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s <br /> SAN JOAQUIN Environmental Health Department <br /> '.. —COUNTY— <br /> COTTAGE <br /> COUNTY—COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following requirements are outlined in the Cottage Food Operations(CFO)regulations and are provided as minimum standards of health <br /> and safety for the preparation of approved cottage foods in the home. <br /> CFO Business Name: CFO Owner Name: <br /> a 1(' bc>ock C. C_C>6Ckr- <br /> CFO Address: CFO City: CFO ZIP: <br /> 59 itco\Q eCcA Ct33 C" <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. P5 ❑ <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? e F— ..'d. Pi <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. F-1 <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. R' ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food F8. ❑ <br /> processor course? <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 DR� ❑ <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 X ❑ <br /> use. <br /> 10. All food preparation and food and equipment storage areas shall be maintained free of r� ❑ <br /> rodents and insects. Y� <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />