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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 sigov org/ehcl <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> rile following requirements am outlined in the Cottage Food Operatrons(CFO)regulations and are provided as rninlmuni sfandards <br /> of health and safety for the preparation of approved cottage foods in the irorno <br /> CFO Business Name: TCFOCity <br /> me <br /> ���e Loc�ve SGL� N1ac>.uS <br /> CFO Address CFO ZIP. <br /> 0 Ccr%A-v C1u\n 1 -�Oc kCV1 g5Z04+ <br /> Facility Requirements: Yes No <br /> 1 The CFO is located in a private dwelling where the CFO operator currently resides 0 ❑ <br /> 2 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. IS ❑ <br /> a. If YES, is the roots used exclusively for storage? ❑ <br /> b. Specify the room(s) that will be used for storage?k;.k�ar ced� 4e� shetL <br /> 1 oIL CPC) •. Win! <br /> 4 Sleeping quarters are excluded from areas used for CFO food preparation or storage, 19 ❑ <br /> Zoning Requirements: Yes No <br /> 5. 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 ❑ <br /> processor course? <br /> a. If YES, copies of certificates are attached. ❑ ❑ <br /> b. If NO, complete course within 3 months of CFO registration. 1 ❑ <br /> 7 The CFO has no more than 1 full-time equivalent employee?(Immediate family or ❑ <br /> household members are not included.) <br /> Sanitation Requirements: Yes No <br /> 8 Kitchen equipment and utensils used to produce CFO products are clean and ® ❑ <br /> maintained in a good state of repair. <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 /> F10 16-26 12r2712012 1 CFO CLASS A CHECKLIST <br />