; and (iii) for the purpose of serving temporarily as a nursing assistant, home health aide, personal care aide, psychiatric assistant, mobility assistant, or child care provider in the United States. (D) Competency evaluation and certification (i) In general On completion of the training provided under subparagraph (C), an alien seeking a CARE visa for the purpose of providing direct care for an individual described in section 101(a)(15)(W)(i)(I) shall be evaluated for competency in accordance with the standards applicable to a nurse aide training and competency evaluation program under sections 483.152 and 483.154 of title 42, Code of Federal Regulations (or successor regulations). (ii) Certification If the Secretary of State makes a determination that an alien seeking a CARE visa described in clause (i) has attained competency in accordance with the standards referred to in such clause, the Secretary may certify such individual for a CARE visa. (E) Numerical limitation Not more than 50,000 CARE visas may be issued annually under this subsection. (3) Prohibition The Secretary of State may not issue a CARE visa to any individual who— (A) has not been certified under paragraph (2)(D)(ii) (unless such individual will only be providing direct care to an individual described in subclause (II) or (III) of section 101(a)(15)(W)(i))