COR-CLA-62

Code
COR-CLA-62
Mercy ID
V-01572-01
Encounter Date
04/20/2004
Last
Cordoba
First
Clara
DOB
08/24/1962
County
Gwinnett
Street
4602 Hunter Ridge
City
Norcross
State
GA
Zip
30092-
Home
(770) 446-6727
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
some high school

Spouse Information

Last
Pelayo
First
Juan
Middle
M.
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
Alcohol & Drug
No
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
As A Child
YES
Relative
YES
Stranger
No
As An Adult
YES
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Clara Cordoba 11/15/1987 Mother w/Stepfather GA/USA
Dolores Pelayo 07/06/1998 Mother w/Stepfather GA/USA
Jonny Pelayo 11/05/1993 Mother w/Stepfather GA/USA
Jose Luis Cordoba 10/04/1978 Adulto/Casado Mexico
Karla Pelayo 07/14/1995 Mother w/Stepfather GA/USA
Mario Tamayo 09/05/1992 Mother w/Stepfather 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
K. Aleman
Referred By
Aurea Mota/walk In