In re D.R. , 117 N.E.3d 1075 ( 2018 )


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  • [Cite as In re D.R., 2018-Ohio-3434.]
    IN THE COURT OF APPEALS OF OHIO
    THIRD APPELLATE DISTRICT
    SHELBY COUNTY
    IN RE:
    CASE NO. 17-17-21
    D.R.
    ADJUDGED DEPENDENT CHILD.
    [JOSHUA R. - APPELLANT]                                     OPINION
    [FELICITY B. - APPELLANT]
    Appeal from Shelby County Common Pleas Court
    Juvenile Division
    Trial Court No. 2015 NEG 0006
    Judgment Affirmed
    Date of Decision: August 27, 2018
    APPEARANCES:
    Kristina M. Morris for Appellant, Felicity B.
    Jeremy M. Tomb for Appellant, Joshua R.
    Anne K. Bauer for Appellee, SCDJFS-CSD
    Case No. 17-17-21
    SHAW, J.
    {¶1} Appellants, Felicity B. and Joshua R., appeal the November 6, 2017
    judgment of the Shelby County Court of Common Pleas, Juvenile Division, granting
    the motion for permanent custody of their child, D.R., filed by Appellee, the Shelby
    County Department of Job and Family Services-Children Services Division,
    (hereinafter the “Agency”).
    {¶2} D.R. was born in December of 2014 to Felicity and Joshua. Joshua was
    later confirmed to be D.R.’s biological father through genetic testing.
    Procedural History
    {¶3} On February 2, 2015, the Agency filed a complaint alleging nearly two-
    month-old D.R. to be a neglected and dependent child pursuant to R.C.
    2151.03(A)(2) & (3) and R.C. 2151.04(A),(B) & (C). In an affidavit accompanying
    the complaint, the Agency alleged that less than a week after his birth, it had
    received reports indicating that D.R. was “under-fed and exhibiting symptoms of
    jaundice without receiving medical treatment.” (Doc. No. 2). The Agency stated
    that Felicity and Joshua “are active clients of the Shelby County Board of
    Developmental Disabilities, and are eligible for developmental disability services
    due to their various medical conditions.” (Id.). The complaint further mentioned
    that Felicity had been diagnosed as a “lower-functioning individual” and that she
    reportedly “functions at the level of a person that is approximately eight years old.”
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    (Id.). The Agency indicated that it was attempting to obtain similar records
    regarding Joshua.
    {¶4} As the basis for the complaint, the Agency alleged that “the parents’
    faults, habits, condition, and lack of adequate parental care have contributed to an
    environment that has caused harm to the subject child.” (Id.). The Agency further
    detailed that “[t]hese circumstances include, but are not limited to, in (sic) infant
    bottles not being sanitized and cleaned properly, periods of overfeeding the child
    mixed with periods of severe underfeeding, and other conditions affecting the
    home.” (Id.). The Agency later filed an amended affidavit which alleged that that
    Felicity and Joshua were “frequently putting the infant in bed with them while they
    fall asleep, creating a risk of suffocation.” (Doc. No. 23).
    {¶5} On February 24, 2015, the Agency filed a case plan regarding D.R. and
    the trial court appointed a Court Appointed Special Advocate (“CASA”) to the case.
    {¶6} On March 10, 2015, the trial court held an adjudicatory hearing on the
    complaint, where testimony was presented. The trial court found by clear and
    convincing evidence D.R. to be a dependent child and adjudicated him the same,
    but found a lack of clear and convincing evidence to find D.R. to be a neglected
    child.
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    {¶7} On April 2, 2015, the CASA filed her report with the trial court,
    recommending that D.R. remain in the custody of Felicity and Joshua with the
    Agency having protective supervision.
    {¶8} On April 29, 2015, the trial court issued a dispositional order approving
    the Agency’s case plan and ordering that D.R. remain in Felicity and Joshua’s
    custody subject to court-ordered protective supervision. Pursuant to the case plan,
    the Agency facilitated in-home coaching/parental education, transportation
    assistance, and childcare services.        Felicity and Joshua also submitted to
    psychological evaluations.
    {¶9} On July 17, 2015, the Agency filed an ex parte motion for emergency
    custody of D.R. As the basis for the motion, the Agency alleged that “D.R. cannot
    be safely maintained in the family home.” (Doc. No. 49). The Agency recited
    Felicity’s and Josh’s inability to follow the pediatrician’s instructions to treat D.R.’s
    respiratory issues by failing to administer the prescribed amount of medicine, and
    by failing to maintain appropriate cleanliness and hygiene standards. The Agency
    also cited a concern with the lack of improvement in the parents’ ability to
    consistently and safely provide for D.R. on a daily basis, despite the intense level of
    services being provided to them, which the Agency contended posed an immediate
    danger to D.R. The trial court subsequently granted the Agency’s ex parte motion
    for temporary custody of D.R.
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    {¶10} The Agency also filed an amended case plan with the trial court, which
    contemplated that D.R. remain in its temporary custody with Felicity and Joshua
    having supervised visitations. The objectives of the case plan were focused upon
    the ultimate goal of reunification.
    {¶11} On July 21, 2015, the trial court held a shelter care hearing, where
    testimony was presented in support of the Agency’s motion for temporary custody.
    In its July 29, 2015 Judgment Entry the trial court found reasonable grounds “that
    the child is in immediate danger from the child’s surroundings, and removal was
    necessary to prevent the child’s physical or emotional harm.” (Doc. No. 59 at 3).
    The trial court further found that “reasonable efforts to prevent the removal of the
    subject child from the home have been made, however due to the parents’ inability
    to properly care for the child and administer the child’s medication, it is in the
    child’s best interest to remain in the custody of the [Agency]”. (Id.). The trial court
    approved and adopted the amended case plan, and ordered D.R. to remain in the
    temporary custody of the Agency.
    {¶12} On October 8, 2015, the trial court conducted a review hearing, where
    testimony was presented indicating that Felicity and Joshua were showing signs of
    progress in consistently maintaining a clean home. D.R.’s health had also improved
    since his removal from the home. The evidence indicated that D.R.’s respiratory
    problems while in his parents’ care were likely caused by overfeeding and D.R.
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    aspirating into his lungs. The trial court determined that it was in D.R.’s best interest
    to continue the Agency’s temporary custody of D.R., with Felicity and Joshua
    having supervised visitation with D.R. at their home.
    {¶13} On June 15, 2016, the Agency filed a motion to approve an amended
    case plan.    The Agency requested that Felicity and Joshua undergo another
    psychological evaluation to receive “additional input, recommendations, and
    measures of progress since the initial evaluation.” (Doc. No. 67).         The Agency
    stated that it “continues to seek additional supports that can make a difference as it
    pertains to reunification planning.” (Id.). The trial court subsequently approved the
    amended case plan.
    {¶14} On July 22, 2016, the Agency filed an amended case plan to include a
    second child, Da. R., who was born to Felicity and Joshua in July of 2016.
    {¶15} On August 3, 2016, the trial court issued a judgment entry indicating
    that a review hearing was held, where testimony was presented establishing that the
    conditions in Felicity and Joshua’s home had deteriorated and the parents had failed
    to make any further progress, despite all the services they had received. At the
    hearing, an agreement was reached between the parties that Felicity and Joshua
    would submit to an updated psychological evaluation.
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    {¶16} On February 16, 2017, the Agency filed a motion for permanent
    custody of D.R.1 In support of its motion, the Agency stated that D.R. had been in
    its temporary custody for twelve or more months of a consecutive twenty-two month
    period and cannot be safely placed with either parent within a reasonable period of
    time. The Agency argued that “[o]ver two years of involvement and following a
    vast array of services and activities, the parental progress has been insufficient with
    reunification not realized or recommended now or at any point in the foreseeable
    future. Due to the parents’ limitations in combination with a high level of resistance,
    the level of risk to D.R. remains extremely high.” (Doc. No. 134 at 2).
    {¶17} On May 19, 2017, the trial court commenced an evidentiary hearing
    on the Agency’s motion for permanent custody of D.R., which continued over the
    course of seven days in the subsequent five months. The Agency presented lengthy
    testimony from several service providers who assisted Felicity and Josh over the
    course of the two and a half years of the Agency’s involvement. The CASA’s
    reports were submitted by stipulation for the trial court to review, in lieu of her
    testimony being presented at the hearing. Felicity testified on her own behalf and
    also presented the testimony of one of her longtime service providers, who was
    contracted to work with her through the Shelby County Board of Developmental
    Disabilities. Joshua did not testify or present any witnesses on his own behalf.
    1
    We note that the Agency originally filed a motion for permanent custody of D.R. on November 1, 2016,
    which was later withdrawn.
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    {¶18} On November 6, 2017, the trial court issued a judgment entry granting
    the Agency’s motion for permanent custody of D.R. The trial court found by clear
    and convincing evidence that the Agency satisfied its burden of establishing that
    D.R. could not be placed with either parent in a reasonable amount of time under
    R.C. 2151.414(E)(1) and (2). Specifically, the trial court determined in its judgment
    entry that:
    Based upon the evidence adduced at hearing the Court finds, by
    clear and convincing evidence, that notwithstanding reasonable
    case planning and diligent efforts by the agency to assist the
    parents to remedy the problems that initially caused the child to
    be placed outside the home, each parent has failed continuously
    and repeatedly to substantially remedy the conditions causing the
    child to be placed outside the child’s home. In making this
    determination, the Court has considered the parental utilization
    of medical, psychiatric, psychological, and other social and
    rehabilitative services and material resources that were made
    available to the parents for the purpose of changing the parent’s
    conduct to allow him or her to resume and maintain parental
    duties. In addition to the cognitive limitations of each parent, the
    Court also finds, by clear and convincing evidence, that each
    parent’s unwillingness or resistance to meeting the case plan
    objectives has significantly contributed to this failing. The Court
    further finds, by clear and convincing evidence, that the child
    cannot be returned to either parent within a reasonable period of
    time and should not be placed with either parent.
    Based upon the evidence adduced at hearing the Court further
    finds, by clear and convincing evidence, that the chronic mental
    retardation of each parent is so severe that it makes the parent
    unable to provide an adequate permanent home for the child at
    the present time or within one year.
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    (Doc. No. 243 at 10). The trial court continued its analysis by considering the best
    interest factors contained in R.C. 2151.414(D)(1) and concluded that granting the
    Agency’s motion for permanent custody is in D.R.’s best interest. In particular, the
    trial court found that:
    D.R. has been in the care of [the Agency] most of his young life.
    He is in need of long term stability and the Court finds it would
    be detrimental to D.R. to allow this situation to continue or to
    return him to his parents. There is simply no indication that
    further case plan efforts with the parents would be beneficial to
    D.R. His placement in foster care has seen an enormously positive
    effect on his health and overall well-being.
    (Id. at 11).   Accordingly, the trial court issued an order granting the Agency’s
    motion for permanent custody of D.R. and terminating Felicity’s and Joshua’s
    parental rights.
    {¶19} Felicity and Josh each filed separate notices of appeal, asserting the
    following assignments of error.
    FELICITY’S ASSIGNMENT OF ERROR NO. 1
    SHELBY COUNTY DEPARTMENT OF JOB AND FAMILY
    SERVICES-CHILD SERVICES DIVISION FAILED TO
    PROVIDE REASONABLE CASE PLANNING AND DILIGENT
    EFFORTS TO ASSIST THE MOTHER TO REMEDY THE
    CONDITIONS THAT INITIALLY CAUSED THE REMOVAL
    OF THE MINOR CHILD FROM THE HOME.
    FELICITY’S ASSIGNMENT OF ERROR NO. 2
    SHELBY COUNTY DEPARTMENT OF JOB AND FAMILY
    SERVICES-CHILD SERVICES DIVISION FAILED TO SHOW
    BY CLEAR AND CONVINCING EVIDENCE THAT THE
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    PERMANENT PARENTAL RIGHTS OF THE MOTHER
    SHOULD HAVE BEEN TERMINATED.
    FELICITY ASSIGNMENT OF ERROR NO. 3
    THE TRIAL COURT VIOLATED MOTHER’S U.S.
    CONSTITUTIONAL FOURTEENTH AMENDMENT RIGHT
    TO DUE PROCESS AND EQUAL PROTECTION UNDER THE
    LAW.
    JOSHUA’S ASSIGNMENT OF ERROR NO. 1
    THE TRIAL COURT’S DECISION WAS AGAINST THE
    MANIFEST WEIGHT OF THE EVIDENCE BECAUSE THE
    EVIDENCE DID NOT SUPPORT A FINDING THAT
    TERMINATION OF PARENTAL RIGHTS OF MOTHER AND
    FATHER WAS IN THE CHILD’S BEST INTEREST.
    JOSHUA’S ASSIGNMENT OF ERROR NO. 2
    THE TRIAL COURT’S DECISION WAS AGAINST THE
    MANIFEST WEIGHT OF THE EVIDENCE BECAUSE THE
    EVIDENCE DID NOT SUPPORT FINDING THAT
    CHILDREN’S SERVICES MADE REASONABLE EFFORTS
    TO PREVENT THE REMOVAL OF THE CHILD OR EFFECT
    REUNIFICATION.
    {¶20} We elect to discuss Felicity’s and Joshua’s assignments of error
    together due to the fact that the issues raised therein are interrelated.
    {¶21} On appeal, Felicity and Joshua contend that Agency failed to use
    reasonable efforts to reunify the family. Specifically, the parents argue that the
    Agency failed to devise a case plan that adequately accommodated their
    developmental disabilities and failed to use diligent efforts to assist them in learning
    how to meet D.R.’s medical needs. Felicity and Joshua further argue that the trial
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    court’s decision to grant the Agency’s motion for permanent custody of D.R. was
    against the manifest weight of the evidence.
    {¶22} Before we address the assignments of error, it is necessary to discuss
    the evidence presented at the seven-day permanent custody hearing.
    Evidence Adduced at Hearing
    1.    Background Regarding the Parents’ Disabilities
    {¶23} The Agency presented several witnesses at the multiple day hearing
    on its motion for permanent custody of D.R. Two of these witnesses were Julie
    Maurer and Kristopher Anderson, who were Felicity’s and Joshua’s Service and
    Support Administrators (“SSA”) with the Shelby County Board of Developmental
    Disabilities (“SCBDD”). Testimony at the hearing indicated that both Felicity and
    Joshua had intellectual disabilities which impaired their cognitive abilities.
    Specifically, the record established that Felicity had a full scale IQ of 75 and
    suffered from fetal alcohol syndrome, and Josh had a full scale IQ of 65. The
    services that Felicity and Joshua received through the SCBDD were voluntary and
    could be terminated at any time if they no longer wanted to receive them.
    {¶24} Ms. Maurer testified that she had worked with Felicity for over
    fourteen years and provided oversight of the services Felicity received, which
    helped Felicity meet her basic needs. Ms. Maurer explained that despite Felicity’s
    disability, which affects her memory and ability to reason, Felicity was employed
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    at We Can Too in St. Marys.2 Mr. Anderson testified that he had been Joshua’s
    SSA for seven years and also helped coordinate the services Joshua received from
    the SCBDD as a result of his disability. He stated that Joshua was employed at NKP
    in Sidney. Both Felicity’s and Joshua’s Individual Service Plans (“ISP”) were
    admitted as exhibits at the hearing. Felicity and Joshua maintained their own
    apartment where they lived together.
    {¶25} The testimony from the SSAs indicated that in addition to their wages,
    Felicity and Josh also received Social Security disability benefits. According to the
    SSAs, Felicity and Joshua had trouble managing their finances therefore the
    SCBDD contracted with Robert E. Miller (“REM”) to be their payee. As their
    payee, REM paid Felicity’s and Joshua’s bills and took them grocery shopping. In
    addition, REM provided them transportation to doctor’s appointments and
    assistance with household chores.3 REM also instituted giving Felicity and Joshua
    weekly spending money because they had mismanaged their finances in the past.
    {¶26} According to the testimony at hearing, Felicity was nearly six months
    pregnant with D.R. before her service providers were aware of the pregnancy. REM
    assisted Felicity in getting to doctor’s appointments and helped the couple obtain
    2
    Testimony subsequent to Ms. Maurer’s indicated that Felicity also worked a “community job” at Kroger,
    which she apparently started during the course of the several day hearing on the motion for permanent
    custody.
    3
    At the time of the hearing, Felicity did not have a driver’s license and Josh had a license but did not have a
    vehicle.
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    the essentials for having a newborn in the home. When Felicity gave birth to D.R.
    in early December of 2014, REM provided 24/7 in-home care to the couple for two
    weeks after D.R. was born. After that point, REM’s assistance was reduced to five
    to seven hours a week because the intensive level of care could not be financially
    sustained.4
    {¶27} Dr. Sarah Marshall was on call when D.R. was born and testified that
    D.R. had jaundice and needed close inpatient and outpatient monitoring. She
    became concerned when Felicity and Josh failed to bring D.R. to a follow up
    appointment.        Even though the jaundice eventually resolved, D.R. developed
    breathing problems, which required breathing treatments and medication. Dr.
    Marshall observed that Felicity and Joshua appeared to fundamentally lack an
    understanding of D.R.’s medical conditions and had trouble keeping track of his
    medications. She testified that Felicity’s and Joshua’s level of confusion was more
    troublesome that the average parent. Dr. Marshall prepared flow charts to assist
    with their comprehension, however, Felicity and Joshua were still not able to relay
    to her a reliable history of the medication they gave to D.R. and were also unable to
    tell her the last time he ate and how much.
    4
    It should be noted that REM’s role was to provide support to Felicity and Joshua individually, based on the
    contract REM had with the SCBDD, and Felicity’s and Joshua’s qualifications for the services. REM’s role
    was not to provide services or support directly to D.R because D.R. did not individually qualify for services
    from the SCBDD.
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    2. Agency’s Involvement: Protective Supervision
    {¶28} According to the ongoing caseworker, Barb Reindel, the Agency first
    became involved shortly after D.R.’s birth based upon the concerns expressed by
    Dr. Marshall and other service providers that Felicity and Joshua were not properly
    feeding D.R. and that the home conditions were unsanitary. Caseworker Reindel
    was assigned to the case on January 27, 2015.
    {¶29} Caseworker Reindel testified that the Agency began providing
    services to assist Felicity and Joshua with learning how to independently parent
    D.R. in February of 2015 after they filed a complaint alleging D.R. to be a dependent
    and neglected child. The Agency created a case plan and provided services with the
    goal of supporting Felicity and Joshua so that they could continue to have D.R. in
    their home. These services included placing D.R. in a full-time accredited daycare,
    providing parenting coaches who assisted Felicity and Joshua with D.R. in the
    home, and arranging transportation to and from daycare for D.R., Felicity, and
    Joshua. Caseworker Reindel noted that Felicity and Joshua had continuous in-home
    support with D.R. during the waking hours of the day. The Agency also contacted
    the Shelby County Department of Health who assigned someone to the case to teach
    Felicity and Joshua about nutrition and assist with D.R.’s feedings.
    {¶30} The Agency coordinated monthly Primary Care Team (“PCT”)
    meetings, which, according to Caseworker Reindel, consisted of ten to twelve
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    people including Felicity and Joshua. The individuals who attended the PCT
    meetings were Caseworker Reindel and other service providers who met to discuss
    the case. For example, both Felicity’s and Joshua’s SSAs from the SCBDD were
    in attendance to assist the team, provide insight into the parents’ individual
    disabilities, and to advocate for the parents.
    {¶31} The testimony at the permanent custody hearing indicated that despite
    the number of services and the amount of support provided to them, Felicity and
    Joshua still struggled to recognize basic health and medical risks that could injure
    D.R. For example, one of the four in-home parenting coaches involved in the case,
    Janice Geise, testified that preparing sanitary bottles to feed D.R. continued to be
    an issue from the time she first starting assisting Felicity and Joshua in December
    of 2014. Coach Geise recalled that Felicity and Joshua consistently failed to
    sterilize the bottle components, which contributed to the nipples and the bottles
    growing mold and mildew. She also testified to witnessing Felicity preparing a
    bottle for D.R. with a gnat floating inside and intervening before Felicity could give
    it to D.R. When D.R. moved to eating baby food, Coach Geise observed both
    parents fail to put enough formula in the cereal to thin it out, despite advising them
    numerous times that thick cereal presented a choking hazard. She also recalled
    times where Josh “rushed” D.R.’s feeding, also presenting a choking hazard, and
    one occasion when she had arrived to the home around lunchtime and Felicity had
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    forgotten to feed D.R. breakfast despite the feeding schedule being posted in the
    home.
    {¶32} Coach Giese also recalled that she found food in the refrigerator which
    had expired years earlier, and she consistently observed trash and small objects able
    to choke D.R. littered on the floor of the home. She explained that Felicity and
    Joshua were not permitted to bathe D.R. without a coach or other service providers
    present because they would forget to wash body parts, not know how much water
    to put into the bath, and generally fail to ensure that the bath was given safely.
    {¶33} In addition to the poor hygiene issues, the record indicates that a major
    concern arose with Felicity’s and Joshua’s inability to administer medications to
    D.R. properly. Coach Geise recalled that early on Felicity and Joshua struggled
    with the multi-step progress of measuring appropriate dosages of over-the-counter
    medications like Tylenol and Benadryl. She had Felicity and Joshua practice
    measuring the correct dosage by placing water in the syringe, but noted there was
    little improvement over time.
    {¶34} The safety risk to D.R. increased when Felicity and Joshua continued
    to fail to follow Dr. Marshall’s instructions for administering D.R.’s breathing
    treatments, which initially consisted of dispensing Buterol, then later Albuterol,
    through a nebulizer mask every four hours. Coach Giese testified that Felicity and
    Joshua failed to administer the medication at night when the home coaches were not
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    there. She also recited an incident where the parents had administered expired
    medication to D.R. before she arrived at the home. She further described times
    where Felicity did not administer the full dosage to D.R. as prescribed, and had to
    be prompted to continue the treatment until the dose was completely gone.
    {¶35} D.R.’s respiratory problems continued to worsen to the point where
    D.R. began to wheeze. Coach Geise stated that Felicity and Josh failed to recognize
    the severity of the situation and had to be prompted to take D.R. to the pediatrician.
    She also recalled an incident in April of 2015 when D.R. had pink eye so severe that
    his eye had swollen shut. When Coach Geise learned that Felicity had no intention
    to seek medical attention, she prompted the parents to take D.R. to the Emergency
    Room for treatment. Eventually, Dr. Marshall prescribed Pulmicort for D.R.’s
    respiratory condition. The Agency mandated that Coach Geise administer the
    medication because an incorrect dosage posed a serious danger to D.R. Coach Geise
    testified that despite having fifteen hours a week of assistance between her and
    another in-home parenting coach assigned to the case, and countless charts and other
    visual materials, the parents did not improve in recognizing and adequately
    addressing the health and medical risks posed to D.R. while in their care.
    {¶36} Diane Aufderhaar, head teacher and administrator at the Kids
    Learning Place where D.R. attended daycare, offered a similar narrative of the
    parents’ inability to maintain sanitary conditions in the home and a lack of
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    comprehension to appropriately address D.R.’s serious health issues.             Ms.
    Aufderhaar recalled that Joshua usually brought D.R. to the daycare center in the
    morning. Joshua was responsible for bringing in the charts which he and Felicity
    used to track D.R.’s feedings. He also brought in the nebulizer for D.R.’s breathing
    treatments and the medication. Ms. Aufderhaar described Joshua as a “very quiet
    person” and who did not make eye contact or initiate conversations with her. (July
    26, 2017 Tr. at 32).
    {¶37} Ms. Aufderhaar stated that in general she had trouble communicating
    with both parents. She testified that the charts brought in by Joshua were not always
    accurate or complete. For instance, the chart would indicate that D.R. had just been
    fed, but D.R.’s behavior indicated otherwise. She recalled a specific incident after
    Felicity had picked up D.R. from daycare and was waiting for a ride. Despite the
    fact that D.R. had just been fed by the staff, Felicity was attempting to feed him
    another bottle in the lobby. In addition to the overfeeding about to take place, Ms.
    Aufderhaar noticed that Felicity was not holding D.R. in a safe feeding position for
    a young infant which posed a choking hazard. She and other staff members
    addressed these issues and others with Felicity and Joshua several times, however,
    no improvement was made.
    {¶38} Ms. Aufderhaar also expressed concerns with Felicity’s and Joshua’s
    inability to recognize and comprehend risks posed to D.R.’s health. She explained
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    that the nebulizer was not properly cleaned when it was brought from the home.
    She described D.R.’s breathing while living with the parents as “raspy” and
    “labored.” (July 26, 2017 Tr. at 38). She recalled that in May of 2015 D.R. had
    “very loose stools” for almost a six-week period and when she spoke to Felicity
    about it, Felicity became defensive and assured her that she had called pediatrician
    and “everything was ok.” (Id. at 53-54). Ms. Aufderhaar further testified that she
    submitted monthly reports to the Agency and attended the PCT meetings.
    {¶39} Ms. Aufderhaar recalled that D.R. began attending the daycare center
    in February of 2015 and was receiving breathing treatments at the time. Ms.
    Aufderhaar explained that in order for the staff to give D.R. the treatments, the
    medication must be in the original packaging with the prescription label attached.
    She described an incident in July 2015 where Felicity brought vials of Albuterol to
    the center in a plastic bag with a prescription label that had been altered with the
    original date crossed out and the current date handwritten over the sticker. As a
    result of the lack of compliance with the center’s safety protocols, the medication
    could not be administered to D.R. Ms. Aufderhaar also recounted an incident on
    July 13, 2015, during which Felicity was giving D.R. the breathing treatment at the
    center.     According to Ms. Aufderhaar, approximately halfway through the
    treatment, Felicity stopped the treatment, asked infant D.R. if he had “enough,” and
    poured the remaining dosage down the drain. (July 26, 2017 Tr. at 24).
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    3. Agency’s Removal of D.R.
    {¶40} On July 17, 2015, D.R. was removed from Felicity and Joshua’s home
    on an emergency basis. Caseworker Reindel testified that the Agency sought
    emergency removal of D.R. from the home due to the “primary high-risk issue”
    which was “[D.R.’s] unmet medical needs.” (Oct. 18, 2017 Tr. at 38). The decision
    to seek emergency removal came immediately after it was reported to the Agency
    that Felicity had failed to administer the complete dosage of medication to D.R. in
    front of the daycare staff and that Felicity had altered the prescription date on the
    label.
    {¶41} These events were the culmination of a series of ongoing episodes that
    demonstrated Felicity’s and Joshua’s lack of understanding of the serious nature of
    D.R.’s health conditions, and the risk posed if they failed to follow the medical
    directives given to them. According to Caseworker Reindel, D.R.’s respiratory
    condition had worsened to the point where he was prescribed breathing treatments
    every four hours. Despite the intense level of intervention by service providers,
    Felicity and Joshua failed to recognized or appreciate the critical nature of D.R.’s
    illness and consequently continually failed to give the breathing treatments as
    prescribed which inevitability prolonged the severity of his medical condition.
    {¶42} Additionally, Felicity and Joshua failed to make progress in maintaining a
    sanitary home while D.R. was in their custody. Caseworker Reindel further noted
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    that the parents had a difficult time making adjustments to D.R.’s developmental
    needs as he grew and struggled to independently handle the unpredictable situations
    that arose out of caring for an infant child. Often times the parents would have to
    be prompted by service providers to make necessary appointments to monitor and/or
    address medical or safety issues. Caseworker Reindel testified that the service
    providers, including D.R.’s pediatrician, recognized that something needed to be
    done and supported the decision to remove D.R. from the home.
    4. Agency’s Temporary Custody of D.R.
    A.   Visitations
    {¶43} Initially Felicity and Joshua had supervised visitations with D.R. at the
    Agency in July of 2015. According to Caseworker Reindel, visitations were moved
    to the parents’ home in September of 2015 to “provide real life opportunities in the
    home setting” where they continued until September of 2016. (Oct. 18, 2017 Tr. at
    112). She further explained the parents were granted unsupervised visitations of
    D.R. in May of 2016 because the Agency “wanted to give [the parents] an
    opportunity” to demonstrate their parenting skills of D.R. (Id. at 113). However,
    the unsupervised visitations were terminated on June 8, 2016 because the parents
    failed to follow certain safety guidelines put in place by the Agency.
    {¶44} Caseworker Reindel elaborated that one issue Felicity and Joshua had
    trouble with in the past was failing to recognize when people were taking advantage
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    of them or posed a danger to them. One such person was Joshua’s brother who
    reportedly not only took advantage of their finances, but also is a registered sex
    offender. As a result, the case plan included a provision that only people who were
    approved by the Agency were permitted into their home. Despite this directive,
    Felicity and Josh had made arrangements for unapproved people to visit their home
    while they had D.R. The parents were also not permitted to bathe D.R. without a
    service provider present as a safety precaution. The parents were not compliant with
    this directive.
    {¶45} The visitations reverted to being supervised at the parents’ home.
    However, after an incident at the home in September of 2016 where Joshua
    reportedly became aggressive with D.R. and the in-home coach, the supervised
    visitations were moved to the Agency.
    {¶46} In April of 2017, visitations were suspended because the Agency had
    received reports from multiple service providers, including the home coaches, foster
    parents, and D.R.’s daycare teachers, that D.R. had become increasingly aggressive
    and agitated immediately after visitations with the parents. D.R. also had trouble
    eating and had been diagnosed with “failure to thrive” due to his weight loss.5
    D.R.’s emotional state began to improve and he also began to gain weight after
    5
    Dr. Marshall, D.R.’s pediatrician, explained that a failure to thrive diagnosis “means that his growth is not
    appropriate and that there’s concern that his growth is so poor, it will start to affect his permanent growth
    and development. A lot of times kids get skinny in a way that they’ll catch up eventually but once it gets to
    a certain degree, we worry that it will have more permanent repercussions.” (May 19, 2018 Tr. at 24).
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    Case No. 17-17-21
    seeing a specialist and being placed on a regimented feeding schedule. Shortly
    thereafter, supervised visitations at the Agency were reinstated. However, D.R.’s
    behavior appeared to immediately regress and visitations were again suspended
    indefinitely on May 4, 2017 out of concern for D.R. emotional health.
    B.    D.R. in Foster Care
    {¶47} Upon the trial court granting temporary custody of D.R. to the Agency
    in July of 2015, D.R. was placed in foster care with Ginger Nanik and her husband.
    Ms. Nanik testified that when D.R. first came to live with her he was seven months
    old and need breathing treatments every four hours. She recalled setting an alarm
    in the middle of night to give D.R. his breathing treatment and to monitor him. Ms.
    Nanik began to notice improvement in D.R.’s breathing within three to four days of
    administering the medications as prescribed. She stated that when she took D.R. to
    see the pediatrician two weeks later, D.R.’s breathing had improved to the point
    where he only needed the treatments on an “as needed emergency basis.” (July 26,
    2017 Tr. at 127).
    {¶48} However, D.R. developed more medical issues as he became older.
    Ms. Nanik stated that D.R. had a number of ear infections which eventually led to
    him having surgery to place tubes in his ears, requiring around the clock post-
    surgery care. She noticed that D.R. began to exhibit aggression issues around the
    age of one-year-old. D.R. was also placed in intensive speech therapy. Ms. Nanik
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    described D.R. as a challenging child both medically and behaviorally. She attended
    the monthly PCT meetings and interacted with Felicity and Joshua multiple times a
    week during their visitations.
    {¶49} When she picked D.R. up from visitations she noticed that Felicity and
    Joshua were unable to relay a consistent history of feeding times, diaper changes,
    and medications given. Felicity and Joshua also missed important observations
    during the visitations. Many times the home coach would prompt the parents to
    give essential information that occurred during the visitations or help the parents
    answer her questions or provide clarifications.
    {¶50} Ms. Nanik addressed D.R.’s failure to thrive diagnosis. Early in 2017,
    she noticed that D.R.’s emotional distress tended to be triggered by visitation with
    Felicity and Joshua. D.R.’s teachers at daycare had noticed a similar pattern because
    many of the visitations occurred during the hours when D.R. was in their care. Ms.
    Nanik explained that she had concerns with D.R. developing chronic diarrhea and
    an aversion to eating. She reflected upon the suspension of visitations and stated
    that D.R.’s demeanor had improved immediately, “there was a noticeable change,
    less aggression, um less tantrums, more cooperative.” (July 26, 2017 Tr. at 186).
    After the suspension of visitations, D.R.’s weight also began to satisfactorily
    increase to the point where the specialist determined he could return to being
    monitored by his pediatrician.
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    C.   Agency Case Planning Efforts
    {¶51} After D.R. was placed in foster care, the Agency devised a case plan
    with the objective of assisting Felicity and Joshua in developing the necessary skills
    to be reunified with D.R. in their home. Specifically, the case plan focused on
    teaching the parents about (1) feeding and nutrition; (2) basic child care, including
    safety issues; (3) sanitary handling of food and appropriate storage; (4)
    understanding time and information management; (5) child development, including
    implementing age appropriate discipline; (6) maintaining a clean and safe home;
    and (7) meeting D.R.’s medical needs.       In order to help the parents meet these
    objectives, the Agency continued to have monthly PCT meetings and to provide the
    parents with two home coaches who alternated days in the home to give the parents
    different approaches to strategies to improve upon these skills.
    1.    Feeding and Nutrition
    {¶52} Coach Geise and the other primary home coach, Nikki Oren, worked
    together to teach the parents about meal planning and proper nutrition. Coach Oren
    testified that she made lists of the food groups and helped the parents select one
    from each category to prepare the meal. The coaches also assisted in making the
    parents’ grocery lists. However, the parents failed to follow through with the meal
    planning and ensuring that D.R. was receiving proper nutrition. With regard to
    feeding, the parents persistently failed to recognize potential choking hazards when
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    D.R. started eating solid foods. Coach Oren recalled instances where D.R. had
    burned his tongue on food because the parents failed to check the temperature before
    serving it to him and other instances where the parents did not cut food into small
    enough pieces to prevent D.R. from choking, despite repeated instruction on safety
    practices. Similarly, Coach Geise recalled a visitation in the home in the Summer
    of 2016 during which D.R. choked on a chip. According to Coach Geise, Felicity
    and Joshua failed to act and relied on Coach Geise to remove the chip from D.R.’s
    mouth. All of these things had been addressed with the parents multiple times by
    the coaches with little or no progress made.
    2.    Basic Child Care
    {¶53} The testimony at the permanent custody hearing also indicated that
    Felicity and Josh failed to improve upon their ability to recognize safety issues and
    provide the appropriate level of intervention and supervision of D.R. during
    visitations. Several examples of the parents’ continued failure to recognize safety
    concerns were recited at the permanent custody hearing. For instance, Coach Geise
    explained that even a year after D.R.’s removal, Felicity and Joshua were still not
    permitted to bathe D.R. alone because of their failures to take certain safety
    precautions. She recalled one day in June of 2016 assisting the parents with giving
    D.R. a bath. According to Coach Geise, as they approached to the bathtub to start
    the bath, excrement was found in the bathtub. Felicity informed Coach Geise that
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    Joshua had defecated in the bathtub. The parents attempted to place D.R. in the
    bathtub before Coach Geise intervened and directed them to clean up the excrement.
    Coach Geise observed Felicity clean the excrement with a washcloth and then
    attempt to use the same washcloth to bathe D.R. Again, Coach Geise intervened
    before the soiled washcloth was used on D.R.
    {¶54} Coach Oren relayed another incident during a visitation where D.R.
    was standing on a picnic table. The parents were not paying attention when D.R.
    fell and began to cry. She recalled that neither Felicity nor Joshua went to D.R., but
    waited for her to intervene and prompt them. She recalled another visitation at the
    Agency during which D.R. unlocked the door, left the visitation room, and shut the
    door. Instead of trying to prevent him from leaving, Felicity began laughing at the
    situation. Coach Geise was the one who retrieved D.R. and brought him back into
    the room.
    {¶55} Another such episode observed by Coach Oren occurred during a
    visitation in February of 2016 when Joshua gave two-year-old D.R. a large marble
    to play with and D.R. immediately put it into his mouth. Felicity took the marble
    out of D.R.’s mouth but then gave it back to D.R. who again tried to put it in his
    mouth. During another visitation in July of 2016, Coach Oren noticed D.R. playing
    with a paint chip on the wall and eventually putting the paint chip in his mouth. She
    alerted the parents to the problem and prompted them to pull the paint chip out of
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    D.R.’s mouth. Coach Oren explained that her role as a coach was to teach them the
    skills and then observe them parent D.R. during the visitations. However, she
    consistently found herself intervening during visitations for D.R.’s safety.
    3.    Sanitary Handling of Food and Appropriate Storage
    {¶56} Despite the efforts of the home coaches in the beginning of the case to
    remediate the issue of the unsanitary bottles, the evidence at the permanent custody
    hearing indicated that the parents failed grasp the basic concept that unsanitary food
    preparation and conditions posed a health risk to D.R. Both coaches testified that
    the parents continued to have problems with keeping the kitchen clean and
    oftentimes there were dirty dishes piled in the sink with stagnant water.        This
    resulted in many of the food storage items containing mold and old food, which
    posed a health hazard to D.R. even after he was removed from the home. In early
    2017, Felicity and Joshua brought food and beverages in containers and sippy cups
    from their home for D.R. to consume during the supervised visitations at the
    Agency. D.R. developed diarrhea and refused to eat after the visitations. Eventually,
    a correlation was discovered between food brought in by the parents and D.R.’s
    symptoms subsided after the parents were not permitted to bring food to the
    visitations. Caseworker Reindel explained that when the issue was addressed with
    the parents, they failed to see the connection and simply did not understand why
    they could not bring food to D.R. anymore.
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    {¶57} The parents also had problems disposing of expired, moldy food in the
    refrigerator and keeping food properly stored. Coach Oren testified that when she
    was first assigned to the case in November of 2015, she observed a large amount of
    mouse feces in the home, including on the kitchen stove. The parents moved homes
    to escape the mice infestation, only the have the same problem in the subsequent
    home. Coach Oren recalled a specific incident where she witnessed a mouse scurry
    back and forth across the parents’ kitchen in September of 2016.
    4.    Understanding Time and Information Management
    {¶58} Caseworker Reindel testified that planning in advance and following
    a varying schedule to meet D.R.’s needs continued to be a seemingly
    insurmountable obstacle for the parents. She cited the specific example of the
    parents’ persistent failure to arrange for transportation to take D.R. to medical
    and/or therapy appointments which were made well in advance. She also recalled
    instances in January of 2016, when the parents were given more autonomy to
    demonstrate their parenting skills, where they failed to follow through in making
    appointments with D.R.’s medical providers and specialists. Caseworker Reindel
    explained that Felicity maintained a “blue binder” that was supposed to help her
    keep track of appointments, schedule follow-ups, and arrange transportation,
    however, this organizational tool proved not to be effective for the parents. She
    recalled that the parents had difficulty adjusting to differing appointment times. For
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    instance, if an appointment and/or visitation had in the past been from 9:30 a.m. to
    10:30 a.m. and was changed to 11:00 a.m. for scheduling purposes, the parents
    would typically miss the appointment because they were unable to make the
    adjustment.
    {¶59} Caseworker Reindel also testified that the parents had difficulty telling
    time and/or assessing the passage of time. She provided an example demonstrating
    the parents’ inability to understand that “at 9:30 on the clock or on your watch, is
    the end of your visit. There’s been times as recent as February of 2017, that Felicity
    was packing up and getting ready to leave fifty minutes early. There were repeated
    incidents of Josh preparing [D.R.] and this is in 2017, prior to the suspension, where
    he would prepare [D.R.] and take him out ten, fifteen minutes early, not exercising
    that full amount of time.” (Oct. 18, 2017 Tr. at 86).
    {¶60} Caseworker Reindel explained that the Agency and other service
    providers constantly reassessed the approaches they used for time management and
    scheduling to help the parents better understand. She personally wrote down
    appointment times on their calendars, and as recently as August and September of
    2017, during the timeframe of the ongoing permanent custody hearing, sat down
    with the parents to devise a new tracking system more comprehensible to them and
    prompted them to put appointments in their phones.
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    5.    Child Development, Including Implementing Age Appropriate
    Discipline
    {¶61} Both home coaches and Caseworker Reindel testified to the parents’
    inability to recognize basic developmental milestones reached by D.R. and to adjust
    to age appropriate parenting of him. As previously mentioned, D.R. exhibited
    challenging behaviors for any caretaker to manage. Caseworker Reindel explained
    that she and the coaches consistently tried to correct Felicity’s propensity to laugh
    at or negatively reinforce D.R.’s aggressive behaviors during visitations. Coach
    Oren testified that D.R. was prone to throwing tantrums during visitations and
    neither parent implemented the discipline strategies that she had worked on with
    them numerous times. Rather, the parents laughed and surmised that D.R. was
    simply in a bad mood. Moreover, neither parent attempted to redirect D.R when he
    was playing with the microwave or standing on toys and other equipment during
    visitations at the Agency.
    {¶62} Both Coach Geise and Caseworker Reindel recalled an incident in
    September of 2016 when the parents were exercising visitation with D.R. and infant
    Da.R. at their home. During the visit, Felicity was changing Da.R.’s diaper on the
    floor. D.R. tripped and bumped in to Da.R. which made Da.R. cry. According to
    Coach Geise, Joshua, who was not in the room at the time, “flew down the stairs
    very angry [and] went to grab [D.R.] by the arm.” (Oct. 18, 2017 Tr. at 255). Coach
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    Geise intervened and explaining that such an aggressive reaction was inappropriate
    for an accident. Felicity did not intervene, stating she was busy with the other child.
    Coach Geise recalled Joshua becoming aggressive and yelling at her. She took D.R.
    outside to meet the foster parents because the visit was almost over. Joshua refused
    to go outside to say good-bye to D.R. Felicity reportedly supported Joshua’s
    behavior, maintaining he was simply trying to discipline D.R.
    6.   Maintaining a Clean and Safe Home
    {¶63} Coach Geise, who was involved in the case for the duration of the
    Agency’s involvement, testified that after the removal of D.R. the parents
    continuously failed to develop the skills to recognize the health risks posed by their
    unsanitary habits. Coach Oren also testified to observing a large amount of mouse
    feces, including on the kitchen stove, and dust clinging to the walls in the parents’
    home. She recalled that the bathrooms were not being cleaned and the floor had not
    been vacuumed. She brought in a vacuum from her home for the parents to use.
    {¶64} Caseworker Reindel further testified that the parents lived in four
    different homes during the course of the Agency’s involvement and the parents had
    the same issue with uncleanliness in each home. She visited the parents during the
    summer of 2017, while the permanent custody proceedings were being held, and
    recalled the filth in the bathrooms of the parents’ home. She noticed that the toilets
    had not been cleaned. When she addressed this with Felicity and Joshua they
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    claimed they did not know that they needed to routinely clean the toilet, and that
    they had not cleaned it since they first moved in five months ago. There was also a
    clogged sink in the home that the parents failed to take steps to repair.
    {¶65} Caseworker Reindel further testified that the parents failed to install
    smoke detectors in the newest residence despite the Agency providing the devices
    to them. She explained that instances such as the ones described above highlight
    the parents’ inability to take initiative, follow through, and problem solve
    independently, and presents a concern when it comes to their ability to properly take
    care of D.R. because the parents will not always have the Agency and the service
    providers to help guide them if they were to regain custody of D.R.
    7.    Meeting D.R.’s Medical Needs
    {¶66} Even though D.R. no longer needed daily breathing treatments after
    he moved into foster care, Felicity and Joshua continued to demonstrate trouble with
    understanding how and when to give over-the-counter medication. Coach Oren
    testified that the parents were persistently confused as to when to use Tylenol or
    Benadryl. She stated that D.R. had allergies so she “constantly quizzed” the parents
    to see if they could discern the different uses for the medications, a concept which,
    according to Coach Oren, they never appeared to grasp. (May 25, 2017 Tr. at 153).
    She recalled an incident in November of 2015 during which D.R. was receiving
    Benadryl and the parents had administered a dose during the visitation. Coach Oren
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    asked the parents before she left what time D.R. would need a second dose. Neither
    parent could answer without guessing. She attempted to show them the correct time
    by using their fingers to count the hours between doses.
    {¶67} Ms. Nanik, D.R.’s foster mother, recalled that Felicity and Josh had
    difficulty recognizing medical issues and how to handle them. For instance, the
    parents had trouble discerning the difference between prescription and over-the-
    counter medication, as well as a failure to independently recognize when medication
    is needed. She recalled a time in 2016 when D.R. had a cold and she was
    administering Benadryl to him for his symptoms. She stated that she noted the times
    she gave D.R. the medicine on the daily sheets, which she provided to the daycare
    when she dropped him off. These sheets were given to the parents routinely during
    their visitations so they could see if D.R. had been receiving medication. D.R.’s
    cold resolved and Ms. Nanik no longer gave him the medication, which was notated
    on the sheets.    Nevertheless, the parents continued to give D.R. Benadryl
    unnecessarily because it had become routine for them, regardless of the fact that
    both home coaches had attempted to instill in them the recognition of symptoms and
    the appropriate use of the medication, and the fact that the daily sheets indicated
    D.R. was no longer taking Benadryl.
    {¶68} Ms. Nanik also stated that Felicity and Joshua attended some of D.R.’s
    appointments with various specialists where a medical history was required to be
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    relayed to the provider. She explained that she gave Felicity and Joshua the first
    opportunity to provide that information. Felicity was the one who attempted to
    provide a medical update. However, she often gave incorrect information to the
    provider. For example, Felicity claimed a number of times that D.R. had asthma,
    when he in fact had never been diagnosed with the condition. Ms. Nanik explained
    that she had to intervene to give the correct information. As for Joshua, she could
    not recall a time where he volunteered to give a medical history of D.R.
    {¶69} Ms. Nanik also noticed a lack of follow through from the parents when
    they had attended D.R.’s speech therapy sessions for a six to eight-week period. She
    explained that during this time the parents were permitted to take D.R. to the
    sessions on their own to give the parents a chance to more independently parent
    D.R. When she picked up D.R. the parents failed to provide her updates and did not
    consistently take notes during the speech therapy sessions. She stated that relaying
    the information from the sessions was important because many of the speech lessons
    and skills were things that they needed to work on with D.R. at home to facilitate
    his improvement.
    D.   Psychological Evaluation of the Parents
    {¶70} Dr. David Hrinko also testified for the Agency at the permanent
    custody hearing and was recognized as an expert in the field of psychology,
    specifically in rendering psychological evaluations in permanent custody cases. Dr.
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    Hrinko conducted an evaluation of Felicity and Joshua in May of 2015 and again in
    September of 2016. He explained that the Agency requested the second evaluation
    to assess whether Felicity’s and Joshua’s ability to function as independent, safe
    parents had improved with the intensive amount of support services being provided
    to them over the past sixteen months.
    {¶71} Dr. Hrinko reviewed nearly a thousand pages that the Agency had
    compiled about the case from numerous sources, including service plans, case notes,
    and progress reports from service providers. He also requested that Felicity and
    Joshua sign releases so he could gather additional information from the SCBDD
    beyond the summaries provided to him by the Agency.               In addition, to the
    voluminous amount of written materials, Dr. Hrinko also interviewed Felicity and
    Joshua.
    {¶72} Dr. Hrinko noted his concern with the parents’ inability to identify the
    tasks that need to be done as it related to D.R. and then initiating those tasks without
    prompting. He testified that he saw “no evidence of them being able to do that
    which is essential to the concept of functioning independently as a parent.” (Oct.
    25, 2018 at 46). He further observed a “pattern” that Felicity and Joshua “function
    relatively well with supports.” (Id. at 54). However, “when you add the additional
    responsibilities of being parents, their weaknesses become more evident and begin
    to place their children at risk, requiring additional supports and that when those
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    additional supports are reduced, then the problems reemerge indicating that their
    ability to function independently as parents is impaired.” (Id.)
    {¶73} Specifically, with regard to Felicity, Dr. Hrinko testified that she has
    the skills to complete tasks when prompted, but without prompting, monitoring and
    assistance, she has difficulty being able to identify problems, identify reactions and
    implement them independently. He further testified that her cognitive impairments,
    which he believed to be the basis for her limitations, “make it difficult for her to
    identify information, so this is not due to depression or some other treatable
    disorder, that can be resolved in a matter of months, therefore increasing her
    capabilities.” (Oct. 25, 2018 at 46). Rather, he described her cognitive limitations
    to be “persistent across the lifetime” and noted that her records indicate that despite
    the amount of services she had received her ability to learn new things and function
    independently as it related to parenting D.R. had not made any significant
    improvement. (Id.) Accordingly, he testified that he did not believe that Felicity
    could acquire the appropriate skills to function as an independent parent to D.R.
    {¶74} With respect to Joshua, Dr. Hrinko noted from the reports from
    numerous sources that Joshua failed to take an active role in improving and
    maintaining the standards in the home and that prompting from the service providers
    was consistently required. He expressed similar concerns about Joshua being able
    to independently parent D.R. without service providers in place and to shift his
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    priorities to learn, develop, and implement skills above and beyond those which are
    necessary to maintain as a single adult. Dr. Hrinko described Joshua’s cognitive
    limitations as putting “him in a position to have trouble thinking across a broad
    period of time. He tends to think about the moment from his point of view which
    makes it difficult for him to understand how his actions impact others, how they
    may create problems down the road and to be able to identify and anticipate potential
    problems to act proactively to avoid problems rather than respond or react to them.”
    (Oct. 25, 2018 at 78). Dr. Hrinko also noted that Joshua was candid with him during
    the interview that “there were things that he could have been doing and should have
    been doing but wasn’t doing.” (Id. at 167).
    {¶75} Dr. Hrinko opined that Joshua’s cognitive limitations placed D.R. at
    risk, despite being provided opportunities for support to develop and improve his
    skills, which have not proven to be sufficiently effective. He further testified that
    he did not think Joshua could become capable of functioning as an independent
    parent to D.R. in a reasonable amount of time.
    {¶76} With an understanding of the evidence presented at the permanent
    custody hearing, we now turn to the issues presented on appeal.
    Felicity’s First Assignment of Error
    Joshua’s Second Assignment of Error
    {¶77} In these assignments for error, Felicity and Joshua maintain that the
    Agency failed to use reasonable efforts and diligent case planning to accommodate
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    their intellectual disabilities. The Ohio Revised Code imposes a duty on the part of
    children services agencies to make reasonable efforts to reunite parents with their
    children where the agency has removed the children from the home. R.C. 2151.419;
    see, also, In re Brown, 
    98 Ohio App. 3d 337
    , 344 (3d Dist.1994). Further, the agency
    bears the burden of showing that it made reasonable efforts. R.C. 2151.419(A)(1).
    “Case plans are the tools that child protective service agencies use to facilitate the
    reunification of families who * * * have been temporarily separated.” In re Evans,
    3d Dist. Allen No. 1-01-75, 2001-Ohio-2302, * 3.
    {¶78} To that end, case plans establish individualized concerns and goals,
    along with the steps that the parties and the agency can take to achieve reunification.
    In re Evans at * 3. Agencies have an affirmative duty to diligently pursue efforts to
    achieve the goals in the case plan. 
    Id. “Nevertheless, the
    issue is not whether there
    was anything more that [the agency] could have done, but whether the [agency’s’]
    case planning and efforts were reasonable and diligent under the circumstances of
    this case.” In re Leveck, 3d Dist. Hancock Nos. 5-02-52, 5-02-53, 5-02-54, 2003-
    Ohio-1269, ¶ 10. We also note that the statute provides that in determining whether
    reasonable efforts were made, the child’s health and safety is paramount. See R.C.
    2151.419(A)(1).
    {¶79} In this instance, the evidence in the record clearly disputes Felicity’s
    and Joshua’s contentions that the Agency failed to take their developmental
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    disabilities into account when devising its case planning.        In addition to the
    recitation of the evidence above demonstrating the numerous supports the Agency
    put into place to initially keep D.R. in the home, and efforts of numerous individuals
    to provide constant assistance to the parents so that they could develop the necessary
    skills to be able to independently parent D.R. once he was removed, Caseworker
    Reindel testified at length regarding how this case was handled differently to
    accommodate the parents’ developmental disabilities. For instance, she explained
    that the Agency constantly modified their approach to the case plan to assist the
    parents in understanding the objectives and invested a substantial amount of time
    and services to the case. The Agency worked very closely with the SCBDD so that
    those professionals could provide additional support and expertise to the Agency
    and its service providers.
    {¶80} Caseworker Reindel further testified that both parents chose not to
    communicate well with Agency and failed to return phone calls. She attempted to
    ameliorate communication problems with the parents by reaching out to the parents’
    service providers at the SCBDD, with whom the parents had an established
    relationship, but the communication did not improve.
    {¶81} Caseworker Reindel also testified to the efforts made by the Agency
    to find long-term options aside from filing for permanent custody of D.R.
    Specifically, the Agency examined eleven possible kinship placements, which were
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    deemed either to be inappropriate or the people in the placements declined
    involvement. The Agency researched long term in-home services, which permitted
    the parents to retain custody of D.R. with services providers assisting on a continual
    basis. However, this option was not only cost prohibitive, but also presented
    concern based upon the parents’ lack of improvement with the current service
    providers under the Agency involvement.         Finally, the Agency worked with
    Felicity’s and Joshua’s SSA’s through the SCBDD who researched adult foster care
    options, under which the entire family would be placed into foster care. However,
    Joshua was not amenable to this option.
    {¶82} For their part, the parents rely primarily on the testimony of Sarah
    Watkins, a program director at REM, the company that acts as Felicity’s and
    Joshua’s payee. Ms. Watkins testified on Felicity’s behalf and stated that she did
    not believe the Agency handled the case appropriately given the nature of the
    parents’ developmental disabilities. Even though Ms. Watkins provided a number
    of critiques regarding the Agency’s case planning, she admitted that she only
    attended six of the thirty-two monthly PCT meetings, and she had stopped attending
    the PCT meetings in September of 2016. Moreover, she stated that even when she
    attended those meetings she failed to speak out or provide suggestions to the Agency
    as to how to better handle the parents’ special needs.
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    {¶83} Based on the foregoing evidence, we conclude that the record in this
    case demonstrates that the Agency used reasonable case planning to assist Felicity
    and Joshua in achieving the goal of reunification with D.R. Moreover, we find that
    the parents have failed to substantiate their claims that the Agency did not
    accommodate their intellectual disabilities during the case planning. Accordingly,
    we find that the Agency’s case planning and efforts were reasonable and diligent
    under the circumstances of this case. Felicity’s first assignment of error and
    Joshua’s second assignment of error are overruled.
    Felicity’s Second and Third Assignments of Error
    Joshua’s Second Assignment of Error
    {¶84} In these assignments of error, Felicity and Joshua claim that the trial
    court’s decision to grant the Agency’s motion for permanent custody was against
    the manifest weight of the evidence. Felicity also claims that the trial court’s
    decision to terminate her parental rights violated her constitutional right to due
    process and equal protection under the law. In making this argument, Felicity
    essentially reiterates her challenge that the trial court’s decision to terminate her
    parental rights was not supported by the evidence presented.
    A.   Summary of Permanent Custody Procedure
    {¶85} R.C. 2151.414 contains procedures that protect the interests of parents
    and children in a permanent custody proceeding. See In re B.C., 
    141 Ohio St. 3d 55
    ,
    2014-Ohio-4558, ¶ 26 (2014). This section of the Revised Code requires that before
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    a juvenile court may terminate parental rights and award permanent custody of a
    child to a proper moving agency, it must find clear and convincing evidence of two
    prongs of the permanent custody test, as required under R.C. 2151.414(B). See In
    re C.W., 
    104 Ohio St. 3d 163
    , 2004-Ohio-6411, ¶ 9 (2004). The outline of this test
    is provided below.
    1.   Permanent Custody Test: First Prong—R.C. 2151.414(B)(1)
    {¶86} The first prong of the test requires a finding by clear and convincing
    evidence that there exists one of the statutorily-prescribed situations of R.C.
    2151.414(B)(1):
    (a) The child * * * cannot be placed with either of the child's
    parents within a reasonable time or should not be placed with the
    child’s parents.
    (b) The child is abandoned.
    (c) The child is orphaned, and there are no relatives of the child
    who are able to take permanent custody.
    (d) The child has been in the temporary custody of one or more
    public children services agencies or private child placing agencies
    for twelve or more months of a consecutive twenty-two-month
    period, * * *.
    (e) The child or another child in the custody of the parent or
    parents from whose custody the child has been removed has been
    adjudicated an abused, neglected, or dependent child on three
    separate occasions by any court in this state or another state.
    R.C. 2151.414(B)(1).
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    2.   Permanent Custody Test: Second Prong—Best Interest of the Child
    {¶87} “If the trial court determines that any provision enumerated in R.C.
    2151.414(B)(1) applies,” it must proceed to the second prong of the test, which
    requires the trial court to “determine, by clear and convincing evidence, whether
    granting the agency permanent custody of the child is in the child’s best interest.”
    (Emphasis sic.) In re A.F., 3d Dist. Marion No. 9-11-27, 2012-Ohio-1137, ¶ 55; see
    R.C. 2151.414(B)(1). The best interest determination is based on an analysis of
    R.C. 2151.414(D).
    {¶88} Under R.C. 2151.414(D)(1), the trial court is required to consider all
    relevant factors listed in that subdivision, as well as any other relevant factors. In
    re H.M., 3d Dist. Logan Nos. 8-13-11, 8-13-12, 8-13-14, 2014-Ohio-755, ¶ 27. The
    factors of R.C. 2151.414(D)(1) include:
    (a) The interaction and interrelationship of the child with the
    child's parents, siblings, relatives, foster caregivers and out-of-
    home providers, and any other person who may significantly
    affect the child;
    (b) The wishes of the child, as expressed directly by the child or
    through the child’s guardian ad litem, with due regard for the
    maturity of the child;
    (c) The custodial history of the child, including whether the
    child has been in the temporary custody of one or more public
    children services agencies or private child placing agencies for
    twelve or more months of a consecutive twenty-two-month period,
    * * *;
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    Case No. 17-17-21
    (d) The child’s need for a legally secure permanent placement
    and whether that type of placement can be achieved without a
    grant of permanent custody to the agency;
    (e) Whether any of the factors in divisions (E)(7) to (11) of this
    section apply in relation to the parents and child.
    {¶89} R.C. 2151.414(D)(1). Under this test, the trial court considers the
    totality of the circumstances when making its best interest determination and no
    single factor is given greater weight than others by the statute. See In re Schaefer,
    
    111 Ohio St. 3d 498
    , 2006-Ohio-5513, ¶ 56 (2006); In re Z.Y., 8th Dist. Cuyahoga
    No. 86293, 2006-Ohio-300, ¶ 13.
    Standard of Review
    {¶90} When an appellate court reviews whether a trial court’s permanent
    custody decision is against the manifest weight of the evidence, the court “weighs
    the evidence and all reasonable inferences, considers the credibility of witnesses and
    determines whether in resolving conflicts in the evidence, the [finder of fact] clearly
    lost its way and created such a manifest miscarriage of justice that the [judgment]
    must be reversed and a new trial ordered.” Eastley v. Volkman, 
    132 Ohio St. 3d 328
    ,
    2012–Ohio–2179, ¶ 20, quoting Tewarson v. Simon, 
    141 Ohio App. 3d 103
    , 115 (9th
    Dist.2001).
    {¶91} In a permanent custody case, the ultimate question for a reviewing
    court is “whether the juvenile court’s findings * * * were supported by clear and
    convincing evidence.” In re K.H., 
    119 Ohio St. 3d 538
    , 2008-Ohio-4825, ¶ 43.
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    Case No. 17-17-21
    “Clear and convincing evidence” is: “[T]he measure or degree of proof that will
    produce in the mind of the trier of fact a firm belief or conviction as to the allegations
    sought to be established. It is intermediate, being more than a mere preponderance,
    but not to the extent of such certainty as required beyond a reasonable doubt as in
    criminal cases. It does not mean clear and unequivocal.” In re Estate of Haynes, 
    25 Ohio St. 3d 101
    , 104, (1986).
    {¶92} In determining whether a trial court based its decision upon clear and
    convincing evidence, “a reviewing court will examine the record to determine
    whether the trier of facts had sufficient evidence before it to satisfy the requisite
    degree of proof.” State v. Schiebel, 
    55 Ohio St. 3d 71
    , 74 (1990). Accord In re
    Holcomb, 
    18 Ohio St. 3d 361
    , 368 (1985), citing Cross v. Ledford, 
    161 Ohio St. 469
    (1954) (Once the clear and convincing standard has been met to the satisfaction of
    the [trial] court, the reviewing court must examine the record and determine if the
    trier of fact had sufficient evidence before it to satisfy this burden of proof.). “Thus,
    if the children services agency presented competent and credible evidence upon
    which the trier of fact reasonably could have formed a firm belief that permanent
    custody is warranted, then the court’s decision is not against the manifest weight of
    the evidence.” In re R.M., M.M., D.M., B.M., 4th Dist. Athens Nos. 12CA43,
    12CA44, 2013-Ohio-3588, ¶ 55 (4th Dist.).
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    Case No. 17-17-21
    {¶93} “Reviewing courts should accord deference to the trial court’s decision
    because the trial court has had the opportunity to observe the witnesses’ demeanor,
    gestures, and voice inflections that cannot be conveyed to us through the written
    record.” In re S.D., 5th Dist. No.2016CA00124, 2016-Ohio-7057, ¶ 20, citing Miller
    v. Miller, 
    37 Ohio St. 3d 71
    (1988). A reviewing court should find a trial court’s
    permanent custody decision against the manifest weight of the evidence only in the
    “ ‘exceptional case in which the evidence weighs heavily against the [decision].’ ”
    Thompkins at 387, quoting Martin at 175.
    {¶94} At the outset we note that in its judgment entry granting permanent
    custody, the trial court found by clear and convincing evidence that D.R. had been
    in the Agency’s temporary custody twelve or more months of a consecutive twenty-
    two-month period. See R.C. 2151.414(B)(1)(d). Alternatively, the trial court also
    found by clear and convincing evidence that D.R. cannot be placed with either
    parent within a reasonable time.     See R.C. 2151.414(B)(1)(a); see also R.C.
    2151.414(E)(1) and (2). The trial court also considered each enumerated factor in
    R.C. 2151.414(D)(1) to find by clear and convincing evidence that granting the
    Agency’s motion for permanent custody is in D.R.’s best interest.
    {¶95} Initially, we note that Joshua maintains that the evidence at the
    permanent custody hearing pertained predominately to Felicity and was insufficient
    as to him. Our examination of the record simply does not support this contention.
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    Case No. 17-17-21
    Rather, the testimony from several witnesses indicates that Joshua chose not to be
    actively engaged in the case and failed to communicate with the Agency and service
    providers.
    {¶96} Felicity and Joshua also highlight instances in the record where they
    had demonstrated some improvement in their skills. While infrequent periods of
    improvement were noted, the record establishes that the overwhelming amount of
    the evidence indicates that the parents failed to sustain a level of improvement of
    those skills necessary to eliminate health and safety risks to D.R. on a continual
    basis without relying the supports put in place by the Agency. Several people
    working with the parents on this case testified to the genuine love that the parents
    have for D.R., however, the record confirms the trial court’s conclusion that the
    parents’ cognitive limitations impaired their ability to acquire the skills needed to
    safely and independently parent D.R. within a reasonable period of time. The
    CASA assigned to the case reiterated the same concerns as many of the Agency’s
    witnesses and stated in her report that:
    I personally have spent hours searching for avenues of help for
    Joshua and Felicity that would give them the supervision they
    require in order to keep [D.R.]. I am confident that there is
    nothing available for the help they require in order to keep [D.R.]
    in their care full-time. Although this is very unfortunate for all
    concerned, Joshua and Felicity, in my opinion, cannot safely take
    care of [D.R.] without a level of constant supervision. This is
    apparent due to the abundant resources that have been given to
    them during this past 26 month period. For all of the resources,
    there has been little to no consistent improvement in Joshua and
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    Case No. 17-17-21
    Felicity’s parenting skills to warrant more time with the parents
    to the detriment of [D.R.].
    (Doc. No. 184 at 6). While we have focused on the parents’ ability to meet the case
    plan objectives in order to be reunified with D.R, we cannot discount D.R.’s need
    for permanency, rather than remaining in continued custodial flux. The record
    further indicates from various sources that the prolonged case proceedings had
    begun to take an emotional toll on D.R. The parents had over two years to
    demonstrate that they could provide D.R. with a safe and legally secure permanent
    placement, but unfortunately, their efforts fell short.
    “* * * [A] child should not have to endure the inevitable to its
    great detriment and harm in order to give the * * * [parent] an
    opportunity to prove her suitability. To anticipate the future,
    however, is at most, a difficult basis for a judicial determination.
    The child’s present condition and environment is the subject for
    decision not the expected or anticipated behavior of unsuitability
    or unfitness of the * * * [parent]. * * * The law does not require
    the court to experiment with the child’s welfare to see if he will
    suffer great detriment or harm.”
    In re W.C.J., 4th Dist. Jackson No. 14CA3, 2014-Ohio-5841, ¶ 48, quoting In re
    Bishop, 
    36 Ohio App. 3d 123
    , 126 (5th Dist.1987).
    {¶97} Upon consideration of the totality of the factors, and recalling that the
    trial court’s judgment may rest upon witness demeanor and nuances that do not
    translate to the written record, we are unable to find that the trial court’s
    determination to grant the Agency’s motion for permanent custody of D.R. was
    against the manifest weight of the evidence. Accordingly, we also find no basis in
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    Case No. 17-17-21
    the record supporting Felicity’s claim that the trial court’s decision to terminate her
    parental rights violated her rights under the Constitution. Therefore, we overrule
    Joshua’s first assignment of error and Felicity’s second and third assignments of
    error.
    {¶98} Based on the foregoing, the assignments of error are overruled and the
    judgment of the trial court is affirmed.
    Judgment Affirmed
    WILLAMOWSKI, P.J. and PRESTON, J., concur.
    /jlr
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Document Info

Docket Number: 17-17-21

Citation Numbers: 2018 Ohio 3434, 117 N.E.3d 1075

Judges: Shaw

Filed Date: 8/27/2018

Precedential Status: Precedential

Modified Date: 1/12/2023