Department of Public Health Online Form - Cottage Food Operation - Class A Registration & Self Certification Checklist
Cottage Food Operation - Class A Registration & Self Certification Checklist

Type of registration*
New Renewal
If you are renewing, please provide your current registration number.
Registration Number 
Have you obtained planning approval to operate as a CFO from the City/County Planning Department?*
Yes No

Business Name*
Owner Name*
Address*
City*
Zip*
County*
Phone*
Email Address 
Website 

Mailing Address (If different
City 
Zip 

Water Source
Please check what type of water source will be used in Cottage Food Facility*
City Water Private Well
Note: If the CFO is serviced by a private well, the water shall be tested by an approved laboratory analysis to verify that it meets State water quality standards for bacteriological and primary inorganic chemicals. Approval to operate will be granted after submitting recent (within 3 months) laboratory results to this Department.
Disposal of Waste
Please check what type of treatment is used to dispose of waste*
Public Sewer Service Private Septic System

Products
The following are the food products allowed in a CFO operation. Please check the items you will be preparing and/or selling. *
Baked Goods
Candy
Churros
Dried Mole Paste
Fruit Empanadas
Granola/Cereals
Dried Pasta
Dry Baking Mixes
Herb Blends
Fruit Tamales/Pies
Nut Butter/Nut Mixes
Sweet Sorghum Syrup
Honey
Mustard
Tortillas
Pizzelles
Dried Tea/Roasted Coffee
Popcorn
Vinegar
Waffle Cones
Jams/Jellies/Preserves
Chocolate Covered Nonperishable Foods
Dried Fruit/Nuts
Trail Mix
Fruit Butter
List all the food products by their common name(s) including all the varieties (ex. Cakes, Chocolate Cake, Lemon Cake, etc.)*
Prohibited Items
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 (CFO). These are food items that do not require refrigeration to keep them safe from bacterial growth that could be a cause of food-borne illness.
Enter your initials here if you agree with the above statement *

Operations
Fill in the days and times the CFO will be open*
Approved areas of CFO within the house (i.e. kitchen, dining room, etc.) *
Food Processor Course
Within 3 months of being approved to operate by the Environmental Health Division, please provide proof of completion of the required California Department of Public Health (CDPH) food processor course. The website for CDPH is www.cdph.ca.gov.
Enter your initials here if you agree with the above statement*
Employee
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, within the registered area of a private home where the cottage food operator resides and where cottage food products are prepared or packaged for direct sale to consumers.
Enter your initials here if you agree with the above statement*
Gross Annual Sales
I understand that I will lose my CFO status and will need to become permitted in a commercial facility if my CFO business exceeds the following gross annual sales figures for the calendar years in the following table:
     Calendar Year Gross Annual Sales
In 2013$35,000
In 2014$45,000
In 2015$50,000

Enter your initials here if you agree with the above statement*
Certification
I agree to grant access to the local health department to conduct an inspection of my cottage food operation's primary domestic residence housing the CFO during normal business hours, during the hours specified on the registration form, or at other reasonable times, for the purposes of inspection or complaint investigation including the collection of food samples.

In addition, I agree to notify Los Angeles County Environmental Health 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 or not the product is sold, consigned or given away.
Enter your initials here if you agree with the above statement*
Name*
Date Submitted

Cottage Food Operation (CFO) - Self-Certification Checklist


The following requirements are outlined in the Cottage Food Operations (CFO) regulations and are provided as minimum standards of health and safety for the preparation of approved cottage foods in the home.  

    Facility Requirements
  • The CFO shall be located in a private dwelling where the CFO operator currently resides.
  • CFO food preparation will take place in the private kitchen within that home.
  • Additional storage used for the CFO will be within the home and used exclusively for storage.
  • Sleeping quarters are excluded from areas used for CFO food preparation or storage.
    Planning Requirements
  • I have complied with the applicable planning requirements for the CFO.
    Employee and Training Requirements
  • All persons preparing or packaging CFO products have completed the California Department of Public Health (CDPH) food processor course. If not, the operator shall complete the course and provide certificate(s) within five days of completion.
  • The CFO has no more than 1 full-time equivalent employee (immediate family or household members are not included).
    Sanitation Requirements
  • Kitchen equipment and utensils used to produce CFO products are clean and maintained in a good state of repair.
  • All food contact surfaces, equipment, and utensils used for the preparation, packaging, or handling of any CFO products shall be washed, rinsed, and sanitized before each use.
  • All food preparation and food and equipment storage areas shall be maintained free of rodents and insects.
    Food Preparation Requirements
    (includes packaging and handling)
  • Warm water, hand soap and clean towels are available for hand washing.
  • Hand washing is required immediately prior to handling foods and after engaging in any activity that contaminates the hands such as after using the toilet, coughing or sneezing, eating or smoking.
  • All food ingredients used in the CFO products are from an approved source.
  • Potable water shall be used for hand washing, ware washing and as an ingredient.
    During the Preparation, Packaging or Handling of CFO Product
  • Domestic activities such as family meal preparation, dishwashing, clothes washing or ironing, kitchen cleaning or guest entertainment are not allowed.
  • Infants, small children, or pets are not allowed.
  • Smoking is not allowed.
  • Any person with a contagious illness shall refrain from work in the CFO.
 
 
*
I certify that I have read and agree with the entire checklist above.


Labeling Requirements

A sample label will be provided to this Department for review and approval. 
Upload

CertificationBy completing the section below I am certifying that I meet the requirements of the California Homemade Food Act, AB 1616 (Gatto) as it pertains to a Class A Cottage Food. Prior to making any changes, I acknowledge that I must notify Los Angeles County Environmental Health Division of any intended changes to the above statement.
Name*
Date*
Note: In order to begin the application review process, you are required to submit a non-refundable registration fee of $103.00, sample labels and a product list. If payment is not received within 30 days from the application submittal date, a new application must be submitted.

An additional fee of $184.00 will be assessed for any complaint investigations.
Submit
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