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SAN J O A Q U I Nnvirronrnental Health Department <br /> COUNTY — <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following requrmmenfs are outhned in the Corta;;e Foal Opetnttorrs(CR))regulations and are provided as rnaernunr standards of health <br /> and safely tot file preparation of approved collage foods in fire h(unC <br /> CFO Business Name. CFO Owner Name- <br /> cL� �i� �.�� �BAKr�IG cNeI S t7^1.i <br /> CFO Address. CFO City CFO ZIP <br /> zfo't o A'Vq 1W6/-Do/ wvty S 71buLf bw 9sioLl <br /> Facility Requirements: Yes No <br /> 1, The CFO is located in a private dwelling where the CFO operator currently resides ( ❑ <br /> 2. All CFO food preparation will take place in the private kitchen within that home. . ❑ <br /> 3. Additional storage used for the CFO will be within the home. ❑ X <br /> a. If YES, is the room used exclusively for storage? ❑ ❑ <br /> b. Specify the room(s) that will be used for storage? <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. ❑ <br /> Zoning Requirements: Yes No <br /> L5.:_l have complied with the applicable zoning requirements for the CFO. _ ❑ <br /> E—mployee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food pt 11processor course? ' � L <br /> a. If YES, copies of certificates are attached. ❑ ❑ <br /> b. If NO, complete course within 3 months of CFO registration. ❑ ❑ <br /> 7. The CFO has no more than 1 full-time equivalent employee?(Immediate family or ❑ <br /> household members are not included ) <br /> Sanitation Requirements: Yes No <br /> 8 Kitchen equipment and utensils used to produce CFO products are clean and ❑ <br /> maintained in a good state of repair <br /> 9. All food contact surfaces, equipment, and utensils used for the preparation, packaging, <br /> or handling of any CFO products shall be washed, rinsed, and sanitized before each ❑ <br /> use <br /> 10 All food preparation and food and equipment storage areas shall be maintained free of ❑ <br /> rodents and insects. <br /> 1868 F. Hazelton Avenue ( Stockton, California 952.05 1 T 209 468-3420 1 F 209 464-0138 1 www.sicelid.com <br />