P.C. v. Super.
Filed 7/13/12 P.C. v. Super. Ct. CA6
California
Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or
relying on opinions not certified for publication or ordered published, except
as specified by rule 8.1115(b). This
opinion has not been certified for publication or ordered published for
purposes of rule 8.1115.
IN
THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
SIXTH
APPELLATE DISTRICT
P.C.,
Petitioner,
v.
THE SUPERIOR
COURT OF SANTA
CLARA COUNTY,
Respondent;
SANTA CLARA COUNTY DEPARTMENT
OF FAMILY AND CHILDREN’S SERVICES,
Real Party in Interest.
H038327
(Santa Clara
County
Super. Ct.
No. JD20237)
P.C. (daughter) was removed from the custody
of petitioner, Doctor P.C. (mother) and declared a dependent child of the court
due to concerns about mother’s mental health and the effect of mother’s
behavior on daughter’s well-being. After
18 months in care, daughter was thriving in a prospective adoptive home. Mother had made no substantive progress in
court-ordered therapy. At the 18-month
review hearing the juvenile court accepted the recommendation of the
County Department of Family and Children’s Services (Department) to
terminate reunification services (Welf. & Inst. Code, § 366.22, subd. (a))
and set a selection and implementation
hearing pursuant to section 366.26.
Mother petitions for a writ of mandate directing the juvenile court to
vacate that order. Mother argues that
there is no substantial evidence to support a finding that returning daughter
to her custody would pose a substantial risk of detriment to the child. Department maintains that the evidence is
sufficient to support the finding. We
agree with Department. Accordingly, we
deny the petition.
I.
Background
Mother and daughter
first came to the attention of Department in 2008, when daughter was eight
years old. Department received a
referral alleging that mother was emotionally abusing daughter by seeking
excessive medical care for her. Mother
claimed the referral was retaliation for her having complained about one of the
doctors.
In 2009,
County (North Carolina)
Department of Social Services received a report that daughter was being given
psychotropic medication she did not need.
That referral was concluded without intervention but the agency received
another referral in January 2010. This
time the allegation was that mother was exposing daughter to medical testing
she did not need. Cynthia Brown, M.D., a
North Carolina physician,
assessed daughter at the request of the agency.
Brown’s evaluation was that mother had been seriously neglecting
daughter, subjecting her to “excessive and unnecessary medical visits,
procedures, testing, medication use, restriction of her diet, restriction of
her activities and instability of her home life from the frequent moves they
have made. [Daughter] has been harmed by
this in that she believes that she has an abnormal brain, balance and memory
problems . . . .†A previous evaluation
“raised concerns for depression and somatization. [Daughter’s] behaviors are reportedly
worsening at school.†Mother had not
been giving daughter recommended medication and had not complied with
recommended counseling. Brown opined,
“Continuing to live in this situation places [daughter] at high risk of
developing mental health disorders such as anxiety, somatization disorders
and/or factitious disorder, and again, I am very concerned that these may
already be present to some degree. It is
my hope that intervention can be done to help this family and to protect
[daughter] from ongoing neglect/abuse.â€
The Buncombe
County agency opened an informal
case and provided services to the family, recommending a psychological
evaluation for mother (who is a licensed psychologist herself) and services to
address daughter’s stress. The agency
also recommended that mother identify and utilize one primary care doctor to
coordinate daughter’s health care.
Mother refused to acknowledge that she might have a mental health
problem and did not cooperate with the other recommendations. Before the case was resolved mother and
daughter moved away. On May 17, 2010, the Buncombe
County agency alerted Department
that mother may have moved to Santa Clara
County where mother’s parents
lived. Mother had refused to share her
new address with the North Carolina
agency because she felt it was harassing her.
In response to the
notice from the North Carolina
agency, Department began investigating in June 2010. Mother refused to cooperate. She refused to consent to Department’s
accessing daughter’s medical records.
She claimed Department was harassing her. And for the next month Department personnel
were unable to contact her.
Consequently, on July 21, 2010,
the juvenile court issued a protective custody warrant and daughter was taken
into custody. The father’s rights had
been terminated previously and, according to mother, his whereabouts were
unknown. Daughter was placed with her maternal
aunt.
Department filed a
petition under section 300, subdivisions (b) and (c), alleging that daughter
came within the jurisdiction of the juvenile court. For the preceding several years mother had
been subjecting daughter to an excessive number of unnecessary medical visits,
procedures, testing, and medications.
The social worker described daughter as appearing “thin, lethargic, with
baggy eyes.†She lacked basic self-help
skills. She could not bathe herself,
sleep independently, or ride a bicycle.
It was believed that the deficits were the result of lack of exposure to
the tasks; daughter did not have any cognitive deficits that would prevent her
from acquiring the skills. Mother
continued to refuse consent for Department to access daughter’s medical
records. Mother’s communication was
consistently described as weird, unorganized, or spacey. Daughter was diagnosed with anxiety
disorder. She was physically
healthy. The juvenile court sustained
the petition.
Over the next 12
months, mother had regular, supervised visits with daughter but was unable to
restrain herself from discussing health, diet, and hygiene issues with the
girl. She contacted caregivers directly
and showed up one day to remove daughter from school due to her fear of a gas
line exploding. She objected to
daughter’s participating in extracurricular activities or overnight camping
trips.
Daughter thrived in
the home of her maternal aunt but her family members were not willing to adopt
her due to their concern about mother’s behavior. Daughter was later placed in a confidential
foster home with a family that indicated a willingness to adopt if
reunification efforts failed. Daughter
continued to do well and continued to have supervised visits with mother.
The 18-month review
hearing was held over three days beginning April 30, 2012. In
its report for the hearing Department requested that the court terminate
services to mother and set a section 366.26 selection and implementation
hearing. Department reported that
daughter had been residing in the concurrent foster home since June 18,
2011. Daughter had no medical, dental,
or developmental problems. She was
developing age-appropriate social interests, social skills, and
self-confidence. She loved school,
maintained good friendships, and was athletic and energetic. She played soccer and basketball. School authorities reported daughter to be
friendly and engaged with peers and teachers.
Notwithstanding
reports of daughter’s well-being, mother had continued to exhibit excessive
concern about daughter’s health and appearance.
In October 2011, mother telephoned the social worker claiming that
daughter needed to see an eye doctor.
Mother made a doctor’s appointment for daughter without consulting the
social worker or the foster parent. The
foster mother reported no complaints from daughter about her eyes and a
subsequent visit to the eye doctor revealed that daughter’s eyes were healthy
and her vision was good. Mother
repeatedly expressed concern that daughter had reported being bullied but
school authorities had no reports of bullying.
Mother objected to allowing daughter to attend an overnight Girl Scout
camp but the juvenile court approved the excursion. Upon learning of the approval, mother
contacted the Girl Scouts, explaining that because of the weather, forest
fires, daughter’s immaturity, and her “physical malaise when [at] high altitude
when in the cold†mother did not want daughter to go on the outing. Mother was also concerned that the school was
not good for daughter. Mother had
attended Palo Alto schools and knew how competitive they were. Mother maintained that if she were to move
out of the country she would put daughter in a private school.
Mother participated in
individual therapy but stopped seeing her therapist in January 2012. According to the therapist, mother did not
think she needed individual therapy but the therapist could not confirm that
mother had achieved her therapeutic goals.
Mother participated in family
therapy beginning in October 2011 but two months later reported that she
was uncomfortable with the therapist and did not think family therapy was
working. Mother continued to blame the
system and criticize the professionals involved. Department did not pursue further therapeutic
interventions. The social worker had
become concerned about mother’s mental health and the risk that she would
kidnap daughter. In January 2102, on
account of these concerns, Department moved visitation, which had always been
supervised, from the maternal grandparents’ home back to Department
offices.
William Alvarez,
Ph.D., evaluated mother to determine if there was a substantial risk of
detriment to daughter if she were returned to mother’s custody. In a report dated January 2012, Alvarez noted
his concern that mother had “not yet acknowledged or addressed the nature or
source of her ongoing concerns regarding perceived medical conditions and/or
threats to [daughter’s] safety.†Mother
had come to the attention of Department as the result of “concerns raised by
multiple medical providers regarding the possibility of Munchausen Syndrome by
Proxy. [¶] Specifically, [mother] sought multiple care providers and medical
tests in relation to many medical and psychological concerns regarding her
daughter (ie: cancer, tumor, bipolar disorder,
Fragile X, multiple sclerosis, endocrine disorder, Cushing’s disease, sepsis,
Adrenoleukodystrophy, rheumatologic disease, early puberty, clumsiness,
etc.). In sum, it was reported that at
minimum [daughter] had undergone 28 different tests or studies (ie: MRI and CT scans) and that [mother] had
raised at least 34 different diseases/conditions that [daughter] may suffer
from. . . .†Alvarez did not believe
mother suffered from Munchausen Syndrome by Proxy but he did believe that she
had emotional and cognitive difficulties “which are currently interfering with
her ability to function to the best of her abilities as a parent.†Mother responded to the evaluation with her
own 16-page (single spaced) critique, charging Alvarez with incompetence and
attempting to justify the multiple tests daughter had previously undergone.
Alvarez testified at
the 18-month review hearing. He referred
to mother’s letter to him as demonstrating her continuing refusal to accept any
responsibility for the dependency and her continued preoccupation with
daughter’s health. She exhibited flight
of ideas, which is associated with mental illness. A priority for mother would be ongoing mental
health treatment, but Alvarez believed that mother was not then capable of
staying in therapy. The risk to daughter
if she were returned to mother’s care could be mitigated in one of two
ways. One would be for mother to become
involved in therapy and become emotionally stable. The other would be for daughter to mature and
develop enough assertiveness that she could resist mother’s inappropriate
attentions. Neither point had been
reached yet.
The social worker
testified that mother had not expressed an understanding of why daughter had
been removed from her care. Her
excessive concern about daughter’s health continued unabated. Kidnapping remained a concern. Mother had mentioned seeking work in
Australia and she told daughter that she would put her in private school
there. Daughter had begun to realize
that mother worried too much about daughter’s health. She loved mother and was happy in her foster
home. She hoped mother would get
treatment so that daughter could live with her again. The social worker believed that if daughter
were returned to mother’s care, mother would continue the behaviors of the past
and daughter would be at high risk for her own mental health problems.
Mother also testified
at the hearing. When asked if she
understood why daughter was in care mother replied, “[I]t’s a very complex
issue.†She did understand that one of
the major concerns was that she took daughter to the doctor too much. She did not think Department knew daughter
well enough to be able to see how she was doing. She was daughter’s “genetic, biological and
super parent mother.†Mother said that
the last time she saw the social worker the meeting was cut short because the
worker was upset over the death of Kim Jong-il.
Mother denied planning to kidnap daughter. She was aware that a pediatrician would be
responsible for coordinating daughter’s health care and did not expect daughter
would need to see other doctors.
The trial court found
that returning daughter to mother’s custody would create a substantial risk of
detriment to the physical or emotional well-being of daughter, citing mother’s
failure to achieve her therapeutic goals and her refusal to acknowledge her
role in the dependency. The court set a
selection and implementation hearing pursuant to section 366.26 for August 28,
2012. Mother challenges the order by way
of petition for writ of mandate. (§
366.26, subd. (l); Cal. Rules of
Court, rule 8.450 et seq.)
II.
Discussion
A.
Issue and Standard of Review
Mother, who appears in
propria persona after having been represented by counsel below, argues that
return of daughter to her custody would not pose a substantial risk of
detriment to daughter. The argument
implicitly challenges the sufficiency of the evidence to support the juvenile
court’s finding.
The pertinent law is
well-settled. “When a child is removed
from parental custody, certain legal safeguards are applied to prevent
unwarranted or arbitrary continuation of out-of-home placement. [Citations.]
Until reunification services are terminated, there is a statutory
presumption that a dependent child will be returned to parental custody.†(In re Yvonne W. (2008) 165 Cal.App.4th 1394,
1400.)
18–month review hearing, the juvenile court must order the child returned to
the custody of his or her parent or legal guardian “unless the court finds, by
a preponderance of
the evidence, that the
return of the child to his or her parent or legal guardian would create a
substantial risk of detriment to the safety, protection, or physical or
emotional well-being of the child.â€
detrimental to return the child at the 18-month review, the court must consider
whether the parent participated regularly in any treatment program set forth by
the plan, the ‘efforts or progress’ of the parent, and the ‘extent’ to which
the parent ‘cooperated and availed himself or herself of services
provided.’ (§ 366.22, subd. (a).)†(Blanca P. v. Superior Court (1996) 45
Cal.App.4th 1738, 1748.) “
[Department] has the
burden of establishing
detriment. [
substantial,
such that returning
a child to
some danger to
the child’s physical
or emotional well-
supra, at p. 1400.)
This court reviews the
record to determine whether substantial evidence supports the juvenile court’s
finding that the child would be at substantial risk of
if returned to the parent’s custody. (Constance
K. v. Superior Court (1998) 61 Cal.App.4th 689, 705.) We examine the evidence in favor of the
juvenile court’s order, and indulge in all reasonable inferences to support the
findings of the court. (In re Misako
R. (1991) 2 Cal.App.4th 538, 545.)
B.
Analysis
Daughter was detained
because of mother’s unfounded concern with daughter’s health and other aspects
of her well-being, which led mother to subject daughter to excessive,
unnecessary medical evaluations.
Mother’s behavior kept daughter out of school, limited her diet, caused daughter
to be depressed and anxious, and led her to believe she suffered from various
conditions, including brain damage.
Accordingly, Department’s plan for reunification required mother to
engage in therapy to help her understand that her unsupported concerns about
daughter were themselves detrimental to the child. Over the course of more than 18 months of
services mother’s understanding of the situation did not evolve. She continued to blame the system and insisted
that she was the one who knew her daughter best. The social worker believed that daughter
would be at risk for future mental health problems if returned to mother’s care
and mother persisted in the behaviors of the past. Dr. Alvarez opined that the risk of harm to
daughter could be mitigated if mother were emotionally stable or daughter were
sufficiently mature and assertive but he did not believe that mother was
emotionally stable or that daughter was mature enough to deal with mother’s
instability. In effect, Alvarez’s
opinion was that if daughter were returned to mother’s custody, mother would
resume the same behavior that led to the dependency and daughter would be
unable to resist the negative effect those behaviors had upon her. This is substantial evidence to support the
juvenile court’s finding that return to mother’s custody would pose a
substantial risk of detriment to daughter.
III.
Disposition
The petition is denied.
Premo,
Acting P.J.
WE CONCUR:
Bamattre-Manoukian,
J.
Grover, J.
name="_ftn1" title=""> [1]
Hereafter all statutory references are to the Welfare and Institutions Code.
Monterey County Superior Court assigned by the Chief Justice pursuant to
article VI, section 6 of the California Constitution.
