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The following requirements are outlined in Ute 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 homo <br />Facility Requirements:Yes No <br />1 <br />2 s <br />0 <br />a. <br />b. <br />4 Sleeping quarters are excluded from areas used for CFO food preparation or storage. <br />Yes No <br />I have complied with the applicable zoning requirements for the CFO.□ <br />Employee and Training Requirements:Yes No <br />□0. <br />□ <br />b. <br />7 □ <br />Sanitation Requirements:Yes No <br />8 0 □ <br />9 □ <br />&□ <br />EHD 16-26 12/27/2012 1 CFO CLASS A CHECKLIST I <br />Kitchen equipment and utensils used to produce CFO products are clean and <br />maintained in a good state of repair. <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />□ <br />□ <br />□ <br />□ <br />□ <br />□ <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 siqov org/ehd <br />CFO ZIP <br />I <br />CFO Owner Name <br />AeSSitg MaCiQS <br />CFO City <br />_____^-Voc LAcvn_____ <br />10 All food preparation and food and equipment storage areas shall be maintained free of <br />rodents and insects <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 />3 Additional storage used for the CFO will be within the home. <br />Zoning Requirements: <br />If NO, complete course within 3 months of CFO registration <br />The CFO has no more than 1 full-time equivalent employee? (Immediate family or <br />household members are not included.) <br />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 />If YES, is the room used exclusively for storage? Q <br />Specify the room(s) that will be used for storage?^t.K-v>QA <br />- ------ .an <br />a. If YES. copies of certificates are attached. <br />CFO Business Name <br />CFO Address <br />I "7 3^) <br />6. Have all persons preparing or packaging CFO products completed the CDPH food <br />processor course?