ALV-MAR-65

Code
ALV-MAR-65
Mercy ID
V-00104-01
Encounter Date
02/22/2000
Last
Alvarez
First
Maria de jesus
DOB
03/06/1965
County
Dekalb
Street
1800 memorial drive j-8
City
Decatur
State
GA
Zip
30317-
Home
(404) 370-3753
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Pineda
First
Carlos
DOB
06/02/1967
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
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Everardo Galvan 06/06/1985 Cousin GA/USA
Omar Pineda 05/03/1992 Parents GA/USA
Yadira Pineda 10/15/1996 Parents GA/USA
Yahiris Pineda 05/13/2001 Parents GA/USA
Yosselin Pineda 07/04/1994 Parents GA/USA
NOTES
Evaluation was on 8/6/02 but Maria did not attend; however she was contacted over the phone before.

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
J. Perez
Data Entry
S. Aviña
Referred By
x7764 Ma. Eugenia