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COMPLIANCE INFO_2020
EnvironmentalHealth
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1600 - Food Program
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PR0546191
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COMPLIANCE INFO_2020
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Last modified
10/8/2020 10:23:05 AM
Creation date
10/8/2020 10:22:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0546191
PE
1608
FACILITY_ID
FA0026140
FACILITY_NAME
GLORIA PICININI HOME KITCHEN
STREET_NUMBER
435
Direction
W
STREET_NAME
MIRAMONTE
STREET_TYPE
DR
City
MOUNTAIN HOUSE
Zip
95391
CURRENT_STATUS
01
SITE_LOCATION
435 W MIRAMONTE DR
P_LOCATION
03
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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Food Preparation Requirements (Includes packaging and handling): Yes No <br /> 11. Hand washing is required immediately prior to handling foods and after engaging in <br /> any activity that contaminates the hands such as after using the toilet, coughing or ® ❑ <br /> sneezing, eating or smoking. <br /> 12. Warm water, hand soap and clean towels are available for hand washing. ® ❑ <br /> 13. All food ingredients used in the CFO products are from an approved source. ® ❑ <br /> 14. Potable water shall be used for hand washing, ware washing and as an ingredient. ® ❑ <br /> 15. Is your water source a private well? ❑ <br /> a.If YES, have you completed testing for bacteria and nitrate? ❑ El <br /> 16. Is your water source a public water system or community services district? ❑ <br /> a.If YES, what is the name of the system or district? VOWAW fax- � <br /> During the preparation, packaging or handling of CFO products: Yes No <br /> 17. Domestic activities such as family meal preparation, dishwashing, clothes washing or <br /> ironing, kitchen cleaning or guest entertainment are excluded from the kitchen. M El <br /> 18. Infants,small children, or pets are excluded from the kitchen. PW ❑ <br /> 19. Smoking is excluded. ® ❑ <br /> 20. Any person with a contagious illness shall refrain from work in the CFO. M ❑ <br /> Labeling Requirements: Yes No <br /> 21. A copy of the label has been submitted to this Department for review and approval. ® ❑ <br /> 22. 1 have attached a sample label. 10 ❑ <br /> By signing below you are certifying that you meet the requirements of the California Homemade Food Act, AB 1616 <br /> (Gatto), as it pertains to a"Class A" Cottage Food Operation. Prior to making any changes, I acknowledge that I must <br /> notify San Joaquin County Environmental Health Department of any intended changes to the above statement. <br /> Cottag d Operator Checklist completed and submitted by: <br /> Cf��iA- i��crn,'(rJj oq v 2020 <br /> re Print Name Date <br /> EHD 16-26 1227/2012 2 CFO CLASS A CHECKLIST <br />
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