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Food Preparation Requirements(includes packaging and handling): Yes No <br /> 11. 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 N ❑ <br /> sneezing,eating or smoking. <br /> 12. Warm water,hand soap and clean towels are available for hand washing. ® ❑ <br /> 13. All food ingredients used in the CFO products are from an approved source. ® ❑ <br /> 14. Potable water shall be used for hand washing,ware washing and as an ingredient. ® ❑ <br /> 15. Is your water source a private well? ❑ <br /> a.If YES,have you completed testing for bacteria and nitrate? ❑ ❑ <br /> 16. is your water source a public water system or community services district? ® ❑ <br /> a.If YES,what is the name of the system or district? <br /> During the preparation,packaging or handling of CFO products: Yes No <br /> 17, Domestic activities such as family meal preparation,dishwashing,clothes washing or ❑ <br /> ironing,kitchen cleaning or guest entertainment are excluded from the kitchen. <br /> 1 B. Infants,small children,or pets are excluded from the kitchen. ❑ <br /> 19. Smoking is excluded. ❑ <br /> 20. Any person with a contagious illness shall refrain from work in the CFO. ® ❑ <br /> Labeling Requirements: Yes No <br /> 21. A copy of the label has been submitted to this Department for review and approval. ® ❑ <br /> 22. 1 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 ecklist completed and submitted by: <br /> &Wkll Pad M 0 tp� 0 <br /> rture Print Name Date <br /> EHD 16.261212712012 2 CFO CLASS A CHECKLIST <br />