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`k <br /> SANsJOAQUIN Environmental Health Department <br /> —COUNTY— <br /> Gr <br /> COUNTY— <br /> Gr ea t n e 5 s' ire vv h, <br /> 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 /> slt� a .Y <br /> C Address: WDVI CFO City: CFO ZIP: <br /> D dc 53 <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. V ❑ <br /> 3. Additional storage used for the CFO will be within the home. 02' El <br /> If YES, is the room used exclusively for storage? ❑ <br /> b. Specify the room(s) that will be used for storage? �(Af G�� <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. � ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. k�l ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food ❑ <br /> processor course? <br /> a. If YES, copies of certificates are attached. ❑ <br /> b. If NO, complete course within 3 months of CFO registration. El' ❑ <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 r <br /> rodents and insects. 6� <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />