"Unlicensed assistive personnel" (UAP) is the formal term for the caregivers, aides, and direct support staff who provide most of the day-to-day care in Washington's adult family homes and in-home settings. The term covers nursing assistants, home care aides, and other unlicensed workers who assist with activities of daily living.
The key word is unlicensed — and it's exactly why delegation exists.
What UAPs can do on their own
Without delegation, a caregiver in Washington can perform non-clinical assistance:
- Bathing, dressing, grooming, and toileting
- Mobility support and transfers
- Feeding assistance
- Taking vital signs (recording them for the nurse to interpret)
- Reminding a resident to take medication (though not administering it)
- Documenting observations and reporting to the RN
What UAPs cannot do without delegation
Clinical tasks require RN delegation under Washington law. A caregiver cannot independently:
- Administer medications
- Draw up or give insulin
- Perform wound care or catheter care
- Manage G-tube feedings
- Make clinical judgments about a resident's condition
For a full breakdown of which tasks can and cannot be delegated, see Caregiver Clinical Tasks Allowed Under WA Nurse Delegation.
How delegation expands what a caregiver can do
Delegation is the legal bridge between what UAPs can do on their own and what they can do with an RN. When a registered nurse delegates a task:
- The RN first assesses the patient to confirm the task is safe and appropriate
- The caregiver is trained on the specific task
- The caregiver demonstrates competency
- Delegation is documented and signed
- The RN provides ongoing supervision, at minimum every 90 days
This is why delegation is sometimes described as "task shifting with a safety net." The caregiver gains the ability to administer medications and handle clinical tasks, while the RN retains legal accountability for how those tasks are performed.
The caregiver credentials required in Washington
To receive delegation in Washington, a caregiver must hold an active, unrestricted credential:
- Nursing Assistant Registered (NAR)
- Nursing Assistant Certified (NAC)
- Home Care Aide (HCA)
Plus, the caregiver must have completed core delegation training through a DSHS-approved provider. Insulin delegation adds a Special Focus on Diabetes requirement.
Why this matters for AFH operators
Every adult family home in Washington relies on unlicensed caregivers — and every one of them needs an RN delegator to keep medication administration and other clinical tasks legal. That's not optional. It's WAC 246-840-910.
Working with a professional delegator like Seattle Nurse Delegation means your caregivers get credentialed, trained, and authorized — and your facility stays survey-ready. We handle new caregiver delegation, new medication delegation, and the quarterly supervisory visits that keep everything compliant.
If you're new to how the whole system works, start with RN Delegation Explained.