Bedford County CYS v. DHS ( 2019 )


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  •                  IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Bedford County Children and Youth                :    SEALED CASE
    Services,                                        :
    Petitioner                :
    :
    v.                        :
    :
    Department of Human Services,                    :    No. 950 C.D. 2018
    Respondent                 :    Submitted: March 22, 2019
    BEFORE:        HONORABLE P. KEVIN BROBSON, Judge
    HONORABLE ANNE E. COVEY, Judge
    HONORABLE CHRISTINE FIZZANO CANNON, Judge
    OPINION NOT REPORTED
    MEMORANDUM OPINION BY
    JUDGE COVEY                                           FILED: July 9, 2019
    Bedford County Children and Youth Services (BCCYS) petitions this
    Court for review of the Department of Human Services (DHS), Bureau of Hearings
    and Appeals’ (BHA) June 29, 2018 order granting minor child’s (Minor)1 mother’s
    (M.N.) request to expunge her indicated report2 of child abuse from the ChildLine &
    Abuse Registry (ChildLine).3 BCCYS essentially presents one issue for this Court’s
    1
    Minor’s date of birth is July 25, 2015.
    2
    Section 6303(a) of the Child Protective Services Law (Law) defines an “indicated report”
    as a report issued by DHS if it “determines that substantial evidence of the alleged abuse by a
    perpetrator exists based on any of the following: (i) [a]vailable medical evidence[;] (ii) [t]he child
    protective service investigation[; or] (iii) [a]n admission of the acts of abuse by the perpetrator.” 23
    Pa.C.S. § 6303(a); see also Section 3490.4 of DHS’ Regulations, 55 Pa. Code § 3490.4.
    3
    Section 3490.4 of the DHS Regulations defines “ChildLine” as
    [a]n organizational unit of [DHS] which operates a Statewide toll-free
    system for receiving reports of suspected child abuse established
    under [S]ection 6332 of the [Law] (relating to establishment of
    Statewide toll-free telephone number), refers the reports for
    investigation and maintains the reports in the appropriate file. . . .
    55 Pa. Code § 3490.4. “[ChildLine] is maintained in accordance with the [Law.]” In re: S.H., 
    96 A.3d 448
    , 450 n.2 (Pa. Cmwlth. 2014).
    review: whether the BHA erred by concluding that BCCYS failed to present
    substantial evidence to prove that M.N. committed child abuse.4 Upon review, we
    reverse.
    On June 1, 2017, BCCYS received a report of M.N.’s and her paramour
    C.C.’s suspected physical abuse of Minor. See Reproduced Record (R.R.) at 11a-13a.
    By June 2, 7 and 26, 2017 letters, BCCYS notified M.N. and Minor’s biological
    father that it received the abuse report and commenced an investigation. See R.R. at
    105a-120a. BCCYS caseworker Ashley Black (Black) investigated the report and
    determined that, while in the primary care of M.N. and C.C., then-17-month-old
    Minor was treated six times in six months for injuries, the causes of which M.N.
    could not readily explain. See R.R. at 11a-13a, 23a-63a, 82a-103a, 148a, 152a.
    As part of UPMC Children’s Hospital of Pittsburgh’s (UPMC) Child
    Abuse Initiative protocol, Child Advocacy Center Division Chief Rachel P. Berger,
    M.D. (Dr. Berger), an expert in child abuse pediatrics, see R.R. at 161a, reviewed
    Minor’s UPMC medical records. Based upon her evaluation, Dr. Berger requested a
    child abuse screening exam, which was conducted on June 7, 2017 at UPMC.
    BCCYS removed Minor from M.N.’s care that same day. On July 31, 2017, BCCYS
    filed an indicated report against M.N. as a perpetrator of abuse against Minor. See
    R.R. at 11a-13a.
    By notice mailed August 21, 2017, DHS informed M.N. that she was
    listed on ChildLine as a perpetrator in an indicated report of child abuse. See R.R. at
    14a. On October 2, 2017, M.N. requested DHS’ Secretary’s review of BCCYS’
    report. See R.R. at 15a-17a. By October 16, 2017 letter, the Secretary’s designee
    4
    BCCYS presents two issues in its Statement of the Questions Involved: (1) whether the
    BHA erred by expunging M.N.’s indicated report, and (2) whether substantial evidence supported
    the BHA’s finding that M.N. committed child abuse. See BCCYS Br. at 6. Because BCCYS did
    not divide its argument, and these issues are subsumed in whether there was substantial record
    evidence to support the BHA’s decision, the issues will be addressed together.
    2
    stated: “We believe the report is accurate and being maintained in a manner
    consistent with the Child Protective Services Law [(Law)5]. Thus[,] the report will
    remain on file as originally reported.” R.R. at 18a. On January 12, 2018, M.N.
    appealed to the BHA. See R.R. at 19a-20a.
    A hearing was held on May 17, 2018 before an Administrative Law
    Judge (ALJ).      See R.R. at 137a-176a.            On June 29, 2018, the ALJ issued an
    adjudication and recommendation that the BHA grant M.N.’s appeal because BCCYS
    failed to prove that M.N. committed child abuse. See R.R. at 123a-135a. Also on
    June 29, 2018, the BHA adopted the ALJ’s recommendation in its entirety. See R.R.
    at 122a. BCCYS appealed to this Court.6
    BCCYS argues that the BHA erred by expunging M.N.’s indicated
    report where BCCYS met its burden of proving by substantial evidence that M.N.
    committed child abuse upon Minor.
    Initially, Section 6341(a)(2) of the Law authorizes “the [S]ecretary to . . .
    expunge an indicated report on the grounds that it is inaccurate or it is being
    maintained in a manner inconsistent with [the Law].” 23 Pa.C.S. § 6341(a)(2).
    “[T]he proper inquiry into whether an indicated report of child abuse should be
    expunged is whether the report is accurate.” B.K. v. Dep’t of Pub. Welfare, 
    36 A.3d 649
    , 653 (Pa. Cmwlth. 2012).
    BCCYS brought this action pursuant to Section 6381(d) of the Law,
    which states:
    Evidence that a child[7] has suffered child abuse of such a
    nature as would ordinarily not be sustained or exist except
    5
    23 Pa.C.S. §§ 6301-6386.
    6
    “Our review [of BHA’s order] determines whether constitutional rights were violated,
    whether errors of law were committed or whether necessary findings of fact are supported by
    substantial evidence.” 
    S.H., 96 A.3d at 453
    n.4.
    7
    Section 6303(a) of the Law defines “child” as “[a]n individual under 18 years of age.” 23
    Pa.C.S. § 6303(a).
    3
    by reason of the acts or omissions of the parent[8] or other
    person responsible for the welfare of the child shall be
    prima facie evidence of child abuse by the parent or
    other person responsible for the welfare of the child.
    23 Pa.C.S. § 6381(d) (emphasis added).                  “Child abuse” is defined in Section
    6303(b.1)(1) of the Law as “[c]ausing bodily injury to a child through any recent act
    or failure to act.” 23 Pa.C.S. § 6303(b.1)(1). “Bodily injury” is defined therein as an
    “[i]mpairment of physical condition or substantial pain.” 23 Pa.C.S. § 6303(a).
    “[BCCYS] has the burden of establishing by substantial evidence that
    an indicated report of child abuse is accurate.”9 Bucks Cty. Children & Youth Soc.
    Servs. Agency v. Dep’t of Pub. Welfare, 
    808 A.2d 990
    , 993 (Pa. Cmwlth. 2002).
    Section 6303(a) of the Law defines “substantial evidence” as “[e]vidence which
    outweighs inconsistent evidence and which a reasonable person would accept as
    adequate to support a conclusion.”10 23 Pa.C.S. § 6303(a); see also G.V. v. Dep’t of
    Pub. Welfare, 
    91 A.3d 667
    (Pa. 2014); In re: S.H., 
    96 A.3d 448
    (Pa. Cmwlth. 2014).
    “If [BC]CYS fails to sustain [its] burden, a request for expungement will be granted.”
    Bucks 
    Cty., 808 A.2d at 993
    .
    8
    Section 6303(a) of the Law defines “parent” as “[a] biological parent . . . .” 23 Pa.C.S. §
    6303(a).
    9
    ‘[I]n an expunction hearing the standard of proof is preponderance of
    the evidence, and the statutory standard for the evidence is
    ‘[e]vidence which outweighs inconsistent evidence and which a
    reasonable person would accept as adequate to support a conclusion.
    23 Pa.C.S. § 6303(a).’’ A.P. v. Dep[’]t of Pub[.] Welfare, 
    98 A.3d 736
    , 742-43 (Pa. Cmwlth. 2014).
    Allegheny Cty. Office of Children, Youth & Families v. Dep’t of Human Servs., 
    202 A.3d 155
    , 163
    (Pa. Cmwlth. 2019). “Whether the evidence satisfies the statutory standard is a question of law.”
    
    Id. 10 “[I]n
    determining whether a finding of fact is supported by substantial evidence, the Court
    must give the party in whose favor the decision was rendered the benefit of all reasonable and
    logical inferences that may be drawn from the evidence of record[.]” S.T. v. Dep’t of Pub. Welfare,
    Lackawanna Cty. Office, Children, Youth & Family Servs., 
    681 A.2d 853
    , 856 (Pa. Cmwlth. 1996).
    4
    At the May 17, 2018 hearing,11 Dr. Berger testified that, under UPMC’s
    Child Abuse Initiative, she receives a spreadsheet every Monday listing the names of
    minor patients for whom ChildLine reports were made by UPMC staff, and she has
    access to UPMC records related thereto.             See R.R. at 148a-151a.         Dr. Berger
    explained that, as part of a quality improvement initiative, she reviews the medical
    records underlying each UPMC ChildLine report to ensure that UPMC staff
    conducted a proper evaluation. See R.R. at 149a-150a. Dr. Berger described: “[I]f
    there is a concern that [] the appropriate testing hasn’t been done, there was not a
    report made when it should have been made, [or] when there needs to be clarification,
    [the] team at the Child Advocacy Center will follow up with those reporting sources
    or with [BCCYS] directly.” R.R. at 150a.
    Dr. Berger recalled that Minor’s name first appeared on her spreadsheet
    after Minor was treated at UPMC on December 31, 2016. See R.R. at 150a. She
    testified that she reviewed UPMC’s reports of Minor’s visits in UPMC’s records
    system, see R.R. at 151a, that reflected:
     December 31, 2016 - UPMC emergency department (ED) evaluation
    for red, swollen penis; right forehead, left and right cheek and left
    elbow bruising, and nose abrasions. See R.R. at 24a-31a, 148a, 150a,
    152a.
     January 11, 2017 - UMPC ultrasound following personal care
    physician visit for swollen penis and scrotum bruising. See R.R. at
    32a-38a, 152a-153a.
     March 18, 2017 - UPMC ED evaluation for a red, swollen right ear.
    See R.R. at 39a-41a, 153a-154a.
     April 5, 2017 - UPMC ED evaluation for inability to bear weight on
    left leg; returned April 6, 2017 for left tibial fracture splinting. See
    R.R. at 42a-48a, 154a-155a.
    11
    M.N. did not appear at the May 17, 2018 hearing. See R.R. at 124a. Because the hearing
    had already been rescheduled twice (at BCCYS’ request, and M.N. had waived the 90-day hearing
    requirement), and M.N. had notice of the May 17, 2018 hearing, the ALJ proceeded in her absence.
    See R.R. at 124a, 142a-143a.
    5
     June 1, 2017 - UPMC ED evaluation for one-day-old scalp
    contusion, a 4- to 5-day-old right eye contusion and right ear
    infection. See R.R. at 49a-53a, 155a-156a.
     June 4, 2017 - UPMC ED evaluation for continued scalp contusion
    tenderness, vomiting and abnormal balance. See R.R. at 54a-57a,
    156a-157a.
    Dr. Berger admitted that she did not personally treat or examine Minor. See R.R. at
    161a.
    Dr. Berger concluded, with a reasonable degree of medical certainty that,
    based on her review of Minor’s records and the nature and locations of the injuries,
    the December 31, 2016 and January 11, April 5, June 1 and June 4, 2017 medical
    visits resulted from child abuse. See R.R. at 152a-166a. She could not say for sure
    that the March 18, 2017 visit was due to child abuse, but nevertheless declared it
    “concerning.” R.R. at 163a. Dr. Berger also pronounced that “[e]ach individual
    injury caused [Minor] substantial pain.” R.R. at 159a.
    Dr. Berger recounted that, based upon the rapid succession in which
    Minor was seen for injuries, on June 7, 2017, she requested that UPMC conduct a
    skeletal survey from Minor’s medical records.12 See R.R. at 57a-63a, 158a. Dr.
    Berger declared that since Minor was removed from M.N.’s care on June 7, 2017 (at
    least until the date of the May 2018 hearing), with the exception of an ear infection,
    Minor had not been treated at UPMC or by his primary care physician. See R.R. at
    65a-78a, 158a-160a. Dr. Berger opined: “[A] clumsy child doesn’t unclumsy in a
    year.” R.R. at 159a. The ALJ found that “Dr. Berger testified credibly.” R.R. at
    127a.
    12
    Dr. Berger did not want to subject Minor to another medical visit. See R.R. at 158a, 161a-
    162a.
    6
    Black testified that she began her investigation on June 9, 2017 13 and, as
    part of her investigation, she reviewed Minor’s medical records, visited Minor and
    interviewed M.N.14 See R.R. at 81a-95a. Black’s testimony consisted primarily of
    her reading her investigation report into the record.            Therein, Black stated that
    “[M.N.] sought medical attention for each of the injuries but could not give any
    explanation as to why or how these injuries occurred at the time.” R.R. at 170a.
    Based upon M.N.’s admissions, Black concluded that M.N. and C.C. “could not
    properly supervise Minor.” R.R. at 170a; see also Supplemental Record (S.R.) at 37;
    R.R. at 174a. Black explained that, although she had regular contact with Minor
    during the investigation, she did not observe that Minor had any injuries. See R.R. at
    174a. Black admitted:
    [BCCYS COUNSEL] Is it fair to say that a primary
    component in your indicated reports for both [M.N. and
    C.C.], you and [BCCYS] relied heavily on the medical
    records and Dr. Berger’s review of those medical records?
    [BLACK] Correct.
    S.R. at 37. Black confirmed that she did not speak to any of Minor’s treating
    physicians, but rather “the records that we had received from [Dr.] Berger, we used
    those to review the injuries.” S.R. at 44; see also R.R. at 80a-103a. The ALJ found
    that “Black testified credibly.” R.R. at 127a.
    13
    Black was out of town when the report was initially made to BCCYS, so she began her
    investigation when she returned to the office on June 9, 2017. See R.R. at 173a.
    Another BCCYS caseworker checked on Minor within 24 hours of receiving the abuse
    report. See R.R. at 173a. Minor was placed into foster care on June 7, 2017, where Minor remained
    for several months before being placed with Minor’s great grandmother. See Supplemental Record
    (S.R.) at 39.
    14
    C.C. did not respond to Black’s interview requests. See R.R. at 174a.
    7
    Based upon the evidence presented, the ALJ made findings15 that Minor
    was a child under the Law, and that Minor’s mother, M.N., was a parent responsible
    for Minor’s care. See ALJ Adj. at 10-11; R.R. at 133a-134a. Regarding whether
    Minor suffered bodily injury, the ALJ concluded that, although “evidence contained
    in the medical records presents a troubling narrative[,]” BCCYS’ case was based
    solely upon uncorroborated hearsay and, thus, M.N.’s appeal must be sustained. ALJ
    Adj. at 11; R.R. at 134a. The ALJ articulated:
    Dr. Berger never saw the subject child. Her testimony was
    based on her review of medical records. [] Black only
    began working on the investigation on June 9, 2017.
    Although she did have some contact with [Minor] (who
    would have been essentially nonverbal, as [Minor] was
    nearing [Minor’s] second birthday when the ChildLine
    report was made) she admittedly never saw any injuries on
    [Minor]. Both witness[es’] knowledge of injuries to
    [Minor] was gained from what they saw in the medical
    records. [] Black also interviewed [M.N.], but testified
    [BC]CYS ‘relied heavily’ on the medical records and the
    records were the ‘primary component’ of the basis for the
    indicated report.
    The records are out[-]of[-]court statements. The medical
    providers who saw [Minor], observed [Minor’s] injuries and
    created the records of the [doctor] and [hospital] visits did
    not testify. Dr. Berger and [] Black testified to what the
    records said, and offered this information for the truth of the
    matter asserted. This is a classic example of hearsay. . . .
    ....
    Ultimately, because the only evidence on this issue is
    uncorroborated hearsay evidence, there is not substantial
    evidence to demonstrate there was bodily injury to [Minor].
    15
    “The [ALJ] is the ultimate finder of fact.” Bucks 
    Cty., 808 A.2d at 993
    . “In adopting the
    ALJ’s adjudication, the BHA became the final fact-finder in this expunction appeal.” R.J.W. v.
    Dep’t of Human Servs., 
    139 A.3d 270
    , 285 (Pa. Cmwlth. 2016). “Absent an abuse of discretion,
    [this Court] will not disturb the BHA’s determinations as to credibility and evidentiary weight.” 
    Id. 8 .
    . . . [T]he [ALJ] is compelled to make her determination
    in accord with the regulations and case law. The relevant
    authorities plainly set forth that [BCCYS] must present
    substantial evidence, which is more than uncorroborated
    hearsay, in order to support an individual being indefinitely
    listed [on ChildLine]. Without non-hearsay evidence,
    there is no substantial competent evidence to support
    [M.N.] being listed on ChildLine. It is ultimately up to
    [BCCYS] to present such evidence, and [it] failed to do so
    in this case.
    ALJ Adj. at 11-12; R.R. at 134a-135a (emphasis added; record citation omitted).
    “Hearsay is defined as an out[-]of[-]court statement, either written or
    oral, offered in court for the purpose of proving the truth of the matter contained in
    the statement.” Feinberg v. Unemployment Comp. Bd. of Review, 
    635 A.2d 682
    , 685
    n.4 (Pa. Cmwlth. 1993). Hearsay “is generally inadmissible because such evidence
    lacks guarantees of trustworthiness fundamental to the Anglo-American system of
    jurisprudence.” Commonwealth v. Chamberlain, 
    731 A.2d 593
    , 595 (Pa. 1999); see
    also Pa.R.E. 802.
    Although, “[u]nder the Commonwealth’s Administrative Agency Law[,]
    Commonwealth agencies shall not be bound by technical rules of evidence at agency
    hearings[,] . . . 2 Pa.C.S. § 505[,]” A.Y. v. Dep’t of Pub. Welfare, Allegheny Cty.
    Children & Youth Servs., 
    641 A.2d 1148
    , 1150 (Pa. 1994), the law is well established
    that “[h]earsay evidence, [a]dmitted without objection,[16] will be given its natural
    probative effect and may support a finding . . . , [i]f it is corroborated by any
    competent evidence in the record, but a finding of fact based [s]olely on hearsay will
    not stand.” Walker v. Unemployment Comp. Bd. of Review, 
    367 A.2d 366
    , 370 (Pa.
    Cmwlth. 1976) (emphasis in original); see also City of Phila. v. Workers’ Comp.
    Appeal Bd. (Knudson), 
    165 A.3d 1039
    (Pa. Cmwlth. 2017); Shapiro v. State Bd. of
    Accountancy, 
    856 A.2d 864
    (Pa. Cmwlth. 2004). Accordingly, this Court has ruled
    16
    Because M.N. did not attend the hearing, Minor’s hospital records were admitted into the
    record without objection.
    9
    that “[h]earsay testimony in an administrative proceeding to expunge a [child abuse
    report] is not substantial evidence unless it is corroborated.” Bucks 
    Cty., 808 A.2d at 993
    .
    Conversely, hearsay subject to an exception is admissible because it is
    “premised on circumstances . . . which enhance the reliability [there]of . . . , and
    render unnecessary the normal judicial assurances of cross-examination and oath[.]”
    
    Chamberlain, 731 A.2d at 595
    . Although the Pennsylvania Rules of Evidence do not
    contain a specific hospital record exception, Section 6108(b) of the Uniform Business
    Records as Evidence Act (Business Records Act) provides:
    A record of an act, condition or event shall, insofar as
    relevant, be competent evidence if the custodian or other
    qualified witness testifies to its identity and the mode of its
    preparation, and if it was made in the regular course of
    business[17] at or near the time of the act, condition or event,
    and if, in the opinion of the tribunal, the sources of
    information, method and time of preparation were such as
    to justify its admission.
    42 Pa.C.S. § 6108(b) (emphasis added). The Pennsylvania Supreme Court reasoned:
    “The basic justification for the [Business Records Act] exception to the hearsay rule
    is that the purpose of keeping business records builds in a reliability which obviates
    the need for cross-examination.” Williams v. McClain, 
    520 A.2d 1374
    , 1376 (Pa.
    1987).
    The Pennsylvania Superior Court has explained that “[t]he practice of
    recording facts has been standardized in the modern hospital and these recorded facts
    are routinely used to make decisions upon which the health and life of the patient
    depend.”      Commonwealth v. Seville, 
    405 A.2d 1262
    , 1265 (Pa. Super. 1979)
    (quotation marks omitted). Accordingly, under the Business Records Act exception
    17
    Section 6108(c) of the Business Records Act defines “business” to include “every kind of
    business, profession, occupation, calling, or operation of institutions whether carried on for profit or
    not.” 42 Pa.C.S. § 6108(c).
    10
    to the hearsay rule, “hospital records [are admissible] to show the fact of
    hospitalization, treatment prescribed, and symptoms found.”18 
    Williams, 520 A.2d at 1376
    ; see also B.E. v. Dep’t of Pub. Welfare, 
    654 A.2d 290
    (Pa. Cmwlth. 1995);
    Pothier v. Dep’t of Transp., Bureau of Traffic Safety, 
    511 A.2d 939
    (Pa. Cmwlth.
    1986); Sprague v. Walter, 
    656 A.2d 890
    (Pa. Super. 1995).
    In order for documents to be admissible under the Business Records Act,
    they must be authenticated “as to their identity or mode of preparation.”19 J.K. v.
    Dep’t of Pub. Welfare, 
    721 A.2d 1127
    , 1133 (Pa. Cmwlth. 1998); see also 42 Pa.C.S.
    § 6108(b). More specifically, in Williams, the Pennsylvania Supreme Court cited to
    the following as “helpful in determining whether a [hospital] record is admissible”:
    A medical record is admissible under the [Business Records
    Act] exception to the hearsay rule if the report: (1) was
    made contemporaneously with the events it purports to
    relate, (2) at the time the report was prepared, it was
    impossible to anticipate reasons which might arise in the
    future for making a false entry in the original, and (3) the
    person responsible for the statements contained in the report
    is known.
    
    Id. at 1376
    (quoting Isaacson v. Mobil Propane Corp., 
    461 A.2d 625
    , 629 (Pa. Super.
    1983)).
    Consequently, the medical records Dr. Berger and BCCYS relied upon
    herein were admissible as a hearsay exception under the Business Records Act.
    18
    “The same built-in reliability does not exist for medical opinions expressed in the hospital
    records.” Primavera v. Celotex Corp., 
    608 A.2d 515
    , 524 (Pa. Super. 1992). Therefore, “[o]pinion
    evidence contained in hospital records is inadmissible where the [person] who authored those
    records is unavailable for cross-examination.” Sprague v. Walter, 
    656 A.2d 890
    , 912 (Pa. Super.
    1995); see also Williams v. McClain, 
    520 A.2d 1374
    (Pa. 1987); Pothier v. Dep’t of Transp.,
    Bureau of Traffic Safety, 
    511 A.2d 939
    (Pa. Cmwlth. 1986).
    19
    Pennsylvania Rule of Evidence 901(a) provides: “To satisfy the requirement of
    authenticating or identifying an item of evidence, the proponent must produce evidence sufficient
    to support a finding that the item is what the proponent claims it is.” Pa.R.E. 901(a) (emphasis
    added).
    11
    Williams. Specifically, Dr. Berger identified the 41 pages of Minor’s medical records
    upon which she relied, described that they were created by the treating medical staff
    and maintained in UPMC’s system, and explained that they were available to her
    under UPMC’s Child Abuse Initiative.                  See R.R. at 148a, 151a-152a, 166a.
    Moreover, Dr. Berger’s opinions were rendered based upon the facts of and
    symptoms leading to Minor’s UPMC hospitalizations, not upon the UPMC staff’s
    opinions or diagnoses.         Because it is also evident from the electronic notations
    thereon that the records were created by treating UPMC staff specifically named
    therein in UPMC’s system within a short time after the corresponding treatments,20
    and they were based upon M.N.’s statements of fact,21 under the totality of the
    circumstances presented in this case, this Court concludes that Minor’s medical
    record “sources of information, method and time of preparation were such as to
    justify [their] admission.” 42 Pa.C.S. § 6108(b); see also Williams; J.K. Because
    BCCYS met its burden of establishing by substantial record evidence that Minor
    suffered child abuse by reason of M.N.’s acts or omissions and, thus, M.N.’s
    indicated report is accurate, the ALJ and the BHA erred by concluding otherwise.
    20
    Although “[i]t is not necessary to show the identity of the maker or his personal
    knowledge of events[,]” under the Business Records Act exception, 
    Pothier, 511 A.2d at 940
    , the
    electronic entries were created by treating UPMC staff in UPMC’s system as follows: December 31,
    2016 at 5:44 p.m. for a 5:40 p.m. visit, and 7:26 p.m. for follow-up, see R.R. at 24a-31a; January
    11, 2017 at 4:01 p.m. for a 3:51 p.m. ultrasound, see R.R. at 38a; March 18, 2017 at 3:22 a.m. for a
    3:16 a.m. visit, see R.R. at 39a-41a; April 5, 2017 notes created between 7:20 p.m. and 9:21 p.m.
    for a 6:53 p.m. visit, see R.R. at 42a-48a; June 1, 2017 at 12:42 p.m. for a 12:26 p.m. visit, see R.R.
    at 49a-53a; June 4, 2017 at 9:46 p.m. for a 9:36 p.m. visit, see R.R. at 54a-57a.
    21
    Because Minor was nonverbal, the records reflect that M.N. was the source of UPMC
    staff’s information about Minor’s symptoms. See UPMC records: December 31, 2016 “Mom
    states” R.R. at 24a; January 11, 2017 “per [M]om” R.R. at 33a; March 18, 2017 “Mother noticed”
    R.R. at 39a; April 5, 2017 “Mother thinks” R.R. at 42a; June 1, 2017 “[Mother] states” R.R. at 49a;
    June 4, 2017 “Mother states” R.R. at 54a. The fact of hospitalizations, symptoms found and
    treatments prescribed are independent of UPMC staff’s and M.N.’s opinions/representations of how
    the injuries occurred and, thus, any reasons for making false statements.
    12
    Based on the foregoing, the BHA’s order is reversed.
    ___________________________
    ANNE E. COVEY, Judge
    13
    IN THE COMMONWEALTH COURT OF PENNSYLVANIA
    Bedford County Children and Youth       :   SEALED CASE
    Services,                               :
    Petitioner       :
    :
    v.                    :
    :
    Department of Human Services,           :   No. 950 C.D. 2018
    Respondent        :
    ORDER
    AND NOW, this 9th day of July, 2019, the Department of Human
    Services, Bureau of Hearings and Appeals’ June 29, 2018 order is reversed.
    ___________________________
    ANNE E. COVEY, Judge