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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 Wane water, hand soap and clean towels are available for hand washing K O <br /> 13 All food ingredients used In the CFO products are from an approved source Q ❑ <br /> 14. Potable water shall be used for hand washing, ware washing and as an ingredient ❑ ❑ <br /> 15 Is your water source a private well? ❑ <br /> a If YES, have you completed testing for bacteria and nitrate? ❑ ❑ <br /> 16 Is your water source a public water system or community services Eldistrict'?La <br /> Ca <br /> a If YES,what is the name of the system or district? Liu�•� a 1 aAhrC)la u+i is Ills <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. [7� ❑ <br /> 20 Any person with a contagious illness shall refrain from work in the CFO. ® ❑ <br /> Labeling Requirements: Yes No <br /> 21. A copy of the label has been submitted to this Department for review and approval. ❑ fa <br /> 22. 1 have attached a sample label. 0 ❑ <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'College Food Operation Pnor to making any changes, I acknowledge that I must <br /> nobly San Joaquin County Environmental Health Department of any intended changes to the above statement <br /> Cottage Food Operator Checklist completed and submitted by. <br /> G1J (�I(;C'2� ZLaI�GtGI by � )S / ZoZ � <br /> Sid ire Pnnf Name Date <br /> EMD 16-20 12!172012 2 CFO CLASS A CHECKLIST <br />