If you are renewing, please provide your current registration number. 

Type of registration *

Have you obtained planning approval to operate as a CFO from the City/County Planning Department? *

Fill in the days and times the CFO will be open *

Approved areas of CFO within the house (i.e. kitchen, dining room, etc.)  

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 *

Note: 
If the CFO is serviced by a private well, the water shall be tested yearly by an approved laboratory analysis to verify that it meets State water quality standards for bacteriological organisms (E.coli & total coliform) and primary inorganic chemicals (nitrate & nitrite). Approval to operate will be granted after submitting recent (within 3 months) laboratory results to this Department.

Water well test results 

Disposal of Wastewater
Please check what type of treatment is used to dispose of waste *

Note: 
In the event of septic system failure or plumbing problem, you are required to notify the local health department immediately.

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

Note
Jams, jellies, preserves, and fruit butter: Cottage food operations which produce jams, jellies, preserves, and other related products must be sure that their products meet the legal established standards of identity requirements for those products as set forth in 21 CFR Part 150. The purpose of the regulation is to maintain the integrity of the food product to ensure consumers consistently get what they expect. The product name and ingredients listed on the label must be factual and comply with the legal definitions and standards of identity or the product may be considered misbranded. Products made with other ingredients that are not defined in 21 CFR 150 cannot be produced by cottage food operations. Addition of other ingredients or alteration of ingredient profiles changes the chemistry of the food, which can allow the growth of various bacteria and toxins under the right conditions. For example, addition of peppers (i.e. jalapeno pepper) to make pepper jelly is not supported by 21 CFR 150 and the addition of this low acid ingredient could cause the formation of botulism toxin in the product if the proper controls are not used.

List all the food products by their common name *

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).
• Non-potentially hazardous food items 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. *

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

A CFO must properly label all cottage food products in compliance with the Federal Food, Drug, and Cosmetic Act, including but not limited to:

• The words "Made in a Home Kitchen" or "Repackaged in a Home Kitchen" in 12-point type on the cottage food product’s primary display panel.
• The name commonly used for the food product or an adequately descriptive name.
• The name of the cottage food operation which produced the food product.
• The address of the cottage food operation which produced the food product.
• The registration or permit number of the "Class A" or "Class B" cottage food operation.
• The name of the county local enforcement agency that issued the permit number.
• The ingredients of the cottage food product in descending order of predominance by weight, if the product contains two or more ingredients.
• 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.
• The net quantity (count, weight, or volume) of the food product, stated in both English (pound) units and metric units (grams).

 
 

Click here for an example of a sample label. 
 

My sample label 

By entering my name below, I certify that 
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, or California Food Handler Certificate. The website for CDPH is www.cdph.ca.gov. You must renew your certificate every 3 years.

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.

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 gross annual sales of $50,000 per year.

By entering my name below I also certify that:

• 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 at reasonable times, for the purposes of inspection or complaint investigation including the collection of food samples.
• I certify that I meet the requirements of the California Homemade Food Act, AB 1616 (Gatto) as it pertains to a Class A Cottage Food.
• In addition, I agree to notify the 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 or not the product is sold, consigned or given away.

Name *

Cottage Food Certificate
Note: You have 90 days to provide your handler certificate to the office. 

Date Applied