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P2 bs 14 s� y <br /> L ss4 .s SAN .IOAQUIN COUNTY Flo 00 Z/O 3 8 <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205 6232 <br /> i�j,- a�.. Telephone:(209) 468-3420 Fax:(209)464-0138 Web:wwwsiaov.org/ehd <br /> a>; <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 collage foods in the home. <br /> CFO Business Name: CFO Owner Name: <br /> T ft'S Of-eXNOWen✓ t NAYV sc of10. <br /> CFO Address: CFO City: CFO ZIP: <br /> 3133Pmnkh'h AW qs <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides 01'/ ❑ <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. 5?` ❑ <br /> a. If YES, is the room used exclusively for storage? [S' ❑ <br /> b. Specify the room(s)that will be used for storage? <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage E ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. R- ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food Imo" ❑ <br /> processor course? <br /> a. If YES, copies of certificates are attached. lg� ❑ <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 �/ ❑ <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. A <br /> 10. All food preparation and food and equipment storage areas shall be maintained free of El / <br /> rodents and insects. / <br /> EHD 16-26 12/27/2012 1 CFO CLASS A CHECKLIST <br /> 1 <br />