CAL-CAR-69

Code
CAL-CAR-69
Mercy ID
V-02628-01
Encounter Date
10/18/2007
Last
Calvillo
First
Carmen
DOB
02/04/1969
County
Clayton
Street
190 Black Forest Rd.
City
Stockbridge
State
GA
Zip
30281-
Home
(678) 272-0267
Other
(404) 389-2739
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
some high school

Spouse Information

Last
Gaspar
First
Salvador
DOB
07/06/1971
Address
ARRESTADO
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
No
Consentimiento De Participar
No

Petitioner

TPO
YES
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
Efren Gaspar 11/03/1998 Mother GA/USA
Jesus Gaspar 06/21/2005 Mother 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
J. Manzo
Referred By
linea-Juana