CEP-HOR-73

Code
CEP-HOR-73
Mercy ID
V-01174-01
Encounter Date
03/13/2003
Last
Cepeda
First
Hortencia
DOB
10/21/1973
County
Gwinnett
Street
2800 Harrington Wood Court
City
Lawrenceville
State
GA
Zip
30044-
Home
(678) 851-1921
Family Status
Two parent family w/children
COB
Colombia
Gender
Female
Housing
Doubling Up
Education Level
High school graduate

Spouse Information

Last
Gonzalez
First
Armando
DOB
04/04/1970
Address
N/A
Telephone
N/A
COB
Colombia
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
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Armando Gonzalez 10/06/1996 Parents GA/USA
Natalia Gonzalez 03/09/1995 Parents GA/USA
NOTES

Media Authoritation

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