DEL-BET-67

Code
DEL-BET-67
Mercy ID
V-01834-01
Encounter Date
02/14/2005
Last
De luna
First
Betty ann
DOB
07/25/1967
County
Other
Street
3553 Chicago Ave. Apt D
City
Riverside
State
CA
Zip
92507-
Home
(951) 662-1686
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Hernandez
First
Fidel
DOB
03/23/1964
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
YES
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Fidel Hernandez 07/28/1995 Mother GA/USA
Nathan de Luna 02/10/1993 Mother GA/USA
Stefan Hernandez 09/08/1997 Mother GA/USA
Vicente de Luna 10/18/1991 Mother 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
E. Lavizzo
Referred By
Rafael Miranda