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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> l 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .�; .. Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sj9ov,om/ehd <br /> ehd <br /> c, <br /> COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br /> SELF CERTIFICATION CHECKLIST <br /> The f0NOW+nO requirements Are outlined rn the C olinge t ood Operations(CFO)rnyrdnUons and ere provided as minimum standards <br /> Of health And safety h)t the ptppoj-atron tit eppmirnd cottnge fonds m the home. <br /> CFO Business Name: CFO Owner Name, <br /> C4-Cr S1w _ GAeR� �#raKcf►s <br /> CFO Address. CFO Cily: CFO ZEP: <br /> Facility Requirements-, Yes No <br /> 1. The CFO is located in a private dwelling where the CFO operator currently resides �] <br /> I <br /> 2. All CFO food preparation will take place in the private kitchen within that home. Q' ❑ <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? Kllf EA! <br /> 4. Sleeping quarters are excluded from areas used for CFO food preparation or storage. L� ❑ <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 ❑ 2 <br /> processor course? <br /> a. If YES, copies of certificates are attached. ❑ <br /> b. If NO, complete course within 3 months of CFO registration. S?' ❑ <br /> 7. The CFO has no more than 1 full-time equivalent employee? (Immediate family or Q' ❑ I <br /> household members are not included.) No eMP&*VeF9 J <br /> Sanitation Requirements: Yes No <br /> B. Kitchen equipment and utensils used to produce CFO products are clean and R ❑ <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 Er ❑ 4 <br /> rodents and insects- <br /> 1 CFO CLASS A CHECKLIST <br /> EHD 16-26 12t27t2012 <br />