IBA-KEY-81

Code
IBA-KEY-81
Mercy ID
V-00353-01
Encounter Date
11/28/2000
Last
Ibarra
First
Keyla
DOB
05/03/1981
County
Dekalb
Street
100 Castor Dr. Apt F2
City
Norcross
State
GA
Zip
30071-
Home
(770) 368-3088
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Viveros
First
Jorge guadalupe
DOB
12/12/1975
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
YES

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
Alexis Viveros 02/27/2000 Parents GA/USA
Gisela Valentin 12/23/1995 Parents GA/USA
Tiffany Viveros 09/07/2001 Mother GA/USA
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Manzo
Data Entry
D. Gomez
Referred By