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ltl ISAIY i—l. r'.... ^V.... 1 <br />rvvfnOhrYlEly T.L. HEAL Tin-UmEEPPART muv l <br />1868 Fast Hazelton Avenue, Stockton, CA 95205-623? <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sagov.org/ehd <br />M - <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 ale provided as minimum standards <br />of health and safety for the preparation of approved cottage foods in the home. <br />CFO Business Name: <br />CFO Owner Name: <br />Urban Icing <br />Britney Hussman <br />Crc A.,1dmw. <br />All CFO food preparation will take place in the private kitchen within that home. <br />CFO Gti. CFO ZII': <br />384 Farinelli Parkway <br />use. <br />Escafon 9532Q <br />FacII-"Y* Pwgni-.ma:.W: <br />M No <br />1. <br />The CFO Is located in a private dwelling where the CFO operator currently resides <br />d£I <br />l <br />2. <br />All CFO food preparation will take place in the private kitchen within that home. <br />Rf <br />❑ <br />use. <br />10. All food preparation and food and equipment storage areas shall be maintained free ofElrodents <br />LV <br />3. <br />Additional storage used for the CFO will be within the home. <br />5 <br />❑ <br />a. If YES: is the room used exclusively for storage?f <br />i <br />b. Specify the . com(s) Lhat -All be :.sed fcr sic age? Closet <br />4. <br />Sleeping quarters are excluded finm•areas used for CFO food preparation or storage. <br />❑ <br />Zoning Requirements: Yes No <br />5. 1 have complied with the applicable zoning requirements for the CFO. 5( ❑ <br />Employee and Training Requirements: Yes No <br />6. Have all persons preparing or packaging CFO products completed the CDPH food d ❑ <br />processor course? J <br />a. If YES, copies of certificates are attached. (_j ❑ <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 El <br />members are not included.) <br />Sanitation Requirements: <br />Yes No <br />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />d Elmaintained <br />in a good state of repair. <br />9. Ail 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 />❑ <br />use. <br />10. All food preparation and food and equipment storage areas shall be maintained free ofElrodents <br />LV <br />and insects. <br />EHD 16-2612127/2012 1 CFO CLASS A CHECKLIST <br />