As stated, your English skills need to be good enough for you to take the course, read the book, understand what is being taught, and be able to successfully pass the tests.
As a general requirement, your English does not have to be the best. There will be some facilities that might not take you if they don't believe your English is good enough. It's not a requirement for the CNA (other than being able to pass the course). But, some nursing homes or hospitals may have their own rules about hiring people who are not as strong in English as they might want.
I cannot make a generalization. Go for it and try it out!
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