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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.orct(ehd <br /> MN <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following requirements are oudmed m the Collage Food OperaLons(CFO)regulations and are pnavded as rrinimum standards <br /> or health and safety for the preparation of approved cottage foods in the home. <br /> CFO Business Name: rP 1 I(2•I CFO Offm N�aT0: 1 <br /> 14e a ✓.. :. r .< /�L'r! /Cf1 <br /> CFO Address: �1 /� � CFO City: CFO ZIP. <br /> 0?0 Fked iiwo i Pic 51 �'I "15-2/z <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. ❑ <br /> 3. Additional storage used for the CFO will be within the home. ,ll,�(/ ❑ <br /> a. If YES, is the room used exclusively for storage? u ❑ <br /> b. Specify the room(s)that will be used for storage? <br /> 4. Sleeping quarters are excluded from areas used for CFO food prepara on or storage. ❑ <br /> Zoning Requirements: Ye No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. d ❑ <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 /> a. If YES, copies of certificates are attached. 111 ❑ <br /> b. If NO, complete course within 3 months of CFO registration. L✓� ❑ <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 ❑ <br /> maintained in a good state of repair. <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 ❑1 ❑ <br /> use. / <br /> 10. All food preparation and food and equipment storage areas shall be maintained free of ( ❑ <br /> rodents and insects. IIIJJJ <br /> EMD 162612i7722012 1 CFO CLASS A CHECKLIST <br />