ORT-DAY-73

Code
ORT-DAY-73
Mercy ID
V-02395-01
Encounter Date
01/12/2007
Last
Arce
First
Dayleen
DOB
12/26/1973
County
Gwinnett
Street
3408 Rolling Ridge
City
Lawrenceville
State
GA
Zip
30044-
Cell
(770) 334-0916
Family Status
Single parent w/children
COB
Puerto Rico
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Santana
First
Humberto
DOB
N/A
Address
N/A
Telephone
N/A
COB
Dominican Rep
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
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
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Casanbot Arce 06/26/1991 DFACS GA/USA
Humberto Santana 12/11/1998 DFACS GA/USA
Miguel Angrelo 06/19/1985 DFACS GA/USA
Rigoberto Santana 12/11/1998 DFACS GA/USA
Virginia Santana 11/22/2000 DFACS GA/USA

Former Spouse 1 Information

Last
Santana
First
Humberto
DOB
N/A
Telephone
N/A
COB
Dominica Rep.
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
J. Manzo
Referred By
linea-Juana