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.siQov.ora/ehd <br />The following requirements <br />Facility Requirements:Yes No <br />□ <br />□ <br />□3. Additional storage used for the CFO will be within the home. <br />0 <br />b. Specify the room(s) that will be used for storage? <br />□ <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 />□If NO, complete course within 3 months of CFO registration.b. <br />□□ <br />YesSanitation Requirements:No <br />□ <br />□ <br />EHD 16-26 12/27/2012 CFO CLASS A CHECKLIST1 <br />10. All food preparation and food and equipment storage areas shall be maintained free of <br />rodents and insects. <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 />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair. <br />6. Have all persons preparing or packaging CFO products completed the CDPH food <br />processor course? <br />1. 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 />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <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: <br />CFO ZIP <br />Q -7 <br />0 <br />K) <br />□ <br />CFO Business Name <br />~Tl\f Michvntvi <br />CFO Address <br />(gra-f h'H tc 4 <br />are outlined in the Cottage Food Operations (CFO) regulations and are provided as minimum standards <br />of health and safety for the preparation of approved cottage foods In the home <br />4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. <br />CFO Owner Name <br />CFO City <br />a. If YES, is the room used exclusively for storage? <br />7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included.)