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,;�=;fir <br /> o� \ SAN JOAQUIN COUNTY <br /> I. ,n <br /> �^1 ENVIRONMENTAL HEALTH DEPARTMENT <br /> . .; 1868 East Harelton Avenue, Stockton, CA 95205-6232 <br /> \r, / Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:v_nwr. uv.or�C h,htl <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The followmq requirements are mi f',oM in the Corsage Food Operations(CFO)regulations and are provided as minimum standards <br /> Of heallh and safety ler the preparation or approved CO(loge roods in the home. <br /> CF O Business Name: CFO Owner Name: <br /> 1 <br /> Lh <br /> CWCFely: CFO ZIP: <br /> St <br /> � t <br /> a 8533 4 <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 preparation or storage. ❑ <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? <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 ❑ <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 pI ❑ <br /> rodents and insects. Y <br /> EHD 16-261212712012 7 CFO CLASS A CHECKLIST <br />