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Food Preparation Requirements (includes packaging and handling): <br />Hand washing is required immediately prior to handling foods and after engaging in <br />any activity that contaminates the hands such as after using the toilet, coughing or <br />sneezing, eating or smoking. <br />Warm water, hand soap and clean towels are available for hand washing. <br />All food ingredients used in the CFO products are from an approved source. <br />Potable water shall be used for hand washing, ware washing and as an ingredient. <br />Is your water source a private well? <br />a.lf YES, have you completed testing for bacteria and nitrate? <br />Is your water source a public water system or community services district? <br />a.lf YES, what is the name of the system or district? <br />During the preparation, packaging or handling of CFO products: <br />Domestic activities such as family meal preparation, dishwashing, clothes washing or <br />ironing, kitchen cleaning or guest entertainment are excluded from the kitchen. <br />Infants, small children, or pets are excluded from the kitchen. <br />Stroking is excluded. <br />Any person with a contagious illness shall refrain from work in the CFO. <br />Labeling Requirements: <br />Yes No <br />EVI D <br />Ef 0 <br />Er E <br />iv <br />D <br />D <br />flL <br />Yes No <br />EI LI <br />R LJ <br />[d <br />Yes No <br />A copy of the label has been submitted to this Department for review and approval. <br />I have attached a sample label. <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 A" 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 arid submitted by: <br /> <br />paN otociatda iptaz(112-5 <br /> <br />Flint Name Date <br />EHD 16-26 12/27/2012 2 CFO CLASS A CHECKLIST