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' a <br /> a SAN JOAQUIN COUNTY <br /> s ENVIRONMENTAL HEALTH DEPARTMENT <br /> a x <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> lw Telephone:(209)468-3420 Fax:(209)46"138 Web:www.sigov.orolehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The folimmg requirements are outlined in the Cottage Food Operations(CFO)regulations and are provided as minimum standards <br /> of heaft and safety forthe preparation of approved mffage fiords in the home. <br /> CFO Business Name: CF er Name: <br /> r �e <br /> CFO 0dres � c`rc l Ili CF City: <br /> Facility Requirements: ( fYes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides [ ❑ <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. [ ❑ <br /> a. If YES, is the room used exclusively for storage? [� ❑ <br /> b. Specify the rown(s)that will be used for storage? Q tE bend rCCLA <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. �tf ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. N ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products comped 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. ❑ <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 /> 8. Kitchen equipment and utensils used to produce CFO products are clean and El <br /> 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 10 ❑ <br /> use. <br /> 10. All food preparation and food and equipment storage areas shall be maintained free of <br /> rodents and insects. ❑ <br /> EHD 16-261212712012 1 CFO CLASS A CHECKLIST <br />