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Ii2 0 <br />to <br />All food preparation and food and equipment storage areas shall be maintained free of <br />0 rodents and insects. III <br />Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair. <br />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 />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 469-3420 Fax: (209) 464-0138 Web: www.sloov.orolehd <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 />CLIAIrPirlePerr <br />CFO Address: <br />9344R W- Gya_n-1- bad <br />Facility Requirements: <br />CFO Owner Name: <br />Lsck 1tAashau)-SIV)e-1 RA <br />CFO City: CFO ZIP: <br />c7tCOLI <br />Yes No <br /> <br />1 <br />1. The CFO is located in a private dwelling where the CFO operator currently resides <br />IN 0 <br /> <br />3. Additional storage used for the CFO will be within the home. <br />*VOI Con,- USCG! <br />. If YES, is the room used exclusively for storage? <br />ro b. Specify the mom(s) that will be used for storage? CA-7 aof butkcim tn pvi eyv uti7( itircur • <br />Zoning Requirements: Yes No <br />5. I have complied with the applicable zoning requirements for the CFO. ot o <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 />If YES, copies of certificates are attached. <br />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 />o <br />Sanitation Requirements: Yes No <br />EHD 16-26 12/27/2012 1 CFO CLASS A CHECKLIST <br />2. All CFO food preparation will take place in the private kitchen within that home. <br />4. Sleeping quarters are excluded from areas used for CFO food preparation or stora 44. t1/4 0 <br />51 0 \(--el":9 no crl-hw <br />II 0 <br />SI 0 <br />or I 14 USCG! <br />cur hams