ILLINOIS DEPARTMENT OF PUBLIC HEALTH
FARMERS MARKET FOOD PRODUCT SAMPLING HANDLER CERTIFICATE APPLICATION FORM
Rev. 04/23
Complete the information below and submit the appropriate required materials and fee.
Applicant Information
Full Legal Name
Phone Number
Street Address
City
State
ZIP Code
Email Address
Applicants Possessing a Valid CFPM
Applicants Who Do Not Possess a Valid CFPM
Individuals possessing a valid food protection
manager certification shall submit the
following:
Individuals who do not possess a valid food
protection manager certification shall submit
the following:
☐ Completed application form.
☐ Completed application form.
☐ Copy of Certified Food Protection Manager
(CFPM) certificate.
☐ Copy of a valid ANSI accredited or other
approved food handler training certificate.
☐ $10.00 certificate fee (non-refundable) via
check, money order, or online payment.
☐ Proof of completion of IDPH Farmers
Market Food Sampling Handler Training.
☐ $40.00 certificate fee (non-refundable) via
check, money order, or online payment.
Child Support Declaration
Under Illinois law, you must select one of the choices below regarding child support and sign the declaration. The
Illinois Department of Public Health will be unable to process your application until a completed statement is
provided. This information is required of ALL applicants, regardless of whether the applicant has ever been
ordered to pay child support. If issues of court‐ordered child support do not apply to you, answer “NO.”
Making a false statement shall subject the applicant to contempt of court {5 ILCS 100/10‐65(c)}.
Are you more than 30 days delinquent in complying with a child support order?
☐ Yes
☐ No
Signature
Date
Mail to: Illinois Department of Public Health
Division of Environmental Health
Food Program
525 W. Jefferson St., 3
rd
Floor
Springfield, IL 62761
I acknowledge that I have downloaded, reviewed, and understand the Pre-Opening and Self-Inspection Checklist
and Farmers Market Food Product Sampling Handler Guide.
Signature
Date
Department Use Only
Date Received
Certificate Number
Fee Paid $ _______________
Farmers Market Sampler Cercate Frequently Asked Quesons
What are the applicaon requirements?
For individuals possessing a valid Cered Food Protecon Manager (CFPM) cercaon, the
following must be submied:
• A completed IDPH Farmers Market Sampler Applicaon.
• A copy of their Cered Food Protecon Manager cercaon.
• Payment of the $10 applicaon fee.
Learn more about cered food protecon managers here: hps://dph.illinois.gov/topics-
services/food-safety/cfpm-fssmc.html
For Individuals who do not possess a valid CFPM, the following must be submied:
• Evidence of successful compleon of a food handler training course.
• A copy of the cercate of compleon from IDPH’s Farmers Market Food Sampling Handler
Training (available on I-TRAIN more informaon below).
• A completed IDPH Farmers Market Sampler Applicaon.
• Payment of the $40 applicaon fee.
Learn more about food handler training here: hps://dph.illinois.gov/topics-services/food-safety/food-
handler-training.html
Where is the Farmers Market Sampler Applicaon located?
The applicaon for the Farmers Market Sampler Applicaon is available on page 6 of the IDPH
Manufactured Food Applicaon, available at this link:
hps://dph.illinois.gov/content/dam/soi/en/web/idph/les/idph-fdd-manufactured-food-applicaon-
0.pdf.
Where can I nd the pre-opening and self-inspecon checklist and Farmers Market Food Product
Sampling Handler Guide?
These resources are available on the IDPH Farmers Market page, Farmers Markets (illinois.gov), under
publicaons. These resources, which are also available on I-TRAIN, should be reviewed prior to
compleng the applicaon.
Where can I nd the Farmers Market Sampler Training?
IDPH’s Farmers Market Food Sampling Training can be accessed on I-TRAIN linked here:
hps://i.train.org. Applicants need to set up an account to access the training. The training can be found
under course number 1061218. The applicaon, pre-opening checklist, and sampler guide are also
available on I-TRAIN. Upon successful compleon of the course, a cercate of compleon will be
available to download or print.
Can all employees in my business use the same sampling cercate?
No. The Farmers Market Sampler Cercate is an individual cercate. Each employee involved in
preparing samples is required to have a cercate.
Can I use this cercate to sample food outside of farmers markets?
No. This cercate is only intended to allow food sampling at farmers markets. You will need to contact
the local health department where you would like to sample to learn about requirements for product
sampling at other venues.
Do I need to take the farmers market training again when I renew my cercate?
No. The training is only required to be completed once but you may take the training again as a
refresher. When renewing your cercate, you must include documentaon that you completed the
training.
Can I sample another vendor’s products?
You may sample another vendor’s products if the product meets the applicable/local requirements to be
sold in the jurisdicon (e.g., coage food registraon or farmers market permit).
Can the local health department inspect me if I have an IDPH sampler cercate?
Yes. The local health department may inspect a vendor to ensure compliance with sanitaon
requirements.
Can the local health department require me to cease sampling?
Yes. The local health department can cease sampling or sales if there is imminent health hazard or if a
product is found to be misbranded, adulterated, or if a product is not in compliance with the permit
exempon.
FARMERS MARKET
Food Product Sampling Handler Guide
Proper Handwashing Station
A proper handwashing facility includes clean water, soap, and paper or
disposable towels for hand drying. If warm water under pressure is not available,
the handwash station must provide gravity fed water. For example, a 5-gallon
container with a spigot that can be turned on to allow potable water to flow over
one’s hands into a waste receiving bucket of equal or larger volume to catch
flowing waste water.
Handwashing facilities must be provided if cutting, slicing, dicing fresh fruits or
vegetables, and preparing food onsite and/or whenever samples are being
served.
Wash Your Hands
The Centers for Disease Control and Prevention (CDC) notes that handwashing,
particularly before and after events, such as food preparation and distribution, is one of
the best ways to remove germs, avoid getting sick, and prevent the spread of germs to
others.
To begin the process, first turn on the water or open the spigot. It is important to wet
your hands with clean, running water (warm or cold). Next apply soap and be sure to
turn off the spigot after soap is applied. Lather your hands by rubbing them together
with the soap. Be sure to lather the backs of your hands, between your fingers, and
under your nails. Scrub your hands for at least 20 seconds. Need a timer? Hum the
"Happy Birthday" song from beginning to end twice. Rinse your hands well under clean,
running water. Dry your hands using a clean paper or disposable towel. Don’t forget to
turn off the spigot with a paper towel.
Time and Temperature
Potentially hazardous foods (also called temperature control for safety (TCS) food
items) shall be maintained at 135°F or above or 41°F or below. Additionally, hot food
storage units, including electrical equipment, propane stoves, grills, etc., must be able
to maintain TCS food items at or above 135°F. An effectively insulated, hard-sided,
cleanable container with sufficient ice or other means, including mechanical
refrigeration, to maintain TCS food at 41°F or below is approved for the storage of TCS
food.
If a thermometer is not available, or you plan on using time in lieu of temperature for
samples, the time each sample was sliced/prepared must be recorded. ALL samples
must be discarded after two hours or within one hour if above 90°F ambient
temperature. Even if the sampling products are out for less than two hours, the
products must be discarded at the end of the Farmers Market.
FARMERS MARKET
Food Product Sampling Handler Guide
Cleaning and Sanitizing
Equipment, food-contact surfaces, and utensils must be cleaned and sanitized when changing from
from working with raw foods to working with ready to eat foods; between uses with raw fruits and vegetables
-
-
and TCS food; before using or storing a food temperature measuring device; and, if used with
TCS food, cleaned throughout the day at least every four hours; and at any time during the
operation when contamination may have occurred.
In the event that you do not bring enough utensils or are displaying food for more than four hours, you are
required to set up a ware wash station that uses a three-basin method for the purposes of washing, rinsing,
and sanitizing equipment and utensils.
Chlorine bleach or other approved sanitizers must be provided for sanitizing utensils, food contact surfaces,
equipment, and wiping cloths. Sanitizers must be used in accordance with the USEPA-registered label use
instructions. An approved test kit must be available to accurately measure the concentration of sanitizing
solution.
To properly sanitize, immerse the object for at least one minute in a clean solution containing at
least 50 parts per million of available chlorine as a hypochlorite and having a temperature of at least 75°F.
This equates to 5 tsp. of chlorine solution per every 5 gallons of water.
To test the chlorine concentration
using a test strip, place the strip in your sanitizing solution. This will either be basin #3 as seen in ware
washing or a commonly used sani
-
bucket used when sanitizing contact surfaces as shown below. Next, as
the test strip is activated by the chlorine solution, compare the color that it changes to the color key on
the test strip tube. This will indicate the concentration of the sanitizing solution.
Sanitizer test kits can be purchased in multiple places on the internet and locally. If searching on the inter-
net, a simple search for “chlorine sanitizer test strips or kit” should point you in the right direction. If using
a wiping cloth intended to be used moist or wiping cloths intended to be air
-
dried, a mechanical clothes
washer and dryer need not be provided.
If you have quesons or concerns about product sampling, contact the IDPH Food Program at DPH.Food@illinois.gov.
Illinois Department of Public Health
Division of Environmental Health
Pre-Opening and Self-Inspecon Checklist for Cered Farmers Market Food Product Samplers
This checklist can be used to assist in conducng a self-inspecon of your stand before preparing or sampling foods. If
you are missing an item on this checklist, DO NOT BEGIN PREPARING OR SAMPLING FOODS, unl corrected.
☐
Handwashing staon including a warm water container with a free-owing spigot (no push
buon) and a bucket of equal or larger size to catch the wastewater. Ensure hand soap, paper
towels, and a waste receptacle are provided.
☐
An eecve means to maintain cold food temperatures below 41°F and frozen foods below
32°F. As an alternave to mechanical refrigeraon, use an eecvely insulated hard-sided,
cleanable container with sucient ice or other cooling means.
☐
Four separate sinks, pails, or basins -- three for washing, rinsing, and sanizing utensils and
equipment, and one for sanizer wiping cloths.
☐
Sucient potable water for food preparaon, ware washing, and handwashing. Hoses used
to obtain potable water must be food grade.
☐
Dishwashing soap and sanizer (bleach, iodine, or quaternary ammonia). Sanizers shall be
USEPA-registered and used in accordance with label use instrucons.
☐
An approved and appropriate test kit, such as test strips, to test sanizer concentraons.
☐
A metal-stemmed thermometer (not glass) accurate to +/- 2°F to 220°F for checking food
temperatures.
☐
Equipment, utensils, etc., in good condion (no chips, ping, rust, etc.). Equipment to be
cleaned and sanized before preparing samples.
☐
Single service arcles, including plasc forks, spoons, or plates, available for consumers.
☐
Utensils (e.g., deli ssue, tongs, etc.) or single-use (disposable) gloves to avoid bare hand
contact with ready-to-eat foods. Latex gloves should not be used to prepare food and/or
handle food.
☐
Food, utensils, single-service arcles (e.g., plasc forks, plates, etc.) and food equipment
stored at least 6 inches above the ground on pallets, tables, or shelves.
☐
Fresh fruits and vegetables selected for quality and washed before cung and distribung
as samples. Prepared and held separately from raw meats, poultry, and seafood.
☐
Sucient (durable and easily cleanable) garbage containers (including dumpsters with lids)
to hold garbage and refuse that accumulates. Containers to be covered when not in use or
lled.
☐
Food stand constructed to prevent contaminaon of food and facilitate cleaning of the food
preparaon area (e.g., smooth, durable, and easily cleanable).
☐
Toxic or poisonous materials stored in a separate area away from food and food preparaon
areas.
☐
Hair restraints available and used by employees handling food so hair is covered and
contained.
Addional Consideraons for Food Safety: Any potenally hazardous food held or stored between 41°F and 135°F must
be destroyed. If you plan on using me in lieu of temperature for samples, the me each sample was sliced/prepared
must be recorded. Samples must be discarded aer two hours or within one hour if above 90°F ambient temperature.
Samples should be discarded at the end of the farmers market.
