Becoming a CNA in Washington as an Immigrant: Documents, English, and Eligibility

Washington does not require US citizenship or permanent residence to become a Nursing Assistant-Certified (NA-C or NAC). The state requires completion of an approved 108-hour training program (or another recognized eligibility route), passing a two-part exam that costs $155 in total, and a Department of Health (DOH) application with a background check. What immigrants most often get wrong is not eligibility but paperwork: the training school, the exam vendors, DOH, and your future employer each ask for different documents at different times. This article lays out who asks for what, how much English is genuinely needed, and where immigration status actually matters (employment, not certification).

Four stages, four sets of documents

The pattern is simple: the state certifies competence; the employer verifies work authorization. Keep the two separate in your planning.

Stage 1: Enrolling in a training program

Approved Washington programs must provide at least 108 clock hours (35 theory, 33 skills lab, 40 clinical) under WAC 246-841A-440. At Huduma CNA Programs in Federal Way, the CNA Traditional course runs 4 weeks, costs $1,100 in tuition plus about $105 for books and supplies, and requires:

• A high school diploma or GED. A secondary school completion document from another country generally satisfies this; bring the original and a translation if it is not in English. If you completed secondary school but cannot obtain records, a Washington GED is the fastest replacement.
• Government photo ID. A passport from any country, a US state ID or driver's license, or a permanent resident card all work for identity purposes at enrollment.
• Background check consent before clinical placement. Clinical facilities require it; the school cannot place you without it.
• Health documentation for the clinical site: a recent TB test and immunization records.

Immigrants who already hold an active Washington Home Care Aide (HCA) credential, common among caregivers who started in home care or adult family homes, qualify for the shorter HCA–CNA Bridge (40 hours, $800) instead of the full program.

Stage 2: English, honestly assessed

Washington does not require an English proficiency test score for the NA-C. Instruction at approved programs, including Huduma, is delivered in English, and both exam parts are in English. The question is not whether you can pass an English test but whether you can do four things:

1. Follow classroom instruction and read a textbook written at roughly a high school level.
2. Understand a resident's request and explain what you are about to do, step by step, in the skills test.
3. Read a multiple-choice knowledge test question and eliminate wrong answers.
4. Document care in short written entries.

If reading is your weak point but you understand spoken English well, the Credentia knowledge test is available in an oral format where questions are read aloud. It is still English. See oral CNA exam in Washington for how it works and how to request it.

If you are unsure, a useful test before enrolling: read a page of any nursing assistant textbook. If you understand it without translating more than a few words per paragraph, you are ready. If not, an ESL course focused on healthcare vocabulary before enrollment costs less than repeating the exam.

Stage 3: The exam and the DOH application

The exam has two parts taken in order. Part 1 is the in-person skills test, administered at Huduma for its own graduates, with a $100 fee paid to the test site. Part 2 is the Credentia knowledge test, $55, which you register for only after your skills pass is recorded. Programs must allow at least four skills attempts. Detailed steps are in the Washington NAC exam guide.

The DOH application is where immigrants have the most questions.

Social Security number. The application asks for one because federal law requires states to collect it for professional credentials. If you have never been issued a Social Security number, DOH provides a way to declare that instead of leaving the field blank; an Individual Taxpayer Identification Number is not a substitute and is not required. Do not enter someone else's number or a made-up number; that is a credentialing offense. Our article on CNAs without a Social Security number in Washington goes deeper.

Background check. DOH runs a name-based statewide check. Applicants who have lived in Washington only a short time may be asked for a fingerprint-based check, which takes longer and carries its own fee. Records from another country are generally outside the check's reach, but you must still answer the application's conviction questions truthfully for any country.

Name consistency. Use the exact name on your passport or government ID across enrollment, exam registration, and the DOH application. Naming conventions that differ from US first-name, last-name order cause registry mismatches. If a name on your ID includes multiple surnames, use all of them consistently.

Fees. Application and annual renewal fees are set by the DOH fee schedule; the credential renews on your birthday each year with no continuing education requirement for a standard NA-C.

Stage 4: Employment and work authorization

This is where immigration status matters. Every US employer must complete Form I-9 and verify that you are authorized to work. Acceptable documents include a permanent resident card, an Employment Authorization Document, or a US passport, among others listed on the form. Employers, not DOH, make this determination.

Practical consequences:

• A person with pending status and a valid Employment Authorization Document can be certified and hired.
• A person without work authorization can be certified but cannot be lawfully employed. Certification does not create work authorization.
• Some clinical facilities require the same I-9 documents before a student clinical placement, because students are on the floor with residents. Ask the school before enrolling if this could affect you.

Large employers such as UW Medicine, Harborview, Swedish, Providence, MultiCare, and Virginia Mason Franciscan's St. Francis in Federal Way hire nursing assistants year-round, as do thousands of licensed adult family homes across King and Pierce counties. Many adult family homes are owned and staffed by immigrants, and bilingual nursing assistants are actively sought for residents who share their language. CNA jobs in Washington lists the main employer types.

Timeline and total cost for a typical immigrant applicant

Most applicants with documents ready move from first class to certification in roughly two to three months. The biggest delays come from missing diploma records and name mismatches, both preventable before day one.

Frequently asked questions

Do I need to be a US citizen to be a CNA in Washington? No. Neither the training program, the exam, nor DOH requires citizenship or permanent residence. Employers require work authorization.

My high school diploma is from another country. Is it accepted? Generally yes, with a translation if it is not in English. If you cannot get the records, earn a Washington GED.

Is there a Spanish or other-language version of the CNA exam in Washington? No. Both parts are in English; the knowledge test can be taken orally in English.

Can I train while my immigration case is pending? Yes. Certification does not depend on status. Employment depends on having valid work authorization at the time of hire.

Will DOH share my information with immigration authorities? DOH uses your application to issue a health credential and run a background check. Its conviction questions and identity verification are about public safety, and the application does not ask about immigration status.

How do I know a program is approved? WABON publishes the list of approved nursing assistant programs. Huduma CNA Programs is on it; ask any school for its approval status before paying.

Start by reading the Washington State CNA requirements for 2026, then check the class schedules for the next day or weekend cohort in Federal Way.