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COMPLIANCE INFO_2023
EnvironmentalHealth
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1600 - Food Program
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PR0548849
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COMPLIANCE INFO_2023
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Last modified
1/16/2024 11:09:43 AM
Creation date
1/16/2024 11:09:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0548849
PE
1608
FACILITY_ID
FA0027993
FACILITY_NAME
JACALYN SOUTHER
STREET_NUMBER
9355
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
9355 E PELTIER RD
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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Food Preparation Requirements (includes packaging and handling): Yes No <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 />Smoking is excluded. <br />Any person with a contagious illness shall refrain from work in the CFO. <br />Labeling Requirements: <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 />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 and submitted by: <br /> <br />Signaturelfl <br /> <br />L f, <br /> <br />/ <br /> <br />rint Name Date <br /> <br />EHD 16-26 12/27/2012 2 CFO CLASS A CHECKLIST
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