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CFO ZIP <br />cFC DAner hisrle <br />0(.11--fj c:-_-)ilvD <br />COCit <br />1_ CY-1 <br />e+.P.11-4ss None <br />- : ) <br />CFO iletci-q*-7. <br />1\f --rfiCr(al <br />.00.) SAN JOAQUIN COUNTY <br />••• ENVIRONMENTAL HEALTH DEPARTMENT <br />1E-68 East Hazeiton Avenue Stockton CA 9525-6232 • <br />Telephone: 1:2C9). 468-3420 Fax: (209) 46.4-o138 Web: v.-vie,' ordlehd <br />COTTAGE FOOD OPERATIONS (CFOs-CLASS A) <br />SELF CERTIFICATION CHECKLIST <br />!"174 0;..7er3borr. (CF01 &rt., ave cie,d aS <br />71" r!," cirri sa!`eri for tr.,: p-cparatto a' sp;xoved cotege to kr, tr.* cre <br />Facility Requirements: Yes No <br /> <br />The CFO is inciatec ir a private dwell no where the CFO operator currently resides <br />All CFO !no prepwation wi to.•:e placejr thu private kitchen within that home <br />A.iddrt Una' storage used for the CFO wiil be within the home. <br />If YES. is the mom used exclusively fo, storage? <br />Specify the room(s) that lt be used for storage? <br /> <br />4 S e e pi r g quarters a:e excluded "rom areas used for CFO forxt eparatior storage. E <br />Zoning Requirements: Yes No <br />5 have complied with the applicable zoning requirements 'or the CFO. <br />Employee and Training Requirements: Yes No <br /> <br />5.Hayia at pe,sons p -eparing a: pac•Kading CFO products completed the CDFH fo <br />For.e.t-...snr course? <br />l' YES, copies of cerif.pates 2re attached. <br />It NO. complete course within 3 months 01 CFO registration <br />7. The CFO has no more than 1 full-time equivalent employee° i:Immediate"z..zrrily or <br />household members are rot included.) <br /> <br />Sanitation Requirements: Yes No <br /> <br />Kitchen equipment and utensils used to pioeuce CFO products are c'ear and <br />mainta -neo in a Gond slate of repair. <br />All food conlact surfaces, equipment, and utersis used for the oreparat.on. packaging. <br />;:y• handling of any CFO products shall be washed, rInsed. aid santtized before cash <br />use. <br /> <br />All food preparation and food and equipment storage areas shall oe ma ntained fee of <br />rodPrits anC insects. <br /> <br />EI-C 16-20 12.27.2012 1 CO CLASS