CAS-MAR-67

Code
CAS-MAR-67
Mercy ID
V-00012-01
Encounter Date
01/05/2000
Last
Castañeda
First
Maria
DOB
02/25/1967
County
Gwinnett
Street
5376 Standford Village Lane
City
Norcross
State
GA
Zip
30371-
Home
(404) 488-1819
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

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
YES
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
Jacqueline Castañeda 07/14/1989 Mother GA/USA
Jessy Castañeda 04/29/1986 Mother GA/USA
Pedro Antonio Castañeda 08/24/1992 Mother GA/USA
NOTES
Signed consent form and promesa before the fire

Media Authoritation

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