Opinion
G038641
1-8-2008
In re S. G. et al., Persons Coming Under the Juvenile Court Law. ORANGE COUNTY SOCIAL SERVICES AGENCY, Plaintiff and Respondent, v. TERESA W. et al., Defendant and Appellant.
Niccol Kording, under appointment by the Court of Appeal, for Defendant and Appellant Teresa W. Roni Keller, under appointment by the Court of Appeal, for Defendant and Appellant Lloyd G. Benjamin P. de Mayo, County Counsel, Karen L. Christensen and Julie J. Agin, Deputy County Counsel, for Plaintiff and Respondent. No appearance for the Minors.
NOT TO BE PUBLISHED
Parents Teresa W. and Lloyd G. appeal from the jurisdictional and dispositional orders removing their daughters, now 18-year-old S. G. and now 10-year-old Domonique G., from their custody. They claim there was insufficient evidence to support the findings that their failure to protect the children subjected them to actual or a substantial risk of serious physical harm. Mother also claims the evidence did not support removal because there were reasonable alternatives. We disagree and affirm.
FACTS
In August 2006 16-year-old S. G. was taken into custody by Orange County Social Services Agency (SSA) a week after she was admitted to Childrens Hospital of Los Angeles (CHLA). Prior to that visit, S. G., who is developmentally disabled and has a below average IQ, had been to at least five hospitals beginning in March 2006, suffering from headaches, abdominal pains, ambulation problems, and musculoskeletal pain.
In April 2006 she stayed one week at Cedars-Sinai Hospital (Cedars). The discharge summary noted that her symptoms had started approximately one to two years prior but had gotten worse in the last six months. The strong belief was that S. G. "was in need of significant psych [sic] evaluation and intervention [but mother] refused. . . . [I]t was reiterated multiple times by the attending [doctor] and the residents that [S. G.] see[k] psychotherapy after discharge. . . ." Also recommended were a rheumatology evaluation, rehabilitation treatment, and an endoscopy.
In June 2006 mother took S. G. to the emergency room at Cedars with similar symptoms. Tiring of the wait, when S. G. attempted to leave she was "not able to ambulate significantly." On release, Cedars instructed she see a neurologist; mother did not take her to this follow up exam because, according to father, she had neither insurance coverage for the test nor transportation. In July, mother obtained a wheelchair for S. G. who had become too weak to walk.
During the summer of 2006 fathers job as a security guard required that he stay on the site 24 hours every day. He visited with the family every week or two. Although he was concerned about S. G., she did not appear unhealthy to him.
One week before the admission to CHLA, which led to S. G.s detention, mother called 911 when S. G. experienced shortness of breath, vomiting, and weakness. Mother refused to have her transported to the hospital for further evaluation once her breath returned to normal, despite the presence of the other conditions.
When S. G. went to CHLA she was so malnourished she could not walk, or eat without vomiting. She weighed less than 78 pounds, having lost 15 pounds in two months. In the hospital she had daily episodes for about 20 minutes where she writhed and screamed. Her muscles had atrophied and she had ongoing headaches, short-term memory loss, and a flat affect. A treating physician stated that "mother ha[d] failed to take [S. G.] to recommended medical care. . . . [W]ithout proper diagnosis and treatment, [S. G.] is at risk of death."
After S. G. started receiving appropriate treatment and medication, including an anti-psychotic drug and a feeding tube, she was able to walk; vomiting stopped and use of the feeding tube decreased. Doctors noted "improvements in function only began once visits with her mother were limited." Her ambulation, which also had begun to improve, regressed and she started falling "apparently only when her father was present." When father visited, S. G. reverted from "sitting up and easily engaging in conversation as she had been doing . . . without her father present, [and began] lying in bed, mute and immobile." The conclusion was that both parents "visits should be limited and closely monitored." During this time parents refused to allow S. G. to have an endoscopy and SSA applied for a court order to carry out the procedure.
In addition, the recommended psychiatric evaluation could not be done because mother "insist[ed] on being present." When a psychiatrist tried to interview S. G., mother and S. G.s older sister answered the questions. The psychiatrist stated "[S. G.] could not put two thoughts together." She reiterated the treating physicians concern that she could not "vouch for [S. G.s] safety once she goes home."
In early October S. G. was transferred to UCI Medical Center for additional psychiatric care. A psychiatrist there filed an application to add an anti-depressant to the anti-psychotic she was already taking, stating he had been unable to obtain the parents permission because they had not returned his phone calls. He diagnosed psychosis and eating disorders not otherwise specified, major depression, malnutrition, nausea, vomiting and headaches. The court approved the request and also ordered Evidence Code section 730 evaluations by a psychologist and a psychiatrist. Even though the medication began to produce results, parents wanted to have it discontinued. When her involuntary hospital hold was about to expire, parents agreed to have her admitted voluntarily but only if she be taken off the psychotropic medications, which was done. Although S. G. was eating, she also continued to receive nutrients from the feeding tube.
In November S. G. was discharged from UCI to her grandmothers care. Domonique had been living there for several years and the court had allowed her to remain. S. G. became withdrawn and had "difficulty functioning in the family and within social networks." The SSA continuing care physician recommended S. G. take an anti-psychotic drug. The in-home therapist had difficulty "fully assess[ing] [S. G.s] . . . condition" and its causes because the family was not disclosing information. She noted S. G. was making "minimal progress" and for her to improve the family needed to be involved and cooperative.
In December the family revealed that when S. G. was 12 years old she had been in a car accident that had caused head trauma. It was "never medically treated"; she only saw a chiropractor for about three months.
By the first part of 2007, although S. G. attended some of her prescribed therapy sessions, she missed several and did not actively participate in many she attended. She untruthfully reported her headaches had stopped when in fact they were "still pretty severe."
S. G.s tutor reported on her significant lack of basic knowledge, including telling time, multiplication and division, and reading three-digit numbers. S. G. had not been to school in at least four years, purportedly being home schooled. Although it had been recommended for months, it was not until April 2007, just before the jurisdictional/dispositional hearing, that mother signed the educational assessment plan. In addition, both mother and grandmother failed to respond to contacts from the psychologist and psychiatrist appointed to conduct the evaluations, causing delays in the hearing.
In granting the dependency petitions the court found, by a preponderance of the evidence, that mother failed to provide S. G. with recommended medical evaluations and treatment placing her at continued risk of serious harm and that father knew or should have known S. G. was at risk for emotional or physical harm or both and failed to protect her. It stated that mother "clearly knew" S. G. was "extremely ill" and "clearly didnt do enough, putting [S. G.] at serious risk of death[,]" and father "knew about it, but didnt do enough." It also found that Domonique, as S. G.s sibling, was "a victim of ongoing neglect" due to the parents "willful and negligent actions."
DISCUSSION
Mother and father contend there was insufficient evidence to support the jurisdictional and dispositional findings. On appeal jurisdictional findings must be upheld if supported by substantial evidence. (In re James C. (2002) 104 Cal.App.4th 470, 482.) In reviewing the sufficiency of the evidence, we consider only whether there is evidence, contradicted or uncontradicted, supporting the trial courts conclusion. We resolve all conflicts in favor of the finding and make all legitimate inferences to affirm the order. (In re John V. (1992) 5 Cal.App.4th 1201, 1212.) The record reveals sufficient evidence to support the findings.
The court may take jurisdiction over a child if it finds by a preponderance of the evidence that "[t]he child has suffered, or there is a substantial risk that the child will suffer, serious physical harm or illness, as a result of the failure or inability of his or her parent or guardian to adequately supervise or protect the child, or the willful or negligent failure of the childs parent or guardian to adequately supervise or protect the child . . . or by the willful or negligent failure of the parent or guardian to provide the child with adequate . . . medical treatment . . . ." (Welf. & Inst. Code, § 300, subd. (b).) "The statutory definition consists of three elements: (1) neglectful conduct by the parent in one of the specified forms; (2) causation; and (3) `serious physical harm or illness to the minor, or a `substantial risk of such harm or illness." (In re Rocco M. (1991) 1 Cal.App.4th 814, 820.)
Mother asserts the latter two elements were not proven. We are not persuaded. Taking those two factors in reverse, we quickly dispose of the first. S. G. was near death when she was taken into custody. That she had improved by the time of the hearing was because evaluation and treatment that had been recommended prior to SSAs intervention had finally begun. Based on her prior conduct there is no reason to believe mother would continue the necessary treatment for S. G. An order for jurisdiction was required to protect against the risk of substantial harm in the future.
Causation is also substantiated. The record shows that most if not all of S. G.s condition had a psychological cause described as "[p]ersistent, chronic psychiatric problems." Doctors had a difficult time conducting a psychiatric evaluation because mother insisted she be present. Although S. G. began to be effectively treated with psychotropic drugs, both parents were opposed to S. G. taking such medication. And when the involuntary hold on her expired, parents voluntarily admitted her to the hospital only on the condition that the drugs be discontinued. At that point, her condition again worsened.
This was consistent with the parents attitude toward recommendations for psychological evaluation and treatment in the past. The discharge report when S. G. left CHLA in April 2006 strongly and repeatedly recommended, among other tests, psychological evaluation and intervention, but mother refused to allow it. And the day before S. G.s discharge from UCI mother was still insisting she did not have an eating disorder.
After S. G. was transferred from CHLA to the UCI medical center, one of S. G.s physicians had to obtain a court order to be able to administer an anti-depressant because, although parents had been informed of the recommended treatment, they would not return the doctors telephone calls to authorize it.
As late as a week before the jurisdiction/disposition hearing, the forensic psychologist performing the Evidence Code section 730 evaluation noted S. G.s family was negatively influencing her against SSA. In addition a treating psychologist noted she was "resistant to the treatment process." She observed "through contact with . . . grandmother that the family does not support active participation in mental health services."
Moreover parents missed at least half of their therapy sessions and parenting classes and at times either failed to engage in or slept through them when attending. And mother refused for months to sign necessary documents to have an educational assessment for S. G.
We sympathize with parents frustration when doctors initially could not find physical causes for S. G.s condition. But we reject their claims that because S. G. was discharged from hospitals or because doctors could not diagnose what was wrong with her, they did not act negligently or irresponsibly. Coupled with discharges were instructions for outpatient evaluation and treatment, something parents ignored. Just looking at her, parents, especially mother who saw her on a daily basis, had to know something was very wrong, and S. G. was so weak she was unable to walk, causing mother to buy her a wheelchair. Yet parents failed take recommended steps to find the cause.
We can also understand if parents had a problem with medical insurance that did not cover a recommended endoscopy and their alleged inability to pay the cost. But once S. G. was detained parents refused to sign an authorization for the procedure, requiring SSA to seek a court order.
Fathers situation is somewhat different because he was not living at home during some of the time when S. G. was weakening. But the record still contains sufficient evidence. In making its ruling the court stated that father was "incredibly nice, caring, [and] loving . . . ." In addition to that statement, father focuses on the actions he did take to protect S. G. He testified that whenever he believed S. G. was ill, he always took her to a hospital, and specifically in spring 2006 when she had no appetite and could not keep food down. He stayed with her for her two-week stay, meeting with doctors, helping with S. G.s medications, and supporting her emotionally. When she was released her conditioned seemed improved.
He also testified that after he moved to his job site in summer 2006, when he saw the girls every other week or so, S. G. looked healthy. Father believed mother had taken S. G. to doctors when necessary during his absence. Had he realized she was as ill as she was when he retuned home, he would have asked mother to get her treatment.
Father testified that when he did return home and saw that S. G. was sick, the next day he took her to a "prestigious[]" and highly reputable hospital so it could properly diagnose S. G.s condition. Again he stayed with her for the weeks she was there until SSA intervened and precluded him from continuing to care for her.
Father contends his testimony was uncontested and uncontradicted and that he did "everything possible" to care for her. But the evidence set out above is contrary and some of his own testimony was contradictory. For example, he testified that in July mother had to get a wheelchair for S. G. because she was too weak to walk. When he was living on his job site, he knew S. G. was "sick for a moment" and had been taken to the emergency room by mother. But he had no knowledge of any instructions from the hospital for S. G.s care and did not call the hospital to obtain any information. He had to have realized the severity of S. G.s condition but did nothing. He generally left S. G.s care to mother.
In addition, doctors reported S. G.s condition deteriorated while father was with her or visiting during her hospitalizations. Further, although he was willing to allow S. G. to take psychtropic medication, mother was not and he deferred to her position despite the severity of S. G.s condition. This leads to the reasonable inference S. G. would not have been treated had she not been detained.
The court found that despite fathers love and care for his daughter, the evidence showed he knew his daughter was ill and knew mother was not sufficiently caring for her and he "didnt do enough" to protect S. G. It continued: "I am hoping that in the future that any time there is a recommended treatment and if your wife scoffs at it, you stick up for yourself and stick up for your daughter and say, the doctors think this is what she needs, we need to explore that and follow the recommendations." The evidence set out above also is contra to fathers assertion the court could not take jurisdiction because the original risk of harm had been cured by the time of the hearing.
Mothers argument there were reasonable alternatives to removal is equally unpersuasive. (Welf. & Inst. Code, § 361, subd. (c)(1).) She relies on S. G.s statements during detention, where early in the process she said she wanted to go home and later asked for increased and unmonitored visitation. At the hearing, she testified her parents had done everything they could have. Although the courts have stated that the "juvenile court should examine the question of parental custody from the childs view point[ citation]" (In re Jamie M. (1982) 134 Cal.App.3d 530, 540), the facts on which mother relies do not change the ruling that reasonable efforts to avoid removal had been made. Parents were given chances to comply with recommended treatment after the detention and to participate in parenting classes. They failed to do so, despite the seriousness of S. G.s condition. That S. G. believed her parents had done everything possible does not make it so.
Because parents did no more than briefly mention any basis for challenging the order as to Domonique, any objections to it are waived. (People v. Stanley (1995) 10 Cal.4th 764, 793.)
Pursuant to Welfare and Institutions Code section 303, the court may retain jurisdiction over a dependent child until she reaches age 21. Although we do not make such a decision, it certainly seems in the best interest of S. G. that the court do so in this case. (See In re Tamika C. (2005) 131 Cal.App.4th 1153, 1160.)
DISPOSITION
The judgment is affirmed.
We Concur:
MOORE, J.
IKOLA, J.