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` A\ SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />r, 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Far. (209) 464-0138 Web: www sinov om)ehd <br />M <br />COTTAGE FOOD OPERATIONS (CFOs -CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />The following requirements ere gunned in the Cottage Food Operations (CFO) regulations and ere provided as minmrum standards <br />of health and safety for the preparation of approved cottage foods in the home. <br />CFO Bminess Name: CFO Owner Name: <br />SV CFO ZIP: <br />CFO Address: CFO try: <br />533 <br />Facilitv Reauirements: Yes No <br />1. The CFO is located in a private dwelling where the CFO operator currently resides —/ <br />7-- <br />2. All CFO food preparation will take place in the private kitchen within that home. El ❑ <br />3. Additional storage used for the CFO will be within the home., / ❑ <br />a. If YES, is the mom used exclusively for storage? ^ Lam' ❑ <br />b. Specify the mom(s) that will be used for storage? QC f <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 C1processor course? <br />a. If YES, copies of certificates are attached. C] ❑ <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: <br />Yes No <br />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair. u ❑ <br />19. 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 11rodents and insects. <br />EHO 16-26 12/27/2012 <br />1 <br />CFO CLASS A CHECKLIST <br />