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Puerto Rico runs an OSHA-approved State Plan under the Puerto Rico Occupational Safety and Health Act (Act No. 16 of 1975) that adopts the federal standard 29 CFR 1910.151(b): where no infirmary, clinic or hospital is in near proximity, an adequately trained first-aider must be available, with no numeric ratio.

Reglamento 8860 (2016), issued under Ley 173-2016, requires directors and educators at child care centers in Puerto Rico to hold current CPR and first-aid certifications, valid for 2 years and overseen by the Department of the Family (Licensing Office).

Puerto Rico's Good Samaritan Act (Act No. 139 of June 3, 1976, as amended by Acts 182-2012 and 62-2021) grants civil-liability immunity to those who voluntarily and gratuitously render emergency aid, except in cases of gross negligence or willful misconduct.

In Puerto Rico the Junta Examinadora de Enfermería (Department of Health / ORCPS) requires 30 contact hours of accredited continuing education per triennium (3 years) to renew a nursing licence, and healthcare-provider CPR/BLS counts as an eligible accredited activity.

Establishments for the care of the elderly in Puerto Rico are overseen by the Department of Health under the CNA/HHA model, where a valid CPR certification is a mandatory credential in addition to occupational training and must be renewed periodically.

Foster-home certification in Puerto Rico is administered by the Departamento de la Familia under the framework of the Family First Prevention Services Act, and a Certificado de Primeros Auxilios (first-aid certificate) is expressly among the requirements and must be kept current.

Online CPR and first aid training is recognized in Puerto Rico, with OSHA's First Aid Best Practices guidance accepting an online component paired with a hands-on skills evaluation.