RIV-GRA-69

Code
RIV-GRA-69
Mercy ID
V-02119-01
Encounter Date
11/09/2005
Last
Rivera
First
Graciela
DOB
05/15/1969
County
Dekalb
Street
not given
City
Lithonia
State
GA
Zip
30058-
Home
(770) 484-0826
Cell
(404) 389-3923
Family Status
Two parent family w/children
COB
Mexico
Gender
Female
Housing
Not Homeless
Education Level
High school graduate

Spouse Information

Last
Rivera
First
Jesus
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
No
Relative
No
Stranger
No
As An Adult
No
Partner
No
Relative
No
Stranger
No

Children

NAME DOB LIVING WITH STATE/COUNTRY
Cindy Rivera 11/03/1993 Parents GA/USA
Jesus Rivera Jr. 01/31/1992 Parents GA/USA
Jonathan Rivera 10/11/1990 Parents GA/USA
Yulissa Rivera 11/29/2000 Parents 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
R. Gonzalez
Referred By
Rafael