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Food Preparation Requirements(includes packaging and handling): Yes No <br /> 11. Hand washing is required immediately prior to handling foods and after engaging in <br /> any activity that contaminates the hands such as after using the toilet, coughing or <br /> sneezing, eating or smoking. <br /> 12. Warm water,hand soap and clean towels are available for hand washing. ❑ <br /> 13. All food ingredients used in the CFO products are from an approved source. <br /> 14. Potable water shall be used for hand washing, ware washing and as an ingredient. Q <br /> 15. Is your water source a private well? El d <br /> a.if YES, have you completed testing for bacteria and nitrate? El n <br /> 16. Is your water source a public water system or community services district? El <br /> a.lf YES,what is the name of the system or district? <br /> During the preparation, packaging or handling of CFO products: Yes No <br /> 17. Domestic activities such as family meal preparation,dishwashing, clothes washing or <br /> ironing,kitchen cleaning or guest entertainment are excluded from the kitchen. <br /> 18. Infants,small children, or pets are excluded from the kitchen. <br /> 19. Smoking is excluded. El <br /> 20. Any person with a contagious illness shall refrain from work in the CFO. El <br /> Labeling Requirements: Yes No <br /> F22. <br /> . A copy of the label has been submitted to this Department for review and approval. El <br /> I have attached a sample label. I/ ❑ <br /> By signing below you are certifying that you meet the requirements of the California Homemade Food Act, AB 1616 <br /> (Gatto),as it pertains to a"Class A"Cottage Food Operation. Prior to making any changes, I acknowledge that I must <br /> notify San Joaquin County Environmental Health Department of any intended changes to the above statement. <br /> Cottage Food Operator Checklist completed and submitted by: <br /> Si re ( �PnNamt `�� � 1� <br /> Date <br /> EHD 1&2612/27/2012 2 CFO CLASS A CHECKLIST <br />