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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Ha7ellon Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:Air�'�i�,cov orci/Mid <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The following requirements are outtood in the Collage Food Operations(CFO)regulations and are provided as minimum standards <br /> of ficafth and safery for the preparation of approved cottage foods in the home. <br /> CFO <br /> F O <br /> Business N—S am <br /> —0: <br /> CFO Owner Name: <br /> ' <br /> 441 <br /> Cfoc " CFOady: <br /> CFO ZIP:1a9 Wy <br /> Y-N}c C C., C)533 � <br /> Facility Requirements: Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides kr 0 <br /> i <br /> 2. All CFO food preparation will take place in the private kitchen within that home. ❑ <br /> for t C 0 1 wit I t me <br /> 3. Additional storage used for the CFO will be within the home. ❑ <br /> used <br /> will <br /> 0 <br /> a It S' is room u exclusively <br /> usIv ly for storage? <br /> g 7 <br /> . If YES, is the room used exclusively for storage? <br /> a 11 or storage?g '? C <br /> fatht room(s)that will be used for storage? <br /> a YES, <br /> CI room(s)t t w I used f <br /> b. Specify the h be a e via <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or Stora <br /> Zoning Requirements: Yes No <br /> 5. 1 have complied with the applicable zoning requirements for the CFO. <br /> Employee and Training Requirements: Yes No <br /> 6. Have all persons preparing or packaging CFO products completed the CDPH food <br /> processor course? 14 El <br /> a. If YES, copies of certificates are attached. El <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 /> 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 /> EHD 16-26 1 2/2 71201 2 i CFO CLASS A CHECKLIST <br />