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gMIN s SAN JOAQUIN COUNTY <br /> n i y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> e Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.ora/ehd <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 <br /> of health and safety forthe preparation of approved cottage foods in the home. <br /> CFO Business Name: - CFO Owner Name: <br /> O oL , t�0 ' ✓i P <br /> CFO Address: CFO City: CF0 ZIP:Facility Requirements: Yes No <br /> 19. The CFO is located in a private dwelling where the CFO operator currently resides Ef ❑ <br /> . All CFO food preparation will take place in the private kitchen within that home. 11' ❑ <br /> 3. Additional storage used for the CFO will be within the home. d ❑ <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 stogy ge. IM ❑ <br /> Zoning Requirements: Yes No <br /> I <br /> 5. I have complied with the applicable zoning requirements for the CFO. ✓ ❑ <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. ❑ ❑ <br /> 7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or Elii household members are not included.) <br /> i <br /> Sanitation Requirements: Yes No <br /> 8. Kitchen equipment and utensils usedlto produce CFO products are clean and d ❑ <br /> maintained in a good state of repair. <br /> U. All food contact surfaces, equipment, and utensils used for the preparation, packaging, Ll <br /> handling of any CFO products shall be washed, rinsed, and sanitized before each <br /> use. <br /> 1,0. All food preparation and food and equipment storage areas shall be maintained free of ❑ <br /> rodents and insects. <br /> EHD 16-261212712012 1 CFO CLASS A CHECKLIST <br />