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AGENDA ITEM #5.D.I TATIICP'CALIP'CRNIAc c aDEPARTMENT OF CONSUMER AFFAIRSDATETOFROMREVIEWEDBYBUSINESS, CONSUMER SERVICES, AND HOUSING AGENCY GAVIN NEWSOM, GOVERNORBoard of Vocational Nursing and Psychiatric Technicians2535 Capitol Oaks Drive Suite 205, Sacramento, CA 95833-2945www.bvnpt.ca.govAugust 21, 2020 Board Members Education and Practice Committee Executive Officer Review Education and Practice Committee Executive Officer SNECMarie Cordeiro, MN, RNSupervising Nursing Education Consultant (SNEC)PREPARED Faye Silverman, MSN/Ed., RN, PHN, WOCNBYNursing Education Consultant (NEC)PROGRAMGurnick Academy of Medical Arts, San Mateo, Vocational NursingProgram – Consideration of Placement on Provisional Status (Director: Dr.Larisa Revzina, San Mateo, San Mateo County -Private)Addendum to Education and Practice Committee Report (July 27,2020)PROGRAM REQUEST:Gurnick Academy of Medical Arts, San Mateo, Vocational Nursing Program (Program) ispresented to the full Board via the Education and Practice Committee with therecommendation for the program to be placed on provisional approval.BACKGROUND:From April 2018 to present, the program had nine consecutive quarters in which theNCLEX-PN pass rates were below 10 percentage points of the respective averageannual pass rates for the state. This data is non-compliant with the California Code ofRegulations (CCR), Section 2530(l) which states:“The program shall maintain a yearly average minimum pass rate on thelicensure examination that does not fall below 10 percentage points of thestate average pass rate for first time candidates of approved vocationalnursing schools for the same period.”

On July 27, 2020, this program appeared before the Education and Practice Committeevia a Webex meeting. The Committee recommended to accept all of the NEC’srecommendations except for recommendations # 4 and # 6 listed below.Staff strongly recommends the reinstatement of recommendations #4 and #6.Staff Recommendation # 4. Require the program to admit no additional classes withoutprior approval by the Board.Staff Rationale: Admission of additional students, including those that fall within thecurrent pattern of admissions as defined in CCR, title 16, section 2526.1(d) would be adisservice to those students and a potential risk to public safety. The uncertainties of thepandemic create the potential for a lower standard of education, especially in light of thedemonstrated deficiencies, is counter to the goals of the program and to the mission ofBVNPT.At this writing, the assigned NEC has not had the opportunity to discuss causes of andpossible remedies for the non-compliant NCLEX-PN pass rates with the programdirector, and hence .is unable to provide guidance for resolution and a concrete plan torectify the deficiencies. The program director and faculty should be enabled to prioritizedeveloping and implementing their remediation plans, and we believe that the addition ofmore students would detract from that effort. Ongoing admissions, which the Boardapproved for this school on October 10, 2007, would not increase the efficacy andefficiency of the program; instead, it would maintain enrollment in a program from whichmany students would not wholly benefit. The Board’s failure to cease ongoing admissionswill prevent the NEC from ensuring the program’s return to regulatory compliance. This,in turn, creates a long-term risk to public safety.Staff Recommendation # 6. Require the program to provide no less than one instructorfor every ten students in clinical experience.Staff Rationale: When a program exhibits deficiencies with regulatory compliance, it issound educational practice to designate qualified staff to focus on review of problemareas. California Code of Regulations (CCR), Section 2534 (d) states that for supervisionof clinical experience, there shall be a maximum of 15 students for each instructor, whichallows the Board the flexibility to direct the program to field a smaller ratio. Requiring theinstruction and oversight of one instructor for fewer students (10 rather than 15) allowsfor increased depth and breadth of clinical instruction.STAFF ANALYSIS:The NEC is concerned about the removal of recommendations # 4 and # 6 from thereport.The NEC must communicate closely with the program director, and evaluate the followingelements to ensure complete compliance with the following regulations:2

Section 2530(a): Sufficient program resourcesSection 2534: Adequacy of clinical experienceSection 2530(l): Licensure examination pass ratesThe COVID-19 pandemic cannot be underestimated in its effect on every aspect of life,including the education of health care providers. The Board is aware that clinical sites forhealth career students have greatly decreased and in some cases have disappeared.Through no fault of their own, program directors are losing critical clinical sites and areunable to continue with a curriculum that mandates measured clinical experience. Theprograms may not be able to maintain adequate resources and staff. Attempts to rectifyproblems in normal times may be exponentially more difficult during this pandemic.However, this cannot be a reason to treat students unfairly by continuing to admit themto a program that lacks resources and acceptable pass rates.STAFF RECOMMENDATIONS:Please note: These are not NEC decisions, rather the recommendations presented atthe Executive Officer Review, the Education and Practice Committee and/or the fullBoard.1. Place Gurnick Academy of Medical Arts, San Mateo, Vocational Nursing Program onprovisional approval for the two-year period beginning August 21, 2020; and issue acertificate accordingly.2. Issue a notice of change in approval status to the program identifying specific areasof non-compliance and requirements for correction as referenced in Section 2526.1and Section 2530(l) of the California Code of Regulations.3. Require the program to submit an action plan to correct their NCLEX-PN first timetesters pass rate by October 1, 2020.4. Require the program to admit no additional classes without prior approval by theBoard.5. Require the program to submit a report to the Board in six months, no later than March15, 2021, and fifteen months, no later than June 15, 2022. The report must include acomprehensive analysis of the program, timeline for implementation, and the effect ofemployed interventions. The following elements must be addressed in the analysis:a. Terminal Objectivesb. Evaluation of Current CurriculumPlease submit:1- Instructional Plan2- Theory and Clinical Objectives for each Term3- Lesson Plans for each Termc. Student Policies to include:1- Admission Policy3

2- Screening and Selection Policy3- Attendance and Remediation Policy4- Evaluation of Student Achievement5- Credit Granting Policyd. Evaluations of Approved Clinical Facilities which determine adequacy in numberand variety to accommodate current and projected students.e. Evaluations of Theory and Clinical Facultyf. Methodologies for:1- Faculty Meetings2- Clinical Evaluationsg. Evaluations of interventions implemented to increase the program’s annualaverage pass rates.6. Require the program to provide no less than one instructor for every ten students inclinical experiences.7. Require the program to comply with all approval standards in Article 4 of theVocational Nursing Practice Act, commencing at Business and Professionals Code,section 2880, and Article 5 of the Board’s Regulations, commencing at CaliforniaCode of Regulations, Title 16, section 2526.8. Require the program to demonstrate incremental progress in correcting theviolations. If the program fails to satisfactorily demonstrate incremental progress, thefull Board may revoke the program’s approval.9. Place the program on the Board’s August 2022 agenda for reconsideration ofprovisional approval.ALTERNATIVE RECOMMENDATION:Staff strongly recommends reconsidering and approving recommendations #4 and #6.Failing that, staff recommends the following:Require the program to submit documents in final form by the fifteenth day of the secondmonth preceding the month of the Board meeting at which the changes will be considered.For this program, the deadline for the first submission is September 15, 2020. Subsequentsubmissions of documents prior to the start of each class will follow the same guidelines.Documentation must include the following: Current Enrollment TableFaculty SpreadsheetFacility SpreadsheetFaculty Student Clinical Assignment for all TermsMaternity and Pediatric Faculty Student Clinical AssignmentAny other documents requested relative to the following elements:o Sufficient program resources as specified in Section 2530(a)o Adequacy of clinical experience as specified in Section 25344

o Licensure examination pass rates as specified in Section 2530(l)Approval of this recommendation enables the NEC to analyze the program resources andlicensure examination pass rates prior to the admission of a new cohort. The above timeline allows the NEC to bring the program back for further Board action, if necessary, butthis is not the best path forward.This recommendation is supported by California Code of Regulations (CCR), Title 16,Section 2533 (f) of the Vocational Nursing Rules and Regulations, which states:“(f) All curricular changes that significantly alter the program philosophy,conceptual framework, content, objectives, or other written documentation asrequired in Section 2526, shall be approved by the Board prior to implementation.Proposed curricular changes must be submitted to the Board in final form by thefifteenth day of the second month preceding the month of the Board meeting atwhich the changes will be considered. Revisions should include:(1)(2)(3)(4)Explanation of changes;Rationale for proposed revision;Description of revised curriculum materials, and;Changes to behavioral objectives, if applicable.”5

BVNPTBOARD OF VOCATIONAL NURSINGAND PSYCHIATRIC TECHNICIANSBUSINESS , CONSUMER SERVICES ANO HOU NG AGENCY GAVI N NEWSOM . GOVERNORDEPARTMENT OF CONSU MER AFFAIRS BOARD OF VOCATIONALNURSING AND PSYCHIATRIC TECHNICIANS2535 Capitol Oaks Drive , Suite 205, Sacramento , CA 95833P (916) 263-7800 I www.bvnpt.ca.govDATEJuly 27, 2020TOBoard MembersVIAMarie Cordeiro, MN, RNSupervising Nursing Education ConsultantFROMFaye Silverman, MSN/Ed., RN, PHN, WOCNNursing Education ConsultantSUBJECTGurnick Academy of Medical Arts, San Mateo, Vocational NursingProgram – Consideration of Placement on Provisional Status (Director: Dr.Larisa Revzina, San Mateo, San Mateo County -Private)STAFF SUMMARY:In accordance with Section 2526.1(c) of the Vocational Nursing Rules and Regulations,“The Board may place any program on provisional approval when aprogram does not meet all requirements as set forth in this Chapter andin Section 2526 ”Section 2530(l) of the Vocational Nursing Rules and Regulations states:“The program shall maintain a yearly average minimum pass rate on thelicensure examination that does not fall below 10 percentage points of thestate average pass rate for first time candidates of approved vocationalnursing schools for the same period.”Gurnick Academy of Medical Arts, San Mateo, Vocational Nursing Program is presentedto the Board for consideration for placement on provisional approval. This program hasnot been compliant with the licensure examination pass rate regulations for the last ninequarters.STAFF RECOMMENDATIONS:1. Place Gurnick Academy of Medical Arts, San Mateo, Vocational Nursing Program onprovisional approval for the two-year period beginning August 21, 2020; and issue acertificate accordingly.