Filed 12/17/21 In re D.Y. CA2/2

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IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION TWO

In re D.Y., a Person Coming 

Under the Juvenile Court Law.

 B310206

 (Los Angeles County

 Super. Ct. No.

 20CCJP05478A)

LOS ANGELES COUNTY 

DEPARTMENT OF CHILDREN 

AND FAMILY SERVICES,

Plaintiff and Respondent,

v.

H.L. and H.Y.,

Defendants and Appellants.

APPEALS from orders of the Superior Court of Los Angeles

County. Julie Fox Blackshaw, Judge. Jurisdictional order 

affirmed and remaining appeal dismissed.
2

Annie Greenleaf, under appointment by the Court of 

Appeal, for Defendant and Appellant H.L.

Megan Turkat-Schirn, under appointment by the Court of 

Appeal, for Defendant and Appellant H.Y.

Rodrigo A. Castro-Silva, County Counsel, Kim Nemoy, 

Assistant County Counsel, and Jane Kwon, Principal Deputy 

County Counsel, for Plaintiff and Respondent.

__________________________________________

The juvenile court found H.L. (mother) and H.Y. (father) 

responsible for their infant son D.Y.’s (son) repeated and 

unexplained bruising. Consequently, the juvenile court exercised 

its dependency jurisdiction over son under Welfare and 

Institutions Code section 300, subdivisions (a) and (b).1 The 

juvenile court removed son from his parents’ custody and, among 

other things, ordered mother and father to participate in a 

parenting course.

On appeal, mother and father challenge the juvenile court’s 

jurisdictional finding under subdivision (a) of section 300. 

Although mother and father do not challenge the juvenile court’s 

jurisdictional finding under subdivision (b) of section 300—and, 

thus, dependency jurisdiction remains regardless of our decision 

here—we consider the parents’ appeals because of the 

ramifications of the court’s true finding under subdivision (a). 

Mother and father also appealed the juvenile court’s dispositional 

orders. However, subsequent proceedings in the juvenile court 

have rendered those issues moot, and we do not address them 

here.

1 Undesignated statutory references are to the Welfare and 

Institutions Code.
3

As discussed below, we conclude substantial evidence 

supports the juvenile court’s jurisdictional finding under section 

300, subdivision (a). Thus, we affirm.

BACKGROUND

1. Events Preceding Petition

Son is mother and father’s only child. Mother and father

are son’s only caregivers, with mother being the primary 

caregiver. Mother and father were born in China and have lived 

in the United States for a number of years. They both speak

Mandarin and were assisted by Mandarin language interpreters 

during the dependency proceedings below.

a. Son’s September 2020 Hospitalization

In September 2020, when son was five weeks old, mother 

noticed swelling and redness on his left ear. At first, mother 

thought an insect had bitten son’s ear. However, because the 

mark became progressively worse over the course of a few days, 

mother brought son to an emergency room. The “ER Physician 

Note” from that visit indicates son was diagnosed with left ear 

edema and mother was advised “to try conservative measures 

such as ice first before follow-up with scheduled appointment 

with pediatrician.”

Two days later, mother brought son to see his pediatrician, 

Dr. Eva Chan. Dr. Chan diagnosed son with hemangioma and a 

heart murmur. She explained the hemangioma would disappear 

within five to seven years.

2 However, because the lesion was on 

2 At the adjudication hearing, expert witnesses explained 

the difference between a hemangioma and a hematoma, which 

distinction is central to this case. According to the Department’s 

expert, a “hemangioma is a benign noncancerous tumor. It’s a 

result of proliferation of blood vessels.” The expert further 
4

son’s ear and was growing fast, Dr. Chan referred son to a 

pediatric dermatologist. (Dr. Chan also referred son to a 

pediatric cardiologistfor his heart murmur.) Mother stated Dr. 

Chan told her if she did not want to wait for her insurance 

company to process the medical referrals, mother could take son 

to Children’s Hospital Los Angeles (hospital) for assessment right 

away. Mother decided to take son to the hospital later that same 

day.

Hospital records indicate son was admitted “with bruising 

along the [left] ear and along the [left] axilla/proximal upper arm”

(i.e., the armpit area). Because there was “no mechanism to 

explain the bruising,” son was admitted to the hospital for a 

nonaccidental trauma workup. Mother stayed with son at the 

hospital for five days. Hospital notes indicate a consultation was 

ordered with both “hematology to rule out bleeding disorders” 

and “ENT for the ear hematoma,” which it was noted “likely will 

explained, “Hemangiomas are very different than hematomas” in 

that hemangiomas “have a very predictable course. . . . [T]hey 

tend to proliferate, meaning get bigger, usually within the first 

three months. Then they will go through a period of either no 

further growth or very slow growth. It’s usually around nine to 

twelve months, maybe a little longer. Then they start to 

inviolate, meaning they start to go away. They can take years 

before they completely go away.” In contrast, the expert stated a 

hematoma “is a collection of blood or a blood clot from injury to 

the [t]issue.” A hematoma “heals, resolves. The blood reabsorbs.”

Significant deep tissue hematomas could take weeks to resolve.

Similarly, the defense expert testified, “a hemangioma is

. . . a natural occurring event . . . a disease process, a diagnostic 

condition, whereas a hematoma is pretty much a traumatic 

event. And in that situation, trauma has to be determined to be 

either accidental or non-accidental.”
5

need to be evacuated in the OR.” Son was also referred to 

ophthalmology to rule out a retinal hemorrhage, cardiology 

because of his heart murmur, as well as pediatric surgery. Son 

had “an extensive hematologic workup that was negative, and 

imaging that was indeterminate for a vascular malformation 

versus hematoma.” The swelling and discoloration of son’s left 

ear “significantly decreased” during his stay at the hospital.

When son was discharged a few days later, mother and 

father were instructed to make follow-up appointments with the

dermatology clinic, pediatric surgery, and ENT-Otolaryngology, 

as well as to return to Dr. Chan for son’s next scheduled 

appointment. Son’s diagnosis at discharge was “Left ear 

hemangioma, unconjugated hyperbilirubinemia [jaundice], 

bilateral axillary [armpit] nodes.”

On October 6, 2020, mother brought son for his next 

routine appointment with Dr. Chan, during which son received 

scheduled vaccinations and Dr. Chan performed a physical 

examination of son. Dr. Chan did not observe any new bruises or 

injuries on son’s body. She noted son had been seen at the 

hospital and was “evaluated for the Hemangioma, according to 

mom, Ultrasound and MRI of the head showed normal results 

with no abnormalities and was advised to observe with no 

intervention.”

b. Son’s October 2020 Hospitalization

A few days later, on October 9, 2020, mother brought son 

for his follow-up visit with the hospital’s dermatology clinic. The 

doctor noted “the lesion [on son’s ear] improved and continues to 

decrease in size and there is a small firm nodule suggestive of a 

resolving auricular hematoma.” Also during that appointment, 

however, an unexplained bruise was seen “spanning his left 
6

lateral abdominal wall.” As a result, the doctor referred son back 

to the hospital, where he was admitted and stayed for two days.

Mother stated she had seen a bruise on son’s torso the day 

before when she was changing his diaper. She did not know why 

son had a bruise but speculated maybe it was because she had 

held him tightly while bathing him. Mother told a hospital social 

worker that, the day before, son had a “regular bath” and she did 

not see bruising at that time but perhaps she had held him “too 

hard.” Father indicated he had not seen bruising on son’s chest

and believed such bruising must have occurred at the hospital. 

However, father had seen a bruise on son’s ear and guessed it 

might have happened if mother had held son too tightly while 

bathing him. Father said neither he nor mother harmed son. He 

felt no one was “telling him and the mother what is going on with 

the child.” After researching on-line, father believed son might

have a blood disease.

Nurses at the hospital reported mother was appropriate 

with son during his hospitalization.

The hospital medical team conducted a number of tests to 

determine a potential cause or causes for son’s bruising. In 

addition to a general examination, a pediatric surgeon and an 

ophthalmology resident doctor examined son. He also underwent 

both an “x-ray skeletal survey” and CT brain scan. Medical 

issues were ruled out as the cause of son’s injuries. Hospital 

notes stated, “No medical etiology could be identified to explain 

[son’s] diagnosis.” According to a hospital child abuse team, son’s 

bruising was consistent with child abuse.

The attending pediatric emergency medicine physician, Dr. 

Jeffrey Birnbaum, indicated “strong opposition to [son] being 

discharged” from the hospital. Dr. Birnbaum noted his concerns
7

included the fact “that this is [son’s] second presentation for 

traumatic injury with unclear mechanism. Mother did not seek 

care for bruising today, it was noted at a follow-up appointment 

with dermatology.” Dr. Birnbaum also noted that, during son’s

first hospital stay, son had an “extensive workup” that was 

“unremarkable” and “negative.” As a result, Dr. Birnbaum felt 

hematologic abnormality was unlikely and suspected

nonaccidental trauma. He noted that although previously there 

“[w]as concern over a vascular malformation of ear but now with 

findings on abdomen, less likely.” Hospital notes also indicated 

son’s “left ear remains fuller than his right ear but the hematoma 

is largely resolved.”

A hospital social worker referred the case to the Los 

Angeles County Department of Children and Family Services 

(Department). Soon after the referral was made, a Department 

social worker spoke with hospital staff as well as with mother 

and father. The social worker determined it was in son’s best

interest to be detained and placed in foster care. Mother and 

father consented and asked that son be placed with Asian Pacific, 

preferably Chinese, caregivers. The Department detained son 

and placed him in foster care.

The Department reported potential child abuse of son to 

the Los Angeles County Sheriff’s Department. A sheriff’s deputy 

responded to the hospital and interviewed Dr. Birnbaum and 

mother. Dr. Birnbaum told the deputy “several medical tests had 

been conducted on the child and [the doctor] found no evidence of 

trauma. However, he along with medical staff were concerned 

about possible abuse to the child as this was the second time 

treating the child in the past two weeks for the same [type] of 

injury.” Mother told the deputy she had brought son to the 
8

hospital for a follow-up dermatology appointment related to his 

ear. She said she informed the doctor of the bruises on son’s 

torso. Mother was concerned son may have a blood disease and 

she wanted him to undergo medical tests. She further explained 

she “was sure” the bruising to son’s torso occurred the day before 

when she was bathing son and he slipped into the tub causing 

mother to grip him tightly with both hands. Mother told the 

deputy “she was upset with medical staff for their accusations of 

abuse on her child. She further stated she came to the hospital

for help regarding the bruising and was in disbelief the medical 

staff made accusations of abuse when she was the one who 

brought the bruises to their attention.”

The deputy reported he saw three bruises on son’s left torso

area, which “were consistent with [mother’s] explanation on how 

her son received them.” The deputy was unable to determine if a 

crime had occurred and recommended “follow-up to determine if 

any form of child abuse is occurring.”

2. Petition

On October 14, 2020, the Department filed a three-count 

section 300 petition on behalf of son (petition). The petition 

alleged one count under section 300, subdivision (a) and two 

counts under subdivision (b). The subdivision (a) count was 

identical to the first subdivision (b) count, which alleged son was 

at risk of serious physical harm because of bruising and swelling 

on his body that was “consistent with non-accidental trauma.” 

Those counts alleged mother’s explanations for how son sustained 

his injuries were not consistent with the injuries and father 

provided no explanation for the injuries. The remaining

subdivision (b) count alleged son was at risk of serious physical 

harm because parents “failed to obtain timely necessary medical 
9

treatment” for son’s injuries. The petition noted the Department 

would be relying on section 355.1, subdivision (a) “to assert that a 

rebuttable presumption exists finding that the minor is a person 

described by” subdivisions (a) and (b) of section 300.

At the detention hearing held a few days later, the juvenile

court noted it was “sympathetic to the parents; however, this is a 

very low burden. Based on the severity of the bruises, further 

investigation needs to take place; but in light of the allegation, 

pursuant to [section] 355.1 (a) the rebuttable presumption, the 

court finds that there is a prima facie case for detaining the child 

and showing the child is a person described by [section] 300.” 

The court ordered son detained from parents and placed in foster 

care. Parents were granted monitored visitation with son. The 

court also ordered the Department to have son tested for 

hemangioma.

3. Further Investigation

The Department continued its investigation and, in late 

November 2020, filed its jurisdiction and disposition report with 

the court. The report indicated that, in mid-November 2020, a

Department social worker spoke with son’s foster parent, who 

reported son was doing well. The foster parent took photographs 

of son before and after his monitored visits with mother and 

father and no new bruising or marks had appeared. On one 

occasion, however, mother stated she observed a bruise on son’s 

left abdomen during a monitored visit. She showed a photograph 

of the bruise to a Department social worker, who reported seeing 

“a bluish color bruise to the left abdomen area on the picture.”

Foster parent’s photographs of son taken prior to the monitored 

visit that same day, however, showed no bruising.
10

The social worker also spoke with mother and father. Both 

mother and father reiterated what they previously had said 

regarding son’s ear and other markings. They stated Dr. Chan 

and the hospital had diagnosed son with a left ear hemangioma 

and were told it would disappear or get smaller over time. 

Neither knew why son had bruising, but believed it was possible 

mother had held son too tightly while bathing him. Father 

thought some of the bruising might have occurred while son was 

hospitalized in October. Mother and father denied any abuse of 

son and explained they had sought timely medical attention for 

son and followed the doctors’ instructions. Both wanted son back 

home in their care as soon as possible. Mother and father had

enrolled in parenting classes.

The social worker followed up with the hospital on the 

juvenile court’s October 2020 order that son be tested for a 

hemangioma. The hospital responded: “Skin hemangiomas 

(birthmarks) are typically based on clinical diagnosis with no 

additional specific studies required. Evaluating [son’s] clinical 

course since presentation, his ear findings are consistent with a 

resolving hematoma, with no current evidence of a hemangioma.”

The social worker also communicated with child abuse 

pediatrician Dr. Catherine DeRidder, requesting her opinion on 

the case. The social worker sent to Dr. DeRidder medical reports 

from the hospitals and doctors who had evaluated son. The 

following day, Dr. DeRidder responded by e-mail, stating she had 

reviewed the documents and believed “ ‘the PMD physician may 

just have not known what was going on with the ear and thought 

that a hemangioma was one possibility but it seems with the 

continued bruising and negative work-up for bleeding disorders, 

that physical abuse is highly likely in this case.’ ” Dr. DeRidder 
11

also stated son “ ‘does have so many bruises which is the most 

common finding in physical abuse.’ ”

The social worker communicated with a sheriff’s detective 

who had interviewed mother and father. The detective stated he 

did “not have concern as to physical abuse” and was “waiting for 

the Department’s investigation outcome.”

In addition, the social worker spoke with Dr. Chan, who 

explained the difference between a hemangioma and a 

hematoma. Dr. Chan stated “hemangioma is the accumulation of 

blood vessels before . . . birth” while hematoma “is the 

accumulation of blood vessel in a certain area of [the] body due to 

trauma from outside.” Dr. Chan noted although hemangioma 

could happen on different parts of the body, it does not cause the

body to bruise more easily. She explained bruises from 

hemangioma last longer than bruises caused by an outside force 

or trauma, stating hemangioma bruises “would last for several 

weeks or 1–2 months.”

In late December 2020, the Department filed a last minute 

report with the court indicating mother and father had completed 

their parenting education program and had continued monitored 

visits with son without incident. It was reported mother and

father “took care of [son] appropriately during the visits. They 

fed him, changed his diaper, and played with him. There were no 

concerns reported.” In a later report for the court, however, the 

Department explained the parenting program parents completed 

did not address the needs of children son’s age but rather taught 

parenting skills relevant to older children. The Department 

asked the juvenile court to order parents to complete a 52-week 

parenting education program that addressed caring for a young

infant.
12

In that same report, the Department also noted mother and 

father often expressed their desire to have son back in their care. 

They did not know how he got the bruises but they insisted they 

never abused him. The Department believed “parents need to 

learn positive stress and anger management focusing on healthy 

ways to cope with stress and anger on why [son] was detained 

from their care, and how this affects them in providing a safe 

care for [son]. The parents’ stress and anger management 

remains a concern for [the Department].” The Department asked 

the court to order mother and father to participate in individual 

counseling.

4. Expert Reports

Prior to the adjudication hearing, the parties submitted 

expert reports for the court.

a. Dr. Karen Imagawa and Amara McHale, FNP-C.

The Department submitted a report by Dr. Karen Imagawa 

and Amara McHale, FNP-C. This report summarized son’s 

September and October 2020 hospitalizations, related medical 

records, and postdischarge follow-up appointments. The report 

concluded: “Based on [son’s] clinical findings, the extensive (nonrevealing) work-up performed, the progression to complete 

resolution of the previously noted concerning findings . . . , and no 

recurrence of any of the concerning findings since placement, it 

appears that: [¶] – The ear findings were a traumatic ear 

hematoma, which subsequently resolved. The left cheek bruise 

also resolved. [¶] – The axillary [armpit] discoloration and masses 

were bruises with underlying hematomas, which subsequently 

resolved. [¶] – [Son] also sustained bruising to his trunk, which 

also progressively resolved.”
13

The report also noted that “bruising should not occur with 

routine daily handling of an otherwise healthy infant (such as 

[son]), and the reported hypothesized cause of the trunk bruising 

raised by mother does not appear to be an adequate explanation 

particularly since she notes that the incident was a ‘regular’ bath

and not an incident during which something occurred in which 

she would have grabbed [son] differently/harder than usual. 

Unexplained bruising/injuries in a young infant such as [son] is 

compatible with non-accidental/inflicted trauma as it is unlikely 

to occur in an infant of [son’s] developmental level who at that 

time was not yet rolling, crawling, pulling to stand or cruising.” 

The report explained it was difficult to determine the precise date 

of son’s injuries based on the color of his bruises but, “[a]t this 

time, based on the available information, non-accidental/inflicted 

trauma remains a concern and the current leading diagnosis.”

b. Dr. Frederic Bruhn

Father submitted a report prepared by Dr. Frederic Bruhn.

Dr. Bruhn was “convinced that no substantial evidence exists 

that demonstrates inflicted physical abuse by the parents of 

[son].” Dr. Bruhn believed “the current situation has arisen 

because of a faulty assessment of the child, perhaps due to a 

language barrier existing in this case and/or by a 

misrepresentation and miscommunication of the actual medical 

records to the Court.”

As to the marks first noted on son’s left ear and armpits,

Dr. Bruhn opined, “The left ear finding was most likely a 

subcutaneous hemangioma as evidenced by the finding of a 

complex cystic malformation anterior to the left ear by 

ultrasound examination” and “ultrasound revealed increased 

vascularity under [the armpit] lesions suggesting bilateral 
14

hemangiomas.” As to the later bruising on son’s torso, Dr. Bruhn 

stated he reviewed color photos provided to him (which were “not 

identified as to time and person”) and “could not identify any 

significant bruising.” He noted a “significant discrepancy” 

between a report to the court stating bruises on son’s torso were 

three to four inches in size and the admitting physician’s report 

stating those bruises were three to four centimeters. Dr. Bruhn 

was concerned these bruises “may have represented another 

underlying deep hemangioma, rather than a bruise.”

Dr. Bruhn stressed that “multiple studies found no 

evidence of other abusive injuries (e.g., no fractures, central 

nervous system bleeds or retinal hemorrhages)” and that the 

Department had noted mother and father “did not seem to have 

many of the usual characteristics of child abusers.” He believed 

“close follow up will probably reveal the underlying diagnosis.” 

He “strongly doubt[ed]that the etiology is inflicted trauma” and 

“strongly suggest[ed] that a Geneticist at [the hospital] be 

consulted to rule out whether this child has one of the many deep 

vascular hemangiomas that are not described.”

5. Adjudication and Disposition Hearings

The adjudication hearing was held over the course of three

days in January 2021, with the disposition hearing also taking 

place on the third day. Among other exhibits, the juvenile court 

admitted the two expert reports described above, over 700 pages 

of hospital records related to son, as well as medical records from 

son’s first emergency room visit and his pediatrician’s office.

The juvenile court heard testimony from Dr. Imagawa and 

Dr. Bruhn, both of whom were qualified to testify as experts in 

pediatric child abuse. Mother also testified.
15

a. Dr. Imagawa’s Testimony

Dr. Imagawa testified son initially had marks or 

discoloration on his head (ear and face) and under his arms, then 

subsequently also on his torso. She stated that, after son’s first 

hospitalization in September 2020, he was discharged with “a 

diagnosis of a hematoma of the left ear that was resolving and 

had significantly resolved during the hospitalization.” As to son’s 

October 2020 hospitalization, Dr. Imagawa testified son 

“shouldn’t be bruising from just getting a bath or holding him 

when he’s taking a bath.” She noted son’s “bruises resolved 

within seven to ten days after he was in placement. And he has 

had no further bruising as far as I am aware, no further lesions, 

no further ear injury, nothing under his arms. And we have all of 

this to document that everything was resolved.”

Dr. Imagawa opined, “with reasonable certainty,” son had

“a hematoma not hemangioma.” Dr. Imagawa explained there 

are no specific tests that can be conducted to diagnose either a 

hematoma or hemangioma. Rather, she explained, such 

diagnoses are done by clinical evaluation and a patient’s history. 

She testified son’s “clinical course is not consistent with 

hemangioma” but rather was consistent with a hematoma. She 

stated there was “no accidental explanation to have caused [son’s] 

ear injury, the bruise on his cheek, the swelling of the temple 

region, the injuries under his arms.” Dr. Imagawa noted because 

son was an infant and not yet mobile, it was “highly concerning 

for child abuse” to see marks on such areas of the body. She 

concluded “these are consistent with inflicted injuries.”

Dr. Imagawa also discussed what she considered 

deficiencies in Dr. Bruhn’s report. She stated it appeared Dr. 

Bruhn did not have access to all of son’s medical records and
16

related photographs. In addition, Dr. Imagawa believed some of 

Dr. Bruhn’s conclusions were inaccurate. For example, she 

testified Dr. Bruhn’s conclusion that the doctors “could not agree 

on a unifying diagnosis ‘hemangioma’ versus ‘hematoma’ [was]

actually not correct. In the records, it indicates this is a 

hematoma. And in the discharge summary, it acknowledges that 

the hematoma had really significantly resolved” and there 

remained a “residual hemangioma.” Dr. Imagawa also noted Dr. 

Bruhn seemed to emphasize an opinion by a doctor who assessed 

son during his September 2020 hospitalization, which opinion 

stated,“ ‘as of now’ ” nonaccidental trauma “ ‘ruled out.’ ” Dr. 

Imagawa explained, however, that opinion predated the 

significant improvement to son’s ear at discharge from the 

hospital and its subsequent total resolution.

b. Dr. Bruhn’s Testimony

Dr. Bruhn testified that “there are certain characteristics of 

abusive parents” that he considers important but not 

determinative. He stated mother and father did not “fit the usual 

mold of abusing parents.” For example, Dr. Bruhn testified

mother “wasn’t trying to hide anything from the doctors,” noting

mother brought son to the doctor when she noticed the lesion on 

his ear getting worse.

Concerning son’s first hospitalization in September 2020, 

Dr. Bruhn noted one doctor had indicated son might have a 

“vascular anomaly.” In light of that potentiality, Dr. Bruhn 

stated a vascular anomaly team should have been consulted but 

was not. He believed the vascular anomaly team, had they been 

consulted,“would have been able to give a reasonable opinion 

whether this was a hemangioma or a hematoma [on son’s ear]. I 

think they could have weighed in on that aspect of the diagnosis.”
17

Dr. Bruhn also noted there are “ ‘mimics of child abuse’ that are 

really medical conditions and haven’t been adequately ruled out 

in this situation.” He mentioned Ehler-Danlos Syndrome and 

certain dermatologic conditions as examples. He stated a test 

exists to rule out Ehler-Danlos Syndrome but it had not been 

done in this case. Dr. Bruhn was not aware of any tests 

performed on son during his October 2020 hospitalization that 

would have ruled out hemangioma. He reiterated he would have 

consulted with a geneticist and a vascular anomaly team.

Dr. Bruhn emphasized this was a complicated case; “I can’t 

tell you what this is. I don’t know, but I know it’s not a 

straightforward NAT [nonaccidental trauma] case.” Dr. Bruhn 

believed son’s ear and armpit markings could be hemangiomas 

but the markings on son’s torso were “more likely a bruise.” 

During his testimony, the court asked Dr. Bruhn to review a 

November 2020 photograph of son’s ear. It was unclear whether

Dr. Bruhn had seen the photograph before. After looking at the

photograph, Dr. Bruhn noted the discoloration of the ear had 

disappeared and there were two nodules on the upper portion of 

the ear. Because the discoloration had disappeared, Dr. Bruhn

stated the photograph was “a point in favor of this being a 

hematoma rather than a hemangioma.” The court also asked Dr. 

Bruhn to compare a September 2020 photograph of son’s armpits 

with a November 2020 photograph of the same area. It appeared 

the marks there had disappeared. Dr. Bruhn stated a 

hemangioma would “probably not” resolve in that amount of time 

but a hematoma “definitely would.” Similarly, Dr. Bruhn

testified, “If it resolved in a short period of time, that would be 

more in favor of a hematoma.” Still, he could not rule out a 
18

hemangioma, noting if a hemangioma were deeper under the skin 

it could be difficult to see.

c. Mother’s Testimony

Mother recounted son’s multiple hospital visits and various 

doctors’ appointments. She explained she followed the doctors’ 

instructions and always brought son in for his scheduled 

appointments and sought out medical care even when not 

scheduled. Mother testified neither she nor father intentionally 

or accidentally hurt son. Speaking through tears, mother stated, 

“I want to state this solemnly to everybody who is listening, all 

the attorneys and Your Honor, that me and my husband really 

love [son], and we are innocent. We want [son] back. [Son] needs 

us and we need [son].”

As to son’s October 2020 hospitalization, mother testified 

she did not know why son had markings on his torso but “the 

doctor kept insisting that I must give an explanation as to what 

gave rise to [son’s] bruises. . . . After some time—they kept 

pressuring me—I surmised that—I guessed that maybe during a 

shower, I could have applied just a bit too much pressure on him, 

that that could cause the bruising. But I don’t know.” Mother 

testified some of the Department social workers who spoke with 

her at the hospital did not speak Mandarin. Mother explained

the social workers used a translator through their iPad to 

communicate with her. Mother believed “the interpretation 

provided that day was not up to standard” and indicated the 

social workers also complained about it.

d. Ruling

On January 11, 2021, after hearing the testimony and 

argument from counsel, the juvenile court sustained the 

subdivision (a) and first subdivision (b) counts of the petition
19

(related to nonaccidental trauma). The court dismissed the 

remaining subdivision (b) count (related to medical neglect). The 

court found son was a person described by section 300.

The court stated, “The fundamental issue before this court 

is whether the discoloration of [son’s] ear, armpits, and abdomen

were a result of a congenital hemangioma or a hematoma 

resulting from inflicted trauma.” The court concluded the marks 

on son’s body were “more likely than not” hematomas. In coming 

to its conclusion, the court “found Dr. Imagawa’s opinion to be 

more cogent, persuasive, and directly supported by the factual 

circumstances of this case. Dr. Bruhn’s opinion was more 

speculative and, upon further questioning at court, did not hold 

up as plausible.” The court considered Dr. Bruhn’s opinion “less 

plausible than Dr. Imagawa’s because his testimony was 

inconsistent with statements in his report. In court he testified 

that [son’s] abdominal discolorations were likely hematoma and 

concluded that perhaps even the ear was a hematoma, as well, 

once he reviewed the photos showing the bruises’ resolution after 

a couple of weeks.” The court noted both experts agreed on the 

differences between hematomas and hemangiomas, that 

hematomas result from trauma, and that hematomas resolve 

within weeks whereas hemangiomas take months or longer to 

resolve.

The court noted Dr. Bruhn “spent much of his testimony 

speculating about possible other causes for [son’s] ear injury, 

specifically stating that genetic testing would assist in 

determining whether [son] has Ehler-Danlos . . . Syndrome, 

which could cause a child to be predisposed to bruising; however

. . . Dr. Bruhn stated that Ehler-Danlos Syndrome is a permanent 

condition and would continue to cause bruising throughout the 
20

inflicted child’s life. But that situation doesn’t match the facts 

before us here. [Son’s] bruising resolved in a couple of weeks, and 

no further bruising has appeared since he was removed from his 

parents’ care.”

Next, the court concluded the hematomas were caused by 

nonaccidental trauma. Although the court “found mother to be 

an attentive and loving parent” and “appropriately emotional 

about having her child removed from her care,” the court found it

significant mother had failed to provide a reasonable or credible 

explanation for son’s injuries. The court stated, “Despite 

mother’s attentiveness to [son], the evidence shows that the child 

was seriously injured in her care; therefore, in light of [son’s] 

repeated occurrences of unexplained bruising and the absence of 

any plausible medical or other explanation about how these 

injuries occurred, the court can reach no other conclusion than

that the parents are responsible for the injuries sustained by 

[son] while he was in their care.”

As to disposition, the juvenile court removed son from 

parents’ custody and ordered, among other things, parents to 

participate in an age-appropriate parenting class as well as to 

continue with their monitored visitation. The court emphasized

its ruling was not punitive against parents but was in son’s best 

interest. The court also ordered the Department to have son 

tested for Ehler-Danlos Syndrome.

6. Appeal

Mother and father appealed the juvenile court’s 

January 11, 2021 jurisdictional and dispositional orders.

7. Postappeal Orders

While these appeals were pending, the juvenile court 

returned son to his parents’ custody. As a result, the Department 
21

filed, and we granted, a motion to dismiss the appeals as to the 

juvenile court’s removal order. Also while these appeals were 

pending, mother and father completed their court-ordered 

parenting program. Thus, the parents’ challenges to the juvenile 

court’s dispositional orders are moot, and we do not address them 

here.

DISCUSSION

Mother and father argue substantial evidence does not 

support the juvenile court’s exercise of jurisdiction under 

subdivision (a). As discussed below, although we agree this is not

a straightforward case, we are not persuaded by the parents’ 

arguments and conclude substantial evidence supports the

juvenile court’s jurisdictional findings.

1. Applicable Law

Under section 300, subdivision (a), the juvenile court may 

assert dependency jurisdiction and declare a child a dependent of 

the court when “[t]he child has suffered, or there is a substantial 

risk that the child will suffer, serious physical harm inflicted 

nonaccidentally upon the child by the child’s parent or guardian. 

For purposes of this subdivision, a court may find there is a 

substantial risk of serious future injury based on the manner in 

which a less serious injury was inflicted, a history of repeated 

inflictions of injuries on the child or the child’s siblings, or a 

combination of these and other actions by the parent or guardian 

that indicate the child is at risk of serious physical harm. For 

purposes of this subdivision, ‘serious physical harm’ does not 

include reasonable and age-appropriate spanking to the buttocks 

if there is no evidence of serious physical injury.” (§ 300,

subd. (a).)
22

Section 355.1, subdivision (a) creates a rebuttable 

presumption that certain injuries are nonaccidental in nature. 

That section provides, “Where the court finds, based upon 

competent professional evidence, that an injury, injuries, or 

detrimental condition sustained by a minor is of a nature as 

would ordinarily not be sustained except as the result of the 

unreasonable or neglectful acts or omissions of either parent, the 

guardian, or other person who has the care or custody of the 

minor, that finding shall be prima facie evidence that the minor 

is a person described by subdivision (a), (b), or (d) of Section 300.” 

(§ 355.1, subd. (a).) “Once the petitioner establishes a prima facie 

case under section 355.1 the burden of producing evidence ‘shifts 

to the parents the obligation of raising an issue as to the actual 

cause of the injury or the fitness of the home.’ [Citation.] ‘The 

effect of a presumption affecting the burden of producing 

evidence is to require the trier of fact to assume the existence of 

the presumed fact unless and until evidence is introduced which 

would support a finding of its nonexistence, in which case the 

trier of fact shall determine the existence or nonexistence of the 

presumed fact from the evidence and without regard to the 

presumption.’ (Evid. Code, § 604.)” (In re D.P. (2014) 225 

Cal.App.4th 898, 903–904; § 355.1, subd. (c).)

Thus, “[w]hile the presumption under section 355.1 

‘disappears upon the introduction of evidence which would 

support a finding of its nonexistence (Evid. Code, § 604), the trier 

of fact, here the juvenile court, must still weigh the inferences 

arising from the [professional’s] testimony which gave rise to the 

presumption against the contrary evidence . . . and resolve the 

conflict. [Citation.]’ [Citation.] . . . ‘Where there is more than 

one inference which can reasonably be deduced from the facts, 
23

the appellate court is without power to substitute its deductions 

for those of the trier of fact.’ ” (In re D.P., supra, 225 Cal.App.4th 

at pp. 904–905.)

“The legislatively declared purpose of these provisions [of 

the Welfare and Institutions Code] ‘is to provide maximum safety 

and protection for children who are currently being physically, 

sexually, or emotionally abused, being neglected, or being 

exploited, and to ensure the safety, protection, and physical and 

emotional well-being of children who are at risk of that harm.’

(§ 300.2, italics added.) ‘The court need not wait until a child is 

seriously abused or injured to assume jurisdiction and take the 

steps necessary to protect the child.’ ” (In re I.J. (2013) 56 

Cal.4th 766, 773.) “ ‘The purpose of dependency proceedings is to 

prevent risk, not ignore it.’ ” (Jonathan L. v. Superior Court

(2008) 165 Cal.App.4th 1074, 1104.) Courts “need not wait for 

disaster to strike before asserting jurisdiction.” (In re K.B. (2021) 

59 Cal.App.5th 593, 603.) Moreover, special protection is given to 

children like son, who are “ ‘of such tender years that the absence 

of adequate supervision and care poses an inherent risk to [his or 

her] physical health and safety.’ ” (In re Christopher R. (2014) 

225 Cal.App.4th 1210, 1216, 1219 [children under the age of six 

at the time of the jurisdiction hearing are of “tender years”].)

2. Standard of Review

We review the juvenile court’s jurisdictional findings for 

substantial evidence. (In re I.C. (2018) 4 Cal.5th 869, 892.) “It is 

well settled that the standard is not satisfied simply by pointing 

to ‘ “isolated evidence torn from the context of the whole record.” ’ 

[Citations.] Rather, the evidence supporting the jurisdictional 

finding must be considered “ ‘in the light of the whole record’ ” ‘to 

determine whether it discloses substantial evidence—that is, 
24

evidence which is reasonable, credible, and of solid value.’ ” 

(Ibid.)

“ ‘ “In making this determination, we draw all reasonable 

inferences from the evidence to support the findings and orders of 

the dependency court; we review the record in the light most 

favorable to the court’s determinations; and we note that issues 

of fact and credibility are the province of the trial court.” ’ ” (In re 

I.J., supra, 56 Cal.4th at p. 773.) Under this standard, our 

review “ ‘begins and ends with a determination as to whether or 

not there is any substantial evidence, whether or not 

contradicted, which will support the conclusion of the trier of fact. 

All conflicts must be resolved in favor of the respondent and all 

legitimate inferences indulged in to uphold the verdict, if 

possible. Where there is more than one inference which can 

reasonably be deduced from the facts, the appellate court is 

without power to substitute its deductions for those of the trier of 

fact.’ ” (In re David H. (2008) 165 Cal.App.4th 1626, 1633.) “We 

do not reweigh the evidence, evaluate the credibility of witnesses, 

or resolve evidentiary conflicts. [Citation.] The judgment will be 

upheld if it is supported by substantial evidence, even though 

substantial evidence to the contrary also exists and the trial court 

might have reached a different result had it believed other 

evidence.” (In re Dakota H. (2005) 132 Cal.App.4th 212, 228.)

3. Justiciability

As an initial matter, we note mother and father challenge 

only the juvenile court’s exercise of jurisdiction under subdivision 

(a). Mother and father do not challenge the juvenile court’s 

exercise of jurisdiction under subdivision (b). Thus, even if we 

were to reverse the juvenile court’s subdivision (a) finding, 

dependency jurisdiction would remain under subdivision (b). In 
25

such circumstances, an appeal is subject to dismissal as 

nonjusticiable. (In re Drake M. (2012) 211 Cal.App.4th 754, 762–

763.) Nonetheless, in such cases an appellate court may address 

the merits of the challenged jurisdictional finding when “the 

finding (1) serves as the basis for dispositional orders that are 

also challenged on appeal [citation]; (2) could be prejudicial to the 

appellant or could potentially impact the current or future 

dependency proceedings [citations]; or (3) ‘could have other 

consequences for [the appellant], beyond jurisdiction.’ ” (Ibid.)

Mother and father urge us to consider their appeal because 

the juvenile court’s subdivision (a) finding could harm them

beyond jurisdiction.3 The Department does not argue otherwise 

or even address this issue on appeal. We elect to consider the 

parents’ challenge to the juvenile court’s exercise of jurisdiction 

under subdivision (a). (In re Drake M., supra, 211 Cal.App.4th at 

pp. 762–763; In re D.P., supra, 225 Cal.App.4th at p. 902.)

4. Substantial evidence supports jurisdiction under 

section 300, subdivision (a) (physical abuse).

Mother and father argue they presented sufficient evidence 

to rebut the section 355.1 presumption. In particular, they claim 

Dr. Bruhn’s testimony rebutted the section 355.1 presumption 

that son’s injuries were nonaccidental and caused by the parents. 

Parents note Dr. Bruhn “testified that the cause of the marks 

could be caused by a vascular anomaly or a genetic disease.” In 

3 Mother and father also urge us to consider their appeal of 

the juvenile court’s subdivision (a) jurisdictional finding because 

that finding served as a basis for the court’s dispositional orders, 

which the parents also appealed. However, as noted above, the 

appeals from the dispositional orders are now moot and, 

therefore, do not constitute grounds for considering their 

subdivision (a) jurisdictional challenge.
26

fact, Dr. Bruhn was not sure what caused the markings on son’s 

body. He testified,“I can’t tell you what this is. I don’t know, but 

I know it’s not a straightforward NAT case.” Assuming this was 

sufficient to rebut the section 355.1 presumption, the juvenile 

court then was required to weigh the conflicting evidence and 

make factual determinations. (In re D.P., supra, 225 Cal.App.4th 

at pp. 904–905.)

We conclude substantial evidence supports the juvenile 

court’s jurisdictional findings. On the one hand, the evidence 

included the parents’ apparent love and concern for son, their 

emphatic denials of intentional harm to son, mother’s suggestion 

that some of son’s bruising could have resulted from her 

innocently holding him too tightly during bath time, and Dr. 

Bruhn’s expert speculation that a variety of genetic or 

dermatologic conditions could have caused son’s markings. On 

the other hand, the evidence also included Dr. Imagawa’s expert 

opinion, as well as other medical doctors’ opinions, that son’s 

repeated presentations with unexplained markings were highly 

indicative of physical abuse. Given the fact that no one could 

definitively state how or why son had the markings he had, 

which importantly by all accounts appear to have been 

hematomas as opposed to hemangiomas, and son clearly was of 

“tender years,” the juvenile court’s subdivision (a) finding was 

supported by substantial evidence.

We are not persuaded by the parents’ attempt to minimize 

the visible markings on son’s body. Parents argue the markings 

on son’s body do not constitute “serious physical harm” under 

subdivision (a). We disagree. When an infant has visible 

swelling and obvious bruising on multiple areas of his body on 

more than one occasion, regardless of whether that infant 
27

appears to be in pain when those areas are examined, those 

injuries certainly can constitute serious physical harm for 

purposes of subdivision (a). While we agree with parents that 

any unexplained bruise on a child does not necessarily constitute 

cause for dependency jurisdiction, this case presents more than a 

single unexplained bruise. Additionally, Dr. Imagawa reported a 

healthy infant such as son would not sustain bruising from 

routine daily handling. Yet here, son, an infant, had repeated 

unexplained markings which multiple doctors considered highly 

concerning for child abuse.

As Dr. Bruhn noted, this is not a straightforward case. 

There are clearly two conflicting sides to the matter. 

Nonetheless, we cannot reweigh the facts or assess credibility of 

witnesses. Those are roles explicitly reserved to the juvenile 

court. (In re I.J., supra, 56 Cal.4th at p. 773; In re David H., 

supra, 165 Cal.App.4th at p. 1633; In re Dakota H., supra, 132 

Cal.App.4th at p. 228.) Significantly, of the two expert opinions 

presented, the juvenile court found Dr. Imagawa’s opinion more 

plausible. The court found Dr. Bruhn’s opinion “more speculative 

and, upon further questioning at court, [it] did not hold up as 

plausible.” Despite the competing evidence, substantial evidence 

supports the juvenile court’s jurisdictional findings under 

subdivision (a).

Finally, after briefing had concluded in this appeal, counsel 

for mother filed a letter alerting the court of new case authority, 

In re Cole L. (2021) 70 Cal.App.5th 591 (Cole L.), which our 

colleagues in Division Seven of the Second District recently 

decided. Mother argues Cole L. supports the parents’ position

here that the juvenile court’s subdivision (a) jurisdictional finding

must be reversed. However, Cole L. is factually distinguishable 
28

from the instant case. In part, the Cole L. court reversed a 

finding of dependency jurisdiction under subdivision (a) based on

incidents of parental domestic violence outside the presence of 

the subject children. (Id. at pp. 602–603.) The court also stated

that “a finding under section 300, subdivision (a), requires 

evidence of a risk of physical injury ‘inflicted nonaccidentally 

upon the child.’ An unintended injury to a bystander child that 

results from an intentional act directed at another—for example, 

due to an object thrown by one parent at another during an 

argument—does not satisfy that statutory requirement.” (Cole 

L., supra, at p. 603.) Cole L. is factually distinct and does not 

change our decision here.

DISPOSITION

The juvenile court’s January 11, 2021 jurisdictional order is

affirmed and the remaining appeal from the juvenile court’s 

dispositional order is dismissed as moot.

NOT TO BE PUBLISHED.

LUI, P. J.

We concur:

ASHMANN-GERST, J.

HOFFSTADT, J.