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No <br />1. <br />2. <br />3. <br />b. <br />4.□ <br />Zoning Requirements:No <br />5.I have complied with the applicable zoning requirements for the CFO.□ <br />Yes No <br />packaging CFO products completed the CDPH food □ <br />□ <br />Sanitation Requirements:Yes No <br />□ <br />&□ <br />□ <br />1 CFO CLASS A CHECKLISTEHD 16-26 12/27/2012 <br />Yes <br />¥ <br />10. All food preparation and food and equipment storage areas shall be maintained free of <br />rodents and insects. <br />□ <br />□ <br />□ <br />□ <br />□ <br />□ <br />□ <br />□ <br />8. Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair. <br />□ <br />CFO ZIP: <br />CFO Owner Name ’ <br />CFO City: --------- <br />Yes <br />¥ <br />Employee and Training Requirements: <br />6. Have all persons preparing or <br />processor course? <br />areas used for CFO food preparation or storage. <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 />San Joaquin County <br />i868NpVJ^ uNMENTAL Health Department <br />Telephone: (209® W®/*6™ St°cW°n. CA 95205-6232 <br />(^9) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />COTTAGE FOOC> OPEPAT'ON8 (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />or health and salety^r "he potion °"eppwed^^ ^tlone and are provided as ml„imum slandards <br />CFO Business Name: ------------------------------ <br />Facility Requirements: <br />The CFO is located in 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 />Specify the room(s) that will be used for storage? <br />Sleeping quarters are excluded from <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.)