In the Interest of J.W., a minor, Appeal of: R.W. ( 2016 )


Menu:
  • J-A10012-16
    J-A10013-16
    NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
    IN THE INTEREST OF: J.W., A MINOR          IN THE SUPERIOR COURT OF
    PENNSYLVANIA
    APPEAL OF: R.W.                            No. 1079 WDA 2015
    Appeal from the Order entered June 16, 2015
    In the Court of Common Pleas of Allegheny County
    Family Court, at No(s): CP-02-DP-0002407-2013
    IN THE INTEREST OF: J.W., A MINOR          IN THE SUPERIOR COURT OF
    PENNSYLVANIA
    APPEAL OF: R.W.                            No. 1446 WDA 2015
    Appeal from the Order entered August 21, 2015
    In the Court of Common Pleas of Allegheny County
    Family Court, at No(s): JV-13-2407
    IN RE: J.W., A MINOR                       IN THE SUPERIOR COURT OF
    PENNSYLVANIA
    APPEAL OF: J.W., BIOLOGICAL FATHER         No. 1080 WDA 2015
    Appeal from the Order entered June 16, 2015
    In the Court of Common Pleas of Allegheny County
    Family Court, at No(s): DP-2407-2013
    JV-13-2407
    IN RE: J.W., A MINOR                       IN THE SUPERIOR COURT OF
    PENNSYLVANIA
    APPEAL OF: J.W., BIOLOGICAL FATHER         No. 1450 WDA 2015
    Appeal from the Order entered August 21, 2015
    In the Court of Common Pleas of Allegheny County
    Family Court, at No(s): JV-13-2407
    No. DP-2407-2013
    J-A10012-16
    J-A10013-16
    BEFORE: GANTMAN, P.J., BENDER, P.J.E., and PANELLA, J.
    MEMORANDUM BY PANELLA, J.:                     FILED SEPTEMBER 02, 2016
    R.W. (“Mother”) and J.W. (“Father”) appeal from the orders entered on
    June 16, 2015, and August 21, 2015, with regard to their minor child, J.W.,
    (“Child”), a male born in November 2013. In the June 16, 2015 order, the
    trial court adjudicated Child dependent pursuant to § 6302(1) of the Juvenile
    Act, 42 Pa.C.S.A § 6301, et seq., and placed him in the care of his maternal
    grandmother, N.K. (“MGG”), in his own home. That order further permitted
    Mother and Father to remain in the home, with the provision that MGG
    supervise all of their contact with the minor child and directed the parents to
    have mental health evaluations. In the August 21, 2015 order, the trial court
    found that Child continues to be dependent under the Juvenile Act and found
    that, despite the parents’ substantial compliance with the permanency plan,
    Child’s safety continues to be at risk because neither parent has been able to
    address the circumstances that led to the June 16, 2015 dependency
    adjudication. The trial court further found that the parents’ mental health
    evaluation was not helpful in determining a manner in which Child will be
    safe in his parents’ unsupervised care. Therefore, the trial court directed the
    parents to undergo individual counseling and couples counseling, to assist
    the parents in “opening up” about the circumstances of Child’s injuries.
    After careful review, we affirm both orders.
    -2-
    J-A10012-16
    J-A10013-16
    In its August 17, 2015 opinion, the trial court set forth the following
    factual background and procedural history regarding this appeal, which we
    incorporate herein, as follows.1
    I. First Dependency Adjudication
    This appeal is from a second adjudication of dependency.
    However, the facts surrounding the first adjudication are
    relevant to the present case. On December 19, 2013, Mother
    took J.W. to the emergency room at Children’s Hospital of
    Pittsburgh (“Children’s Hospital”) due to unexplained marks that
    she discovered on his face and body. See Testimony of
    Transcript (“T.T.”), dated January 31 & February 4, 2014, at 12-
    13. Mother testified that she had been at home with J.W. since
    Father had left for work on the morning of December 19, 2013.
    
    Id. at 229.
    Father returned to the home around midnight, from a
    work engagement, at which time [m]other went to shower as
    she had not been able to do so while Father was at work. 
    Id. at 231.
    Following an approximate seven[-]minute shower, Mother
    noticed what she believed to be a red rash on J.W.’s face. 
    Id. at 233.
    After contacting J.W.’s pediatrician’s office, Mother
    examined the remainder of J.W.’s body and discovered “small
    irregular marks on his lower abdomen.” 
    Id. at 235.
    Not knowing
    how he obtained the “marks” on his body, Mother took J.W. to
    the Children’s Hospital emergency room.
    The emergency room physician contacted Dr. Jennifer
    Wolford, an attending physician in the Children’s Hospital Child
    Advocacy Center, to further examine J.W. See [i]d. at 9. During
    her examination of J.W., Dr. Wolford discovered additional
    markings on J.W.’s back; she diagnosed the marks on J.W.’s
    back, abdomen and face as bruises that could not have been
    self-inflicted. See T.T., dated January 31 & February 4, 2014, at
    12, 19. Following Dr. Wolford's examination, J.W. had a skeletal
    survey, which initially2 did not reveal any fractures. 
    Id. at 18.
          However, a referral was subsequently made to the Office of
    Children, Youth and Families (CYF). 
    Id. at 139.
    1
    We note that the trial court made an apparent clerical error in its opinion
    when it stated that the appeal was from its February 16, 2015 order. See
    Trial Court Opinion, 8/17/15 at 1.
    -3-
    J-A10012-16
    J-A10013-16
    CYF caseworker Nicholas Zdral was appointed to
    investigate the circumstances of J.W.’s injuries and interviewed
    Dr. Wolford as well as both parents. 
    Id. Following Mr.
    Zdral’s
    interview with the parents, CYF “decided to obtain an emergency
    court order to remove” J.W. from the home. 
    Id. at 159.
         Following a shelter hearing on January 2, 2014, J.W. was placed
    with his maternal great aunt and uncle. 
    Id. J.W.’s follow-up
    skeletal survey at Children’s Hospital
    revealed a healing fracture in his right radius.3 See T.T., dated
    January 31 & February 4, 2014, at 20. Dr. Wolford testified that
    such an injury would have only resulted from an amount of force
    being applied to the bone and was consistent with abuse.
    At the adjudicatory hearing on January 31, 2014, I found
    J.W. dependent due to the unexplained injuries that he
    sustained, which could not have happened without an adult’s
    knowledge. J.W. was subsequently placed in the physical custody
    of his parents; however, all contact with Mother and Father was
    to be supervised. J.W.’s dependency case was ultimately closed,
    and court supervision terminated, on August 8, 2014, when
    Mother and Father completed all of their family service plan
    goals.
    Il. Current Dependency Adjudication
    On April 25, 2015, the family returned to Children’s
    Hospital due to injuries that J.W. sustained from an alleged
    accidental fall in the home. See T.T., dated June 3, 2015, at 39.
    According to Mother, while she was carrying J.W. in her arms
    that morning, she missed a step and fell down the stairs of her
    home. See T.T., dated June 16, 2015, at 57. Upon realizing that
    J.W. was favoring his left leg, Mother contacted the pediatrician
    to schedule an appointment for J.W. later that morning. 
    Id. at 58.
    After meeting with J.W.’s primary care physician, Dr. Brad
    Kramer, Mother and Father took J.W. to have x-rays conducted
    at the Cranberry Township site of UPMC Passavant. 
    Id. at 64.
         After reviewing the x-ray results, Dr. Kramer informed Mother
    that J.W. had fractured his right tibia and would need to see a
    pediatric orthopedic surgeon at Children’s Hospital. 
    Id. Upon learning
    that they would have to take J,W. to Children’s Hospital,
    Mother and Father demonstrated discontent with having to
    -4-
    J-A10012-16
    J-A10013-16
    return to Children’s Hospital by contacting their attorney, Wendy
    Williams, and their families, prior to actually taking J.W. to the
    hospital. 
    Id. at 64,
    93. After being convinced that taking J.W. to
    Children’s Hospital was in his best interest, Mother and Father
    took J.W. to meet with a pediatric orthopedic surgeon. 
    Id. Prior to
    seeing pediatric orthopedic surgeon, Dr. Timothy
    Ward, J.W. was first examined by the emergency room
    physicians. See T.T., dated June 16, 2015, at 142. Although the
    emergency room physician assistant recommended that J.W.
    receive a skeletal survey, the parents initially refused such
    treatment. See T.T., dated June 3, 2015, at 39. Due to the
    parents’ reluctance and the nature of J.W.’s injuries[,] the
    physician assistant contacted Dr. Wolford[,] who then
    recommended that the skeletal survey be completed due to
    J.W.’s past injuries, and the fact that the 2014 skeletal survey
    revealed J.W.’s previous right radial fracture. 
    Id. at 40.
    Mother
    and Father did not inform the physician assistant of J.W.’s prior
    injuries or the fact that J.W.’s previous right radial fracture, in
    connection with the prior dependency case, had been revealed
    pursuant to a skeletal survey. See T.T., dated June 16, 2015, at
    149.
    Following a great deal of back and forth between the
    parents, their attorney and the emergency room staff, Mother
    and Father ultimately agreed to the skeletal survey under the
    condition that they were permitted to observe the procedure.
    
    Id. at 65.
    Following the completion of the skeletal survey, a
    second fracture was revealed in J.W.’s left radius. See T.T.,
    dated June 3, 2015, at 40. After the emergency room physicians
    finished treating J.W. for his two fractures, the family met with
    Dr. Ward, the pediatric orthopedic surgeon to whom Dr. Kramer
    had referred them. See T.T., dated June 16, 2015, at 11.
    During their consult with Dr. Ward, the parents failed to
    accurately characterize J.W.’s prior involvement with Children’s
    Hospital and CYF. 
    Id. at 11-12.
    Despite the fact that J.W. was
    previously admitted in 2013 for bruises on his face and body, the
    parents told Dr. Ward that J.W. was treated for a wrist fracture
    and implied that CYF’s involvement in the case was rather brief.
    
    Id. During the
    June 16, 2015 hearing, Dr. Ward testified that
    although he found J.W.’s contralateral fractures unusual, he
    “allowed the appearance of the family” and his short interaction
    -5-
    J-A10012-16
    J-A10013-16
    with the family to “considerably” affect his opinion.5 
    Id. at 9,
    11.
    After speaking with Dr. Wolford and receiving J.W.’s complete
    medical history, Dr. Ward amended his initial medical opinion,
    that J.W.’s injuries were not due to abuse. 
    Id. at 15-16.
    Due to
    J.W.’s previously unexplained bruises, the parents’ “failure to be
    forthright” regarding their involvement with CYF, the parents’
    misrepresentation regarding the discovery of J.W.’s 2013 right
    radial fracture on the skeletal survey, and their lack of candor to
    the emergency room physicians, Dr. Ward later concluded that
    J.W.’s injuries were the result of abuse. 
    Id. at 30.
    On April 30, 2015, CYF received a child line report for J.W.
    See T.T., dated June 3, 2015, at 149. Following an interview
    with both parents and an evaluation of their home, CYF
    caseworker Robert Banks filed a petition for dependency on May
    07, 2015. A two-day adjudicatory hearing was held on June 3
    and June 16, 2015 on CYF’s dependency petition, after which
    [the trial court] entered the Order that is the subject of this
    appeal.
    ___________________________________________________
    1
    Father testified that when asked about the marks on J.W.’s
    body, he told Mother that he was unaware as to how J.W. came
    to have the marks on his face or body. See T.T., dated January
    31 & February 4, 2014, at 318.
    2
    A subsequent skeletal survey was scheduled for January 2,
    2014. Dr. Wolford testified that it is hospital protocol to conduct
    a subsequent skeletal survey as healing fractures “show up
    better” than acute fractures on the x-rays. See T.T., dated
    January 31 & February 4, 2014, at 20.
    3
    Pediatric radiologist, Dr. Stefano Bartoletti, stated that he was
    able to later identify the healing fracture on the initial skeletal x-
    rays after identifying the fracture on the subsequent skeletal
    survey x-rays. See T.T., dated January 31 & February 4, 2014,
    at 125, 127.
    4
    The parents alleged that J.W.’s injuries in connection with the
    prior adjudication were caused by hospital personnel in
    performing the skeletal survey. See T.T., dated January 31 &
    February 4, 2014, at 266-269. [The trial court] did not adopt
    this theory in connection with the past case.
    -6-
    J-A10012-16
    J-A10013-16
    5
    At the hearing on June 3, 2015, Dr. Wolford testified that the
    fact that J.W. had a fracture on his right leg and left arm, as a
    result of this accident, was "highly concerning" for abuse. See
    T.T., dated June 3, 2015, at 42
    Trial Court Opinion, 8/17/15, at 1-6 (unpaginated; footnotes in original).
    In the June 16, 2015 order, the trial court adjudicated Child dependent
    pursuant to the Juvenile Act and placed him in the care of MGG, in his own
    home, permitting Mother and Father to remain in the home, with the
    provision that MGG supervise all of their contact with the minor child. The
    order also directed the parents to have mental health evaluations.
    The trial court continued the factual background and procedural history
    of the case in its opinion entered on October 30, 2015, as follows.
    On August 21, 2015, following a permanency review
    hearing on the above-captioned matter at which all parties were
    represented by counsel, [the trial court] found that the minor
    child, J.W., continues to be a Dependent Child pursuant to the
    Pennsylvania Juvenile Act (See 42 Pa.C.S. §6302(1)). Despite
    the parents’ substantial compliance with the permanency plan,
    the [trial court] found that J.W.’s safety continues to be at risk
    because neither parent has been able to address the
    circumstances which led to the June 16, 2015 dependency
    adjudication. [The trial court] further found that the mental
    health evaluation was not helpful in determining a manner in
    which J.W. will be safe in his parents' unsupervised care. . . .
    Following the adjudicatory hearing, [the trial court]
    scheduled a permanency review hearing for August 21, 2015,
    and [the trial court] ordered the parents to attend mental health
    evaluations to determine if there were any mental health issues
    that they could address which would insure J.W.’s safety. At the
    August 21, 2015 Permanency review hearing[,] the mental
    health    evaluator,    Dr.   Patricia   Pepe,    testified that,
    notwithstanding their “faking good” scores on the child abuse
    -7-
    J-A10012-16
    J-A10013-16
    potential inventory, neither Mother nor Father had any mental
    health issues.2 Because the mental health evaluation was not
    helpful in determining what was necessary for J.W. to be in his
    parents’ unsupervised care, [the trial court] ordered Mother and
    Father to enter into individual therapy, followed by couples
    therapy, with the hope that either party would be more
    forthcoming once he or she is protected by confidentiality.
    Thereafter, couples therapy could perhaps be more productive.
    ________________________________________________
    2
    Dr. Pepe also indicated that the parents told her that [the trial
    court] had concluded that the injury which resulted in the
    current dependency adjudication was “accidental.” [The trial
    court] made no such finding. [The trial court] simply noted that
    the medical evidence alone (without consideration of the history
    or the parents’ conduct) would not provide clear and convincing
    evidence of dependency.
    Trial Court Opinion, 10/30/15, at 1-2 (unpaginated; footnote omitted;
    footnote in original).2
    On July 16, 2015, Mother and Father timely filed notices of appeal,
    along with concise statements, pursuant to Pa.R.A.P. 1925(a)(2)(i) from the
    trial court’s June 16, 2015 order at Docket Nos. 1446 WDA 2015 and 1450
    WDA 2015, respectively. On September 21, 2015, Mother and Father timely
    filed notices of appeal, along with concise statements, pursuant to Pa.R.A.P.
    2
    The August 21, 2015 order permitted Child to be placed with his parents,
    as long as the maternal grandparents or paternal grandparents supervised
    the contact between the parents and Child. Further, the order directed that
    the parents would have separate counselors.
    -8-
    J-A10012-16
    J-A10013-16
    1925(a)(2)(i) from the trial court’s August 21, 2015 orders, at Docket Nos.
    1779 and 1780, respectively.3
    Mother’s Appeals at Docket Nos. 1079 WDA 2015 and 1446 WDA 2015
    In her brief on appeal, Mother raises the following issues.
    I. Whether the trial court committed an error of law or abused its
    discretion by making an adjudication of dependency with regard
    to the minor child, J.W., when the adjudication was not
    supported by clear and convincing evidence, as the trial court
    based its finding upon an unspecified harm that could occur in
    the future, despite evidence showing that J.W. received proper
    care at all times?
    II. Whether the trial court committed an error of law or abused
    its discretion in finding that J.W. was without proper parental
    care or control when it based its dependency upon information
    from a past dependency case involving J.W., even though
    [Mother] was providing proper care for J.W. at the time the
    current action was filed?
    III. Whether the trial court committed an error of law or abused
    its discretion by making a dependency finding based on
    allegations that were outside of the scope of the dependency
    petition, and also where the Appellant [Mother] did not have
    advance notice of those allegations, in violation of the
    Appellant’s [Mother’s] rights to due process and fundamental
    fairness?
    IV. Whether the trial court committed an error of law or abused
    its discretion when, after a permanency hearing, it found that
    J.W. continued to be a dependent child solely due to its concern
    that neither parent was forthcoming about J.W.’s unexplained
    injuries in a prior dependency case, even though the parents
    3
    In an order entered on October 16, 2015, this Court, acting sua sponte,
    consolidated Mother’s two appeals and Father’s two appeals, and directed
    that Father’s appeal be listed consecutively to Mother’s appeals. We address
    both Mother’s and Father’s appeals in one Memorandum for ease of
    disposition.
    -9-
    J-A10012-16
    J-A10013-16
    satisfactorily completed all of their requirements in the current
    case?
    V. Whether the trial court committed an error of law or abused
    its discretion by requiring Appellant [Mother] to participate in
    individual therapy and in couples therapy, in violation of
    Appellant [Mother’s] right to privacy?
    Mother’s Brief, at 8-9.
    Mother asserts that we should reverse the dependency finding and
    disposition in the June 16, 2015 adjudication and order, because CYF failed
    to satisfy its burden of proof by clear and convincing evidence. She alleges
    that the trial court committed an error of law and abused discretion by not
    basing its decision upon current circumstances and facts of record. Rather,
    the trial court relied on information from a prior closed dependency case,
    speculating that Child may not receive proper medical care in the future,
    which is contrary to the weight of the evidence. See Mother’s Brief, at 15-
    16.
    Mother further contends that she was deprived of due process and
    fundamental fairness, as she did not have sufficient notice of the allegations
    that the trial court used as a basis for its decision. Mother states:
    At issue in this case were the injuries sustained by the
    child when Mother fell down the stairs, while holding the child,
    on April 25, 2015. [T]he court acknowledged that the medical
    evidence on its own does not establish dependency, and the
    parents were never provided with any notice that a hypothetical
    failure to obtain medical care in the future, or J.W.’s unexplained
    injuries in the past, would be at issue in the current proceeding.
    The medical experts agreed that the child could have sustained
    his injuries as a result of Mother’s fall. The trial court therefore
    - 10 -
    J-A10012-16
    J-A10013-16
    erred in basing a finding of dependency upon the speculation or
    possibility that the child may be denied medical care in the
    future, when the facts of record established that the child did in
    fact receive proper medical care. Such speculations cannot be
    used to justify a dependency finding, particularly when the
    finding required a state agency to intervene into the privacy of
    family life[,] and also deprived Child’s parents of their custodial
    rights.
    Mother’s Brief, at 16.
    Mother also argues that there is no evidence, in the record in this
    case, that shows that the parents are currently incapable of providing proper
    care and control to Child, which is essential to a dependency finding. Thus,
    Mother maintains that the trial court erred as a matter of law and abused its
    discretion by making a dependency finding without clear and convincing
    evidence of each component necessary to support the finding. Accordingly,
    Mother urges that this Court should reverse the June 16, 2015 adjudication
    and order.
    Additionally, with regard to the August 21, 2015 order, Mother asserts
    that the trial court acknowledged that the parents had completed all of the
    requirements the court and CYF had imposed, which included cooperating
    with CYF and participating in a psychological evaluation. Nevertheless, the
    trial court imposed a new requirement for the parents to attend individual
    therapy and couples therapy, although the psychological evaluation showed
    that there were no mental health concerns. Mother contends that the trial
    court’s position, that it could not close the current dependency case until the
    - 11 -
    J-A10012-16
    J-A10013-16
    parents acknowledged responsibility for Child’s injuries, was unsupported by
    statutory and case law. Moreover, Mother argues that a requirement to
    accept   responsibilities   for   past,    unexplained   injuries   should   not   be
    determinative in a dependency action, particularly when the injuries in
    question arose during a prior dependency case and were completely
    unrelated to the injuries in the current case. Accordingly, Mother requests
    this Court to vacate the permanency review order entered on August 21,
    2015. See Mother’s Brief, at 17-18.
    Father’s appeal at Docket Nos. 1980 WDA 2015 and 1450 WDA 2015
    Father raises the following issues.
    1. Was the [t]rial [c]ourt’s dependency finding against the
    weight of the evidence given the testimony in the case
    supporting the Appellant’s [Father’s] contention that the child’s
    injuries were accidentally sustained in a fall?
    2. Did the [t]rial [c]ourt abuse its discretion in placing undue
    weight on the parents’ alleged failure to inform emergency
    department staff about their son’s prior wrist fracture and
    reluctance to agree to a skeletal survey?
    3. Did the [t]rial [c]ourt abuse its discretion in giving undue
    weight to the child’s prior involvement with CYF?
    4. Did the [t]rial [c]ourt abuse its discretion in finding that the
    parents did not take responsibility for the child’s wrist fracture?
    5. Did the [t]rial [c]ourt err in making the inconsistent findings
    that [Child] continues to be a dependent child and, at the same
    time, finding that the Parents have completed all tasks required
    of them and substantially complied with the Permanency Plan
    put into place for their family?
    - 12 -
    J-A10012-16
    J-A10013-16
    6. Did the [t]rial [c]ourt err in finding that the child remains a
    dependent when it failed to set forth specific and attainable goals
    for the child’s Permanency Plan including failing to state the
    likely date on which the child’s placement goals may be
    achieved?
    7. Did the [t]rial [c]ourt err in ordering the Parents to enter into
    individual and couple’s therapy?
    8. Did the [t]rial [c]ourt err in entering a disposition contrary to
    the child’s best interests?
    Father’s Brief at Docket Nos. 1080 WDA 2015 and 1450 WDA 2015, at 2-3.
    Father asserts that Child broke his wrist and then CYF became
    involved and imposed a set of goals on the parents. He further alleges that
    the parents met all obligations given to them, and the case was terminated.
    Father states that, in April 2015, Mother fell down the stairs while holding
    Child and both Mother and Child were injured. Father claims that the parents
    promptly took Child to the pediatrician, then for x-rays, then to Children’s
    Hospital, where staff again contacted CYF. Father argues that the trial
    court’s findings, that the parents had not taken full responsibility for Child’s
    previous injury, and had “nearly” prevented Child from receiving necessary
    medical care, are unsupported by the record.
    Father states that the trial court did not find that one of the parents
    had abused child. Nevertheless, the trial court found Child dependent and
    imposed multiple conditions on the parents. Father contends that the trial
    court abused its discretion in making the findings and that the second
    adjudication   of   dependency   is   against   the   weight   of   the   evidence.
    - 13 -
    J-A10012-16
    J-A10013-16
    Accordingly, Father requests this Court to reverse the trial court adjudication
    of dependency/disposition and permanency review orders entered on June
    16, 2015 and August 21, 2015. See Father’s Brief, at 6.
    Our standard of review in a dependency case as follows.
    [T]he standard of review in dependency cases requires an
    appellate court to accept findings of fact and credibility
    determinations of the trial court if they are supported by the
    record, but does not require the appellate court to accept the
    lower court’s inferences or conclusions of law. We review for
    abuse of discretion[.]
    In re L.Z., 
    111 A.3d 1164
    , 1174 (Pa. 2015) (citation and quotation marks
    mitted).
    The Juvenile Act defines a “dependent child” as
    [a] child who:
    (1) is without proper parental care or control, subsistence,
    education as required by law, or other care or control necessary
    for his physical, mental, or emotional health, or morals. A
    determination that there is a lack of proper parental care or
    control may be based upon evidence of conduct by the parent,
    guardian or other custodian that places the health, safety or
    welfare of the child at risk[.]
    42 Pa.C.S.A. § 6302(1).
    This Court clarified the definition of “dependent child” further.
    The question of whether a child is lacking proper parental care or
    control so as to be a dependent child encompasses two discrete
    questions: whether the child presently is without proper parental
    care and control, and if so, whether such care and control are
    immediately available.
    - 14 -
    J-A10012-16
    J-A10013-16
    In re G.T., 
    845 A.2d 870
    , 872 (Pa. Super. 2004) (quotation marks and
    citations omitted). See also In re J.C., 
    5 A.3d 284
    , 289 (Pa. Super. 2010).
    Additionally, we note that “[t]he burden of proof in a dependency proceeding
    is on the petitioner to demonstrate by clear and convincing evidence that a
    child meets that statutory definition of dependency.” 
    G.T., 845 A.2d at 872
    (citation omitted).
    This Court has explained that
    a court is empowered by 42 Pa.C.S. § 6341(a) and (c) to make
    a finding that a child is dependent if the child meets the
    statutory definition by clear and convincing evidence. If the court
    finds that the child is dependent, then the court may make an
    appropriate disposition of the child to protect the child's physical,
    mental and moral welfare, including allowing the child to remain
    with the parents subject to supervision, transferring temporary
    legal custody to a relative or public agency, or transferring
    custody to the juvenile court of another state. 42 Pa.C.S. §
    6351(a).
    In re D.A., 
    801 A.2d 614
    , 617 (Pa. Super. 2002) (en banc).
    The Juvenile Act defines “Aggravated circumstances” as including the
    following circumstances:
    (2) The child or another child of the parent has been the victim
    of physical abuse resulting in serious bodily injury, sexual
    violence or aggravated physical neglect by the parent.
    42 Pa.C.S.A. § 6302(2).
    The Juvenile Act defines “serious bodily injury” as “bodily injury which
    creates a substantial risk of death or which causes serious, permanent
    - 15 -
    J-A10012-16
    J-A10013-16
    disfigurement or protracted loss or impairment of the function of any bodily
    member or organ.” 42 Pa.C.S.A. § 6302.
    The Juvenile Act, in turn, defines “aggravated physical neglect” as,
    “Any omission in the care of a child which results in a life-threatening
    condition or seriously impairs the child’s functioning.” 
    Id. Upon a
    determination that aggravated circumstances exist, the
    Juvenile Act states the following.
    (c.1) Aggravated circumstances.— If the county agency or
    the child’s attorney alleges the existence of aggravated
    circumstances and the court determines that the child is
    dependent, the court shall also determine if aggravated
    circumstances exist. If the court finds from clear and convincing
    evidence that aggravated circumstances exist, the court shall
    determine whether or not reasonable efforts to prevent or
    eliminate the need for removing the child from the home or to
    preserve and reunify the family shall be made or continue to be
    made and schedule a hearing as required in section 6351(e)(3)
    (relating to disposition of dependent child).
    42 Pa.C.S.A. § 6341(c.1).
    Regarding the disposition of a dependent child, subsections (e), (f),
    (f.1), and (g) of § 6351 of the Juvenile Act provides the trial court with the
    criteria for its permanency plan for the subject child. Pursuant to those
    subsections, the trial court is to determine the disposition that is best suited
    to the safety and protection and physical, mental, and moral welfare of the
    child.
    The Juvenile Act further provides in pertinent part:
    (e) Permanency hearings.—
    - 16 -
    J-A10012-16
    J-A10013-16
    (1) [t]he court shall conduct a permanency hearing for
    the purpose of determining or reviewing the permanency
    plan of the child, the date by which the goal of
    permanency for the child might be achieved and whether
    placement continues to be best suited to the safety,
    protection and physical, mental and moral welfare of the
    child. In any permanency hearing held with respect to the
    child, the court shall consult with the child regarding the
    child’s permanency plan in a manner appropriate to the
    child's age and maturity. . . .
    (2) If the county agency or the child’s attorney alleges
    the existence of aggravated circumstances and the court
    determines that the child has been adjudicated
    dependent, the court shall then determine if aggravated
    circumstances exist. If the court finds from clear and
    convincing evidence that aggravated circumstances exist,
    the court shall determine whether or not reasonable
    efforts to prevent or eliminate the need for removing the
    child from the child's parent, guardian or custodian or to
    preserve and reunify the family shall be made or continue
    to be made and schedule a hearing as provided in
    paragraph (3).
    ***
    42 Pa.C.S.A. § 6351(e)(1)-(2).
    Section 6351(f) of the Juvenile Act prescribes the pertinent inquiry for
    the reviewing court:
    (f) Matters to be determined at permanency hearing.-
    At each permanency hearing, a court shall determine all of
    the following:
    (1)      The continuing necessity for and appropriateness
    of the placement.
    - 17 -
    J-A10012-16
    J-A10013-16
    (2)     The appropriateness, feasibility and extent of
    compliance with the permanency plan developed for the
    child.
    (3)    The extent of progress made toward alleviating
    the circumstances which necessitated the original
    placement.
    (4)    The appropriateness and feasibility of the current
    placement goal for the child.
    (5)      The likely date by which the placement goal for
    the child might be achieved.
    (5.1)   Whether reasonable efforts were made to finalize
    the permanency plan in effect.
    (6)       Whether the child is safe.
    (7)      If the child has been placed outside the
    Commonwealth, whether the placement continues to be
    best suited to the safety, protection and physical, mental
    and moral welfare of the child.
    ***
    (9) If the child has been in placement for at least 15 of
    the last 22 months or the court has determined that
    aggravated circumstances exist and that reasonable
    efforts to prevent or eliminate the need to remove the
    child from the child’s parent, guardian or custodian or to
    preserve and reunify the family need not be made or
    continue to be made, whether the county agency has filed
    or sought to join a petition to terminate parental rights
    and to identify, recruit, process and approve a qualified
    family to adopt the child unless:
    (i) the child is being cared for by a relative best
    suited to the physical, mental and moral welfare of
    the child;
    (ii) the county agency has documented a
    compelling reason for determining that filing a
    - 18 -
    J-A10012-16
    J-A10013-16
    petition to terminate parental rights would not
    serve the needs and welfare of the child; or
    (iii) the child’s family has not been provided with
    necessary services to achieve the safe return to
    the child’s parent, guardian or custodian within the
    time frames set forth in the permanency plan.
    ***
    (f.1) Additional determination. — Based upon the
    determinations made under subsection (f) and all relevant
    evidence presented at the hearing, the court shall determine one
    of the following:
    (1) If and when the child will be returned to the child’s
    parent, guardian or custodian in cases where the return
    of the child is best suited to the safety, protection and
    physical, mental and moral welfare of the child.
    (2) If and when the child will be placed for adoption, and
    the county agency will file for termination of parental
    rights in cases where return to the child’s parent,
    guardian or custodian is not best suited to the safety,
    protection and physical, mental and moral welfare of the
    child.
    (3) If and when the child will be placed with a legal
    custodian in cases where return to the child’s parent,
    guardian or custodian or being placed for adoption is not
    best suited to the safety, protection and physical, mental
    and moral welfare of the child.
    (4) If and when the child will be placed with a fit and
    willing relative in cases where return to the child’s parent,
    guardian or custodian, being placed for adoption or being
    placed with a legal custodian is not best suited to the
    safety, protection and physical, mental and moral welfare
    of the child.
    (5) If and when the child will be placed in another living
    arrangement intended to be permanent in nature which is
    approved by the court in cases where the county agency
    - 19 -
    J-A10012-16
    J-A10013-16
    has documented a compelling reason that it would not be
    best suited to the safety, protection and physical, mental
    and moral welfare of the child to be returned to the
    child’s parent, guardian or custodian, to be placed for
    adoption, to be placed with a legal custodian or to be
    placed with a fit and wiling relative.
    (f.2) Evidence. – Evidence of conduct by the parent that places
    the health, safety or welfare of the child at risk, including
    evidence of the use of alcohol or a controlled substance that
    places the health, safety or welfare of the child at risk, shall be
    presented to the court by the county agency or any other party
    at any disposition or permanency hearing whether or not the
    conduct was the basis for the determination of dependency.
    (g) Court order.— On the basis of the determination made under
    subsection (f.1), the court shall order the continuation,
    modification or termination of placement or other disposition
    which is best suited to the safety, protection and physical,
    mental and moral welfare of the child.
    ***
    In its August 17, 2015 opinion, the trial court provided the following
    discussion of Mother’s and Father’s issues:
    Mother’s and Father’s first three issues on appeal concern
    [the trial court’s] finding that both parents have failed to
    acknowledge responsibility for the child’s previous injuries that
    led to the February, 2014 dependency finding. Therefore, it is
    necessary to address the issue of the previous dependency
    adjudication and the responses thereto.
    At the outset[,] it must be recognized that the previous
    dependency finding in 2014 was based on the fact that J.W.
    sustained injuries that could not have resulted without the
    knowledge of an adult. Thus, while [the court] did not make the
    specific finding that J.W. was the victim of inflicted abuse by an
    identified perpetrator, [the court] certainly found the parents to
    be responsible for these injuries.6 My ruling at that time
    contemplated a situation where these[ ] injuries to the child
    - 20 -
    J-A10012-16
    J-A10013-16
    were the result of some type of accident within the knowledge of
    one of the parents. This failure of the parents to take
    responsibility for the prior injuries became a significant issue in
    the current adjudication, where J.W. sustained two additional
    fractures, as noted in the adjudicatory order of June 16, 2015.
    These injuries cannot be considered in a vacuum.
    Appellate cases have upheld adjudications solely based upon
    prognostic evidence. See In re E.B., 
    83 A.2d 426
    , 433 (Pa.
    Super. 2013) (holding, “it is well-settled that ‘a finding of
    dependency can be made on the basis of prognostic evidence
    and such evidence is sufficient to meet the strict burden of proof
    necessary to declare a child dependent.” (citing In re R.W.J.,
    
    826 A.2d 10
    , 14 (Pa. Super. 2003))) [sic]. Certainly, in this
    case, where this previously dependent young child has suffered
    two additional fractures, the continued insistence of the parents
    that they are not responsible for the first incident establishes
    dependency by clear and convincing evidence.7
    Furthermore, this failure to take responsibility for the prior
    injuries has had an effect on J.W.’s medical treatment. Upon
    learning from Dr. Kramer that J.W. would need to be taken to
    Children’s Hospital to see a pediatric orthopedic surgeon, Mother
    and Father appeared to be less concerned with J.W.’s safety and
    more preoccupied with whether he would be removed from their
    care. Despite just learning that their son had suffered a tibia
    fracture, Mother and Father expressed their aversion to taking
    the child to Children’s Hospital, only choosing to do so after
    being informed that it was the only place that the minor child
    would receive the necessary treatment for a broken bone on a
    Saturday. See Testimony of Transcript, (“T.T”), dated June 16,
    2015, at 93.
    Moreover, once arriving at Children’s Hospital, Mother and
    Father demonstrated further reluctance to have J.W.
    appropriately treated by initially refusing to allow the medical
    staff to perform a skeletal survey. Although the 2014 skeletal
    survey revealed a radial fracture of which the parents were
    unaware, both Mother and Father did not want the hospital staff
    to perform a skeletal survey, as they believed it was solely based
    on the prior allegations of abuse. 
    Id. at 122.
    The parents’
    objection to the skeletal survey demonstrates a lack of
    responsibility for the safety of their son[,] and shows that
    - 21 -
    J-A10012-16
    J-A10013-16
    Mother    and    Father   were    more   worried     that   they
    “were going down the same path” and that J.W. “would be taken
    from them again.” 
    Id. at 144,
    152. Yet, were it not for the most
    recent skeletal survey, J.W.’s second radial fracture would not
    have been discovered or treated.
    The testimony of the emergency room physician, Dr.
    Farrell, demonstrates that Mother and Father were not
    forthcoming with information about J.W.’s previous injuries,
    which were relevant to his most recent treatment. Although both
    the orthopedic resident and physician’s assistant questioned
    Mother and Father regarding J.W.’s previous medical history,
    Mother and Father did not disclose his previous fracture or
    bruises. Only after learning that the treating physicians wanted
    to complete a skeletal [scan] did Mother and Father disclose the
    minor child’s previous injuries. See Testimony of Transcript
    (“T.T.”), dated June 16, 2015, at 53. Were it not for the
    information provided to Dr. Farrell by Dr. Kramer and Dr.
    Wolford, the skeletal survey, which revealed the second radial
    fracture, may not have been conducted.
    Moreover, the orthopedic surgeon, Dr. Ward, testified that
    the parents’ failure to (1) provide a complete medical history for
    the minor child and (2) accurately represent CYF’s past
    involvement with the family caused him to prematurely conclude
    that J.W.’s injuries were not indicative of abuse. Dr. Ward
    testified that Mother and Father never informed him of the
    previous bruises that J.W. sustained. Additionally, Dr. Ward
    stated that Mother and Father implied that their previous
    involvement with CYF was “brief” and “quickly set,” which it
    most certainly was not. 
    Id. at 21.
    Even if Mother and Father did
    not explicitly state that their involvement with CYF was brief,
    their failure to adequately characterize CYF’s involvement in
    2014 caused Dr. Ward to prematurely render a medical opinion
    that J.W.’s injuries were attributable to the accidental falling.
    Although initially believing the child’s injuries to be unusual, Dr.
    Ward’s medical opinion was swayed due to the incomplete and
    partially inaccurate medical history that Mother and Father
    provided
    Therefore, it is clear that in refusing to provide both Dr.
    Farrell, the emergency room physician, and Dr. Ward, the
    orthopedic surgeon, with a complete medical and factual history
    - 22 -
    J-A10012-16
    J-A10013-16
    regarding J.W.’s previous injuries, Mother and Father
    demonstrated not only their inability to accept responsibility for
    the his [sic] prior injuries, as 
    discussed supra
    , but also, their
    current inability to provide J.W. with adequate care or control.
    The parents’ reluctance in cooperating with the medical
    professionals at Children’s Hospital would not be so alarming if
    their reluctance did not pose a danger to the child’s physical
    health. [The trial court] cannot overlook the fact that Mother and
    Father’s lack of candor could have thwarted the very treatment
    that led to the discovery of an additional fracture.
    In    the    concise   statements,     Mother     and    Father
    mischaracterize [the trial court’s] prior adjudicatory findings.
    [The court] must emphasize that the absence of a finding of
    abuse in the first dependency hearing does not in itself establish
    a finding that no abuse took place. [The trial court’s] previous
    dependency finding did not hinge on whether or not Mother or
    Father inflicted the trauma, but on the fact that the child
    sustained trauma, which the medical evidence confirmed could
    have not have [sic] resulted without an adult’s knowledge. The
    record of the February 2014 adjudicatory hearing reflects [the
    trial court’s] finding that a child of that age is not in a position to
    cause the injuries he sustained[,] and that some adult had
    knowledge of how J.W. sustained his injuries. Although [the trial
    court] did not identify a perpetrator or state that the minor child
    had been abused, [the court] did not make an alternative finding
    that the trauma was not inflicted. Therefore, the parents’
    arguments that [the court] made a finding that J.W. was not
    abused are unsupported by the record.
    The [trial court] further noted that the fact that the
    previous dependency case was closed after Mother and Father
    met all of their goals is not indicative of the parents’
    acknowledgement of responsibility for the minor child’s prior
    injuries. As stated in [the trial court’s] June 16, 2015 findings of
    fact, it is the parents’ most recent conduct with respect to the
    prior incident that demonstrates their failure to accept
    responsibility for the accuracy of the prior finding. At most,
    Mother’s and Father’s completion of their previous dependency
    goals demonstrates a propensity to cooperate with court orders;
    it does not, however, demonstrate their acceptance of the
    accuracy of the prior finding, or their willingness to accept
    responsibility for J.W.’s prior injuries.8
    - 23 -
    J-A10012-16
    J-A10013-16
    The parents’ [next] issue on appeal avers that [the trial
    court] erred and abused [its] discretion in adjudicating the child
    dependent where the medical evidence on its own does not
    establish dependency and there was no evidence that parent
    failed to obtain proper medical attention for J.W. With respect to
    the parents’ first argument, [the trial court] did not base [its]
    findings or the dependency adjudication solely on the medical
    evidence. As noted, [the medical evidence] is concerning, but
    alone does not establish clear and convincing evidence. What
    [the trial court] did find, by clear and convincing evidence, was
    that it became evident in this adjudication that the parents failed
    to acknowledge responsibility for the prior injuries, and[,]
    therefore, J.W. is at risk for medical professionals not receiving
    all of the information necessary to treat him and to assess
    whether he is in danger. There is ample evidence in the record
    that Mother and Father were not candid or forthcoming with
    information regarding the child’s previous history. Multiple
    witnesses, including Mother and Father, testified to the parents’
    reluctance to not only have the minor child treated at Children’s
    Hospital, but also to submit to the skeletal survey, without which
    the second fracture would not have been discovered. Therefore,
    the parents’ arguments with respect to [this] issue on appeal
    should be dismissed.
    ___________________________________________________
    6
    While the parents cooperated with services and did what was
    asked of them by CYF, resulting in the closure of the prior case
    closed [sic] after approximately eight months, it is clear that the
    parents never acknowledged responsibility for the injury.
    7
    As stated in [the trial court’s] adjudicatory order, [the trial
    court], as well as other professionals in this case, very well may
    have been influenced by the fact that the parents appear to be
    such nice, respectable people who have a nice home and plenty
    of resources.
    8
    In retrospect, the case should not have been closed without
    such an acknowledgement.
    Trial Court Opinion, 8/17/16, at 7-12 (unpaginated; footnotes and emphasis
    in original).
    - 24 -
    J-A10012-16
    J-A10013-16
    In the October 30, 2015 opinion, the trial court explained:
    Both Mother and Father appeal [the] August 21, 2015
    Order of Court.1
    ***
    In their concise statements, Mother and Father both assert
    9 matters complained of, which can be grouped into three basic
    issues, specifically:
    1. That [the trial court] committed an error of law and an
    abuse of discretion in finding that J.W. continues to be
    dependent because parents were not forthcoming about
    what happened to this child when he was an infant,
    despite the parents’ substantial compliance with the
    permanency plan. See Mother’s and Father’s Concise
    Statement of Matters, at paragraphs 1, 2, 3, 6 and 8.
    2. That [the trial court] committed an error of law and an
    abuse of discretion in failing to set forth appropriate goals
    for J.W.’s permanency plan or a likely date on which the
    permanency goals maybe achieved. See Mother’s and
    Father’s Concise Statement of Matters, at paragraphs 4
    and 5.
    3. That [the trial court] committed an error of law and an
    abuse of discretion in ordering the parents to attend both
    individual therapy and ultimately couples therapy, and
    requiring the parents’ contact with J.W. to continue to be
    supervised at all times by either the paternal
    grandparents or maternal grandparents. See Mother’s
    and Father’s Concise Statement of Matters, at paragraphs
    7 and 9.
    Ultimately, Mother’s and Father’s issues on appeal, (which
    are not addressed in the Opinion in support of the adjudication)
    (August, 17, 2014) stem from [the trial court’s] finding that J.W.
    continues to be a dependent child despite the fact that both
    parents have substantially complied with the permanency plan.
    However, compliance with the permanency plan does not equal
    progress. The mental health evaluations were ordered in order
    to assess whether a mental health issue was the reason why the
    - 25 -
    J-A10012-16
    J-A10013-16
    parents were unwilling to acknowledge their responsibility for the
    injuries to the child as an infant and their resulting reluctance to
    cooperate with medical providers, with respect to the recent
    fractures. Had the mental health evaluations revealed a mental
    health condition, which caused the parents to place the child at
    risk, then appropriate mental health goals could be identified so
    that this condition could be addressed.
    Both parents deny responsibility for J.W.’s injuries as an
    infant, despite [the trial court’s] finding that an adult was aware
    of the cause of the injuries. Instead, there appears to be a
    “circling of the wagons” or a “conspiracy of silence.” See In Re
    L.Z., 
    111 A.3d 1164
    (Pa. 2015). Dr. Pepe’s testimony that the
    parents do not have mental health issues may have ruled out
    one potential explanation as to why the parents have been
    unable to address the circumstances that led to the dependency
    adjudication.
    However, without an explanation for the parents’ behavior,
    the conditions cannot be remedied[,] and J.W. cannot safely be
    placed in the parents[’] care without supervision. As a result, [the
    trial court] ordered both parents to seek individual counseling
    with the hope that either Mother or Father will be forthcoming
    with information regarding the circumstances of J.W.’s previous
    injuries, so that the parents may then work towards remedying
    the conditions that led to the most recent dependency
    adjudication.
    For the foregoing reasons, the August 21, 2015 Order of
    Court should be affirmed.
    ______________________________________________
    1
    Currently pending before the Court are Mother’s and Father’s
    appeals of the June 16, 2015 dependency adjudication at docket
    numbers at 1079 WDA 2015 and 1080 WDA 2015. As the
    present matter has been consolidated with the pending appeals,
    this opinion will only address facts and issues which were not
    addressed in the prior opinion. For more detail, see the Trial
    Court Opinion, dated August 17, 2015.
    Trial Court Opinion, 10/30/15, at 2-4 (footnote in original).
    - 26 -
    J-A10012-16
    J-A10013-16
    In In re L.Z., our Supreme Court considered the question of whether
    this Court, sitting en banc, improperly reversed the determination of the trial
    court that the child at issue suffered child abuse, and, through the
    application of the presumption of prima facie evidence of abuse set forth at
    23 Pa.C.S.A. § 6381(d), that the abuse was perpetrated by his mother.
    There, a twenty-month-old male infant was brought to an emergency
    room by his mother and his maternal aunt, to be treated for a deep cut
    nearly halfway around the base of his penis. The physicians at the hospital
    noted bruising to the child’s cheeks, severe diaper rash, and a yeast
    infection on the front of his body. Both women cared for the child together.
    The physicians suspected child abuse, as the women’s explanations for the
    injuries to the child were consistent with abuse, and the injuries were
    inconsistent with the women’s explanations. The physicians also suspected
    that the injuries were non-accidental.
    The physician who treated the child at the hospital testified at the
    dependency adjudication hearing as an expert in pediatric medicine. When
    the doctor was asked whether the dark bruising to child’s cheeks would
    “cause a child severe pain,” she responded, “I am sure it couldn’t have been
    very 
    comfortable.” 111 A.3d at 1168
    . The doctor testified that the injuries
    (the penile laceration, cheek bruises and diaper rash/yeast infection) were
    “consistent with a pattern of suspected child abuse,” and that the child was a
    “victim of child abuse.” 
    Id. - 27
    -
    J-A10012-16
    J-A10013-16
    The trial court found that the child was a victim of child abuse as
    defined at 23 Pa.C.S.A. § 6303, and that the mother was the perpetrator of
    the abuse. 
    See 111 A.3d at 1168-1169
    . The court transferred temporary
    legal custody of the child to the county agency, and placed the child in his
    maternal   grandfather’s   physical   custody,   with   his   parents   receiving
    supervised weekly visitation. The trial court also entered an order finding
    that aggravated circumstances existed because the child was “the victim of
    physical abuse resulting in serious bodily injury, sexual violence, or
    aggravated neglect by the parent; proven as to Mother.” 
    Id. at at
    1169.
    The trial court concluded that the county agency did not need to make
    further efforts to reunify the child with his mother.
    The mother filed an appeal to this Court. Sitting en banc, the majority
    of the Court affirmed the dependency adjudication but vacated the abuse
    determination. The dissent, authored by this jurist, and joined by Judge
    Bender and then-Judge, now Justice, Wecht, took the position that the
    majority improperly limited the evidentiary presumption of § 6381(d) to find
    prima facie evidence of an abuser’s identity only when the abuser was
    proven to be present at the time of the injuries. See 
    id. at 1171.
    The guardian ad litem filed an appeal with our Supreme Court, which
    held that the presumption set forth in § 6381(d) was applicable to the case,
    and that the mother offered no testimony to rebut it. See 
    id. at 1186.
    The
    Court concluded that the trial court properly found that the mother
    - 28 -
    J-A10012-16
    J-A10013-16
    perpetrated the abuse on the child either by inflicting the injuries, or by
    failing to protect the child from his maternal aunt. Accordingly, the Supreme
    Court reversed this Court’s en banc decision, and reinstated the trial court’s
    order. See 
    id. The Supreme
    Court stated:
    [C]hild abuse cases often involve a child presenting to a
    hospital with significant injuries that are entirely consistent with
    common types of child abuse and entirely inconsistent with the
    implausible explanations concocted by the parents and
    responsible persons to avoid allegations of child abuse. As noted,
    in cases where multiple caregivers are involved, the individuals
    frequently “circle the wagons” or alternatively point fingers at
    each other. As the children may be too young or fearful to
    describe the abuse, CYS agencies are left to prove their case
    with only the physical evidence of injuries that would not
    ordinarily be sustained but for the action of the parents or
    responsible persons and the implausible statements of the
    parents and responsible persons. Thus, while they can prove the
    existence of abuse rather easily, they have no ability to assign
    responsibility for the heinous act among the responsible adults.
    As Judge Tamilia observed in 1993, “the Legislature deemed it
    wise and necessary to establish a different evidentiary standard”
    by enacting Section 6381’s(d)’s presumption to avoid this
    evidentiary conundrum and protect children from future abuse.
    [In the Interest of J.R.W., 
    631 A.2d 1019
    , 1023 (Pa. Super.
    1993)]. . . . We emphasize that, when a child is in the care of
    multiple parents or other persons responsible for care, those
    individuals are accountable for the care and protection of the
    child whether they actually inflicted the injury or failed in their
    duty to protect the child.
    Moreover, the Legislature balanced the presumption of
    Section 6381(d) by making it rebuttable as it merely establishes
    “prima facie evidence” that the parent perpetrated the abuse.
    23 Pa.C.S. § 6381(d). As commonly understood, prima facie
    evidence is “[s]uch evidence as, in the judgment of the law, is
    sufficient to establish a given fact, or the group or chain of facts
    constituting the party’s claim or defense, and which if not
    - 29 -
    J-A10012-16
    J-A10013-16
    rebutted or contradicted, will remain sufficient.” Black’s Law
    Dictionary 825 (6th ed. Abridged 1991). Accordingly, evidence
    that a child suffered injury that would not ordinarily be sustained
    but for acts or omissions of the parent or responsible person is
    sufficient to establish that the parent or responsible person
    perpetrated that abuse unless the parent or responsible person
    rebuts the presumption. The parent or responsible person may
    present evidence demonstrating that they did not inflict the
    abuse, potentially by testifying that they gave responsibility for
    the child to another person about whom they had no reason to
    fear or perhaps that the injuries were accidental rather than
    abusive. The evaluation of the validity of the presumption would
    then rest with the trial court evaluating the credibility of the
    prima facie evidence presented by the CYS agency and the
    rebuttal of the parent or responsible person.
    Applying Section 6381(d) as set forth above to the case at
    bar, we affirm the trial court’s determination that [the mother]
    perpetrated the abuse in the form of the laceration, the cheek
    bruising, and the severe diaper rash and yeast infection. First,
    because the medical evidence presented by [the agency]
    demonstrated that [the child’s] injuries were neither accidental
    nor self-inflicted and because [the child] was only in the care of
    [his mother and aunt], the injuries were shown to be “of such a
    nature as would ordinarily not be sustained or exist except by
    reason of the acts or omissions of the parent or other person
    responsible for the welfare of the child[.]” 23 Pa.C.S. § 6381(d).
    Ergo, either [the aunt or mother] or both inflicted the abuse [the
    child] suffered or failed to protect him from the other’s abuse.
    [The mother] failed to rebut the presumption by presenting
    evidence or testimony from her, [the aunt] or her boyfriend
    establishing that [the child] was not in her care when the injuries
    were suffered and that she had no reason to question her
    decision to leave [the child] in [his aunt’s] care. Likewise,
    neither [the aunt] nor anyone on her behalf testified. [The
    mother and aunt’s] self-serving claims made at the hospital were
    neither under oath nor subject to cross-examination. They were
    outside-the-record and do not constitute rebuttal evidence.25
    Instead, ample, uncontested, unrebutted evidence existed
    for the trial court to presume that [the mother] perpetrated the
    abuse on [the child]. . . .
    - 30 -
    J-A10012-16
    J-A10013-16
    Additionally, the trial court did not abuse its discretion in
    discrediting [the mother’s] implausible out-of-court explanation
    and instead crediting the treating doctor’s testimonial
    determination that the cheek bruising was classic child abuse.
    The court found Dr. Silver credible given the pattern of bruises
    showing that someone squeezed [the child’s] face between her
    thumb and fingers, bruising which could have occurred during
    the window of time [the mother] acknowledged having control of
    [the child] and bruising that the doctor testified would have
    cause [the child] severe pain. Moreover, even assuming [the
    mother] did not inflict the penile laceration or the cheek bruising,
    she is still responsible for [the child’s] injuries by failing to
    protect him from [the aunt], absent rebuttal from [the mother]
    that she had no reason to fear leaving [the child] with [the
    aunt].
    We conclude that the presumption of Section 6381(d) is
    applicable to this case and that [the mother] offered no
    testimony to rebut it. Thus, the trial court properly found [the
    mother] perpetrated the abuse on [the child] either by inflicting
    the injuries or failing to protect [the child] from [the aunt].
    ____________________________________________________
    25
    Moreover, we would not fault a trial court for failing to credit
    any explanations that would have been given considering the
    implausibility of the other assertions provided at the hospital
    regarding [the child’s] injuries.
    
    Id. at 1185-1186
    (footnote in original; footnote omitted).
    Multiple caretaker child abuse situations are rife with credibility
    determinations for the trial court, and call for the trial court to make
    credibility determinations as to the plausible and implausible explanations
    for the child’s injuries. See 
    id. at 1186
    n.25.
    After a careful review of the record in this matter, we find the trial
    court’s credibility findings are supported by competent evidence in the
    record. See In re 
    R.J.T., 9 A.3d at 1190
    . We also find no deprivation of
    - 31 -
    J-A10012-16
    J-A10013-16
    Mother’s and Father’s constitutional guarantees to due process of law, for
    the reasons expressed by the trial court in its opinion, quoted above. We
    find no error of law or abuse of the trial court’s discretion in ordering, in the
    August 21, 2015 order, the parties to undergo individual and couples
    therapy, after the psychological evaluation, in order to reach a determination
    of the identity of the perpetrator of the abuse on Child. We, therefore, find
    Mother’s and Father’s appeals lack merit. Accordingly, we affirm the June 16,
    2015 and August 21, 2015 orders of the trial court.
    Orders affirmed.
    Judgment Entered.
    Joseph D. Seletyn, Esq.
    Prothonotary
    Date: 9/2/2016
    - 32 -
    

Document Info

Docket Number: 1079 WDA 2015

Filed Date: 9/2/2016

Precedential Status: Precedential

Modified Date: 4/17/2021