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° SAN JOAQUIN COUNTY <br /> fs�, gin. <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464.0138 Web:www slaov ora/ehd <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The follovnns roquuomonts are ouflmod on the College Food Operafrons(CFO)regulations and are provided as mmtmum standards <br /> of health and safety for the prepefabon of approved Carlos&foods In the home <br /> CFO Business Name: CFO Owner Name: <br /> U Vn CI(�rfCn <br /> CFO <br /> Aftess: CFO City: CFO <br /> ZIP: <br /> 1-7q C,' <br /> Facility Requirements: Yes 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 room(s)that will be used for storage? <br /> 4 Sleeping quarters are excluded from areas used for CFO food preps tion or storage ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have Complied with the applicable zoning requirements for the CFO. ed ❑ <br /> Employee and Training Requirements: Yes No <br /> 6 Have all persons preparing or packaging CFO products completed the CDPH food <br /> processor course? ❑ e <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 shell 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 C1rodents and Insects <br /> 81 EHO 1a-26 t2lD21512 t CFO CLASS A CHECKLIST <br />