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ry <br /> de,4u{ : SAN JOAQUIN COUNTY <br /> •�A A� <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> r. :s <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Ew Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following requirements are outlined in the 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 home. <br /> CFO Business Name: CFO Owner Name: <br /> 2)0 -\ ErtiLA DcAckr <br /> CFO Address: CFO City: CFO ZIP: <br /> 601 a CU (1 53"�;T <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. ERS ❑ <br /> 3. Additional storage used for the CFO will be within the home. 9-- ❑ <br /> a. If YES, is the room used exclusively for storage? W'w <br /> b. Specify the room(s)that will be used for storage? Y) koi-e n Gky-W ow+n` )&'A ,� <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. R' ❑ <br /> Zoning'Requirements: Yes No <br /> 5. [ 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. �W��� ti�J Q� ❑ <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.) <br /> Sanitation Requirements: Yes No <br /> 8. Kitchen equipment and utensils used to produce CFO products are clean and 2' ❑ <br /> maintained in a good state of repair. <br /> 9. All food contact surfaces, equipment, and utensils used for the preparation, packaging, <br /> Elor 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 1212712012 1 CFO CLASS A CHECKLIST <br />