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Nevada Assisted Living Leadership Day Attestation Form
Today's Date
(Required)
MM slash DD slash YYYY
First Name
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Last Name
(Required)
Facility Name
(Required)
Email
(Required)
Number of CEU Credit Hours
(Required)
Format:
Up to five (5) CEUs
CEU's Requested
(Required)
BELTCA
NSBN
BELTCA Administrator ID Number (if applies)
(Required)
NSBN License Number (if applies)
(Required)
Attestation Statement
(Required)
Yes
By selecting 'Yes' above, you hereby attest that all information entered above is accurate as related to the number of hours attended during this training event.
Event Survey
Please evaluate the Agenda and Speakers below:
Evaluate the Overall Agenda and Timing
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Evaluate the Event Location: Las Ventanas of Summerlin
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Additional Feedback - Event Location
Evaluate the Event Date: March 6, 2026
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Additional Feedback - Event Date
Please select your Top 3 Speakers
Choose three (3)
(Required)
LaShuan Bethea, National Center for Assisted Living
Albert Ruiz, Department of Public Safety
Jen Bruning, Incite Strategic Partners
Shauna Kapsner, Care Providers of Minnesota
Johna Rusch and Terri Buster, Nevada Health Authority
Listed by the order they appeared
Please select your Top 3 Speaking Topics
Choose three (3)
(Required)
What Assisted Living Leaders Need to Know: A National NCAL Update
Understanding Fire Safety Inspections at an Assisted Living Facility
Boom Goes the Dining Room: Updating Dining Programs for A New Generation
Personal Leadership and the Leadership System - A Key To Leading A High-Performing Organization
Top 10 Citations, Regulatory Updates and General Q&A
Listed by the order they were presented
Please select Topics you would like to see in the next convention
Choose as many topics
(Required)
Medication Management and Administration
Disease Management
Mental and Behavioral Health
Compliance Programs
Employee Satisfaction, Engagement, and Retention
Federal Codes and Legislation
Facility Management and Environmental Services
Quality Assurance and Performance Improvement
Regulatory Survey and Inspection Process
Other
list below:
Additional Feedback - Other topics
Please enter any additional comments about the agenda, speakers, or topic relevancy
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