Code
SAL-CAT-89
Mercy ID
V-03368-01
Encounter Date
07/21/2010
Last
Salinas
First
Catalina
DOB
09/15/1989
County
Dekalb
Street
2931 North Drive
City
Doraville
State
GA
Zip
30340-
Cell
(678) 600-2629
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Preschool

Spouse Information

Last
N/A
First
N/A
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
DFACS County
Alcohol & Drug
No
# of DUIs
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
Driver License Date
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
Esmeralda Gonzalez 11/02/2008 Mother GA/USA
Jamie Salinas 02/26/2010 Mother GA/USA

Former Spouse 1 Information

Last
Gonzalez
First
Brinalto
DOB
07/26/1986
Telephone
N/A
COB
El Salvador
Home Owner
No
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