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77ie following requirements are outlined in the Cottage Food Operations (CFO) regulations and are provided <br />NoYes <br />□a1.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. <br />□3.Additional storage used for the CFO will be within the home. <br />□□If YES. is the room used exclusively for storage?a. <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 I have complied with the applicable zoning requirements for the CFO. <br />Employee and Training Requirements:Yes No <br />□ <br />□□If YES. copies of certificates are attached.a <br />0 □b If NO. complete course within 3 months of CFO registration. <br />7.0 □ <br />Sanitation Requirements:Yes No <br />□ <br />9 □ <br />□ <br />Pun 17Z7 7/?ni7 1 cfo ci a cmfcki i^t <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />6 Have all persons preparing or packaging CFO products completed the CDPH food <br />processor course? <br />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 />The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included.) <br />fate <br />CFO ZIP <br />as mmtmum standards <br />of health and safety' for the preparation of approved cottage foods m the home <br />CFO Business Name <br />CFO Address ~ <br />\jelite <br />Facility Requirements: <br />10. All food preparation and food and equipment storage areas shall be maintained free of <br />rodents and insects. <br />8 Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good stale of repair. <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Te/ep/ione: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br />CFO Ovzner Name . .