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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.sjcjov,or.Q/ehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The foilowing requirements are outlined in the Collage Food Operations(CFO)regulations and are provided as minimum standards <br /> of health and safety for the preparation of approved collage foods in 111e horns. <br /> CFO Business Name: CFO Owner Name. <br /> Fk,je Lm\ge So,,� �eSSica N� ac�us <br /> CFO Address: CFO City:tt CFO ZIP. <br /> 7 �o G�in}� Glu4j ` �TOC I� cvt CAS i OZ}- <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides 9 ❑ <br /> 2. All CFO food preparation will take place in the private kitchen within that home. S ❑ <br /> 3. Additional storage used for the CFO will be within the home. Q ❑ <br /> a. If YES, is the room used exclusively for storage? [ ❑ <br /> b. Specify the room(s) thatwill be used for storage?y,,.kvav% �i r p . sect Sv1e1� <br /> qn'r CPO r.yeckken4 <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. ��`�❑' <br /> Zoning Requirements: Yes No <br /> [E:1 have complied with the applicable zoning requirements for the CFO. & ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food Elprocessor course? <br /> a. if YES, copies of certificates are attached. ❑ ❑ <br /> b. If NO, complete course within 3 months of CFO registration. E9 ❑ <br /> 7. The CFO has no more than 1 full-time equivalent employee? (immediate family or El <br /> members are not included.) <br /> Sanitation Requirements: Yes No <br /> & Kitchen equipment and utensils used to produce CFO products are clean and ® ❑ <br /> maintained in a good state of repair. y <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. <br /> EHD 16-26 12f27f2012 CFO CLASS A CHECKLIST <br />