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<br />6. Have all persons preparing or packaging CFO products completed the CDPH food <br />processor course? <br />If YES, copies of certificates are attached. <br />If NO, complete course within 3 months of CFO registration. <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 No Facility Requirements: <br />Yes No Zoning Requirements: <br />LI 5. I have complied with the applicable zoning requirements for the CFO. <br />Yes No Employee and Training Requirements: <br />1. 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. o <br />3 Additional storage used for the CFO will be within the home. <br />If YES, is the room used exclusively for storage? <br />Specify the room(s) that will be used for storage? Dilayea <br />o <br />4 Sleeping quarters are excluded from areas used for CFO food preparation or storage. o <br />CFO Owner Name <br /> <br />Ve Freeze 06 e-4 LL <br /> <br />CFO Address CFO City , <br />L6CI <br />CFr3,usiness Name <br />1H1ASO Df <br />el isso evoLVkl <br />CFO ZIP r z <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 <br />use. <br />10 All food preparation and food and equipment storage areas shall be maintained free of <br /> <br />Yl 0 <br />rodents and insects. <br />Er <br />LI <br />SAN JOAQUIN COUNTY <br />ENVIRONMENT-AL kikALfil DEPArritligiif <br />1888 Eget 11§1@lton Av@rio, Ototklon, CA §§N§=§N <br />Telephonc (200) 4601420 Nit (H) 4§4:01#1 Viphi www sioov orolehd <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />The followng requirements are outlined HI the Cottage Food Operations (CFO) regulations and 0/0 provided as minimum standards <br />of health and safety for Ow preparation of approved cottage foods in the Warn <br />Sanitation Requirements: Yes No <br />END 16-26 12/27i2012 CFO CLASS A CHECKLIST