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3. <br />4. <br />Yes No <br />□ <br />0 <br />Yes No <br />P □ <br />ED □ <br />& <br />EHD 16-26 12/27/2012 1 CFO CLASS A CHECKLIST <br />□ <br />□□ <br />CFO ZIP. <br />CFO Owner Name: <br />tojk OoVin&yi <br />“CFO City: <br />□ <br />___ <br />No <br />□ <br />□ <br />NoYes <br />iT <br />Yes <br />E <br />0 <br />(a fovpi-y gxzm <br />.. 0 <br />Facility Requirements: <br />1. The CFO is located in <br />2. <br />°J <br />a private dwelling where the CFO operator currently resides <br />All CFO food preparation will take place in the private kitchen within that home. <br />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 />Sleeping quarters are excluded from areas used for CFO food preparation or storage. <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjqov.org/ehd <br />Zoning Requirements: <br />5- * have complied with the applicable zoning requirements for the CFO. <br />Employee and Training Requirements: <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. <br />7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included.) <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />CFO Business Name: - <br />CFO Address: <br />__3?A0 (MmHg Dr <br />Sanitation Requirements: <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 />rodents and insects.