved preceptors but does not post it. Email NHAP@cdph.ca.gov and ask for the list for the counties where you want to train (NHAP page).

There are no AIT programs to enroll in. A California AIT is a preceptor-led placement that NHAP approves in a specific facility (HSC 1416.55(b); 1416.2), so you are looking for a preceptor and a facility willing to take you.

State associations: California Association of Health Facilities (CAHF) · LeadingAge California. CAHF runs the Nursing Home Leader Academy, a nine-month leadership program in which participants can earn up to 60 CEs, counting its included events; it is not an AIT. Neither site lists AIT placement, preceptor matching or exam prep, but member facilities may host AITs, and association staff may know preceptors.

For the full step-by-step on approaching facilities and preceptors, see How to Find an AIT Preceptor and an Approved Program.

Continuing education and renewal

A license “shall expire 24 months from the date of issuance” (HSC 1416.42(a)), so there is no single statewide renewal date. NHAP mails the renewal form, CDPH 512, “approximately sixty (60) days prior” to expiration, and you file “at least 30 days prior to the expiration” (1416.42(b)). At renewal you choose active or inactive.

• 40 hours of approved CE per two-year license, “at least 10 total hours shall be specifically in the area of aging or patient care” (HSC 1416.50(c)).
• Approved subjects: resident care, personnel, financial, environmental, regulatory, organizational, patient care and aging (1416.50(d)).
• Providers: NHAP-approved, or approved by NAB’s National Continuing Education Review Service (NCERS). NCERS certificates go to NAB’s registry, so there is nothing to mail (NHAP page). According to a June 2024 notice circulated by CAHF, NHAP stopped approving new CE providers and courses on July 1, 2024.
• Credit caps per two-year period: teaching up to 16 hours; precepting 1 hour a week, up to 20; college courses 15 hours per semester unit (16 CCR 3151).
• Inactive licenses need no CE, and the holder cannot practice. To reactivate, show 40 hours from the last two years (HSC 1416.48).

Late renewal. A delinquency fee applies if NHAP has not received your renewal “one day after the license expires” (1416.42(c)): $1,002 in all, against $814 on time. You may not work on an expired license (1416.45). A lapsed license “may be reinstated within three years following the date of expiration” (1416.42(d)); after that it is canceled and you would need to qualify again, so ask NHAP about the path.

Licensed in another state: reciprocity and the provisional license

California has no separate license by endorsement. Out-of-state administrators apply on the reciprocity route, CDPH 524: a current valid license, the California education standard in force when you were first licensed (1416.22(a)(2)), and a pass on the California state exam. The national exam endorsement rule above applies (1416.20(c)).

Provisional license (HSC 1416.40). If you hold a current license in another state and have worked as a licensed administrator “within the last five (5) years”, NHAP can issue a one-time, one-year provisional license so you can work in a California facility while you complete the state exam. It is not issued until your background check clears, you must pass the state exam within the year, and it “may not be renewed or extended” (1416.40(e)). The bundled fee is $2,772 (CDPH 525).

What it costs

CDPH’s fees effective July 1, 2025. Check CDPH’s fee page for the current fee before you pay.

AIT application	$439 (CDPH 502)
Licensing exam after the AIT, bundled	$1,540 (CDPH 503)
State exam on the master’s or reciprocity route, bundled	$1,540 (CDPH 524)
Provisional license, bundled	$2,772 (CDPH 525)
State exam, second and third attempts	$622 (CDPH 520)
AIT retraining after three failures	$439 (CDPH 526)
Renewal, active or inactive: on time / late	$814 / $1,002 (CDPH 512)
Preceptor certification	$250 (CDPH 516)

Fingerprinting is $32 to the state Department of Justice and $17 to the FBI, plus the Live Scan vendor’s fee.

The rules behind the California license

The legal sources for nursing home administrator licensure in California, and the facility rules cited above.

• StatuteHealth and Safety Code, Division 2, Chapter 2.35: Nursing Home Administrators’ Act (1416 to 1416.86)
• NHA regulations (Justia mirror)16 CCR Division 31, 3100 to 3180
• Licensing programCDPH Nursing Home Administrator Program (NHAP)
• State examCDPH: State Examination
• PreceptorsCDPH: NHAP Preceptor Program
• FeesCDPH: NHAP fees
• Facility rules (Justia mirror)22 CCR Division 5: Chapter 3, skilled nursing facilities (72001 and following)
• National examsNAB: exam information
• Federal rule42 CFR Part 483 (eCFR)

Citations verified against official sources, September 2026. Provided for reference, not legal advice; the current official text governs. Mirrors are labeled where an official public link is not available. NHAP’s page gives the Act as 1416 through 1416.84; the chapter runs to 1416.86, its severability clause.

Common questions