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SAN )0 A Q U I N Environmental Health Department <br /> C0UNI Y <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> ' SELF CERTIFICATION CHECKLIST <br /> I <br /> The following requirements are outland in the Cotlaye Food Operations(CFO)regulations and are provided ns minimum standards of health <br /> and safely for the preparation of approved cottage foods in lire home. <br /> CFO Business Name. CFO Owner Nmne <br /> TGI:nI i f♦L ✓�L r SBA K Hk r S 17^61Pj tS— -- — <br /> CFO Address: f CFO City CFO ZIP <br /> z(,l o k6/q 1WU7P.11 W�9 _1 S mac{ �✓ 9sioz/ <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides 1� ❑ <br /> 2. All CFO food preparation will take place in the private kitchen within that home. `t1 ❑ <br /> 3. Additional storage used for the CFO will be within the home. ❑ CK <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 /> 5. I ha�comp�liedth theapplicable 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 El <br /> course? ' <br /> a. If YES, copies of certificates are attached. (A ❑ <br /> b. If NO, complete course within 3 months of CFO registration. ❑ ❑ <br /> %. 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 El <br /> 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 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />