Dyfs v. S.I. Imo S.I., a Minor ( 2014 )


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  •                      RECORD IMPOUNDED
    NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-2878-12T1
    NEW JERSEY DIVISION OF YOUTH
    AND FAMILY SERVICES,1
    APPROVED FOR PUBLICATION
    Plaintiff-Respondent,
    August 20, 2014
    v.
    APPELLATE DIVISION
    S.I.,
    Defendant-Appellant.
    __________________________________
    IN THE MATTER OF S.I., a minor.
    __________________________________
    Submitted May 29, 2014 - Decided July 2, 2014
    Published
    Before   Judges     Sapp-Peterson,     Lihotz    and
    Maven.
    On appeal from the Superior Court of New
    Jersey, Chancery Division, Family Part,
    Hudson County, Docket No. FN-09-270-12.
    Joseph E. Krakora, Public Defender, attorney
    for appellant (Erin L. Pinder, Designated
    Counsel, on the briefs).
    John J. Hoffman, Acting Attorney General,
    attorney   for   respondent   (Andrea  M.
    Silkowitz, Assistant Attorney General, of
    1
    On June 29, 2012, the Department of Children and Families
    was reorganized and the Division of Youth and Family Services
    was renamed as the Division of Child Protection and Permanency.
    L. 2012, c. 16, eff. June 29, 2012 (amending N.J.S.A. 9:3A-
    10(b)).
    counsel;   Joyce   Calefati   Booth,                 Deputy
    Attorney General, on the brief).
    Joseph E. Krakora, Public Defender, Law
    Guardian,   attorney   for minor (Olivia
    Belfatto Crisp, Assistant Deputy Public
    Defender, on the brief).
    The opinion of the court was delivered by
    LIHOTZ, J.A.D.
    Defendant S.I. appeals from a Family Part order, entered
    following     a   fact-finding      hearing,        which    determined       she    had
    abused and neglected her minor grandchild for whom she was the
    legal custodian.2         S.I. refused consent to allow the child to
    undergo   a    mental     health   evaluation       because       she     believed   the
    child was being "manipulative" and merely "acting out."                              The
    Division of Youth and Family Services (the Division) executed an
    emergency removal and sought a psychiatric evaluation to discern
    whether   the     child    was    suicidal.     S.I.        challenges      the   trial
    judge's factual findings, as well as her application of the law
    to the facts.       Specifically, S.I. disputes: (1) the single act
    of   withholding    her     consent     for   the    mental       health    evaluation
    demonstrated      medical    neglect;     (2)   she     failed       to    exercise     a
    minimum   degree     of    care    by   withholding         her   consent     for    the
    2
    It is not clear how long the child was in S.I.'s                         care and
    custody.   S.I. testified the child had been in her                           care for
    twelve years. The Division's complaint stated an order                         granting
    S.I. custody was entered three years earlier, but the                          document
    is not included in the record.
    2                                    A-2878-12T1
    evaluation; and (3) the child suffered or was at imminent risk
    of suffering harm because she withheld her consent.
    We have considered the arguments advanced by the parties.
    Although we find no fault with the Division's initial decision
    to remove the child to effectuate a mental health evaluation, we
    conclude   the      record   lacks    substantial        credible      evidence     that
    S.I.'s conduct amounted to medical neglect or recklessly created
    a substantial risk to the child's mental health or physical
    safety.    N.J. Div. of Youth & Family Servs. v. A.L., 
    213 N.J. 1
    (2013).         Accordingly,    we    reverse      the    finding      of   abuse       or
    neglect.
    These facts are taken from the April 5, 2012 fact-finding
    hearing.        During the hearing the State presented testimonial
    evidence     from     two    Division     workers        and    admitted,       without
    objection,      documents    evidencing      the   initial      referral     and      the
    Division's investigation.            S.I. testified in her own behalf.3
    A school nurse contacted the Division after a note written
    by S.I.'s then twelve-year-old grandchild was discovered, which
    stated:    "I    want   to   kill     myself.      I     hate   my     life."       When
    confronted, the child explained she wrote the note more than a
    month earlier, but admitted being depressed.                         She stated she
    3
    We note the child's parents                   attended      the    fact-finding
    hearing, but did not testify.
    3                                      A-2878-12T1
    "ha[d] no plan on how she's going to hurt herself."                           Further,
    the child expressed fear of S.I., complaining her grandmother
    hits her in the back "once per week."                     The child insisted she
    did not want to return to S.I.'s care.
    A mobile crisis unit was contacted.                    The record states a
    response    team    went    to   the     school,    but    does     not    include   the
    results of the child's evaluation.
    The school's vice principal contacted S.I. asking her to
    come to the school.          S.I. complied.        When told of the discovered
    note, S.I. did not believe the child was suicidal or desired to
    end her life.            The vice principal informed the Division S.I.
    became     "extremely       upset"     after      the     child's     comments       were
    disclosed and she "could not be calmed."                       S.I. insisted the
    child    was    acting     out   after    being    punished.         She    repeatedly
    denied the child's allegations of physical abuse, and suggested
    the     child      was     merely      rebelling.           S.I.      declined       the
    recommendation she take the child to the hospital for a mental
    health evaluation.
    The vice principal advised the Division worker when he told
    S.I. the child feared returning home, S.I. responded "She don't
    want me.       I don't want her."         S.I. then left the school without
    the child.       Subsequent calls by the vice principal to S.I. went
    4                                   A-2878-12T1
    unanswered.    The school called the Division after S.I. left the
    school.
    Division Special Response Unit (SPRU) worker Pedro Cereno
    responded to the school.   He interviewed the child, who said she
    disliked school because classmates bullied her, called her names
    and made fun of her appearance.       The child complained S.I. yells
    at her, which causes "feelings of depression" and "she would
    rather be dead than go through these things."           Although the
    child did not have a plan to harm herself, she feared returning
    home as "she d[id] not feel safe."       Finally, the child expressed
    she had limited contact with her parents.
    Following unanswered calls to S.I., Cereno traveled to her
    home.     The child remained in the school building with another
    SPRU worker.
    Cereno spoke to S.I. regarding the note found by school
    officials and urged her to take the child to the hospital for a
    psychiatric evaluation.    S.I. declined, stating the child was
    being manipulative as "she ha[d] not gotten her way."            S.I.
    explained the child was spoiled and accustomed to getting what
    she wanted; however, S.I. had lost her job and the family could
    no longer afford to spend money as before.        S.I. characterized
    the child's conduct as reflective of her rebellion because she
    5                          A-2878-12T1
    had "behavioral issues."              Finally, S.I. remarked she was being
    treated for depression as a result of her own circumstances.
    S.I. vehemently denied the child's claims of physical abuse
    and the use of corporal punishment.                   S.I.'s daughter, who also
    lived    in    the   home,      confirmed       the   child     was    not    physically
    abused.
    After Cereno again discussed the need to take the child to
    the hospital, S.I. insisted it was unnecessary and stated she
    refused       to   "play   into    [the       child's]     manipulation."           S.I.
    additionally stated she did not want to go to the hospital for
    fear her own depression might trigger an anxiety attack.
    Cereno explained if S.I. continued to refuse, the Division
    would be required to remove the child to obtain the evaluation.
    S.I. suggested the Division should "assume custody of the child
    because she wasn't taking the child to the hospital."                             Cereno
    also testified S.I. "remained adamant of the fact that if the
    child didn't want to be in the home, that she was not going to
    have    her    there."       Cereno     then     offered      to    provide    homemaker
    services for the household, but S.I. responded:                       "Hell [n]o."
    S.I.    refused     to    sign   the     notice     of      emergency   removal.
    Consequently, the Division effected a Dodd removal and assumed
    6                                   A-2878-12T1
    the child's temporary care, custody, and supervision.4           The child
    was   immediately   taken   to   Jersey   City   Medical    Center     for    a
    psychological evaluation, where she "was screened, not deemed a
    risk and . . . released."
    Sarah Overholser, the caseworker who assumed responsibility
    for the case after the child was removed, also testified.                  She
    stated the Division's investigation revealed the child's claims
    of physical abuse by S.I. were "unfounded."5          The Division also
    communicated   with   the   child's     parents,   who     expressed     they
    maintained regular contact with her.
    4
    "'A "Dodd removal" refers to the emergency removal of a
    child from the home without a court order, pursuant to the Dodd
    Act, which, as amended, is found at N.J.S.A. 9:6-8.21 to -8.82.
    The Act was authored by former Senate President Frank J. "Pat"
    Dodd in 1974.'" N.J. Div. of Youth & Family Servs. v. P.W.R.,
    
    205 N.J. 17
    , 26 n.11 (2011) (quoting N.J. Div. of Youth & Family
    Servs. v. N.S., 
    412 N.J. Super. 593
    , 609 n.2, (App. Div. 2010)).
    5
    A "substantiated" finding is one where "the available
    information, as evaluated by the child protective services
    investigator, indicates by a preponderance of the evidence that
    a child is an abused or neglected child as defined in N.J.A.C.
    10:133-1.3 because the alleged child victim has been harmed or
    placed at risk of harm by a parent or guardian." An
    unsubstantiated finding, therefore, is one where the evidence is
    insufficient to make such an evaluation.    This differs from an
    "unfounded" finding, which is made when "[t]here is not a
    preponderance of evidence that the alleged child victim was
    harmed or placed at substantial risk of harm;" or "[t]here is
    not a preponderance of evidence indicating that a parent or
    guardian and child were involved." 
    N.S., supra
    , 412 N.J. Super.
    at 607 n.1 (alteration in original) (citation omitted).
    7                                A-2878-12T1
    S.I. testified regarding her meeting with school officials
    and    her   interview       by    the   Division.       She     stated    the     vice
    principal declined her requests to talk to the child when she
    did not want to return home.                 S.I. asked what she should do and
    what the school was going to do, but the vice principal just
    "shrugged"; so she left.               She insisted the vice principal never
    stated the child needed a psychiatric evaluation.
    In speaking with Cereno, S.I. related she lost her job and
    "had   gotten      very    ill    with   depression"     and    "had    basically     a
    breakdown."        S.I. explained her depression and anxiety caused
    her    to    become       "mixed-up,"        "overwhelm[ed],"     and     unable     to
    adequately explain her position or "get [] Cereno to understand"
    her view of the child's behavioral concerns.                      S.I. stated the
    child was "not being abused physically or any other way."                          S.I.
    noted since her employment ended, she discovered the child's
    "failing grades [and] horrible attitude toward her aunts."                         S.I.
    started to address these issues with the child, who reacted by
    "crying and ranting and raving."                    S.I. believed the child's
    comments,     as   related        by   the   vice   principal,    showed    she     was
    "acting out."
    S.I. professed she loved the child, denied stating she did
    not want her, and insisted she wanted what was best for her.
    She steadfastly asserted the child would "never have committed
    8                              A-2878-12T1
    suicide."       Rather,    she    suggested      the    child   "was      being
    vindictive" because a few days earlier             S.I. had forbade the
    child from attending the local Boys and Girls Club until her
    grades improved.     S.I. believed the child was "just a teenager
    acting   out    because   she    was   failing    and   I   wanted     her    to
    redirect."
    S.I. also related she feared going to the hospital because
    of her own depression and anxiety.            She asserted her daughter
    offered to take the child to the hospital, but Cereno would not
    permit the aunt to accompany the child to the hospital.
    At the conclusion of the hearing, the judge entered her
    oral opinion.     She found S.I. was "a very intelligent, obviously
    well-educated woman" and recognized the difficulty associated
    with being and raising a teenage girl.           However, she found S.I.
    refused to take the child for a mental health assessment when
    "[c]learly the child was in probable danger of having some kind
    of a serious mental episode."          Addressing S.I.'s explanation of
    the child's behavior, the judge commented:
    whether [the child's behavior] was just for
    attention or whether it was really serious,
    that's not [a decision] for the caregiver to
    make. . . .      [T]hat's for the experts.
    That's for the people in the Medical Center
    or wherever who will sit down and do mental
    testing on someone to make sure that they
    are not a danger to themselves.
    9                               A-2878-12T1
    The judge related concerns for teenage suicide, the emotional
    turmoil caused by bullying, and a young person's inability to
    fully appreciate the consequences of his or her actions and the
    possibility of change in the future, stating:
    [W]ould      she    have    done    it?      Nobody    knows
    that.
    But as the caregiver, do you have the
    obligation to do everything that you can to
    make sure that this child will not harm
    herself? You bet you do.
    The judge determined S.I. "was obligated to take this child
    for   a   medical      health   assessment       after    [she]    had        threatened
    suicide   and    she    refused    to   do     so."      S.I.   received       specific
    instructions regarding how to address the issue, but refused to
    comply.         Accordingly,      the     judge       determined        the    Division
    established by a preponderance of the evidence that the child
    was "abused or neglected" and S.I.'s failure to act amounted to
    medical neglect.
    After dispositional hearings, the child was placed in the
    legal and physical custody of her father, and the litigation was
    terminated.      S.I. filed this appeal.
    S.I. argues the trial judge erred in finding the Division
    met its burden to show medical neglect by a preponderance of the
    evidence as the judge's factual findings were not supported by
    adequate,    substantial,       and     credible      evidence     in    the    record.
    10                                     A-2878-12T1
    S.I. urges the findings of abuse or neglect cannot be sustained
    solely because she disagreed with the Division's recommendation
    that the child needed a mental health evaluation.                       Moreover, she
    contends a single instance of allegedly blocking suggested care
    does    not   rise       to   the   level   of     gross   negligence    or   reckless
    disregard for the child's safety.
    Our standard of review on appeal is narrow.                       We defer to
    the Family Part's findings of fact based on those findings.
    N.J. Div. of Youth & Family Servs. v. G.L., 
    191 N.J. 596
    , 605
    (2007).       "[F]indings by the trial judge are considered binding
    on appeal when supported by adequate, substantial and credible
    evidence."      N.J. Div. of Youth & Family Servs. v. Z.P.R., 
    351 N.J. Super. 427
    , 433 (App. Div. 2002) (citing Rova Farms Resort,
    Inc. v. Investors Ins. Co. of Am., 
    65 N.J. 474
    , 484 (1974)).
    Deference      to    a    trial     court's      supported   factual     findings    is
    warranted because the trial judge "has the opportunity to make
    first-hand credibility judgments about the witnesses who appear
    on the stand [and] . . . has a 'feel of the case' that can never
    be realized by a review of the cold record."                    N.J. Div. of Youth
    & Family Servs. v. E.P., 
    196 N.J. 88
    , 104 (2008).                       Nevertheless,
    "[w]here the issue to be decided is an 'alleged error in the
    trial     judge's        evaluation    of     the    underlying    facts      and   the
    implications to be drawn therefrom,' we expand the scope of our
    11                              A-2878-12T1
    review."       
    G.L., supra
    ,   191    N.J.   at   605   (quoting    In    re
    Guardianship of J.T., 
    269 N.J. Super. 172
    , 188-89 (App. Div.
    1993)).    The trial judge's legal conclusions and the application
    of those conclusions to the facts are subject to plenary review.
    Manalapan Realty, L.P. v. Twp. Comm. of Manalapan, 
    140 N.J. 366
    ,
    378 (1995).
    The adjudication of abuse or neglect is governed by Title
    9, which is designed to protect children who suffer serious
    injury inflicted by other than accidental means.            G.S. v. Dep't
    of Human Servs., 
    157 N.J. 161
    , 171 (1999) (citing N.J.S.A. 9:6-
    8.8).     See also N.J.S.A. 9:6-8.21 to -8.73 (governing protection
    of abused and neglected children).            "The statute in question
    addresses harm to a child[.]"         
    A.L., supra
    , 213 N.J. at 8.           An
    "abused or neglected child" is defined in N.J.S.A. 9:6-8.21(c)
    as
    a child less than 18 years of age whose
    parent or guardian, as herein defined, . . .
    or a child whose physical, mental, or
    emotional condition has been impaired or is
    in imminent danger of becoming impaired as
    the result of the failure of his parent or
    guardian, as herein defined, to exercise a
    minimum degree of care . . . in supplying
    the child with adequate food, clothing,
    shelter, education, medical or surgical care
    though financially able to do so or though
    offered financial or other reasonable means
    to do so . . . .
    12                            A-2878-12T1
    Whether a parent or guardian has engaged in acts of abuse
    or neglect is considered on a case-by-case basis and must be
    "'analyzed in light of the dangers and risks associated with the
    situation.'"    N.J. Dep't of Children & Families v. R.R., __ N.J.
    Super. ____, ____ (App. Div. 2014) (slip op. at 7) (quoting
    
    G.S., supra
    , 157 N.J. at 181-82).          Under the statutory standard,
    "something more than ordinary negligence is required to hold the
    actor liable."     
    G.S., supra
    , 157 N.J. at 178.              Proscribed is
    "conduct   that   is    grossly    or     wantonly    negligent,    but     not
    necessarily intentional."         
    Ibid. The standard "implies
    that a
    person   has   acted   with   reckless    disregard    for   the   safety    of
    others."   
    Id. at 179.
           However, whether a particular event is
    mere negligence, as opposed to gross or wanton negligence, can
    be difficult to determine.          See N.J. Div. of Youth & Family
    Servs. v. T.B., 
    207 N.J. 294
    , 309 (2011).
    A court considering whether a parent or guardian's conduct
    meets the statutory standard must analyze all facts, N.J. Div.
    of Youth & Family Servs. v. V.T., 
    423 N.J. Super. 320
    , 329 (App.
    Div. 2011), and decide whether the parent or guardian exercised
    a minimum degree of care under the circumstances.              N.J. Div. of
    Child Prot. & Permanency v. J.A., ___ N.J. Super. ___, ___ (App.
    Div. 2014) (slip op. at 9).
    13                              A-2878-12T1
    During the fact-finding hearing, the State bears the burden
    and must present proofs to establish abuse or neglect as defined
    in the statute.        
    P.W.R., supra
    , 205 N.J. at 32; N.J.S.A. 9:6-
    8.46(b).         Specifically,     the   State   must    "demonstrate           by     a
    preponderance of the competent, material and relevant evidence
    the probability of present or future harm" to the minor child.
    N.J. Div. of Youth & Family Servs. v. S.S., 
    372 N.J. Super. 13
    ,
    24 (App. Div. 2004) (citation omitted), certif. denied, 
    182 N.J. 426
    (2005).
    We    recognize       that     "the     elements      of        proof          are
    synergistically related."          
    V.T., supra
    , 423 N.J. Super. at 329,
    (citation    and    internal     quotation    marks     omitted).          In    this
    regard, "[o]ne act may be substantial or the sum of many acts
    may be substantial" to prove abuse or neglect.                        
    Id. at 320
    (citation and internal quotation marks omitted).                  A court need
    not wait until a child is actually harmed or neglected before it
    can   act   to    address   parental      conduct   adverse      to    a   minor's
    welfare.    N.J. Div. of Youth & Family Servs. v. V.M., 408 N.J.
    Super. 222, 235-36 (App. Div.) (citing In re Guardianship of
    D.M.H., 
    161 N.J. 365
    , 383 (1999)), certif. denied, 
    200 N.J. 505
    (2009), cert. denied, ___ U.S. ___, 
    130 S. Ct. 3502
    , 
    177 L. Ed. 2d
    1095 (2010).
    14                                A-2878-12T1
    "[N]on-intentional        conduct     is   sufficient    to   warrant       a
    finding of abuse if injury to the child is demonstrated."                    
    S.S., supra
    , 372 N.J. Super. at 24 (citing 
    G.S., supra
    , 157 N.J. at
    175-82).       However, when "there is no evidence of actual harm,
    . . . the statute requires a showing of 'imminent danger' or a
    'substantial risk' of harm before a parent or guardian can be
    found to have abused or neglected a child."                   
    A.L., supra
    , 213
    N.J. at 8 (citing N.J.S.A. 9:6-8.21(c)).                   If an isolated act
    "appears to be aberrational," labeling the parent a child abuser
    may be inappropriate.            N.J. Div. of Youth & Family Servs. v.
    K.A., 
    413 N.J. Super. 504
    , 512-13 (App. Div. 2010), certif.
    dismissed, 
    208 N.J. 355
    (2011).
    Guided by these principles we examine the facts in this
    matter.    The issue presented is whether S.I.'s refusal to take
    the    child     to    the   hospital      for    a   psychiatric    evaluation
    constituted a failure to exercise a minimum degree of care,
    recklessly creating "harm, or [the] substantial risk thereof[.]"
    N.J.S.A. 9:6-8.21(c)(4)(b).          A teenager's expression tantamount
    to    thoughts    of   suicide    should     never    be   ignored   by   adults.
    However, the facts presented here are so limited we can only
    conclude this evidence fails to prove the child was in "imminent
    danger" or that a "substantial risk" of harm would result from
    15                                A-2878-12T1
    S.I.'s refusal to seek immediate psychiatric review, which are
    prerequisites to sustain a finding of abuse or neglect.
    The Division presented Cereno's report, which included the
    school's reaction to finding the child's note on December 8,
    2011.   The child admitted penning the note, sometime in October,
    possibly six to eight weeks earlier.               The child stated she was
    depressed, but also affirmed she had no plans on how to harm
    herself.    In his discussion with the child, Cereno noted the
    child related poor relationships with her family members and
    alleged physical and verbal conflict with S.I.
    When confronted with the note stating the child "wanted to
    kill herself," school and Division workers appropriately reacted
    to determine the depth of the child's depression.                   The facts
    show the child was upset, possibly distraught by her perceived
    treatment by S.I., and she was also troubled by her classmates'
    conduct,    a   longstanding    problem      the    school   was   purportedly
    addressing.     But the record contains no evidence that describes
    the child's behaviors when she was examined by the mobile crisis
    unit or any recommendation by those responders after speaking
    with the child.       The record also lacks evidence demonstrating
    the effect of S.I.'s conduct.          The judge observed, mental health
    concerns    attendant    to     the    behavior      identified    by    school
    officials   are   a   subject   left   for    experts   to   determine.         At
    16                               A-2878-12T1
    trial,    no   evidence    was     offered    assessing    the     level   of    risk
    posed.     When S.I. refused to take the child to the hospital,
    certainly at that time the child's safety was secured by the
    intervention of school and Division officials.                   Acting as parens
    patriae, the Division had the child examined.                    Therefore, even
    though S.I. declined to take the child to the hospital because
    she   disagreed       with        the   Division's        assessment       of     the
    circumstances, she did not thwart efforts to obtain the desired
    evaluation.      The Division later learned the hospital could not
    identify any underlying medical or mental health conditions, and
    did not recommend a course of necessary treatment, or diagnose a
    risk requiring immediate care.
    There are additional undisputed facts not addressed in the
    judge's    opinion,       which    support     S.I.'s     belief     the    child's
    comments did not manifest urgent attention.                S.I.'s decision was
    informed by her parental experience, from which she concluded
    the   child     was     exhibiting      teenage    rebellion        after       being
    disciplined for poor school performance.                   These include: S.I.
    had raised the child for most of her life, without incident or
    intervention     from     the     Division;    S.I.'s     recent     unemployment
    caused her to more closely scrutinize the child's behaviors,
    which she identified as more disrespectful as she entered her
    17                                  A-2878-12T1
    teens;   and     S.I.    related       the        child's    previous    attempts       at
    manipulation, when disciplined or denied what she wanted.
    S.I. also had demonstrated her care for the child's well-
    being.      She detailed proactive efforts undertaken to curtail
    peer bullying and implement protocols with teachers to aid the
    child in the event of future incidents.                        S.I. also initiated
    counseling for the child to assist with these concerns.
    Admittedly,       when    told    of        her   granddaughter's     interview
    comments and the feelings she expressed in the uncovered note,
    S.I. became upset, angered, and her statements suggest she felt
    rejected.      We do not countenance S.I.'s lack of cooperation with
    the   school     or     the    Division.            Her     decision    declining       to
    immediately     seek     a    mental    health          evaluation     perhaps    was     a
    mistake; however, it cannot be said to rise to the level of
    gross or wanton negligence.
    We also cannot ignore S.I.'s view of her granddaughter's
    behavior in part was justified by the Division's investigation,
    which concluded the child's claims of physical abuse at the
    hands of S.I. were unfounded, not merely unsubstantiated.                               The
    child's claim of estrangement from her parents                          also was not
    supported by the parents' statements.
    The trial judge did not reject S.I.'s testimony                             as not
    credible.      Rather, she rejected S.I.'s view on the need for the
    18                                  A-2878-12T1
    child's mental status examination based on a general concern for
    teenage suicide and the emotional effects of bullying.                                    There is
    no evidential support for the judge's finding that this child
    "was in probable danger of having some kind of mental episode."
    The    record     contains       no     expert         evidence        or    even     admissible
    documentary       evidence       supporting           this    assertion.            Indeed,     the
    record reflects only the judge's opinion, which cannot be used
    to substantiate legal conclusions.                           "Judges at the trial and
    appellate level cannot fill in missing information on their own
    or take judicial notice of harm.                            Instead, the fact-sensitive
    nature    of     abuse    and     neglect         cases,       turns        on    particularized
    evidence."         
    A.L. supra
    ,        213    N.J.       at   28    (internal         citation
    omitted).
    Examining       the    totality           of    the    facts     and        circumstances
    facing    this     family,       we   cannot          conclude     S.I.'s         emotional     and
    angry response to her granddaughter's comments was grossly or
    wantonly negligent, made knowing that injury was likely or made
    with    reckless       disregard       that       substantial          likelihood         of   harm
    would     befall       the    child.             No        evidence     was       presented       to
    demonstrate the child's physical, mental, or emotional condition
    was    impaired    or     that    she      was        in   imminent     danger       of    harming
    herself     as     a     result       of     S.I.'s          decision        to    decline      the
    recommendation for an immediate evaluation.                                  Accordingly, the
    19                                       A-2878-12T1
    judge's conclusion to the contrary cannot withstand scrutiny and
    the   underlying     evidence   is    insufficient      to    show   abuse    or
    neglect.
    Our comments must not be misunderstood as questioning the
    Division's precautionary response to assure the child received a
    mental health evaluation.        When the SPRU worker was confronted
    with the child's comments during her interview and her feelings
    expressed in the uncovered note, along with S.I.'s refusal to
    take the child straight to the hospital, the need to act was
    manifest.    In fact, S.I.'s extreme emotional response prevented
    her from offering a reasoned alternative course, leaving removal
    as the only available option.         However, rather than resorting to
    Title 9, the Division has extensive authority to assure children
    are protected under the State's child welfare laws pursuant to
    N.J.S.A.    30:4C-11   and    -12.     As    detailed    by    Chief   Justice
    Rabner's opinion in A.L., these statutory provisions authorize
    not only services, but as necessary, care and custody.                    
    A.L., supra
    , 213 N.J. at 30-34.        Every event requiring the Division's
    intervention does not result from abuse or neglect.
    Moreover, our holding intends to underscore the need for
    evidence to support a claim of abuse or neglect, as interpreted
    by the Court in A.L.      This includes proof of actual harm or, in
    the   absence   of   actual   harm,   "the   Division    was    obligated     to
    20                               A-2878-12T1
    present competent evidence adequate to establish [the child was]
    presently     in   imminent     danger    of     being   impaired      physically,
    mentally or emotionally."         N.J. Div. of Child Prot. & Permanency
    v. M.C., __ N.J. Super. ___, ___ (App. Div. 2014) (slip op. at
    3) (citations omitted).         These essential proofs cannot merely be
    based   on   the   Division's     view    that    the    parent   or    guardian's
    decision on behalf of a child was ill-advised.                         Rather, the
    Division must demonstrate harm or show the likelihood of an
    imminent substantial risk of harm rising above mere negligence.
    
    A.L. supra
    , 231 N.J. at 28; 
    S.S., supra
    , 372 N.J. Super. at 24.
    Such evidence is absent here.            Accordingly, S.I.'s demonstrated
    failure to comply with the recommended psychiatric evaluation
    was   not    proven   to   be   medical       neglect    under    N.J.S.A.     9:6-
    8.21(c)(4).
    Reversed.
    21                                A-2878-12T1