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SAN JOAUMN COUNTY <br /> ENVIRONMENTAL HFA <br /> I DFPAR l Mf_NT <br /> 1868 East Hazellon Avenue, ."tockton, CA 95205-6'2.3'2 <br /> c Telephone:(2.09)468.1421 Fax:(209)464-0138 Web:www.sipov.orq/ehrJ <br /> COTTAGE FOD CDS -It,"I'A 1SONS (CFOs-CLASS A) <br /> SELF CERAT!t -'iCAION CHECKLIST <br /> the following requirements are outlined in the "X. ;arnr,s;CFC))regulations and ere provided as minimum standards <br /> of health and safety for the preparation of appn)vcd_�ttsgv too::s irr•r ;home. <br /> CFO Business Name i CFC Owner Name- <br /> 'Sk Name- <br /> 'S ^Ccd LL _ __ I S�-1A_N_ti_Af\1t70 <br /> CFO Address I CFO City CFO ZIP <br /> 26t S LOCCK LKI NOOWA1{'I HAUS `l53l I <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides Z ❑ <br /> 2. All CFO food preparation will take place in the private kitchen within that home. Kr' ❑ <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? <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. ❑7] <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. JZ1 ❑ <br /> 7. The CFO has no more than 1 full-time eq a ent employee? (Immediate family or JZ/ ❑ <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 Er' ❑ <br /> maintained in a good state of repair. <br /> 9. All food contact surfaces, equipment, and utensils used for the preparation, packaging, El <br /> 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 /> rodents and insects. lllddd <br /> EHD 16-26 12/27/2012 1 CFO CLASS A CHECKLIST <br />