J

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NON

- PRECEDENTIAL DECISION

- SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: K.W., A MINOR

APPEAL OF: J.D.E., MOTHER :

:

:

:

:

:

:

:

: IN THE SUPERIOR COURT OF

PENNSYLVANIA

No. 584 WDA 2022
Appeal from the Order Entered April 19, 2022 In the Court of C ommon Pleas of Allegheny County Orphans ’ Court at CP

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- AP

- 0000228

- 2021

IN THE INTEREST OF: K.W., A MINOR

APPEAL OF: J.D.E., MOTHER :

:

:

:

:

:

:

:

: IN THE SUPERIOR COURT OF

PENNSYLVANIA

No. 586 WDA 2022
Appeal from the Order Entered April 19, 2022 In the Court of Common Pleas of Allegheny County Orphans’ Court at CP

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- AP

- 0000229

- 2021

IN THE INTEREST OF: M.W., A MINOR

APPEAL OF: J.D.E., MOTHER :

:

:

:

:

:

:

:

: IN THE SUPERIOR COURT OF

PENNSYLVANIA

No. 587 WDA 2022
Appeal from the Order Entered April 19, 2022 In the Court of Common Pleas of Allegheny County Orphans ’ Court at CP

- 02

- AP

- 0000230

- 2021J

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BEFORE: DUBOW, J., MURRAY, J., and PELLEGRINI, J. *

MEMORANDUM BY MURRAY, J.: OCTOBER 21, 2022

J.D.E. (Mother) appeals from the order s involu ntarily terminating her

parental rights to her three daughters, K.W., K.L.W. (a/k/a K.W.) , and M.W. 1

Upon review, we affirm.

K.W., K.L.W. and M.W. (Children) are the three youngest of Mo ther’s

eight children. K.W. and K.L.W. are twins, born in October 2018; M.W. was

born in May 2020. The family has been involved with the Allegheny County

Office of Children, Youth & Families (CYF) since 2001. The orphans’ court

explained:

Mother and Father have a lengthy history with CYF in Allegheny County. Their oldest child was born on August 17, 2001, and CYF referrals date back to 2001, when he was a baby and removed from their care. Beginning in 2008, the referrals to CYF became more “consistent,” according to the caseworker. In March 2018, CYF received a referral that the parents’ oldest child was lock ed up inside the home and was not “let out to go to school, use the bathroom, shower or eat.” Their oldest child was removed from their home and a corresponding Childline [report] , for unreasonably restraining or confining a child, was subsequently indica ted. CYF filed a petition for dependency on the oldest child and three other children [not K.W., K.L.W. or M.W.] that were residing in the home at the time. The oldest child was adjudicated dependent and CYF withdrew the petitions on the three other chil dren in July 2018. Because the oldest child was dependent, CYF remained active with the family and provided various services, which included bus tickets to assist with transportation

_________________ __________ ______ ____ _______

* Retired Senior Judge assigned to the Superior Court.

1 The orphans’ court also terminated the parental rights of L.C.W. (Father), who has appealed at 570 WDA 2022, 571 WDA 2022, and 572 WDA 2022. This Court consolidated Father’s appeals on May 31, 2022, and listed Father’s appeal for disposition by this panel on October 3, 2022.J

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needs. The caseworker testified that fifty tickets were requested and p rovided in October 2018, which corresponded to when [] K.W. and K.L.W. were born.

In late November 2019, CYF received a referral from Children’s Hospital regarding the twins. Dr. Adelaide Eichman, a stipulated expert in child abuse and pediatrics, testif ied about her involvement with K.W. and K.L.W. at the time of their admission to Children’s Hospital of Pittsburgh on November 26, 2019. Dr. Eichman testified that upon examination,

t he twins were 13 months old. The girls were quite small. They weighed about 11 pounds, which is roughly the size of a two

- month

- old. So the girls were very tiny in terms of height and weight. They had badly controlled eczema on their skin. And the girls were developmentally delayed. They were at the level of a nine

- mont h

- old, approximately, at that point.

The twins were also found to have Vitamin D deficient rickets, which per Dr. Eichman , is a bone condition caused by a lack of Vitamin D in their diet prior to the hospital admission. Dr. Eichman testified that she recommended hospitalization for two reasons. Dr. Eichman said that the twins were so malnourished that they exhibited signs of refeeding syndrome, due to electrolyte abnormalities, which required the refeeding to be done slowly and carefully. Dr. Eichman also recommended hospitalization to ensure that the twins did not have an underlying medical condition that was the cause of their low weight. Parents were not receptive to the twins being hospitalized, per Dr. Eichman.

Dr. Eichman testified her medical conclusion was that the twins did not have a medical condition that prevented them from gaining weight and that their low we ight was a result of an inadequate diet. Mother told Dr. Eichman when the twins were initially hospitalized, that the twins were breastfeeding every two hours, that they were on a vegan diet but ate chicken fingers, and Mother was giving them some kind of supplement. Dr. Eichman testified that Mother stated “she kept herself alkalined” but Dr. Eichman was not familiar with what kind of diet that was.

Dr. Eichman stated that the twins did not have celiac disease. Additionally, the eczema that they had, w hile a common skin condition, was not well

- controlled and as a result [,] the twinsJ

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were scratching quite a bit until it cracked and bled. Dr. Eichman also testified that the children each functioned with the developmental abilities of a nine

- month

- old, de spite being thirteen months of age. The parents reported to Dr. Eichman that the twins “had many words;” however, Dr. Eichman had only heard them babble. Dr. Eichman testified that the twins were observably different, in that they were smaller and not as developmentally advanced for their age, and a reasonable caregiver would be able to recognize that they were not on track with growth or development. After their admission on November 26, 2019, the twins were discharged from the hospital on December 5, 2 019, to the care of their parents. The parents met with the nutritionist and the general pediatrics team during the twins’ hospitalization, and they were provided with verbal and written instructions regarding their care and feeding, per Dr. Eichman. Add itionally, multiple weight checks were scheduled for the twins post

- discharge, which included bringing them into the office and a home nurse coming to the family home. Dr. Eichman testified that during their hospitalization, the twins were gaining,

on ave rage, twenty grams per day, which was viewed favorably in the light of the feeding schedule put in place to avoid refeeding syndrome.

Despite the instruction and education provided to the parents, the scheduled appointments for weight checks in the home a nd the doctor’s office, and the evidence that the twins were capable of gaining weight as demonstrated during their hospitalization, the twins were readmitted to Children’s Hospit al in January 2020. Dr. Eichma n testified that the readmission was due to the fact that they were not showing the weight gain that would have been expected while in Parents’ care and because the parents had missed several of the twins’ doctors’ appointments. Moreover, the eczema that h ad been treated with topical steroids had not improved while in Parents’ care.

CYF obtained an Emergency Custody Authorization to remove the twins in January 2020 and the caseworker testified that at the time of the removal the twins appeared very small. Mother had told CYF that she had the twins “on a vegan diet and that she was also breastfeeding but also feeding them smoothies with fruit, hemp seeds, walnut milk.” The caseworker testified that despite being hospitalized twice in a two

- month time frame due to nutritional deficiencies[,] and discussions with the parents about the severity of the twins’ presentation in November 2019[,]J

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Mother and Father did not seem to understand how serious the situation was.

After the twins’ removal in January 2020, CY F put in Homebuilders, a thirty

- day intensive in

- home services program, to support the family. Homebuilders’ goal, per CYF, was to work with the parents with scheduling and keeping appointments and addressing the children’s needs. The parents did not app ear to gain any additional insight from these services and Homebuilders suggested that Parents receive a neuropsychological evaluation, as well as in

- home mental health services. The caseworker testified that the twins were placed into [a] foster home at that time and eventually moved into a relative[’s] foster home in April 2020.

Mother had her eighth child, M.W., on May 16, 2020, and CYF obtained an Emergency Custody Authorization that same day. At the hospital discharge, the newborn[, M.W.,] was placed into the same relative[’s] foster home as the twins. The twins were adjudicated dependent on May 20, 2020. CYF filed a petition for dependency on [M.W.,] the newborn, based on the significant concerns the agency had with respect to the parents’ ability to appropriately feed and follow through with medical appointments. M.W., the newborn, was adjudicated dependent on June 25, 2020. Between the November 2019 hospitalization and the January 2020 hospitalization, twelve Childline [reports] were filed and ind icated against Mother and Father for causing serious medical neglect, failure to provide proper nutrition and hydration, and failure to provide proper medical care.

This [c]ourt need not recite the extensive findings within the permanency review orders wi th respect to Mother and Father, as they are evident within [] CYF Exhibit 5

- Certified Court orders. Without question, at the time the termination petitions were filed by CYF on November 4, 2021, and at the time of the termination proceedings on April 8, 2022, Mother and Father had made minimal progress towards remedying the issues and were in minimal compliance with the family service plan goals, despite CYF offering and providing services and evaluations aimed at efforts to reunify. See CYF Exhibit 5

- Certified Court Orders.

At the time of the termination hearing, the twins (K.W. and K.L.W.) were three and a half years old and had been in care twenty

- seven consecutive months. M.W. was almost two yearsJ

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old and had been in care her entire life, twenty

- t hree consecutive months. Not subject to the instant matter, Mother and Father’s oldest child resided outside of the home, and the three older sisters resided in the care of Parents, all four of whom are dependent.

Orphans’ Court Opinion, 6/27/22, at 2

- 8 (record citations and footnotes

omitted ).

The orphans’ c ourt conducted the termination hearing on April 8, 2022.

The C hildren were represented by legal counsel, “appointed by court order,

after [the Orphans’] Court conducted a conflict analysis.” Id. at 2. CYF

presented testimony from Dr. Eichman; CYF caseworker, Ashley Hobbs;

licensed psychologist, Dr. Terry O’Hara; an d licensed psychologist Dr. Beth

Bliss. Mother, Father, and Children’s maternal grandmother testified in

opposition to termination. By orders dated April 8, 2022, and entered April

19, 2022, the o rphans’ c ourt terminat ed Mother’s parental rights pursuant to

23 Pa.C.S.A. § 2511(a)(2),(5), (8) and (b). Mo ther timely appealed. Both

Mo ther and the orphans’ c ourt have complied with Pa.R.A.P. 1925. 2

_________________ __________ ______ ____ _______

2 Mother filed separate notices of appeal for each child. At 587 WDA 2022, Mother failed to file her concise statement simultaneously with her notice of appeal pursuant to Pa.R. A.P. 1925(a)(2). On June 7, 2022, this Court ordered Mother to file her concise statement by June 17, 2022. She timely complied by filing the concise statement in the orphans’ court on June 9, 2022, and in this Court on June 13, 2022. Thus, Mother has p reserved her appellate issues. See In re K.T.E.L. , 983 A.2d 745, 747 n.1 (Pa. Super. 2009) (failure to simultaneously file a Rule 1925(b) statement did not result in waiver where appel lant later filed the statement and there was no allegation of prejudice from the late filing). This Court consolidated Mother’s appeals on June 15, 2022.J

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Mother presents the following questions for review:

1. Did the trial court abuse its discretion and/or err as a matter of law in granting the petition [s] to involuntarily terminate Mother ’ s parental rights pursuant to 23 Pa.C.S. § 2511(a)(2), (5), and (8)?

2. Did the trial court abuse its discretion and/or err as a matter of law in concluding that CYF met its burden o f proving by clear and convincing evidence that termination of Mother ’ s parental rights would best serve the needs and welfare of the children pursuant to 23 Pa.C.S. § 2511(b)?

Mother’s Brief at 10.

In reviewing Mo ther’s issues,

our standard of review req uires [us to] accept the findings of fact and credibility determinations of the trial court if they are supported by the record. If the factual findings are supported, appellate courts review to determine if the trial court made an error of law or abused its discretion. As has been often stated, an abuse of discretion does not result merely because the reviewing court might have reached a different conclusion. Instead, a decision may be reversed for an abuse of discretion only upon demonstration of manif est unreasonableness, partiality, prejudice, bias, or ill

- will.

As [the Supreme Court] discussed in In re: R.J.T. , [9 A.3d 1179, 1190 (Pa. 2010) ], there are clear reasons for applying an abuse of discretion standard of review in these cases. [U]nlike trial courts, appellate courts are not equipped to make the fact

- specif ic determinations on a cold record, where the trial judges are observing the parties during the relevant hearing and often presiding over numerous other hearings regarding the child and parents. R.J.T. , 9 A.3d at 1190. Therefore, even where the facts

cou ld support an opposite result, as is often the case in dependency and termination cases, an appellate court must resist the urge to second guess the trial court and impose its own credibility determinations and judgment; instead, we must defer to the trial judges so long as the factual findings are supported by the record and the court’s legal conclusions are not the result of an error of law or an abuse of discretion.J

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In re Adoption of S.P. , 47 A.3d 817, 826

- 27 (Pa. 2012) (some citations

omitted).

CYF ha s the burden to prove by clear and convincing evidence that its

asserted grounds for termination a re valid. In re R.N.J. , 985 A.2d 273, 276

(Pa. Super. 2009). “[T ]he standard of clear and convincing evidence is defined

as testimony that is so clear, direct, weighty and convincing as to enable the

trier of fact to come to a clear conviction, without hesitance, of the truth of

the precise facts in issue.” Id. Under 23 Pa.C.S.A. § 2511
, “the court must

engage in a bifurcated process prior to terminating parental rights.” In re

L.M. , 923 A.2d 505, 511 (Pa. Super. 2007). Initially, the focus is on the

conduct of the parent pursuant to § 2511(a). Id.

Section 2511(a)

With respect to grounds for termination under Section 2511 (a), we need

only agree “as to any one subsection in order to affirm

the termination of parental rig hts .” In re A.S. , 11 A.3d 473, 478 (Pa. Super.

2010). Here , w e address the second subsection, which provides for

termination when a parent’s

repeated and continued incapacity, abuse, neglect or refusal of the parent has caused the child to be without ess ential parental care, control or subsistence necessary for his physical or mental well

- being and the conditions and causes of the incapacity, abuse, neglect or refusal cannot or will not be remedied by the parent.

23 Pa.C.S.A. § 2511(a)(2).J

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S ection 2511(a)(2) “emphasizes the child’s present and future need for

‘essential parental care, control or subsistence necessary for his physical or

mental well

- being.’” In re E.A.P. , 944 A.2d 79, 82 (Pa. Super. 2008) (citation

omitted) . Grounds for termination under subsection (a)(2) are not limited to

affirmative misconduct. Id. “Where the parent does not exercise reasonable

firmness in declining to yield to obstacles, h er [paren tal] rights may be

forfeited.” Id. at 83

. The grounds for termination under § 2511(a)(2) may

include acts of refusal a s well as incapacity to perform parental duties. In re

S.C. , 247 A.3d 1097, 1104 (Pa. Super. 2021). We have long recognized that

a par ent is required to make diligent efforts toward the reasonably prompt

assumption of full parental responsibilities. In re Adoption of M.A.B. , 166

A.3d 434, 443 (Pa. Super. 2017)

.

Mother asserts the trial court erred in finding grounds for termination

under Section 2511(a)(2) . She argues:

The record failed to provide sufficient evidence to make finding under 23 Pa.C.S. § 2511(a)(2). CYF failed to prove that Mother had a continuing incapacity

... that caused the [C] hildren to be without essenti al parental care or that Mother cannot or will not remedy any such incapacity. The record demonstrates that Mother could provide proper care and control of the Children. CYF acknowledged that Mother provide d nutritionally appropriate food during visitation. The [Child Health Evaluation and Coordination Services (CHESCS)] Nurse testified that Mother verbalized an understanding of the immunizations and well child checks and had a good understanding of the twi ns ’ allergies.

It was also undisputed that the three older minor children in Mother’ s care never had nutritional issues or failure to thrive

concerns. Mother ’s ability to provide essential parental care toJ

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her other children is relevant. ( Interest of S.K .L.R. , 256 A.3d 1108, 1124 (Pa. 2021) )

. Mother’s Brief at 17

- 18 (record citations omitted).

CYF counters that Mother has “been unable to do what is critical for

reunification.” Participant’s Brief at 29. CY F further asserts that Mother has

“not made progress in understanding, accepting, and acknowledging any

aspect of why [her C]hildren are in care.” Id. While Children’s counsel

acknowledges that Mother “has made progress on her court ordered goals,”

counse l further asserts that “the primary reason the [C]hildren came in to care

continues to exist.” Appellee Brief at 14.

As indicated by CYF and Children’s counsel, the record supports the

orphans’ court’s termination of Mother’s parental rights under 23 Pa. C.S.A. §

2511(a)(2). The court addressed Mother and Father’ s shortcomings :

With respect to 23 Pa. C.S. § 2511(a)(2), this [c] ourt found that CYF clearly and convincingly proved the requisite grounds. Goals were set forth for Mother and Father in order t o remedy the incapacity, abuse, neglect or refusal that caused [C] hildren to be without proper parental care necessary for their physical and mental well

- being. These goals included parenting, visitation, cooperation with service providers and the agency, and of significant import [] , some demonstrated accountability and understanding of what happened that lead to the twins’ severe malnutrition and developmental d elays.

Mother and Father ’ s efforts on addressing the goals throughout this case could be best described as stagnant. At each and every permanency review hearing, the found that Mother and Father made “ minimal progress ” towards alleviating the circumsta nces which necessitated the original placement. Parents both appeared to be perpetually stuck and would regularly revisit the reasons why [C] hildren were removed and adjudicated dependent despite this [c] ourt, at each hearing, encouraging theJ

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parents to a ddress the goals and ordering services to assist their efforts towards reunification.

At the same time, CYF also made attempts to get Mother and Father to better understand what they needed to accomplish for these three young children to be returned to t heir care. Both parents, and Mother in particular , were extremely hostile toward the CYF caseworker and these hostilities increased as the case continued.

Orphans’ Court Opinion, 6/27/22, at 12

- 13 (emphasis added)

. The court

further found “it deeply tro ubling that the parents, at the time of the contested

termination proceeding, continued to demonstrate almost a disconnect with

their current situation.” Id. at 14.

The record supports the o rphans’ court’s analysis. The parties stipulated

that Dr. Adelaide Eichman, from the Division of Child Advocacy at Pittsburgh

Children’s Hospital, was an expert “in child abuse and pediatrics.” N.T.,

4/8/22, at 6. In November 2019, Dr. Eichman diagnosed the twins as

malnourished, and concluded they “did not have an adequate diet prior to

their hospitalization.” Id. at 8

- 9. Dr. Eichman recalled that neither parent

“was receptive to the children being hospitalized.” Id. at 9. Dr. Eichman

opined that “ a reasonable caregiver would recognize that the kids were not on

track with their growth or development.” Id. at 12. The Children improved

at the hospital and were discharged to Mother and Father in December 2019.

Dr. Eichman testified, “it was my diagnosis that the children had su ffered from

medical neglect.” Id. at 17. Her “assessment [was] that the children’s

nutritional needs were not being met in their home environment ” ; s heJ

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confirmed the situation w as “a near fatality for the children
, ” and the parents

took no responsibility

. Id. at 17, 21.

CYF caseworker Ashley Hobbs testified to becoming involved with the

family in January 2020. Id. at 26. However, CYF had “ referrals and cases

t hat dated back to 2001 when [the parents’ oldest child] was a baby.” Id. at

29. Ms. Hobbs stated that Mother “not understanding what [Children] need

for nutrition is a huge concern.” Id. at 35. The twins were placed in foster

care and adjudicated depen dent in May 2020; their younger sister, M.W., was

born a few days later. Id. at 37. CYF obtained an emergency order for

custody of M.W., who was discharged from the hospital and placed in foster

care with her twin sisters; the court adjudicated M.W. depe ndent in June 2020.

Id. Both parents had “liberal supervised visits ... with conditions that the

parents could take one or both twins out into the community without

supervision, not to exceed two hours.” Id. at 40. The parents also had

unsupervised vis itation with M.W. Id. at 41. However, in October 2020, the

parents alleged that the twins had been sexually abused. Id. at 42. The twins

were evaluated at Children’s Hospital and no abuse “was identified.” Id. at

42. T he visits were changed to being supervised at the parent’s home. Id.

at 43 . The parents alleged sexual abuse of the Children again, during a visit,

in September 2021. Id. at 45. Ms. Hobbs continued:

There w[ere] a lot of issues surrounding developmental therapy for the girls, and the girls were unable to get the therapy unless they were at visits with their parents. But even then [,] they were late to appointments or they no

- showed or they did not respondJ

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to scheduled appointments. And therefore, it was decided after a
permanency rev iew [hearing], it was ordered on December 10, 2020, that [foster parents were] appointed secondary educational decision

- makers so that the twins could [receive] the developmental therapy that they needed.

Id. at 46

- 47.

With respect to Mother’s mental health, Ms. Hobbs testified Mother was

referred to services, but she never acknowledged “to any service provider or

the agency that [ the parents] have problems and need treatment.” Id. at 50.

In January 2022, Ms. Hobbs emailed Mother about her missed mental health

evaluations

. Id. at 55. Mother responded that “ she had to cancel her

evaluation because of scheduling conflicts, as someone needed to be home

with [her other] children during the school day. ” Id. When Ms. Hobbs emailed

Mother a bout whether “there was a reason the evaluation for [Father] was

cancelled as well,” M other answered:

I didn ’ t ask you to schedule the evaluations, Ashley. Quit putting your wrong words in an e

- mail and trying to make it seem like it ’ s coming out our mout hs. I simply told you I reached out to Dr. Bliss to reschedule these evaluations and instead of Dr. Bliss calling us back to get that done, you all ran to each other like little kids would do and harped on that moment. Listen, unexpected things do occur in a person’s life but that’s not expected of you to give real news because you are a child. You have fabricated this whole ordeal since my babies were falsely removed and I finally heard it out of the horse ’ s mouth, what I already knew, that my babies we re medically kidnapped by the CYF system. I pray for you and the people you flock with. You are an evil person and God got the final say, not you or your system. Leave me with respect, peace, and knowing that you are full of crapola. Sovereign, [Mother]

Id. at 55

- 56.J

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Ms. Hobbs described Mother as cooperating with CYF “to a bare degree.”

Id. at 61. She explained that Mother would

do the basic court [

- ] ordered things to a degree. However, to get th ese thin gs ac c omplished, it takes a l ot of time, it takes a lot of constant checking to make sure that appointm ents are bein g kept

or [the parents are] meeting with the appropriate people. And so that has, I would say, caused progress to take more time than it should.

Id.

Dr. O’Hara, a licensed psychologi st with expertise in child and forensic

psychology
, performed individual and interactional evaluations of the family

in July 2020. Id. at 98. He conducted an individual evaluation of Mother . Dr.

O’Hara testified , “ from my perspective at the time there were significant issues

– from my perspective, hypothetically speaking, with that level of concern,

without any services, it would be difficult from my perspective to make

progress.” Id. at 105

- 06. He also stated :

[I] n [Mother]’s case, her struggling with a variety of treatment providers, that can sometimes be an indication of a personality disorder. Someone who has a lot of d ifficulties working with others and so forth can be an indicator

-- one indicator for a personality disorder. That was a hypothesis that I didn ’ t have a whole lot of evidence of at the time, but it was some thing I suggested should be explored in more detail.

Id. at 104

- 05.

However, Dr. O’Hara add ed:

I’ m really limited in what I can say about the parties now. I haven ’ t seen them in approximately two years. But at the time of the evaluations, it was my perspective that mental healthJ

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treatment and the services that I outlined in my reports were strongly advisable for both [ Mother and Fa ther].

Id. at 107.

Approximately two years later, in 2022, Mother was evaluated by

licensed psychologist, Dr. Bliss. The parties stipulated to Dr. Bliss being an

expe rt in child and forensic psychology. Id. at 117. Dr. Bliss performed

individual and interactional evaluations of Mother, as well as Father, the

Children, and the foster parents

. Mother canceled her appointments with Dr.

Bliss several times, and Dr. Blis s gave her “ one more chance ... it was her last

chance. And she did show up for the March 8, [ 2022 ,] appointment

. ” Id. at

119

. In response to CYF’s question s , Dr. Bliss testified:

[Mother] denied ever receiving any formal treatm ent. She ’s never been hospita lized or prescribed meds. She reported completing parenting c lasses. And the psych evals from Dr. O ’ Hara and the neuropsych

... she said she w as not a ware of bein g given any diagnoses from these evaluat ions.

Q . And ho w would you report her insight and judgment ?

A. I would say it’s low

.
Q. An d why do you say that?

A. She also has the same defensive ness and guardedness [as Father,] to a more significant degree, but I had a lot of concerns in general with her functioning. She presented as extremely disorganized. Having difficu lty recalling certain things. Distrusting of people in the system, almost to a paranoid level, reporting s ome almost delusional thinking. So there were concerns with her general cognitive functioning.

Id. at 125.J

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Dr. Bliss further addressing Mother’s ability to parent, stat ing that

Mother would

[n] eed to show significant improvement of [her] understanding of the [C]hildren’ s medical needs and what happened and how [the parents] can ensure that it won’ t happen again in the future. Mom needs to better understand and get control of these cognitive symptoms ... [which] greatly impact her ability t o parent.

Id. at 131.

The orphans’ c ourt found the “testimony of Dr. O’Hara and Dr. Bliss

further solidified” Mother’s failure to progress toward “accountability and

understanding of what happened with the twins.” Orphans’ Court Opinion,

6/27/22, at 22, 24. The court concluded Mother “had a goa l to cooperate with

service prov iders and CYF and ... failed to make any modicum of progress ...

throughout the life of the case.” Id. at 21. Accordingly, the court concluded

that Mother’s repeated and continued incapacity to parent caused the Children

to be without essential care, and the incapacity could or would not be

remedied. See 23 Pa.C.S.A. § 2511(a)(2). W e discern no error in the

termination of Mother’s parental rights under Section 2511(a)(2).

Section 2511(b)

Mother also argues the orphans’ court erred in finding grounds for

terminati o n under Section 2511(b), which requires the court “give primary

consideration to the develop mental, physical and emotional needs and welfare

of the child.” 23 Pa.C.S.A. § 2511(b). Mo ther claims that termination of her

parental rights was contrary to the Children’ s needs and welfare becauseJ

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Mother has a bond with Children, “who need the benefits they derive from

their relationship with Mother .” Mo ther’s Brief at 23

. “Only if t he court determines that the parent’s conduct warrants

termination of his or her parental rights does the court engage in the second

part of the analysis pursuant to Section 2511(b): determination of the needs

and welfare of the child under the standard of best interests of the child.” In

re L.M. , 923 A.2d 505, 511 (Pa. Super. 2007). When the trial court considers

a child’s needs and welfare, the “extent of any [parental] bond analysis ...

necessarily depends on the circumstances of the particular case.” In re

K.Z.S. , 946 A.2d 753, 763 (Pa. 2008).

[I]n addition to a bond examination, the trial court can equally emphasize th e safety needs of the child, and should also consider the intangibles, such as the love, comfort, security, and stability the child might have with the foster parent. Additionally, this Court stated that the trial court should consider the importance of

c ontinuity of relationships and whether any existing parent

- child bond can be severed without detrimental effects on the child.

In re A.S.
, 11 A.3d at 483 (citations omitted).

It is undisputed that Children have a bond with Mother. However, the

twins hav e resided in the pre

- adoptive home of foster parents since A pril

2020, and M.W. joined them shortly after her birth in May 2020. Ms. Hobbs

testified:

I have observed a clear and definite bond and attachment between the foster parents and the [C] hildren.

... The girls seem very comfortable with the foster parents. They ’ re very happy when they ’ re around them. They smile, they go to them if they need something. They ’ ll ask questions and say, auntie or uncle, can you get me this, can you d o that. T hey often are sitting onJ

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their laps or playing with them during my visits. And the [foster parents] ar e very attentive to their needs when they need something.

N.T., 4/8/22, at 62

- 63. Ms. Hobbs stated that the Children are

“developmentally on target” an d foster parents meet their emotional needs.

Id. at 63.

In addition, Ms. Hobbs opined that termination was in the Children’s

best interest . She explained:

Because at this time, over the course of over two y ears, neither of the parents have taken any form of respo n sibility for any missed, no

- sh owed, rescheduled doctors ’ appointm ents that essentially led their chil dren to c ome into care. Over the two years that I have w orked with them , there really has been minimal progress with respect to that.

And with respect to even acknowledging with other services, if a service does not occur, it ’ s the [provider’s] fault. I t’s not the parents’ fault. They do not know how to take responsibility for

even minor things that a person can take responsibility for. A nd that would

... cause these [C]hildren to potentially be in harm’s way moving forward as they get older. There’ s a concern that their educational ne eds are not going to be met. There’s a concern that thei r medical needs will not be met. And any of their other basic needs may not be met due to the [parents’] lack of responsibility and acknowledgment across the board, not just specifically the reasons that the kids came int o care.

Id. at 64

- 65.

The o rphans’ court credited Ms. Hobbs’ testimony, as well as the

testimony of Dr. O’Hara and Dr. Bliss. The orphans’ court explained :

The [c] ourt does believe Mother and Father when they express their love for these three children. However, the twins have been in care twenty

- seven consecutive months and the younger child has been in care since birth. The [c] ourt accepts the very credible testimony of Dr. O’Hara and Dr. Bliss, and agrees that thatJ

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termination meets the needs and welfare of these children and termination is in the Children’s best interest

. These parents had two individual evaluations by separate evaluators roughly eighteen months apart and these evaluations demonstrated that neither Mother nor Father were any further along in gaining the necessary judgment and insight to parent these chil dren

. Furthermore, Mother and Father failed to present any credible testimony or evidence to overcome the evidence that overwhelmingly supported this conclusion. This [c] ourt found that any potential negative impact [from termination] would be mitigated by the fact that [Children] have been in relative placement this entire time and have exposure and contact with additional, extended family members, who also love and support t hem

. For these reasons, the [c] ourt did not commit an error of law or abuse of discretion in finding that termination best met the needs and welfare of these children.

Orphans’ Court Opinion, 6/27/22, at 29

- 30 (emphasis added)

.
Consistent with the foreg oing , we discern no error by the orphans’ co urt

in terminating Mother’s parental rights under 23 Pa.C.S.A. § 2511 (b).

Orders affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq. Prothonotary

Date: 10/21/2022