CAS-BLA-72

Code
CAS-BLA-72
Mercy ID
V-02014-01
Encounter Date
08/19/2005
Last
Flores
First
Blanca
DOB
08/14/1972
County
Dekalb
Street
5953 North Dekalb Drive
City
Doraville
State
GA
Zip
30340-
Home
(770) 414-6863
Cell
(678) 458-1909
Work
(678) 663-8209
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
Grade school

Spouse Information

Last
Flores
First
Selvin
DOB
01/31/1980
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
YES
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
No
Stranger
YES

Children

NAME DOB LIVING WITH STATE/COUNTRY
Bianci Flores 09/25/2001 Parents GA/USA
Blanca Castillo 10/17/1990 Adulto/Casado GA/USA
Fernando Salazar 05/02/1992 Father Mexico
Israel Flores 10/21/1999 Parents GA/USA
Luis Salazar 08/28/1998 Mother w/Stepfather GA/USA
Maria Salazar 11/01/1994 Mother w/Stepfather GA/USA
Marta Flores 08/20/2002 Parents GA/USA
Sandra Salazar 05/21/1993 Mother w/Stepfather GA/USA
NOTES

Media Authoritation

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