1

Filed 2/2/23 Conservatorship of S.A. CA1/2

NOT TO BE PUBLISHED IN OFFICIAL REPORTS

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 This opinion has not been certified for publication or 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

FIRST APPELLATE DISTRICT

DIVISION TWO

Conservatorship of the Person 

of S.A.

CONTRA COSTA COUNTY 

PUBLIC GUARDIAN,

Petitioner and 

Respondent,

v.

S.A.,

Objector and Appellant.

 A164805

 (Contra Costa County

 Super. Ct. No. P21-01236)

S.A. appeals from an order of conservatorship under the LantermanPetris-Short Act. She contends the trial court erred in admitting psychiatric 

records under the business records exception to the hearsay rule that 

contained inadmissible multiple hearsay, opinions and conclusions. We 

affirm.

BACKGROUND

I.

The Petition

On August 26, 2021, the Contra Costa public guardian (public

guardian) filed a petition for appointment of temporary conservator and 
2

conservator of the person of S.A. (Welf. & Inst. Code, §§ 5350, 5352, 5352.1.) 

The petition alleged that S.A. was gravely disabled as a result of a mental 

disorder and unwilling to accept, or incapable of accepting, treatment 

voluntarily. A supporting declaration from a psychiatrist at John Muir 

Behavioral Health Center (John Muir) attested to S.A.’s grave disability and 

need for a conservatorship, with explanatory details set forth in the 

declaration of a treating therapist. An order appointing temporary 

conservator was filed the same day. 

S.A. had been admitted to John Muir on August 5, 2021, and was 

discharged on September 14, 2021. She subsequently entered a different 

psychiatric facility, Canyon Manor, where she remained at the time of trial. 

With S.A.’s concurrence, several hearing dates were continued until, at 

a hearing on January 11, 2022, S.A. objected to the petition and requested a 

“time not waived” court trial. Trial was set for January 25, then continued 

several more times until March 1. 

II.

The Trial

The sole witness at trial was clinical psychologist Dr. Jennifer 

Weinstein, who testified for the public guardian as an expert in psychology 

and grave disability. Weinstein interviewed S.A. at Canyon Manor on 

February 22, 2022, for about 40 minutes, which she testified was an adequate 

period of time to evaluate S.A. for grave disability. Weinstein also spoke with 

S.A.’s conservator, social worker and father, and reviewed records from John 

Muir and Canyon Manor. She testified that the medical records are the kind 

of records commonly relied upon in her field. Based on the interviews and 

her review of the medical records, Weinstein concluded that S.A. was gravely 

disabled. 
3

Weinstein diagnosed S.A. with schizophrenia. This diagnosis requires 

the presence for more than a month of two or more symptoms, one of which 

must be disorganized speech, delusions or hallucinations (“positive 

symptoms”) and the other of which may be a “negative symptom” such as lack 

of motivation, isolating oneself or difficulty with activities of daily living. The 

symptoms interfere with judgment, insight, cognition, and ability to plan and 

follow through on a plan, take care of needs like hygiene and shelter, and 

interact socially with appropriateness. Weinstein testified that schizophrenia 

is a chronic disorder but there may be times when symptoms are more severe 

and times when they are “more managed.” S.A. was taking Clozaril, an 

antipsychotic medication that requires a blood test every two weeks to 

monitor for a rare blood disease. Weinstein testified that medication can help 

reduce symptoms, case management can help maintain self-care and use of 

medication, and living in a structured placement can be a treatment for a 

patient who needs daily intervention assistance. 

A. S.A.’s Interview

Weinstein testified that S.A. was oriented to who and where she was 

during the interview on February 22. S.A. told Weinstein that prior to her 

placement she had tried to exit a vehicle “while being driven or about to be 

driven” by her case manager, and said that she would have been harmed if 

she had not tried to exit the vehicle. S.A. made comments that Weinstein 

deemed delusional, including that “in 2017 someone on drugs got into her 

body and made her overdose on DMT, which is a type of drug” and “ ‘[t]hey

got into my body and lifted up out of my body.’ ”

Weinstein testified that S.A. had “some insight” into having a mental 

health condition: S.A. said she had previously been diagnosed with 

“dissociative identity disorder amnesia and bipolar disorder” and “agree[d]
4

with those diagnoses, but [was] also diagnosed with schizoaffective disorder 

and [did] not agree with that diagnosis.” Weinstein explained that “insight” 

in this context means the patient’s understanding of her own psychiatric 

condition and needs for psychiatric care, which is often correlated with an 

ability to willingly engage in needed treatment. 

S.A. told Weinstein that her history of symptoms included auditory 

hallucinations, depression, anxiety and trouble focusing. She said she had 

previously taken the medication Invega Sustenna at a local clinic, and had 

been taking Clozaril for five months. She told Weinstein that if the 

conservatorship ended, she planned to live with her fiancé. She declined to 

give a name or number for the fiancé, saying she had had people stalk her, 

she did not feel comfortable sharing and she did not think he would want her 

to share his private information. S.A. told Weinstein that people had 

followed her to her fiancé’s house and said they would “light a bomb . . . [¶] 

[o]n fire” if she went to his house. Weinstein testified that paranoid 

delusions—concerns “that others are out to harm oneself” and “collaborating 

against oneself”—are a symptom of schizophrenia. 

B. Records-Based Testimony

Weinstein was asked about a number of entries in S.A.’s medical 

records from John Muir (exhibit 2) and Canyon Manor (exhibit 3), which were 

admitted over S.A.’s objections, with redactions, as business records under 

Evidence Code section 1271.

1 

1 Further statutory references will be to the Evidence Code unless 

otherwise specified.

Counsel for the public guardian offered the records into evidence under 

section 1271, stating that they were accompanied by declarations complying 

with section 1561. S.A.’s attorney objected that several entries within the 
5

Weinstein testified that an entry in exhibit 2 stating that “patient upon 

arriving to the unit continued to be very psychotic and disorganized,” and 

describing S.A. as “labile, agitated, aggressive towards staff and requiring 

physical restraint,” showed the psychiatric symptoms S.A. was suffering from 

when she transitioned from the community to the psychiatric facility. A 

description of S.A. as “appearing internally preoccupied, uncooperative and 

disorganized,” which are symptoms that “can significantly interfere with 

functionality” when unmanaged, supported the diagnosis of schizophrenia. 

Asked about the notation “active AH” in an August 9, 2021 entry, 

Weinstein testified that “AH” stands for auditory hallucinations. She 

testified that the entry, which read, “ ‘active AH, believes she’s possessed by 

Satan,’ ” was evidence of a symptom of schizophrenia that she relied upon in 

forming her diagnosis, and that auditory hallucinations and “delusional belief 

of possession” can interfere with thinking, judgment and decision-making. 

Weinstein testified that a note stating, “ ‘[r]eports being possessed by 

multiple persons’” was similar to a statement S.A. made during the 

February 2022 interview and revealed a delusion, which is a symptom of 

schizophrenia. Another note stated “ ‘DZ Zyprexa due to,’ quote, ‘it has a 

chemical in it that’s not good. I want to be back on the Seroquel.’ ” Weinstein 

testified that this entry “reveal[ed] that [S.A.’s] mental state or diagnosis or

delusion in this case interfered with her ability to accept treatment.” 

exhibits were inadmissible on hearsay or foundation grounds and asked the 

court to receive the exhibits subject to examination of the witness and 

objection to specific portions. The court received the exhibits subject to 

further redactions, and subsequently heard argument and ruled upon 

objections to specific portions. 
6

An entry from August 24 stated that S.A. was “still hearing the voice of 

Isaiah, her guardian angel” and felt comforted by this; an entry from 

August 26 said S.A. denied hearing Isaiah’s voice that day but still felt “in 

contact with him.” Weinstein testified that these records “reveal the patient’s 

belief that would be labeled a delusion about a contact with somebody who is 

otherwise known to others as a fantasy,” which is a symptom of 

schizophrenia. 

An October 14, 2021 entry in exhibit 3, the Canyon Manor records,

related that when asked about demons, S.A. said a peer “was possessed by 

the demon, and the demon transferred from the peer to her, and she felt it. 

She indicates that she prayed to St. Michael, and that it went away. And 

that St. Michael and her father are close, but she did not wish to discuss 

that.” Weinstein testified this was evidence of a paranoid delusional belief at 

a different period of time, further supporting the schizophrenia diagnosis. 

Weinstein saw further evidence of paranoid delusions in a

November 11, 2021 entry relating S.A.’s report that she “has anxiety when 

seeing people eating. She gets nauseated and cannot eat in public and then 

indicates demons gave her gluttony in the form of an eating disorder. [¶] And 

once she ate in a restaurant, and the waiter gave her quote, blood, guts, 

fingernails and eyeballs, end quote, instead of food.” Weinstein testified that 

these delusions “interfered with [S.A.’s] proper nourishment or ability to 

nourish herself.” 

A note from November 24, 2021, said S.A. planned to move to her 

fiancé’s cousin’s house but could not talk about her fiancé and said he was 

famous. Weinstein testified that this note affected her opinion about S.A.’s 

mental health condition in that the plan appeared to “potentially lack 

grounding in reality.” Weinstein testified that a belief about having a fiancé 
7

“could be a delusion” and a belief that the fiancé is famous was “possibly or 

likely a grandiose delusion,” which is a belief that “oneself or others 

connected to oneself are of a super extraordinary nature or have powers or 

are somehow extraordinary.” 

A further entry related that S.A. “ ‘indicates that the demons are less 

bothersome because she’s not at home, and then pauses and says she doesn’t 

believe in demons anymore,’ that it was, quote ‘set up by human people,’ end 

quote. And then: ‘She suspects people from high school who don’t like that 

she’s marrying a famous person harass her.’ ” Weinstein testified that this 

entry revealed paranoid delusions, confusion about whether the delusions 

exist and “paranoia about being harassed or set up by others.” 

A December 2021 note that reported S.A. saying she “doesn’t have 

distorted thoughts anymore and denies demons currently,” showed that S.A.’s 

“delusion beliefs” had changed; the same entry related that S.A. planned to 

discharge to her fiancé’s house, which indicated that a “possibly or likely a 

delusion” continued despite the change regarding the delusion about the 

demon. 

A note dated January 17, 2022, indicated that S.A. had started 

attending “higher functioning groups,” her participation was “limited” and 

she still did not understand why she was at Canyon Manor and wanted to be 

released from conservatorship. Weinstein testified that this note revealed 

that “while there has been some improvement in symptom reduction, her 

ability to grasp the reason behind her admission and her ability to 

meaningfully engage[] in the treatment is limited.” It also showed a 

“fixation” or “focus” on being released, which Weinstein had also observed in 

S.A. 
8

In Weinstein’s opinion, S.A. had “some insight” into the fact that she 

had a mental health “difficulty or diagnosis,” but it was “limited by her 

symptoms . . . and her diagnosis,” leaving her unable to understand the 

nature of her psychiatric condition and her need for the psychiatric care she 

was receiving. Asked if she believed S.A. would continue to take her 

medication if she was released from conservatorship, Weinstein said S.A. had 

not spoken of planning to stop taking her medication but opined that S.A. 

would not have enough assistance or structure in the community to support 

continuing her current medication regimen, with its required blood draw. 

Although S.A.’s symptoms had lessened since her admission to John Muir, 

Weinstein testified that symptoms “[m]ost often” return and become more 

severe when medication is stopped. 

Asked how S.A.’s mental disorder affected her ability to provide for her 

basic needs, Weinstein stated that S.A.’s symptoms—including paranoid and 

grandiose delusional thinking and auditory hallucinations—interfered with 

her ability to differentiate reality from fantasy, make decisions, take care of 

herself on a day-to-day basis, and use judgment. In Weinstein’s opinion, S.A. 

was not at that time able to “rationally advocate for herself in order to obtain 

shelter.” 

C. Cross examination

Weinstein testified on cross examination that during her interview S.A. 

said she was not currently experiencing symptoms of mental illness but a 

year and a half ago had heard voices for a week. S.A. said she had received 

an injection of Invega Sustenna at a clinic in September 2021 and had been 

receiving these shots on a monthly basis; she did not feel safe in the car with 

the case manager who was driving her to get the injections; and this case 

manager was the driver in the incident that occurred prior to her 
9

hospitalization. She told Weinstein that she had previously taken a different 

medication called Latuda, which Weinstein testified was a mental health 

medication. S.A. told Weinstein that she received $990 per month in Social 

Security disability payments and, if released from conservatorship, she would 

have her disability income changed to direct deposit and Uber to the grocery 

store or use a delivery service to obtain food. She also suggested an 

alternative post-discharge plan of working with the social worker at Canyon 

Manor to arrange for transfer to an “equal level” placement called Villa 

Fairmont. She told Weinstein she had been assaulted by a resident at 

Canyon Manor. 

D. Conclusion of the Trial

After the public guardian rested its case in chief and S.A. rested 

without presenting evidence, the court overruled S.A.’s general hearsay 

objection to exhibit 2, explaining that it had reviewed the document and 

found it trustworthy pursuant to Conservatorship of S.A. (2018) 

25 Cal.App.5th 438 (S.A.). The court recognized there could still be objections 

to specific entries and asked S.A.’s counsel to identify the portions he objected 

to. In addition to entries that appeared to be summaries or restatements of 

entries by other staff, counsel objected to entries “indicating a clinical 

judgment”—specifically, “poor insight,” “psychotic” and “processing or fully 

comprehending information.” The court overruled these objections. 

Regarding exhibit 3, S.A. objected to information that did not clearly 

come from within the facility or from S.A. herself, as well as

“recommendations, opinions, goals of the facility.” Counsel then stated 

objections to specific entries in exhibit 3. After hearing argument, the court 

overruled many of the objections and sustained others, resulting in further 

redactions. 
10

Following arguments on the merits, the court found S.A. was gravely 

disabled and was to “remain at the MHRC [Mental Health Rehabilitation 

Center] level.” The court found clear and convincing evidence to support 

imposition of three of the four disabilities the public guardian requested: 

S.A. was not permitted to have a driver’s license, to possess a firearm or other 

deadly weapon, or to enter into legal contracts. The court did not find clear 

and convincing evidence to support removing S.A.’s power to refuse or 

consent to treatment. 

DISCUSSION

Where specified conditions are met, the business records exception to 

the hearsay rule allows admission of a writing “made as a record of an act, 

condition, or event” “in the regular course of a business” to prove the act, 

condition or event. (§ 1271.) S.A. acknowledges that medical records may be 

admissible under the business records exception “to prove the acts, 

conditions, and events recorded therein.” (S.A., supra, 25 Cal.App.5th at 

p. 447; § 1271.) She argues, however, that much of the contents of the 

records here was not admissible because it did not satisfy requirements of the 

exception, including personal knowledge of the person who created the 

record, contemporaneous recording and demonstration of applicable 

exceptions for hearsay within the records. Her claims fall into two main (and 

sometimes overlapping) categories: Objections to admission of multiple levels 

of hearsay and objections to records relating opinions and conclusions rather 

than observations of acts, conditions or events. 

I. 

Governing Principles

“The business records exception requires a foundational showing that 

(1) the writing was made in the regular course of business; (2) at or near the 
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time of the act, condition, or event; (3) the custodian or other qualified 

witness testifies to its identity and mode of preparation; and (4) the sources of 

information and mode and method and time of preparation indicate 

trustworthiness.” (S.A., supra, 25 Cal.App.5th at p. 447; § 1271.) “These 

requirements may be satisfied by affidavit.” (S.A., at p. 447; § 1561.)2 “The 

trial court has wide discretion to determine whether there is a sufficient 

foundation to qualify evidence as a business record; we will overturn its 

decision to admit such records only upon a clear showing of abuse.” (S.A., at 

p. 447.)

“The key to establishing the admissibility of a document made in the 

regular course of business is proof that the person who wrote the information 

or provided it had knowledge of the facts from personal observation.” 

(Jazayeri v. Mao (2009) 174 Cal.App.4th 301, 322.) “Only that portion of the 

record is admissible which states facts which would be admissible had the 

person who made the record been called as a witness and had been examined 

in court; that is, only that portion of the record, made by one who could 

qualify as a perceptive witness to the matter recorded, is admissible.” (People 

v. Salcido (1966) 246 Cal.App.2d 450, 462.) Where a record contains 

statements of others, those statements cannot be admitted for their truth 

2 Section 1561 requires that records be accompanied by “the affidavit of 

the custodian of records or other qualified witness” and specifies the matters 

that must be addressed. Most relevant here is that “[t]he records were 

prepared by the personnel of the business in the ordinary course of business 

at or near the time of the act, condition, or event.” (§ 1561, subd. (a)(3).) 

S.A. does not raise any issues on appeal pertaining to the affidavits

accompanying the records; her claims focus on the content of particular 

entries within the records.
12

unless there is an applicable hearsay exception for each level of hearsay. 

(People v. Sanchez (2016) 63 Cal.4th 665, 674-675.)

Psychiatric records have been distinguished from what S.A. calls

“purely medical” records in that psychiatric records “tend to be opinions, 

rather than the record ‘of an act, condition or event’ which is admissible 

under Evidence Code section 1271” and a “psychiatric diagnosis is often 

merely the reasoning or thought process of the psychiatrist rendering the 

opinion, and as such cannot be deemed to be the record ‘of an act, condition or 

event.’ ” (People v. Young (1987) 189 Cal.App.3d 891, 912; People v. Reyes 

(1974) 12 Cal.3d 486, 503.) Reyes commented on the distinction between such 

a psychiatric diagnosis and one based on straightforward observation: “ ‘ “It 

is true that some diagnoses are a statement of a fact or condition, for 

example, a diagnosis that a man has suffered a compound fracture of the 

femur is a record of what the person making the diagnosis has seen[,] but this 

is not true where the diagnosis is but the reasoning of the person making it

arrived at from the consideration of many different factors.” ’ ” (Ibid.)

The trial court in the present case took particular guidance from S.A., 

which held that a conservatee’s medical records, redacted for “conclusions, 

opinions, and remote or immaterial matters” she identified, were admissible 

under the business records exception. (S.A., supra, 25 Cal.App.5th at 

pp. 442, 447.) Rejecting the conservatee’s arguments that the medical 

records were inadmissible hearsay and an expert witness improperly testified 

to case-specific facts in the records that were not otherwise proven, S.A. 

explained: “S.A. argues that not every entry expressly states that the person 

who recorded it was the direct observer. She points, for example, to an entry 

that begins ‘Per staff . . . ’ and questions whether the writer witnessed the 

events. But the trial court considered these arguments, reviewed the records, 
13

and found the [facility] records were ‘clearly the reports of persons and staff, 

licensed psychiatric technicians, . . . who are reporting [S.A.’s] observed 

conduct’ and the board and care facility records were ‘obviously the 

observations . . . of the people in the psychiatric program.’” (S.A., at p. 448.)

With respect to expert testimony based upon medical records, “[a]n 

expert witness may rely on hearsay in forming an opinion, and may tell the 

jury ‘in general terms’ that she did so, but may not ‘relate as true casespecific facts asserted in hearsay statements, unless they are independently 

proven by competent evidence or are covered by a hearsay exception.’ ” (S.A., 

supra, 25 Cal.App.5th at p. 448, quoting People v. Sanchez, supra, 63 Cal.4th 

at pp. 685-686.) Sanchez applies to conservatorship proceedings. (S.A., at 

p. 448; Conservatorship of K.W. (2017) 13 Cal.App.5th 1274, 1284.)

II.

Analysis

A. S.A. Has Not Demonstrated an Abuse of Discretion 

Regarding Multiple Hearsay.

S.A. argues that exhibits 2 and 3 contained multiple hearsay that the 

trial court erroneously admitted without requiring the public guardian to 

establish a hearsay exception for each level. 

S.A. describes exhibit 2 as a five-page summary drafted by Ameek S. 

Mundi, DO, that provides an overview of S.A. for each day she was detained 

at the facility but does not state that the information was known to Dr. 

Mundi personally or identify the source of the information, so that “[e]very 

entry contains an unknown level of hearsay.” She contends the trial court 

erred in treating statements from one staff member to another as reliable, 

citing two pages of the reporter’s transcript that reflect questions based on 

particular entries in exhibit 2. As to exhibit 3, S.A. points to a number of 
14

specific entries: She argues it is unclear whether statements attributed to 

her were made directly to the social worker who wrote an assessment 

appearing at page 8; some of the weekly progress reports at pages 52-57 

include a section that summarizes information received from other 

employees; an intake report at pages 58-59 refers to log notes from John Muir 

containing statements by S.A.’s family and outpatient social worker as well 

as psychiatric and social history; and it is “unclear” whether information 

stated in “comment boxes” in weekly progress reports at pages 70, 74 and 75 

was known personally to the comment writer. 

S.A.’s arguments fail for several reasons. First, for many of the entries 

she challenges, S.A. provides citations only to exhibits 2 or 3, neither of which 

was included in the record on appeal. Consequently, our review is limited to 

what we can glean from discussion of the exhibits at the hearing. The 

discussion reflected in the reporter’s transcript is often insufficient to permit 

consideration of a given entry in context without reference to the document 

itself. It is S.A.’s burden to provide an adequate record to assess error, and 

failure to do so requires that the issue be resolved against her. (Hernandez v. 

California Hospital Medical Center (2000) 78 Cal.App.4th 498, 502.) S.A. 

thus has not satisfied her burden of affirmatively demonstrating error (ibid.) 

with respect to many of the entries she challenges.

Second, some of S.A.’s challenges are to entries that the reporter’s 

transcript indicates may in fact have been redacted. For example, with 

reference to pages 56, 57 and 58 of exhibit 3, the trial court agreed that an 

“intake report” relating statements from “the case manager” appeared to 

come from an external source—i.e., did not relate observations from staff at 

Canyon Manor. Counsel for the public guardian agreed that a portion of 

another note on page 58, also reflecting information obtained from another 
15

facility at intake, should be redacted, and the court stated it would not look 

at this information. The court held that a passage on page 58 that was 

ambiguous as to whether the information came directly from S.A. would be 

redacted, as would a report of prior diagnoses that did not clearly come from 

S.A. and another passage on page 59 that S.A.’s attorney viewed as 

speculative and counsel for the public guardian did not object to redacting. 

Third, from our review of the reporter’s transcript, we see no basis for 

finding the trial court abused its discretion in admitting the entries it found 

to come within the scope of the business records exception. 

The foundation of S.A.’s claim is that many of the entries in the records 

do not expressly state that the matter related was personally observed by the 

individual who wrote the entry. S.A. argues that the trial court could not 

know a source was trustworthy (§ 1271, subd. (d)) without knowing who the 

source was, could not know whether multiple layers of hearsay were relayed 

without knowing where the source obtained the information, and could not 

determine whether an entry was made close in time to the incident (§ 1271, 

subd. (b)) without knowing when the incident was witnessed. 

We are aware of no requirement that each entry in medical records 

such as these specify its author or expressly state that the author observed 

the recorded incident, and the decision in S.A., supra, 25 Cal.App.5th 438, is 

to the contrary. S.A. rejected the argument that entries lacking an express 

statement of personal observation were inadmissible because the trial court, 

which had considered the conservatee’s arguments and reviewed the records, 

concluded the entries were “ ‘clearly the reports of persons and staff, licensed

psychiatric technicians, . . . who are reporting [the conservatee’s] observed

conduct’ ” and “ ‘obviously the observations . . . of the people in the psychiatric

program.’ ” (Id. at p. 448.) The same conclusion is implicit here in the trial
16

court’s finding that the entries were from a trustworthy source within the

facility. (See also People v. Orey (2021) 63 Cal.App.5th 529, 551-552

[trustworthiness, in context of public employee record exception (§ 1280)

“may be established by showing that a written report is based on the

observations of a public employee who has a duty to observe the events and to

report and record them accurately”].)3 To the extent the entries in exhibits 2

and 3 related S.A.’s conduct and statements—as opposed to diagnoses and

evaluations of her condition, as will be discussed—they were records written

by staff whose job it was to record observations relevant to S.A.’s treatment 

in the regular course of their employment at the facility.

We are also unaware of any requirement that individual entries specify

they were made at or near the time of the observation recorded. Part of the

required foundation for admission under section 1271 is an affidavit from the

custodian of records attesting that “[t]he records were prepared by the 

personnel of the business in the ordinary course of business at or near the 

time of the act, condition, or event.” (§ 1561, subd. (a)(3).) S.A. does not 

claim the custodian’s declaration in this case lacked this attestation and, 

having failed to include the records or accompanying declarations in the 

appellate record, has not demonstrated any such error.4

3 Both the business records exception and the public employee records 

exception require that “[t]he sources of information and method and time of 

preparation were such as to indicate its trustworthiness.” (§§ 1271, subd. (d),

1280, subd. (c).) 

4 S.A. notes that the custodians’ declarations do not assert the entries 

were written by the person who witnessed the event described or that only 

events witnessed by staff were documented. She cites only to exhibits 2 and 3 

and, as we have said, she did not make the exhibits part of the record on 

appeal. 
17

The trial court properly relied upon S.A. to rule that entries describing 

observations of “trustworthy source[s]” “within the facility” were admissible 

under section 1271. This included entries relating statements made by S.A., 

which were admissible as party admissions. (§ 1220.)5 As noted above, the 

trial court redacted entries relating information that appeared to come from 

sources outside the facility or did not clearly appear to have come from S.A.’s 

own statements.

For instance, as indicated above, S.A. cites two pages of the reporter’s 

transcript in connection with her assertion that the trial court erroneously 

admitted statements from one staff member to another. At the first of these 

pages, the trial court overruled S.A.’s objection to a question asking 

Weinstein about an August 9 note referring to “active AH,” which Weinstein 

testified stands for auditory hallucinations. S.A. argued at trial that the 

reference was inadmissible without a showing of how the author of the note 

learned the information and concluded there was a hallucination, and she 

now contends the trial court erred in accepting the public guardian’s position 

that the business records exception does not require that a record list “ ‘who 

heard what when.’ ” As S.A.’s counsel acknowledged at trial, the note 

continued, “believes she’s possessed by Satan,” thus implicitly explaining that 

S.A. voiced the delusional belief. In overruling the objection, the trial court 

stated that “[g]iven the context of the notes,” the second statement provided a 

trustworthy basis for the first and “the entries as a whole appear to be from 

within the facility and from a trustworthy source.” 

5 S.A. recognizes that such statements are admissible if reported by 

the individual who directly heard her make them; her objection to these 

entries is that they do not affirmatively demonstrate she made the 

statements to the author of the entry. 
18

At the second page S.A. cites, the trial court overruled her objection to a 

question about an August 10 entry that stated, “Reports being possessed by 

multiple persons.” S.A. objected that there was a “long sequence of entries on 

different dates,” which counsel viewed as possibly including multiple layers of 

hearsay because it appeared the author was summarizing others’ reports

rather than contemporaneously recording an incident. The public guardian

pointed to the declaration of the custodian of records stating these were

records of acts, conditions or events “as regularly taken and recorded in the 

course of this business,” and the court overruled the objection. 

The reporter’s transcript reflects that the trial court carefully 

considered each entry to which S.A. objected: The court heard, considered 

and ruled on S.A.’s objections to Weinstein’s testimony based on the medical 

records as they arose during the course of that testimony, then later heard, 

considered and ruled on additional objections to the documents themselves.6 

We find no abuse of discretion in its determination that entries in S.A.’s 

medical records, by staff whose job it was to record their observations of 

S.A.’s conduct, were trustworthy and made in the regular course of the 

facility’s business. (S.A., supra, 25 Cal.App.5th at p. 448.)

6 As one example of the court’s attention to hearsay issues, during its 

discussion of the records with counsel, after agreeing that an entry in 

exhibit 3 should be redacted because the information appeared to come from 

an “external source,” the court interjected that an entry in exhibit 2 had the 

“same report of the exiting vehicle” that “seem[ed] to come from an external 

source” and commented, “the end result is that I have that information in 

this case from [S.A.], but I want to respect the Hearsay Rule for its purposes.” 
19

B. The Trial Court Did Not Abuse Its Discretion in Admitting

Records Reflecting S.A.’s Observed Conduct.

S.A. contends the trial court erroneously admitted entries that related 

inadmissible opinions and conclusions rather than the acts, conditions or 

events permitted under section 1271. Specifically, she points to entries in 

exhibit 2 stating she was “ ‘unable to engage in an interview,’ ” “ ‘very 

psychotic,’ ” “ ‘disorganized,’ ” “ ‘labile,’ ” “ ‘aggressive towards staff,’ ” 

“ ‘responding to internal stimuli,’ ” “ ‘internally preoccupied,’ ” had “ ‘poor 

insight,’ ” had “ ‘paranoid delusions,’ ” had “ ‘auditory hallucinations and 

delusional thinking,’ ’’ was “ ‘showing improvement,’ ” was “ ‘anxious but 

otherwise doing ok,’ ” and was “ ‘not agitated, aggressive, or threatening.’ ” 

In S.A.’s view, while an entry stating that she was seen talking to someone 

when she was alone in the room, or quoting something she said, would be an 

admissible observation, the above remarks are inadmissible opinions and 

conclusions “filtered through the mental process of the writer.” Similarly, 

regarding exhibit 3, S.A. references a social worker’s report at page 8 that 

“intertwines statements made by [S.A.] with opinions and conclusions”;

weekly progress reports at pages 52-57 that include sections describing the 

doctor’s impressions of S.A. that day (“MSE”), relating “items the doctor 

considers important” (“IMP”) and providing instructions to staff for the 

coming week (“Plan”); and a report at page 66 that contains the social 

worker’s conclusion regarding S.A.’s “threat risk” as well as descriptions of 

the social worker’s observations. 

Again, to the extent S.A.’s challenges to the trial court’s rulings depend 

on citation to pages in exhibits 2 or 3, her failure to include the exhibits in 

the appellate record compels us to find she has not affirmatively 

demonstrated error. For instance, we have no means of evaluating S.A.’s 
20

assertion that the social worker’s report at page 8 of exhibit 3 “intertwines 

statements made by [S.A.] with opinions and conclusions.” S.A. does not 

point to any discussion of this entry on the record that might illuminate its 

details, and our review of the reporter’s transcript discovered references to 

page 8 only in connection with objections to information derived from sources 

outside the facility. 

Additionally, as with the multiple hearsay objections discussed above, 

some of the entries S.A.’s appellate briefs challenge as opinions and 

conclusions appear to have been redacted by trial court. For example, the 

entry at page 66 of exhibit 3 to which S.A. objected at trial was redacted7 and 

the court sustained S.A.’s objection to the “plan” portion of the entries. 

As for S.A.’s general contention that the trial court erroneously 

admitted entries relating opinions and conclusions, we disagree. While 

courts have observed that a psychiatric diagnosis “tend[s] to be [an] opinion[]” 

based on “the reasoning or thought process of the psychiatrist rendering” it 

(People v. Young, supra, 189 Cal.App.3d at p. 912; People v. Reyes, supra, 

12 Cal.3d at p. 503), an observable psychiatric symptom is an “act, condition 

or event” within the meaning of section 1271. S.A. views descriptions in the 

records such as “psychotic,” “aggressive,” “responding to internal stimuli,” 

“delusional” and having “poor insight” as conclusions and opinions because 

they do not relate what the observer saw in literal terms: As earlier noted, in 

7 S.A. does not explain in her opening brief what she means by the 

social worker’s “conclusion” regarding her “threat risk”; her reply brief refers 

to page 66 as containing a “ ‘client unsafe behavior assessment’ ” that is then 

referred to as a “risk assessment.” At trial, referring to page 66 of exhibit 3, 

S.A.’s attorney objected to an entry describing S.A. “fidgeting, saying that she 

wants to go into a facility where she could smoke” and stating, “ ‘This may be 

a reason for her to attempt AWOL.’ ” 
21

S.A.’s view, to be admissible, an entry would have to state that she was seen 

talking to someone when she was alone in a room rather than that she was 

hallucinating or delusional, or quote something S.A. said without 

characterizing it as a threat or a delusion.

The trial court viewed the challenged entries as “observations of staff 

who are not lay people” but rather “trained professionals of varying degrees.” 

In the context of medical records from a psychiatric facility, the court saw 

terms such as “psychotic” or “lack of insight” as “boiling down a series of 

behaviors into one description . . . without being a diagnosis.” We agree. In

this context, entries stating S.A. appeared “aggressive,” “delusional,” and 

“psychotic” described S.A.’s conduct and condition; they were more like 

“terms of art,” as the public guardian characterized them, than reasoned 

diagnoses based on consideration of multiple factors. 

S.A.’s analogy to Palmer v. Hoffman (1943) 318 U.S. 109 (Palmer) is

unpersuasive. Palmer held that a railroad employee’s accident report, 

although made in the regular course of business, was not a routine record of 

the business’s day-to-day operations within the meaning of a business records 

exception. The Court explained that the purpose of the exception was to 

lessen the time and expense required to use in litigation records that were 

“considered reliable and trustworthy for major decisions in the industrial and 

business world.” (Id. at p. 112.) As the Court observed in a subsequent case, 

the accident report “did not qualify as a business record because, although 

kept in the regular course of the railroad’s operations, it was ‘calculated for 

use essentially in the court, not in the business.’ ” (Melendez-Diaz v. 

Massachusetts (2009) 557 U.S. 305, 321, quoting Palmer, at p. 114.)

S.A. contends the log notes in exhibits 2 and 3 are “more like accident 

reports discussed in Palmer than systematic and routine entries” in that each 
22

entry “is the product of a writer making a judgment that a particular incident 

or issue is significant, and is filtered through that judgment,” and the “filter 

may include more than one person’s perception.” To the contrary, Palmer 

supports the admissibility of the records at issue here. S.A.’s medical records 

are trustworthy precisely because they document the observations of staff 

whose job was to record such observations, which were relied upon in the 

course of the facility’s day-to-day business of assessing and treating 

psychiatric patients.

As we have said, the trial court “has broad discretion in admitting 

business records under Evidence Code section 1271” (People v. Dorsey (1974) 

43 Cal.App.3d 953, 961), and “it has been held that the foundation 

requirements may be inferred from the circumstances.” (Ibid.) The trial 

court here distinguished between a diagnosis, which all recognized would not 

be admissible as a business record, and observations made by facility staff 

whose job was to keep records of S.A.’s behavior and condition for use in her 

assessment and treatment. We find no abuse of discretion.

DISPOSITION

The judgment is affirmed. 
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STEWART, P.J.

We concur.

RICHMAN, J.

MARKMAN, J. *

Conservatorship of S.A. (A164805)

*

 Judge of the Alameda Superior Court assigned by the Chief Justice 

pursuant to article VI, section 6 of the California Constitution.