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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sioov.orplehd <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 am provided as minimum standards <br /> of health and safety for the preparation of approved college foods in the home. <br /> CFO Business Name: CFO Owner Name: <br /> RAWA1,5 rjcH&,l I RFIrMIA SAffliffiRnLA <br /> CFO Address: CFO City: CFO ZIP: <br /> 2111 S odeYe Del 1im6 Ilse `t,53 <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides J�K ❑ <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? t t —0' ❑ <br /> b. Specify the room(s)that will be used for storage? ��kCtl P� G1vYl �oih�fy <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. 1:1 ❑ <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. •G ❑ <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food ❑ <br /> processor course? <br /> a. If YES,copies of certificates are attached. . ❑ ❑ 3 \_�../L <br /> b. If NO,complete course within 3 months of CFO registration. ❑ (Y^"� <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 /> or handling of any CFO products shall 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 ,,� ❑ <br /> rodents and insects. <br /> EHD1626121272012 - -1 - - - - CFO CLASS A CHECKLIST <br />