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alp"'"•• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205 232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web;www ov.or lehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLA S A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following repuiro is are outlined fn the Cottage Food Operations(CFO)regulations end am as minimum standards <br /> o/health and safety/or I partition of approved cottage foods in the home. <br /> CFO Business Nam' —TC—FO <br /> Owner Name: <br /> CFO Address: CFO City: CFO ZIP. <br /> 0 1fv. i>( G q S3-7,6 <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwe\thee <br /> the CFO operator urrently resides RF ❑ <br /> 2. All CFO food preparation will take place ' private kitchen wi inthathome. ❑3. Additional storage usedfor the CFOhin the home. 0 ❑ <br /> a. If YES, is the room used exstorage? 0 ❑b. Specify the room(s)that wilor s rage?4. Sleeping quarters are excluded fromed for F food preparation or storage. ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning require ents for a CFO. 53 ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or pack/3onths <br /> products completed CDPH food <br /> processor course? ❑ D <br /> a. . If YES, copies of certificatesed. ❑ ❑ <br /> b. If NO, complete course witof CFO registration.7. The CFO has no more than 1 full-tint employee?(Immediate family rhousehold members are not includ 1 e+ <br /> Sanitation Requirements: Yes No <br /> 8. Kitchen equipment and utensil used to produce CFO products are clean and ❑ <br /> maintained in a good state of pair. <br /> 9. All food contact surfaces, ipment,and utensils used for the preparation, packaging, <br /> or handling of any CFO p ucts shall be washed, rinsed, and sanitized before each 0 ❑ <br /> use. <br /> 10. All food preparation an food and equipment storage areas shall be maintained free of ❑ <br /> rodents and insects. <br /> EHD 9626121272012 1 CFO CLASS A CHECKLIST <br /> r <br />