San Joaquin Form Ehd 16 27 PDF Details

Navigating the terrain of starting a Cottage Food Operation (CFO) in San Joaquin County has been made straightforward with the comprehensive San Joaquin Ehd 16 27 form, designed under the California Homemade Food Act AB 1616. Created to regulate home-based food businesses, this form serves as a tool for entrepreneurs to register or permit their operations, guiding them through various requirements from product types to safety standards. Offering insights into allowable food products, such as baked goods, dried mixes, and certain confections, it sets clear boundaries by prohibiting potentially hazardous foods like those with cream or meat fillings. The form not only addresses direct and indirect sales classifications but also emphasizes compliance with product labeling laws, waste disposal, water source testing, and public health guidelines. For cottage food operators, understanding the importance of submitting detailed product descriptions, adhering to precise labeling requirements, and fulfilling local health department protocols is crucial. The document further outlines the need for food handler education, limits on employee numbers, and restrictions on delivery methods, ensuring that all CFOs maintain safety and quality from preparation to the point of sale. As a framework for operational compliance and public health safety, the San Joaquin Ehd 16 27 form exemplifies the proactive steps taken by San Joaquin County to support small food businesses while protecting consumers.

QuestionAnswer
Form NameSan Joaquin Form Ehd 16 27
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesCFO REG PERMITTING FORM san joaquin cottage food form

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Environmental Health Department

COTTAGE FOOD OPERATIONS (CFO)

REGISTRATION/PERMITTING FORM

(CALIFORNIA HOMEMADE FOOD ACT AB 1616 (GATTO))

CFO Business Name:

Owner Name:

Date:

 

 

 

CFO Physical Address:

CFO City:

CFO Zip:

 

 

 

Website (If applicable):

Telephone:

 

 

 

 

1.Categories:

“Class A” (Direct Sales Only) $155

“Class B” (Direct & Indirect Sales) $310

2. Prohibited Items:

Initial if you agree to abide by the following: ________

Foods containing cream, custard, or meat fillings are potentially hazardous and are NOT ALLOWED. Only foods that are defined as “non-potentially hazardous” are approved for preparation by a Cottage Food Operation. These foods include items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness.

3.“Class A” Self Certification Checklist:

Checklist completed (“Class A” CFOs Only)

4.Products:

Please check the items you will be preparing and/or selling.

Baked Goods

Candy

Churros

Buttercream Frosting/Icing*

Dried Mole Paste

Fruit Empanadas

Granola/Cereals

Cotton Candy

Dried Pasta

Dry Baking Mixes

Waffle Cones

Buttercream Fondant/Gumpaste*

Herb/Spice Blends

Fruit Tamales/Pies

Seasoning Salt

Candied Apples

Honey

Mustard

Dried Grain Mixes

Flat Icing

Pizzeles

Nut Mixes/Nut

Butters

Trail Mix/ Dried Fruit

Salted Caramel/Fudge

Popcorn/ Popcorn Balls

Vinegar

Fruit Butter**

Ground

Chocolate

Jams/Jellies**

Fried or Baked Donuts and Waffles

Dried Fruit

Marshmallows/

Marshmallow

Bars*

Dried or Dehydrated Vegetables

Dried Vegetarian- Based Soup Mixes

Vegetable and Potato Chips

1868 E. Hazelton Avenue | Stockton, California 95205 | T 209 468-3420 | F 209 464-0138 | www.sjcehd.com

Sweet Sorghum Syrup

Fried or Baked Donuts and Waffles

Roasted Coffee (Beans/Grounds)

Dried Hot Chocolate

Environmental Health Department

Chocolate Covered Nonperishable Food

Other_____________________________

* Do not contain eggs, cream, or cream cheese

** If preparing jams, jellies or fruit butters, include a list of ingredients (attach separate page if needed). These items must comply with standards described in Part 150 of Title 21 of the Code of Federal

Regulations http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?CFRPart=150

Food Descriptions:

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5. Product Labeling:

Initial if you agree to abide by the following: ________

For a detailed description, see the CDPH document “Labeling Requirements for Cottage Food Products.” All cottage food products must be properly labeled in compliance with the Federal, Food, Drug, and Cosmetic Act (21 U.S.C. Sec. 343 et seq.) The label must include:

Submit one example label for one of your CFO products.

The words “Made in a Home Kitchen” in 12-point type.

The name commonly used to describe the food product.

The name city, state and zip code of the cottage food operation which produced the cottage food product. If the firm is not listed in the current telephone directory then a street address must also be declared. (A contact phone number or email address is optional but may be helpful for consumers to contact your business.

The registration or permit number of the cottage food operation which produced the cottage food product and in the case of “Class B” CFOs, the name of the county where the permit was issued.

The ingredients of the food product, in descending order of predominance by weight, if the product contains two or more ingredients.

The net quantity (count, weight, or volume) of the food product. It must be stated in both English (pound) units and metric units (grams).

A declaration on the label in plain language if the food contains any of the eight major food allergens such as milk, eggs, fish, shellfish, tree nuts, wheat, peanuts, and soybeans. There are two approved methods prescribed by federal law for declaring the food sources of allergens in packaged foods: 1) in a separate summary statement immediately following or adjacent to the ingredient list, or 2) within the ingredient list.

If the label makes approved nutrient content claims or health claims, the label must contain a “Nutrition Facts” statement on the information panel.

O The use of the following eleven terms are considered nutrient content claims (nutritional value of a food): free, low, reduced, fewer, high, less, more, lean, extra lean, good source, and light. Specific requirements have been established for the use of these terms. Please refer to the Cottage Food Labeling Guideline for more details.

O A health claim is a statement or message on the label that describes the relationship between a food component and a disease or health-related condition (e.g., sodium and hypertension, calcium and osteoporosis). Please refer to the Cottage Food Labeling Guideline for more details.

Labels must be legible and in English (accurately translated information in another language may accompany it).

Labels, wrappers, inks, adhesives, paper, and packaging materials that come into contact with the cottage food product by touching the product or penetrating the packaging must be food-grade (safe for food contact) and not contaminate the food.

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Example:

Note: For the “Issued in County” - Identify the jurisdiction (city/county) where you are obtaining approval.

6.Disposal of Waste:

Please check what type of treatment is used to dispose of waste

Public Sewer Service

Private Septic System

In the event of septic system failure or plumbing problem, you are required to notify San Joaquin County Environmental Health Department immediately.

7.Water Source:

Pease Identify the water source to be used in Cottage Food Facility (check one box)

Name of Public Water System or Community Services District:

Private Water Supply**, Identify the source (well, spring, surface, etc.):

Private Water Supply: Initial Water Quality Results

Check boxes below if initial water testing has been completed.

All testing must be done at a State Certified Laboratory. Either attach lab results or provide name of lab, date & results in space provided next to type of test.

*(Testing frequency for transient Non-Community Water Systems after initial testing)

Bacteriological Test (quarterly*):

Nitrate Test (yearly*):

Nitrite Test (every 3 years*):

**Additional information may be required if food is prepared from a home with a private water supply – check with local jurisdiction.

8.Food Processor Course: Initial if you agree to abide by the following: ________

Within 3 months of being approved to operate by the Environmental Health Department, please provide proof of completion of the California Food Handler course in lieu of the California Department of Public Health (CDPH) food processor course.

For more information see CDPH website www.cdph.ca.gov/programs/Pages/fdbCottageFood.aspx

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9. Employee:

Initial if you agree to abide by the following: ________

I understand that I may not have more than one full-time equivalent cottage food employee, not including a family member or household member of the cottage food operator, working within the registered or permitted area of a private home where the cottage food operator resides and where cottage food products are prepared or packaged for direct, indirect, or direct and indirect sale to consumers.

10. Delivery Limitation:

Initial if you agree to abide by the following: ________

I understand that I may accept orders and payments via the internet, mail or phone. However, all “Class A” and “Class B” CFO products must be delivered directly (in person) to the customer. The CFO products may not be delivered via the United States Postal Service, UPS, FedEx, or using any other indirect delivery method as deliveries are regulated by, and subject to, CDPH registration and state and federal requirements.

11.Owner’s Statement:

I, ________________________________________, agree to grant access to the local health department to

conduct an inspection of my cottage food operation (mark one)

“Class A”: In the event of a consumer complaint or reported food-borne illness

“Class B”: For regular annual facility inspections and in the event of a consumer complaint or food-borne

I, ________________________________________, agree to notify the San Joaquin County

Environmental Health Department prior to modifying my food list, type of operation, and/or method of selling, distributing, or otherwise providing my CFO products to the consumer or retailers, regardless of whether the product is sold, consigned, or given away.

Owner’s Signature

Print Name

Date

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