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COMPLIANCE INFO_2022
EnvironmentalHealth
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1600 - Food Program
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PR0548000
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COMPLIANCE INFO_2022
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Last modified
11/1/2022 3:36:21 PM
Creation date
11/1/2022 3:31:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0548000
PE
1608
FACILITY_ID
FA0027378
FACILITY_NAME
CHAVINA'S
STREET_NUMBER
231
STREET_NAME
FOREST HILLS
STREET_TYPE
DR
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
231 FOREST HILLS DR
P_LOCATION
03
QC Status
Approved
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SJGOV\jcastaneda
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EHD - Public
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Food Preparation Requirements (includes packaging and handling): <br />Yes No <br />11. <br />Hand washing is required immediately prior to handling foods and after engaging in <br />V <br />❑ <br />22. <br />any activity that contaminates the hands such as after using the toilet, coughing or <br />Lb <br />❑ <br />sneezing, eating or smoking. <br />12. <br />Warm water, hand soap and clean towels are available for hand washing. <br />❑ <br />13. <br />All food ingredients used in the CFO products are from an approved source. <br />��/ <br />�v <br />❑ <br />14. <br />Potable water shall be used for hand washing, ware washing and as an ingredient. <br />15. <br />Is your water source a private well? <br />❑ <br />,❑/ <br />Lb <br />a. if YES, have you completed testing for bacteria and nitrate? <br />❑ <br />❑ <br />16. <br />Is your water source a public water system or community services district? <br />Sd <br />❑ <br />a. If YES, what is the name of the system or district? City Of Tracy <br />During the preparation, packaging or handling of CFO products: <br />Yes <br />No <br />17. <br />Domestic activities such as family meal preparation, dishwashing, clothes washing or <br />❑ <br />ironing, kitchen cleaning or guest entertainment are excluded from the kitchen. <br />18. <br />Infants, small children, or pets are excluded from the kitchen. <br />❑ <br />19. <br />Smoking is excluded. <br />❑ <br />20. <br />Any person with a contagious illness shall refrain from work in the CFO. <br />❑ <br />Labeling Requirements: <br />Yes No <br />21. <br />A copy of the label has been submitted to this Department for review and approval. <br />V <br />❑ <br />22. <br />1 have attached a sample label. <br />Lb <br />❑ <br />By signing below you are certifying that you meet the requirements of the California Homemade Food Act, AB 1616 <br />(Gatto), as it pertains to a "Class X Cottage Food Operation. Prior to making any changes, I acknowledge that I must <br />notify San Joaquin County Environmental Health Department of any intended changes to the above statement. <br />Cottage Food Operator Checklist completed and submitted by: <br />ielica Chaves <br />Print Name <br />10/02/2022 <br />Date <br />EHD 16-2612/27/2012 2 CFO CLASS A CHECKLIST <br />
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