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a tn• SAN JOAQUIN COUNTY <br />Z' yz ENVIRONMENTAL HEALTH DEPARTMENT <br />h i <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />r- , ssY6 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sicov.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 />Dulcenea's Cakes and Bakes By Candy Albor Candy Albor <br />CFO Address: CFO Clty: CFO ZIP: <br />1635 Court Drive Tracy, CA 95376 <br />Facility Requirements: Yes No <br />1. The CFO is located in a private dwelling where the CFO operator currently resides <br />Qf <br />❑ <br />2. All CFO food preparation will take place in the private kitchen within that home. <br />❑ <br />3. Additional storage used for the CFO will be within the home. <br />❑ <br />a. If YES, is the room used exclusively for storage? <br />❑ <br />b. Specify the room(s) that will be used for storage? spare room next to kitchen <br />4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. <br />V <br />❑ <br />Zoning Requirements: Yes No <br />5. 1 have complied with the applicable zoning requirements for the CFO. v ❑ <br />Employee and Training Requirements: Yes No <br />6. Have all persons preparing or packaging CFO products completed the CDPH food ❑ <br />processor course? <br />a. If YES, copies of certificates are attached. ❑ ❑ <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.) <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 />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 9r ❑ <br />use. <br />10. All food preparation and food and equipment storage areas shall be maintained free of S/ ❑ <br />rodents and insects. <br />EHD 16-26 12/272012 1 CFO CLASS A CHECKLIST <br />I <br />