VAL-ROS-82

Code
VAL-ROS-82
Mercy ID
V-03075-01
Encounter Date
05/18/2009
Last
Valles
First
Rosa
DOB
09/16/1982
County
Dekalb
Street
3621 Meadowglen Village Lane
City
Doraville
State
GA
Zip
30340-
Cell
(770) 334-0419
Family Status
Single parent w/children
COB
Mexico
Gender
Female
Housing
Doubling Up
Education Level
Grade school

Spouse Information

Last
Solis
First
Sergio-Joselino
DOB
09/28/1983
Address
N/A
Telephone
N/A
COB
Honduras
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
Alexas Valles 04/24/2008 Mother GA/USA
Joseph Misael Valles 01/16/2004 Mother GA/USA
karen I. Valles 03/28/2007 Mother GA/USA

Former Spouse 1 Information

Last
Isaguirre
First
Jose lino
DOB
09/28/1983
Telephone
N/A
COB
Honduras
Home Owner
No
NOTES

Media Authoritation

NO DOY PERMISO
DOY PERMISO
No
Limitado Impresos
No
Limitado Educativo
No
Limitado CL
No
Intake
G. Landeros
Data Entry
J. Manzo
Referred By
linea-Juana