ESP-SAR-75

Code
ESP-SAR-75
Mercy ID
V-02074-01
Encounter Date
10/22/2005
Last
España
First
Sara
DOB
09/26/1975
County
Dekalb
Street
4159 Chuck St. #8E
City
Clarkston
State
GA
Zip
30021-
Cell
(404) 399-1986
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Hernandez
First
Jesus
DOB
N/A
Address
N/A
Telephone
N/A
COB
Mexico
Home Owner
No
Driver
No
Home Owner
No
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
YES
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Alvaro Hernandez 11/07/1995 Parents GA/USA
Jesus Hernandez 10/09/1999 Parents GA/USA
Sandy Hernandez 03/28/1993 Parents GA/USA
Sonia Hernandez 06/07/1996 Parents GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
R. Gonzalez
Referred By