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naut"• 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.siaov.org/ehd <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: CFO Owner Name: <br />CA -)C ( his L�Ck N -et, C�_ <br />CFO Address: CFO City: CFO ZIP: <br />I Ccccc�3 N. 2. 2d. l t0l� V 2\ a53 <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. t_9 ❑ <br />a. If YES, is the room used exclusively for storage? [YJ ❑ <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. 10, ❑ <br />Employee and Training Requirements: Yes No <br />6. Have all persons preparing or packaging CFO products completed the CDPH food 11processor course? <br />a. If YES, copies of certificates are attached. ❑/ Id <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.) ad <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 />I" <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 El <br />and insects. <br />EHD 16-261212712012 1 CFO CLASS A CHECKLIST <br />