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6n�r <br /> SAN JOAQUIN COUNTY <br /> z` y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sicov.ora/ehd <br /> 1 aq� <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 for the preparation of approved cottage foods in the home. <br /> CFO Business Name:PS i npi CFO Owner ame: <br /> 66 q I UY 0 O til <br /> CFO Address: CFO City: - CFO ZIP: <br /> �I �I Ili C1533b <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. '163 ❑ <br /> 3. Additional storage used for the CFO will be within the home. ❑ 0 <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. 1 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 �7f 1:1processor course? % <br /> a. If YES,copies of certificates are attached. W ❑ <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 El <br /> members are not included.) <br /> Sanitation Requirements: Yes No <br /> 8. Kitchen equipment and utensils used to produce CFO products are clean and �p El <br /> in a good state of repair. 5� <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 �p ❑ <br /> rodents and insects. Y' <br /> EHD 16-2611272012 1 CFO CLASS A CHECKLIST <br />