CAC-SAY-67

Code
CAC-SAY-67
Mercy ID
V-00848-01
Encounter Date
02/19/2002
Last
Caceres
First
Sayonara
DOB
03/10/1967
County
Gwinnett
Street
1171 Bailing Dr.
City
Lawrenceville
State
GA
Zip
30043-
Home
(404) 483-5247
Family Status
Two parent family w/children
COB
Ecuador
Gender
Female
Housing
Not Homeless
Education Level
Some College

Spouse Information

Last
Kennely
First
Steven
DOB
11/07/1969
Address
N/A
Telephone
N/A
COB
EEUU
Home Owner
YES
Driver
No
Home Owner
YES
SOLO
No
Court Mandated
No
Program Completed
No
DFCS Mandated
No
Alcohol & Drug
No
Partner Referred to Tepestri
No
Recidivism/Court
No
New Incident
No
Promesa de Confidencialidad
No
Consentimiento De Participar
No

Petitioner

TPO
No
Stay Away Condition
No
Mutual
No

Defendant

TPO
No
Stay Away Condition
No
Mutual
No
Driver
YES
As A Child
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Elvis Kennely 11/07/2000 Parents GA/USA
Eriks Kennely 11/07/2000 Parents GA/USA
Juan Izquierdo 04/19/1986 Parents GA/USA
Lee Kennely 03/17/1990 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
K. Aleman
Referred By
x7764 Rebecca