In re O.D.- L. , 2021 Ohio 79 ( 2021 )


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  • [Cite as In re O.D.- L., 
    2021-Ohio-79
    .]
    IN THE COURT OF APPEALS OF OHIO
    SECOND APPELLATE DISTRICT
    MONTGOMERY COUNTY
    IN RE: O.D.-L.                                 :
    :
    :   Appellate Case No. 28865
    :
    :   Trial Court Case No. 2018-1374
    :
    :   (Appeal from Common Pleas Court-
    :   Juvenile Division)
    :
    :
    ...........
    OPINION
    Rendered on the 15th day of January, 2021.
    ...........
    MATHIAS H. HECK, JR., by JAMIE J. RIZZO, Atty. Reg. No. 0099218, Assistant
    Prosecuting Attorney, Montgomery County Prosecutor’s Office, Appellate Division,
    Montgomery County Courts Building, 301 West Third Street, 5th Floor, Dayton, Ohio
    45422
    Attorney for Appellee, Montgomery County Children Services
    CRISTY N. OAKES, Atty. Reg. No. 0081401, 2312 Far Hills Avenue, Suite 143, Dayton,
    Ohio 45419
    Attorney for Appellant, Mother
    .............
    DONOVAN, J.
    -2-
    {¶ 1} Mother appeals from a judgment of the Montgomery County Court of
    Common Pleas, Juvenile Division, which terminated her parental rights and granted
    permanent custody of her child, O.D.-L., to Montgomery County Children’s Services
    (MCCS). Mother filed a timely notice of appeal on August 6, 2020.
    {¶ 2} O.D.-L. was born on September 5, 2017. He tested positive for controlled
    substances at birth and, as a result, he was removed from Mother’s custody and placed
    on a safety plan with Maternal Grandmother. 1 MCCS eventually became concerned
    about Maternal Grandmother’s custody of O.D.-L. and her understanding of his medical
    needs. Specifically, O.D.-L. suffers from hypoxic ischemic encephalopathy (HIE), an
    irreversible condition in which brain tissue is either missing or deteriorating. As a result
    of his condition, O.D.-L. is unlikely to ever be able to walk or speak. O.D.-L. was initially
    fed through an NG-tube, a device inserted through the child’s nose down into his stomach.
    Eventually, a gastronomy tube (G-tube) was surgically inserted so that O.D.-L.’s food
    could be fed directly into his stomach.
    {¶ 3} Because of his condition, O.D.-L. required the services of a full-time
    caretaker, and he had several weekly medical appointments. O.D.-L.’s brain damage
    has caused several other serious conditions, including cerebral palsy, quadriplegia,
    muscle spasms, seizures, kidney issues, urine-reflux issues, and trouble swallowing.
    Nevertheless, Maternal Grandmother informed MCCS that O.D.-L.’s medical issues were
    merely the result of his premature birth, and that she believed that O.D.-L. would
    1 As noted by the trial court, O.D.-L. has no legal father, although a particular man was
    alleged to be the child’s father. MCCS met with the alleged father on two occasions and
    provided him with information regarding the case plan and court proceedings. However,
    the alleged father chose not participate in the case and never established paternity of
    O.D.-L.
    -3-
    eventually be able to play soccer. Maternal Grandmother also stated that O.D.-L. was
    able to focus on people, known as tracking, even though he could not. The record
    established that Maternal Grandmother also missed several of O.D.-L.’s medical
    appointments, informing MCCS that she was overwhelmed with the number of weekly
    appointments that she was required to attend with O.D.-L.
    {¶ 4} On March 23, 2018, MCCS filed a complaint alleging that O.D.-L. was an
    abused, neglected, and dependent child; he was removed from the custody of Maternal
    Grandmother and placed in the interim custody of MCCS. On April 3, 2018, MCCS filed
    an amended complaint requesting temporary custody to Maternal Grandmother, or in the
    alternative to MCCS. At the adjudication hearing on May 16, 2018, the magistrate found
    O.D.-L. to be neglected and dependent, and the parties agreed to place O.D.-L. in the
    temporary custody of Maternal Grandmother.
    {¶ 5} In October 2018, O.D.-L. was removed for a second time from the custody of
    Maternal Grandmother. MCCS caseworker Luke Conover testified that, during the six
    months before the second removal from Maternal Grandmother’s custody, O.D.-L. had
    not gained any weight. This led MCCS to conclude that Maternal Grandmother did not
    appreciate the severity of O.D.-L.’s condition and that she was unable to properly care for
    him. Following the removal, O.D.-L. was placed with a foster family that was ultimately
    unable to meet his many needs. O.D.-L. was then placed with a second foster family,
    the Dimmicks, where he remained for the duration of the proceedings. The Dimmicks,
    however, are not a foster-to-adopt foster family.
    {¶ 6} Prior to MCCS’s seeking permanent custody of O.D.-L., Mother was placed
    on a case plan. Mother’s case plan objectives were to get alcohol and/or drug treatment
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    and follow any recommendations, get a mental health assessment, attend parenting
    classes, attend O.D.-L.’s medical appointments, sign releases of information, meet with
    a caseworker monthly, attend visits with O.D.-L., and provide drug screens.
    {¶ 7} The record established that Mother failed to complete a mental health
    assessment. Mother completed an alcohol and drug assessment at Family Services, but
    she failed to follow any recommendations based upon the assessment.                  Two drug
    screens were administered to her in 2018, and Mother tested positive on both occasions
    for methamphetamine and amphetamines, after which she simply refused to be tested
    again. MCCS informed Mother that a refusal would be considered as the equivalent of
    a positive drug screen, but Mother still refused to submit to any further testing.
    {¶ 8} Conover testified that while he was O.D.-L.’s assigned caseworker, Mother
    attended only 50 to 65 percent of his medical appointments. MCCS caseworker Tairya
    Fields testified that, once she was assigned to O.D.-L.’s case, Mother attended only
    approximately ten percent of his medical appointments. Furthermore, Mother had not
    been properly trained to feed O.D.-L. through his G-tube because she failed to attend the
    appointments where she would have been trained.
    {¶ 9} Significantly, on the days of her scheduled visits at MCCS, the foster mother
    fed O.D.-L., because Mother had not received the necessary training. Mother was also
    frequently late to the meetings. Conover testified that MCCS was also concerned with
    Mother’s improper holding and support of O.D.-L.’s head and neck. Additionally, the
    police had to remove Mother and Maternal Grandmother from one meeting because they
    became disruptive.
    {¶ 10} Fields testified that in February 2019, Mother began attending meetings
    -5-
    more frequently than she had previously. However, Mother refused to allow MCCS to
    enter her home, insisting on meeting with Fields outside. Thus, MCCS was unable to
    verify that Mother’s home was safe and appropriate for O.D.-L.
    {¶ 11} On August 19, 2019, MCCS filed a motion for permanent custody of O.D.-
    L.   On November 5, 2019, Mother filed a motion requesting that legal custody be
    awarded to Maternal Grandmother. A hearing was held before the magistrate regarding
    both motions on November 5, 2019. The guardian ad litem (GAL) recommended that
    permanent custody of O.D.-L. be awarded to MCCS.             On November 22, 2019, the
    magistrate granted MCCS permanent custody of O.D.-L. Mother filed objections to the
    magistrate’s decision on December 4, 2019. Mother supplemented her objections on
    February 8, 2020. In a judgment issued on July 27, 2020, the juvenile court overruled
    Mother’s objections and adopted the magistrate’s decision awarding permanent custody
    of O.D.-L. to MCCS.
    {¶ 12} It is from this judgment that Mother now appeals.
    {¶ 13} Mother’s first assignment of error is as follows:
    MCCS     DID   NOT     INVESTIGATE       THE    EXISTENCE       OF OTHER
    RELATIVES, OTHER THAN MATERNAL GRANDMOTHER.
    {¶ 14} In her first assignment of error, Mother contends that the juvenile court erred
    by granting permanent custody to MCCS because it did not fully investigate the possibility
    of placing O.D.-L. with relatives other than Maternal Grandmother.
    {¶ 15} This court has held that the consideration of whether a child can be placed
    with a relative is not a statutory requirement. In re R.L., 2d Dist. Greene Nos. 2012-CA-
    32, 2012-CA-33, 
    2012-Ohio-6049
    , ¶ 46. “That possibility is a matter that ought to be
    -6-
    considered in connection with the child's interaction and relationship with the child's
    parents, relatives, foster caregivers, out-of-home providers, and any other person who
    may significantly affect the child.” 
    Id.,
     citing In re F.C., 2d Dist. Montgomery No. 23803,
    
    2010-Ohio-3113
    , ¶ 24. Accordingly, the trial court had no obligation to consider placing
    O.D.-L. with a relative. In re E.S., 2d Dist. Clark No. 2016-CA-36, 
    2017-Ohio-219
    , ¶ 59.
    Unlike biological parents, other relatives or friends seeking placement are not afforded
    special status or presumptive rights. 
    Id.
     A trial court need not find a child's relative
    unsuitable before granting an agency permanent custody, and a court is not required to
    favor a relative where an award of permanent custody serves the child's best interest. 
    Id.,
    quoting In re A.C.H., 4th Dist. Gallia No. 11CA2, 
    2011-Ohio-5595
    , ¶ 44.
    {¶ 16} Therefore, awarding permanent custody to MCCS without investigating all
    possible relatives for placement, standing alone, is not reversible error. Notably, Mother
    failed to identify any other suitable relative for placement.
    {¶ 17} Mother’s first assignment of error is overruled.
    {¶ 18} Mother’s second assignment of error is as follows:
    THE COURT FAILED TO CONSIDER THE SUITABILITY OF MATERNAL
    GRANDMOTHER AS A POSSIBLE CUSTODIAN FOR O.D.-L.
    {¶ 19} In her second assignment, Mother argues that the juvenile court erred by
    failing to properly consider the suitability of Maternal Grandmother as a custodian for
    O.D.-L.
    {¶ 20} However, “ ‘[a] parent has no standing to assert that the court abused its
    discretion by failing to give the [grandparent] legal custody; rather, the challenge is limited
    to whether the court's decision to terminate parental rights was proper.’ ” In re L.W., 8th
    -7-
    Dist. Cuyahoga No. 104881, 
    2017-Ohio-657
    , ¶ 23, quoting In re S.G., 3d Dist. Defiance
    No. 4-16-13, 
    2016-Ohio-8403
    , ¶ 52, citing In re Pittman, 9th Dist. Summit No. 20894,
    
    2002-Ohio-2208
    , ¶ 70. If permanent custody to the children services agency is in the
    children's best interest, legal custody to a relative necessarily is not. In re V.C., 8th Dist.
    Cuyahoga Nos. 102903, 103061, and 103367, 
    2015-Ohio-4991
    , ¶ 60, citing In re M.S.,
    8th Dist. Cuyahoga Nos. 101693 and 101694, 
    2015-Ohio-1028
    , ¶ 11.
    {¶ 21} In the instant case, Maternal Grandmother was not hindered from asserting
    her rights at any point in the proceedings before the magistrate and the juvenile court.
    Maternal Grandmother intervened before the magistrate, filed her own motion for
    allocation of parental rights, and testified at the permanent custody hearing.
    Significantly, Maternal Grandmother failed to appeal the juvenile court’s decision
    overruling her motion and awarding permanent custody of O.D.-L. to MCCS. Thus,
    Mother has no standing to assert Maternal Grandmother’s interests as a potential
    custodian of O.D.-L. Rather, Mother's challenge to the juvenile court's judgment granting
    permanent custody to MCCS is limited to whether the trial court improperly terminated
    her own parental rights.
    {¶ 22} Mother’s second assignment of error is overruled.
    {¶ 23} Mother’s third assignment of error is as follows:
    MOTHER WAS DENIED THE EFFECTIVE ASSISTANCE OF COUNSEL
    BY HER TRIAL ATTORNEY’S FAILURE TO ASK MOTHER QUESTIONS
    ABOUT HER CASE PLAN OBJECTIVES AND FAILURE TO OBJECT TO
    INADMISSIBLE EVIDENCE.
    {¶ 24} Mother argues that the she received ineffective assistance of counsel during
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    the permanent custody hearing. Specifically, Mother contends that her counsel was
    ineffective for the following reasons: 1) failing to ask Mother questions with respect to her
    completion of her case plan objectives; 2) focusing on Maternal Grandmother’s ability to
    provide suitable care for O.D.-L., claiming that Maternal Grandmother’s testimony was
    the “best evidence” of that; 3) failing to call Maternal Grandmother as a witness so he
    could have directly examined her; and 4) failing to object to a comment made by the
    magistrate during the permanent custody hearing.
    {¶ 25} The test for ineffective assistance of counsel applied in criminal cases is
    equally applicable to permanent custody proceedings. In re J.P., 2d Dist. Montgomery
    No. 27093, 
    2016-Ohio-5351
    , ¶ 65. Under the two-pronged test set forth in Strickland v.
    Washington, 
    466 U.S. 668
    , 
    104 S.Ct. 2052
    , 
    80 L.Ed.2d 674
     (1984), the represented party
    must demonstrate that counsel's performance was deficient and fell below an objective
    standard of reasonable representation, and that he or she was prejudiced by counsel's
    performance. See also State v. Bradley, 
    42 Ohio St.3d 136
    , 
    538 N.E.2d 373
     (1989).
    Proof of both parts of the test is necessary to establish the claim of ineffective assistance
    of counsel. Bradley at 142.
    {¶ 26} The standards for ineffective assistance of counsel “do not establish
    mechanical rules”; rather, the focus is the fundamental fairness of the proceeding whose
    result is being challenged. Strickland at 670. To establish the first prong of ineffective
    assistance, there must be “a substantial violation” of one of counsel's essential duties to
    his or her client, Bradley at 141, and the adequacy of counsel's performance must be
    viewed in light of all of the circumstances surrounding the trial court proceedings.
    Strickland at 688. Trial counsel is entitled to a presumption of competency. State v.
    -9-
    Calhoun, 
    86 Ohio St.3d 279
    , 289, 
    714 N.E.2d 905
     (1999). To establish the second prong
    of ineffective assistance, the represented party must demonstrate that, but for counsel's
    errors, there is a reasonable probability that the result of the trial would have been
    different. Strickland at 694.    “A reasonable probability is a probability sufficient to
    undermine confidence in the outcome.” 
    Id.
    {¶ 27} A represented party is not deprived of effective assistance of counsel when
    counsel chooses, for strategic reasons, not to pursue every possible trial tactic. State v.
    Brown, 
    38 Ohio St.3d 305
    , 319, 
    528 N.E.2d 523
     (1988). The test for a claim of ineffective
    assistance of counsel is not whether counsel pursued every possible defense; the test is
    whether the defense chosen was objectively reasonable. Strickland. A reviewing court
    may not second-guess decisions of counsel which can be considered matters of trial
    strategy. State v. Smith, 
    17 Ohio St.3d 98
    , 
    477 N.E.2d 1128
     (1985). Debatable strategic
    and tactical decisions may not form the basis of a claim for ineffective assistance of
    counsel, even if, in hindsight, it looks as if a better strategy had been available. State v.
    Cook, 
    65 Ohio St.3d 516
    , 524, 
    605 N.E.2d 70
     (1992).
    {¶ 28} Initially, Mother argues that her counsel was ineffective for failing to ask her
    questions about to her case plan objectives, including substance abuse treatment she
    received and her attendance of O.D.-L.’s medical appointments.            At the permanent
    custody hearing, the following exchange occurred between Mother and her counsel
    during her direct examination:
    Counsel: Okay. And, uh, do you know if your [Maternal Grandmother] has
    visited with [O.D.-L.] on a regular basis?
    Mother: Yes, sir.
    -10-
    Q: Yeah. And, uh, at some of those visits did you also – or at some of
    those appointments or visits – uh, did you attend those appointments as
    well?
    A: Um, [Maternal Grandmother] attends most of his medical appointments.
    Um, sometimes I haven’t because I’ve been having a lot of car trouble
    myself. So, my car has just been a big, uh, pain in my butt, if you will.
    Q: Now, during those – I want to say – I’ll say the visitations – let’s separate
    them.    The visits, when she visits with [O.D.-L.] have you observed
    [Maternal Grandmother] to be appropriate?
    A: Yes. Oh, yes.
    Q: Nurturing?
    A: Oh, yes. Definitely. [Maternal Grandmother] is a wonderful mother and
    a wonderful grandmother.
    Q: Now, let’s get back to the medical appointments.            Was [Maternal
    Grandmother], during those appointments, appropriate?
    A: And did she appear to understand the child’s needs?
    Q: Yes. She – she’s very willing to understand, and she – she’s, um, been
    trying to teach herself through, um, videos, how to do the G-tube and how
    it works, and how to properly care for O.D.-L. Um, yes, sir.
    {¶ 29} Thus, the record establishes that Mother’s counsel did, in fact, ask her about
    attending O.D.-L.’s medical appointments, and she clearly indicated that Maternal
    Grandmother attended the majority of the appointments because Mother’s “car trouble”
    restricted her from attending on a regular basis. Additionally, the focus of the permanent
    -11-
    custody hearing from Mother's perspective was to establish that Maternal Grandmother
    could provide an appropriate and suitable home for O.D.-L. and properly provide suitable
    medical care for him. The purpose of Mother’s testimony was to establish the basis for
    an award of custody to Maternal Grandmother, not Mother. Therefore, we fail to see how
    any questions relating to Mother’s work on her case plan objectives or her attendance at
    a substance abuse treatment facility would have furthered that goal. Furthermore, given
    Mother’s history of drug abuse and her previously discussed failure to complete her case
    plan objectives, it may have been counsel’s strategy to avoid asking questions which
    could have damaged her case.
    {¶ 30} Mother also argues that counsel’s focus on questioning her regarding
    Maternal Grandmother’s caregiving ability constituted ineffective assistance because
    Maternal Grandmother’s own testimony was the “best evidence” of that. Again, the focus
    of the permanent custody hearing from Mother’s perspective was to establish the basis
    for an award of custody to Maternal Grandmother. Mother even filed a motion to award
    custody of O.D.-L. to Maternal Grandmother.         Additionally, Maternal Grandmother’s
    testimony regarding her ability to provide a suitable environment for O.D.-L. was not the
    “best evidence” of her caregiving pursuant to Evid.R. 1002, nor was her testimony any
    more probative than the testimony of other witnesses who had observed her interactions
    with O.D.-L. The “best evidence” rule pursuant to Evid.R. 1002 stands for the proposition
    that an original writing or recording is the best evidence of its content. The rule does not
    state that one witness’s testimony has more probative value than the testimony of another
    witness.   Thus, Maternal Grandmother’s testimony regarding her ability to care and
    provide for O.D.-L. was no more probative than Mother’s testimony or the testimony of
    -12-
    any of the other witnesses regarding their observations of Maternal Grandmother’s
    caregiving ability.
    {¶ 31} Furthermore, Mother argues that counsel was ineffective for failing to call
    Maternal Grandmother as a witness so that he could have directly examined her.
    However, the record establishes the magistrate called Maternal Grandmother as a
    witness and examined her as if on direct, and Mother’s counsel was given the opportunity
    to cross-examine Maternal Grandmother. Under the rules of evidence, “[i]n Ohio, cross-
    examination is not limited to the subject matter of direct examination. * * * It is available
    for all matters pertinent to the case that the party calling the witness would have been
    entitled or required to raise.” State v. Treesh, 
    90 Ohio St.3d 460
    , 481, 
    739 N.E.2d 749
    (2001). Accord State v. Perez, 
    124 Ohio St.3d 122
    , 
    2009-Ohio-6179
    , 
    920 N.E.2d 104
    ,
    ¶ 128 (saying that “[u]nder Evid.R. 611(B), cross-examination is not limited to the scope
    of direct examination, but may cover ‘all relevant matters' ”).
    {¶ 32} Accordingly, Mother’s counsel was free to inquire of Maternal Grandmother
    regarding any subject he deemed to be relevant. Here, the record establishes that
    Mother’s counsel questioned Maternal Grandmother regarding her ability to provide
    adequate care to O.D.-L., her ability to attend his medical appointments, and her
    willingness to take classes regarding O.D.-L.’s medical conditions.         Since Mother’s
    counsel was able to cross-examine Maternal Grandmother at the permanent custody
    hearing, Mother did not receive ineffective assistance based upon his initial failure to call
    her as a witness.
    {¶ 33} Lastly, Mother argues that her counsel was ineffective for failing to object to
    a remark made by the magistrate during the following exchange during the permanent
    -13-
    custody hearing:
    The Court: Mother, do you need to leave?
    Mother: Yes, I do.
    The Court: Okay. Thank you.
    Mother: I feel sick.
    The Court: You should feel sick.
    Mother: I feel sick. [O.D.-L.] bonds with his mommy. You guys are sick.
    {¶ 34} The above exchange occurred during the testimony of O.D.-L.’s foster
    mother, who was describing the bond that had developed between O.D.-L. and all of the
    members of the foster family.       While the magistrate’s remark was imprudent and
    unprofessional, the comment did not constitute evidence of any kind, and there is no
    indication that the juvenile court relied upon the comment in any way when it awarded
    permanent custody of O.D.-L. to MCCS. There is no evidence in the record that Mother
    was prejudiced by the magistrate’s comment.          Therefore, Mother’s counsel was not
    ineffective for failing to object the magistrate’s comment.
    {¶ 35} Mother also argues that counsel should have objected when he was
    questioning Fields about alleged bruising suffered by O.D.-L. at the foster home, and the
    magistrate limited any further questioning by Mother’s counsel regarding bruises. The
    magistrate stated that the permanent custody hearing was not the venue for that type of
    inquiry, and there was another judicial process in place for that type of complaint.
    Additionally, prior to the magistrate’s restricting any further questioning regarding bruising
    on O.D.-L., Fields testified that MCCS had sent nurses out to the foster home to
    investigate the cause of the bruising, and the foster family was found to have not been
    -14-
    responsible for the bruising. Thus, Mother’s counsel was not ineffective for failing to
    object to the magistrate’s decision to restrict further questions about O.D.-L.’s bruises,
    which had been found by MCCS to be unrelated to any care provided by the foster family.
    {¶ 36} Mother’s third assignment of error is overruled.
    {¶ 37} Mother’s fourth assignment of error is as follows:
    THE TRIAL COURT ERRED WHEN IT GRANTED PERMANENT
    CUSTODY OF O.D.L. TO MCCS, WHEN THE BEST OPTION AVAILABLE
    WAS LEGAL CUSTODY TO MATERNAL GRANDMOTHER.
    {¶ 38} “In a proceeding for the termination of parental rights, all of the court's
    findings must be supported by clear and convincing evidence.” In re M.S., 2d Dist. Clark
    No. 2008-CA-70, 
    2009-Ohio-3123
    , ¶ 15, citing R.C. 2151.414(E). A reviewing court will
    not overturn a court's grant of permanent custody to the State “ ‘if the record contains
    competent, credible evidence by which the court could have formed a firm belief or
    conviction that the essential statutory elements * * * have been established.’ ” In re R.L.,
    2d Dist. Greene Nos. 2012-CA-32, 2012-CA-33, 
    2012-Ohio-6049
    , ¶ 17, quoting In re
    A.U., 2d Dist. Montgomery No. 22287, 
    2008-Ohio-187
    , ¶ 9. We review the trial court's
    judgment for an abuse of discretion. See In re C.F., 
    113 Ohio St.3d 73
    , 
    2007-Ohio-1104
    ,
    
    862 N.E.2d 816
    , ¶ 48.
    {¶ 39} As this Court has noted:
    A children services agency that has been awarded temporary
    custody of a child may move for permanent custody. R.C. 2151.413(A).
    Before the court may award the agency permanent custody of a child, the
    court must conduct a hearing. R.C. 2151.414(A)(1).
    -15-
    A trial court may not grant a permanent custody motion unless the
    court determines that (1) it is in the best interest of the child to grant the
    agency permanent custody, and (2) one of the conditions set forth in R.C.
    2151.414(B)(1)(a)-(d) exists.
    (Emphasis added.) In re J.E., 2d Dist. Clark No. 07-CA-68, 
    2008-Ohio-1308
    , ¶ 8-9.
    {¶ 40} R.C. 2151.414 provides that, in finding that “the permanent commitment is
    in the best interest of the child” a court must consider all relevant factors, including the
    statutory factors listed in division (D) of the section: “(1) the interaction and
    interrelationship of the child with the child's parents, relatives, foster parents and any other
    person who may significantly affect the child; (2) the wishes of the child; (3) the custodial
    history of the child * * *; (4) 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; and (5) whether any of the factors in R.C. 2151.414(E)(7) through (11) are
    applicable.” In re S.J., 2d Dist. Montgomery No. 25550, 
    2013-Ohio-2935
    , ¶ 15.
    {¶ 41} Regarding O.D.-L.’s interactions and interrelationships, his severe medical
    conditions render it difficult to establish whether he was bonded with anyone. O.D.-L.
    was unable to show many signs of affection and did not laugh. Conover testified that
    sometimes O.D.-L. simply lies in place without moving. Conversely, O.D.-L.’s foster
    mother testified that O.D.-L. had bonded with her family and that he smiled at them. The
    foster mother also testified that her other children listened to music with O.D.-L. and that
    he seemed very comfortable. The foster family also read him bedtime stories and was
    very sensitive to his needs.
    {¶ 42} As previously stated, O.D.-L. tested positive for controlled substances at
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    birth, and as result, he was removed from Mother’s custody and placed on a safety plan
    with Maternal Grandmother. MCCS eventually developed concerns regarding Maternal
    Grandmother’s custody of O.D.-L. and her understanding of his medical needs. Because
    of the extent of his condition, O.D.-L. required the services of a full-time caretaker, and
    he had several weekly medical appointments due to conditions including cerebral palsy,
    quadriplegia, muscle spasms, seizures, kidney issues, urine-reflex issues, and trouble
    swallowing.
    {¶ 43} Maternal Grandmother unrealistically believed that O.D.-L. would eventually
    be able to play soccer. Maternal Grandmother also believed tht O.D.-L. was able to
    focus on people, even though he could not.        The record established that Maternal
    Grandmother missed several of O.D.-L.’s medical appointments and told MCCS that she
    was overwhelmed with the number of weekly appointments that she was required to
    attend with him.
    {¶ 44} As previously stated, O.D.-L. was removed for a second time from the
    custody of Maternal Grandmother because he had not gained weight over a six-month
    period. This led MCCS to the conclusion that Maternal Grandmother did not appreciate
    the severity of O.D.-L.’s condition and that she was unable to properly care for him.
    {¶ 45} We also note that while O.D.-L. was on the safety plan, Mother brought
    O.D.-L. to see his alleged father, who physically assaulted Mother in front of O.D.-L. As
    previously stated, the alleged father never sought to establish paternity and refused to
    participate in any of the proceedings.
    {¶ 46} In contrast, Foster Mother testified that she had taken O.D.-L. to each of his
    approximately 150 medical appointments since he was placed in her care.             Foster
    -17-
    Mother testified that she had learned about O.D.-L.’s medical needs and had experience
    in caring for him. Both Foster Mother and Foster Father had received G-tube training
    and could feed O.D.-L. properly. Foster Mother testified that O.D.-L. was on a daily
    schedule and very well cared for.
    {¶ 47} R.C. 2151.413 dictates when a children services agency may seek
    permanent custody of a child.       With some exceptions, R.C. 2151.413(D) generally
    requires a children services agency to pursue permanent custody of a child that has been
    in the agency's temporary custody for 12 or more months of a consecutive 22-month
    period. As noted by the juvenile court, on March 23, 2018, MCCS filed a complaint
    alleging that O.D.-L. was an abused, neglected, and dependent child, and he was
    removed from the custody of Maternal Grandmother and placed in the interim custody of
    MCCS. On April 3, 2018, MCCS filed an amended complaint requesting temporary
    custody to Maternal Grandmother, or in the alternative to MCCS. At the adjudication
    hearing on May 16, 2018, the magistrate found O.D.-L. to be neglected and dependent,
    and the parties agreed that O.D.-L. would be placed in the temporary custody of Maternal
    Grandmother. The juvenile court found that, pursuant to R.C. 2151.414(B)(1)(d), the
    date of the adjudication was the appropriate date from which to calculate the “twelve of
    twenty-two” requirement. On August 19, 2019, MCCS filed a motion for permanent
    custody of O.D.-L. O.D.-L. had therefore remained in the custody of MCCS throughout
    this time period, which clearly exceeded 12 months of the 22-month period and satisfied
    R.C. 2151.414(B)(1)(d).
    {¶ 48} Finally, we agree with the juvenile court’s finding that O.D.-L.’s secure
    placement could not be achieved without granting MCCS permanent custody. O.D.-L.
    -18-
    has been removed twice from Maternal Grandmother’s custody. The record established
    that Mother had failed to complete her case plan objectives.         Mother completed an
    alcohol and drug assessment at Family Services, but failed to follow any
    recommendations based upon the assessment. She tested positive on two drug screens
    administered to her in 2018, after which she simply refused to be tested again. MCCS
    informed Mother that a refusal would be considered as the equivalent of a positive drug
    screen, but she still refused to submit to further testing.
    {¶ 49} Mother missed a large percentage of O.D.-L.’s medical appointments.
    Furthermore, she was not properly trained to feed O.D.-L. through his G-tube because
    she failed to attend the appointments where she would have been trained. There were
    also some issues with Mother’s visitation with O.D.-L., including lateness, inability to feed
    or properly hold O.D.-L., and disruptive behavior, as described above.          Mother also
    refused to allow MCCS to enter her home, so MCCS was unable to verify that Mother’s
    home was safe and appropriate for O.D.-L.
    {¶ 50} It was clear that O.D.-L. required a legally secure placement and that such
    security could not be achieved without a grant of permanent custody to MCCS. In other
    words, the juvenile court's finding that granting permanent custody to MCCS was in O.D.-
    L.’s best interest was supported by clear and convincing evidence, and no abuse of
    discretion is established.
    {¶ 51} Mother’s fourth assignment of error is overruled.
    {¶ 52} All of Mother’s assignments of error having been overruled, the judgment of
    the juvenile court is affirmed.
    .............
    -19-
    HALL, J. and WELBAUM, J., concur.
    Copies sent to:
    Mathias H. Heck, Jr.
    Jamie J. Rizzo
    Cristy N. Oakes
    B.D
    D.L.
    Michael Booher
    Hon. Anthony Capizzi