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1 <br /> SAN JOAQUIN COUNTY <br /> vfJ'q <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sioov.oro/ehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> Ttw following requirements are outlined In the Cottage Food Operations(CFO)regulations and am provided as minimum standards <br /> of health and safety for the preparation of approved coftage foods In ttw Mme. <br /> CFO Business Nam aaurFu <br /> e: _ Q n <br /> CFO Address: _ ,_3G CFO ZIP��/T/'�/,q�� <br /> Z � <br /> Jf <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides Rf ❑ <br /> 2. All CFO food preparation will take place in the private kitchen within that home. ❑ <br /> 3. Additional storage used for the CFO will be within the home. ❑ <br /> a° If YES, is the room used exclusively for storage? ❑ <br /> b.' Specify the room(s)that will be used for storage? I �� <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. ❑ <br /> r <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 ❑ Q( <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 ® ❑ <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 �, Li <br /> in a good state of repair. �7 <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 ❑ <br /> rodents and insects. <br /> EHO 16.26 12272012 1 CFO CLASS A CHECKLIST <br />