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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />x <br />1868 East Hazelton Avenue, Stockton, CA 95205-623 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wwwwww slD�olehd <br />a COTTAGE FOOD OPERATIONS (CFOs -CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />The following requirements are <br />outlined of peed co <br />Footiagfoods Operations <br />the home. regulations and are provided as minimum standards <br />of heath and safety for the prep <br />;FO Business Name: Laura DIScsla <br />Better With Butter, LLC CFO ZIP: <br />CFO city: 96242 <br />;FO Address: Lodi <br />1517 Iris Drive <br />Yes Na <br />Facility Requirements: ® Li1. 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. M 11 ❑ <br />3. Additional storage used for the CFO will be within the home. ® ❑ <br />a. If YES, is the room used exclusively for storage? <br />b. Specify the roOm(s) that will be used for storage? Kitchen, Dining Room & Garage <br />4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. [N ❑ <br />Yes No <br />Zoning Requirements: <br />[n <br />❑ <br />5. 1 have complied with the applicable zoning requirements for the CFO. <br />Yes <br />No <br />Employee and Training Requirements: <br />6. Have all persons preparing or packaging CFO products completed the CDPH food <br />ZI <br />El <br />processor course? <br />® <br />El <br />If YES, copies of certificates are attached. <br />a. <br />b. If NO, complete course within 3 months of CFO registration. <br />❑ <br />❑ <br />7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included) <br />Yes <br />No <br />Sanitation Requirements: <br />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />® <br />❑ <br />maintained in a good state of repair. <br />9. All food contact surfaces, equipment, and utensils used for the preparation, packaging, <br />rinsed, and sanitized before each <br />® <br />❑ <br />or handling of any CFO products sha11 be washed, <br />use. <br />All food and food and equipment storage areas shall be maintained free of <br />IN <br />❑ <br />1o. preparation <br />rodents and Insects. <br />EHD 16-26 1212712012 <br />1 CFO CLASS A CHECKLIST <br />